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Clin Transplant:sofosbuvir +daclatasvir联合ribavirin或不联合ribavirin治疗移植后丙肝复发和严重肝纤维化患

2017-12-08 MedSci MedSci原创

sofosbuvir (SOF)+daclatasvir(DCV)联合利巴韦林或不联合利巴韦林治疗存在严重肝纤维化的丙型肝炎病毒(HCV)感染的肝移植患者是有效且安全的。

2012年,意大利一项名为"病人计划"(Patient Program)的项目在直接抗病毒药物(DAA)批准之前,开始为丙型肝炎病毒(HCV)感染的肝移植患者,进行治疗。真实的研究("real-life" study)旨在评估sofosbuvir (SOF)+daclatasvir(DCV)联合利巴韦林或不联合利巴韦林的治疗疗效和安全性。

本研究纳入意大利15家肝脏移植中心的存在严重肝纤维化的丙型肝炎病毒(HCV)感染的肝移植患者。采用sofosbuvir (SOF)、daclatasvir(DCV)联合利巴韦林或不联合利巴韦林治疗24周。治疗后,对第12周的可持续病毒学应答(SVR12)进行评估。

本研究共纳入87例患者,男性为75.9%,平均年龄为58.4±7.2岁,83.9%的患者为HCV 基因1型,81.6%的患者为肝硬化患者。52例患者(59.8%)接受利巴韦林治疗。治疗后,79例患者(90.8%)获得可持续病毒学应答(SVR12)。3期肝纤维化患者100%获得SVR12,88.7%的肝硬化患者获得SVR12(91.5%的Child-Pugh A患者获得SVR12, 83.3%的Child-Pugh B和C患者获得SVR12)。依据治疗方案,80%的sofosbuvir (SOF)+daclatasvir(DCV)治疗组患者,获得SVR12

,98.1%的sofosbuvir (SOF)+daclatasvir(DCV)联合利巴韦林组患者,获得SVR12。在随访过程中,2例sofosbuvir (SOF)+daclatasvir(DCV)治疗组患者,发生病毒学复发。4例sofosbuvir (SOF)+daclatasvir(DCV)治疗组患者和1例sofosbuvir (SOF)+daclatasvir(DCV)联合利巴韦林治疗组患者在治疗过程中死亡。

sofosbuvir (SOF)+daclatasvir(DCV)联合利巴韦林或不联合利巴韦林治疗存在严重肝纤维化的丙型肝炎病毒(HCV)感染的肝移植患者是有效且安全的。

原始出处

Lionetti R, Calvaruso V, Piccolo P, et al. Sofosbuvir plus daclatasvir with or without ribavirin is safe and effective for post-transplant hepatitis C recurrence and severe fibrosis and cirrhosis: a prospective study.Clin Transplant, 2017, Nov 30. doi: 10.1111/jvh.12840.

