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NEJM:Sofosbuvir 及Velpatasvir治疗基因型1、2、4、5及 6的HCV感染患者的效果

2016-01-02 MedSci MedSci原创

采用简单的治疗方案以有效治疗长期感染丙型肝炎病毒(HCV)的患者,仍然是一个尚未满足的医疗需求。

采用简单的治疗方案以有效治疗长期感染丙型肝炎病毒(HCV)的患者,仍然是一个尚未满足的医疗需求。

本研究进行了一项3期双盲安慰剂对照试验,包括了未治疗的以及既往接受治疗的感染了基因型1、2、4、5或6的HCV患者,包括伴有代偿性肝硬化的患者。将基因型1、2、4或6的HCV患者随机按5:1接受核苷酸抑制剂sofosbuvir以及NS5A抑制剂velpatasvir,每日一次,固定剂量组合的片剂或安慰剂,共治疗12周。由于本研究领域基因型5 的感染率较低,因此本研究中基因型5的HCV患者并未随机分配,而是分配至sofosbuvir–velpatasvir治疗组。主要终点为患者治疗12周后的持续病毒学应答。

624名接受sofosbuvir–velpatasvir的患者中,34%为HCV基因型1a,19%为基因型1b,17%为基因型2,19%为基因型4,6%为基因型5,7%为基因型6。8%的患者为黑种人,19%的患者存在肝硬化,32%的患者既往曾接受治疗。接受sofosbuvir–velpatasvir治疗的患者中,持续病毒学反应率为99%。两名均为HCV基因型1的患者接受sofosbuvir–velpatasvir治疗,存在病毒学复发。116名接受安慰剂治疗的患者都未出现持续病毒学应答。sofosbuvir–velpatasvir治疗组患者出现15名(2%)严重不良反应事件,安慰剂组无一例严重不良反应事件。

从结果可以看出,未治疗以及既往曾接受治疗的感染基因型1、 2、 4、 5 或 6 的HCV患者,包括出现代偿性肝硬化的患者,经sofosbuvir–velpatasvir一日一次治疗,治疗12周后,最终会出现较高的持续病毒学反应率。

原始出处:

Jordan J. Feld, Ira M. Jacobson et al.. Sofosbuvir and Velpatasvir for HCV Genotype 1, 2, 4, 5, and 6 Infection. N Engl J Med 2015; 373:2599-2607December 31, 2015DOI: 10.1056/NEJMoa1512610.


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    2016-01-08 andruhn

    好东西,值得分享,学习了!

    0

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    2016-01-04 ymljack
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    2016-01-04 bbjsj_1981
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在有效的范围内广泛使用一个简单的治疗方案治疗慢性感染丙型肝炎病毒的患者(HCV)仍然是一个未满足的医疗需求。

丙肝肝移植患者抗病毒治疗新方案—更快、更安全

接受肝移植的丙肝患者的新肝组织最终都会出现感染。在这些移植的组织严重受损前需进行抗病毒治疗,但是传统的移植后治疗时间长达一年,存在潜在毒性并且可能导致器官排斥反应。最近,在美国肝病研究协会(The Liver Meeting® 2014)上,梅奥诊所的研究者报道:肝移植后采用两种新的口服药物治疗,安全有效并且治疗只需12周即可完成。该项研究的负责人Pungpapong博士说:“该研究是首个在肝移植

NEJM:Ledipasvir/Sofosbuvir治疗提高了HIV-1/HCV共感染患者的持续病毒学应答率

有效治疗丙型肝炎病毒(HCV)和人类免疫缺陷病毒1型(HIV-1)共感染患者仍然是一个未得到满足的医疗需求。    研究人员进行了一项多中心、单组、开放性的研究,涉及的患者为HIV-1和基因型为1或4的HCV共感染患者,他们曾接受替诺福韦和恩曲他滨与依法韦仑,rilpivirine,或拉替拉韦进行抗逆转录病毒治疗。所有患者接受ledipasvir(一种NS5A抑制剂)

EASL 2014:sofosbuvir+RBV对HCV肝硬化患者安全有效

HCV感染门静脉高压或肝硬化失代偿的患者,对于干扰素治疗的耐受性较差,低效,存在感染和死亡的风险。无干扰素治疗方案是一种理想的治疗。 哈佛大学Beth Israel Deaconess医学中心研究人员发现,sofosbuvir+利巴韦林治疗HCV肝硬化和门脉高压症(CPT 5-10)患者安全有效。该研究结果公布于2014年4月12日的EASL2014会议上。 患者随机接受48周的sofosbuvi

NEJM:HCV基因型2或3患者——sofosbuvir/velpatasvir优于标准治疗方案

在第2阶段的试验中,用核苷酸聚合酶抑制剂sofosbuvir和NS5A抑制剂velpatasvir的组合治疗导致在慢性感染丙型肝炎病毒(HCV)基因型2或3的患者持续病毒学反应的比例很高。研究人员进行了两次随机,3阶段,开放性研究,涉及到的患者为HCV基因型2或3并且接受过治疗的,还有那些没有接受过治疗的,包括代偿性肝硬化患者。在一项试验中,HCV基因型2的患者被随机以1:1的比例分配接受sofo

LANCET:Sofosbuvir联合利巴韦林可有效治疗 HCV、HIV 共感染患者

尽管不含干扰素的治疗方案已经被批准治疗HIV和2、3型HCV的共感染患者,但是以干扰素为基础的治疗方案对HIV和1、4型HCV型共感染患者来说仍然是的一个常用的选择。然而该方案由于其显著的临床毒性、与抗逆转录病毒药物的相互作用限制了该方案的应用。法国巴黎圣路易斯医院的研究者在 LANCET 2月3日在线发表了一文评估不使用干扰素的情况下、sofosbuvir联合利巴韦林治疗HIV/HCV共感染患者

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