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    2018-08-25 xuyu
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    2018-06-03 bsmagic9140
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1789161, encodeId=b0181e891616f, content=<a href='/topic/show?id=0c8814344f5' target=_blank style='color:#2F92EE;'>#plant#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14344, encryptionId=0c8814344f5, topicName=plant)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f5b299, createdName=xuyu, createdTime=Sat Aug 25 14:06:00 CST 2018, time=2018-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1796136, encodeId=b7a21e961366e, content=<a href='/topic/show?id=691c1e765a0' target=_blank style='color:#2F92EE;'>#Transplant#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17765, encryptionId=691c1e765a0, topicName=Transplant)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=232a2500033, createdName=1249859em38(暂无昵称), createdTime=Sun Jul 15 05:06:00 CST 2018, time=2018-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656924, encodeId=f74d16569241d, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sun Jun 03 12:06:00 CST 2018, time=2018-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1793350, encodeId=3f221e93350aa, content=<a href='/topic/show?id=b614154551f' target=_blank style='color:#2F92EE;'>#Ribavirin#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15455, encryptionId=b614154551f, topicName=Ribavirin)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3fc52500170, createdName=12498cbcm00(暂无昵称), createdTime=Tue Sep 04 19:06:00 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1808177, encodeId=9c1018081e777, content=<a href='/topic/show?id=f94d81342e5' target=_blank style='color:#2F92EE;'>#肝纤维#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81342, encryptionId=f94d81342e5, topicName=肝纤维)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Sun Nov 11 18:06:00 CST 2018, time=2018-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1466041, encodeId=7eef146604107, content=<a href='/topic/show?id=217c292009' target=_blank style='color:#2F92EE;'>#ATA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2920, encryptionId=217c292009, topicName=ATA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Sun Dec 10 14:06:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1500786, encodeId=1cef1500e86be, content=<a href='/topic/show?id=4a27165246a' target=_blank style='color:#2F92EE;'>#Sofosbuvir#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16524, encryptionId=4a27165246a, topicName=Sofosbuvir)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=50d29462111, createdName=Tommy1952, createdTime=Sun Dec 10 14:06:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587596, encodeId=a2d2158e596ff, content=<a href='/topic/show?id=419c565653' target=_blank style='color:#2F92EE;'>#Daclatasvir#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5656, encryptionId=419c565653, topicName=Daclatasvir)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb0d17523353, createdName=guojianrong, createdTime=Sun Dec 10 14:06:00 CST 2017, time=2017-12-10, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1789161, encodeId=b0181e891616f, content=<a href='/topic/show?id=0c8814344f5' target=_blank style='color:#2F92EE;'>#plant#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14344, encryptionId=0c8814344f5, topicName=plant)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f5b299, createdName=xuyu, createdTime=Sat Aug 25 14:06:00 CST 2018, time=2018-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1796136, encodeId=b7a21e961366e, content=<a href='/topic/show?id=691c1e765a0' target=_blank style='color:#2F92EE;'>#Transplant#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17765, encryptionId=691c1e765a0, topicName=Transplant)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=232a2500033, createdName=1249859em38(暂无昵称), createdTime=Sun Jul 15 05:06:00 CST 2018, time=2018-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656924, encodeId=f74d16569241d, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sun Jun 03 12:06:00 CST 2018, time=2018-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1793350, encodeId=3f221e93350aa, content=<a href='/topic/show?id=b614154551f' target=_blank style='color:#2F92EE;'>#Ribavirin#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15455, encryptionId=b614154551f, topicName=Ribavirin)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3fc52500170, createdName=12498cbcm00(暂无昵称), createdTime=Tue Sep 04 19:06:00 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1808177, encodeId=9c1018081e777, content=<a href='/topic/show?id=f94d81342e5' target=_blank style='color:#2F92EE;'>#肝纤维#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81342, encryptionId=f94d81342e5, topicName=肝纤维)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Sun Nov 11 18:06:00 CST 2018, time=2018-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1466041, encodeId=7eef146604107, content=<a href='/topic/show?id=217c292009' target=_blank style='color:#2F92EE;'>#ATA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2920, encryptionId=217c292009, topicName=ATA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Sun Dec 10 14:06:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1500786, encodeId=1cef1500e86be, content=<a href='/topic/show?id=4a27165246a' target=_blank style='color:#2F92EE;'>#Sofosbuvir#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16524, encryptionId=4a27165246a, topicName=Sofosbuvir)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=50d29462111, createdName=Tommy1952, createdTime=Sun Dec 10 14:06:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587596, encodeId=a2d2158e596ff, content=<a href='/topic/show?id=419c565653' target=_blank style='color:#2F92EE;'>#Daclatasvir#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5656, encryptionId=419c565653, topicName=Daclatasvir)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb0d17523353, createdName=guojianrong, createdTime=Sun Dec 10 14:06:00 CST 2017, time=2017-12-10, status=1, ipAttribution=)]
    2017-12-10 heli0118
  7. [GetPortalCommentsPageByObjectIdResponse(id=1789161, encodeId=b0181e891616f, content=<a href='/topic/show?id=0c8814344f5' target=_blank style='color:#2F92EE;'>#plant#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14344, encryptionId=0c8814344f5, topicName=plant)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f5b299, createdName=xuyu, createdTime=Sat Aug 25 14:06:00 CST 2018, time=2018-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1796136, encodeId=b7a21e961366e, content=<a href='/topic/show?id=691c1e765a0' target=_blank style='color:#2F92EE;'>#Transplant#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17765, encryptionId=691c1e765a0, topicName=Transplant)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=232a2500033, createdName=1249859em38(暂无昵称), createdTime=Sun Jul 15 05:06:00 CST 2018, time=2018-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656924, encodeId=f74d16569241d, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sun Jun 03 12:06:00 CST 2018, time=2018-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1793350, encodeId=3f221e93350aa, content=<a href='/topic/show?id=b614154551f' target=_blank style='color:#2F92EE;'>#Ribavirin#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15455, encryptionId=b614154551f, topicName=Ribavirin)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3fc52500170, createdName=12498cbcm00(暂无昵称), createdTime=Tue Sep 04 19:06:00 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1808177, encodeId=9c1018081e777, content=<a href='/topic/show?id=f94d81342e5' target=_blank style='color:#2F92EE;'>#肝纤维#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81342, encryptionId=f94d81342e5, topicName=肝纤维)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Sun Nov 11 18:06:00 CST 2018, time=2018-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1466041, encodeId=7eef146604107, content=<a href='/topic/show?id=217c292009' target=_blank style='color:#2F92EE;'>#ATA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2920, encryptionId=217c292009, topicName=ATA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Sun Dec 10 14:06:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1500786, encodeId=1cef1500e86be, content=<a href='/topic/show?id=4a27165246a' target=_blank style='color:#2F92EE;'>#Sofosbuvir#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16524, encryptionId=4a27165246a, topicName=Sofosbuvir)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=50d29462111, createdName=Tommy1952, createdTime=Sun Dec 10 14:06:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587596, encodeId=a2d2158e596ff, content=<a href='/topic/show?id=419c565653' target=_blank style='color:#2F92EE;'>#Daclatasvir#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5656, encryptionId=419c565653, topicName=Daclatasvir)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb0d17523353, createdName=guojianrong, createdTime=Sun Dec 10 14:06:00 CST 2017, time=2017-12-10, status=1, ipAttribution=)]
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