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Liver Int:Daclatasvir治疗CHC患者疗效显著

2017-09-28 MedSci MedSci原创

总之,研究表明,daclatasvir治疗后,99%的患者达到的可持续病毒学应答状态能够持续。肝脏疾病进展和新发肝细胞癌的病例少见。NS5A替换在非应答患者中的持续时间超过NS3替换。

Daclatasvir在不同的丙型肝炎病毒(HCV)人群中实现了高持续性的病毒学应答(SVR),本研究旨在评估Daclatasvir治疗长期的有效性和安全性。

该研究纳入的研究对象是协议可用的CHC患者。研究评价的主要指标是SVR12(12周时获得可持续病毒学应答)的可持续性。次要指标包括分析非应答者和实现应答后复发患者的HCV序列、疾病进展的特征。

研究结果表明,在2012-02-24至2015-06-17,该研究纳入并随访了1503例CHC患者,这些患者采用以daclatasvir为基础的治疗方案,随访日期截止到2015-10-13。其中,60%的患者为男性,18%的患者年龄≥65岁,87%的患者为HCV基因1a(42%)或者1b (45%)型感染,18%的患者存在肝硬化。中位随访时间为111周(范围:11-246周)。在1489例患者中,1329例CHC患者在12周时获得可持续病毒学应答(SVR12),其中1316例患者直到最后随访时,仍保持SVR状态。9例应答患者在24周随访时,疾病复发;3例应答患者在24周随访后,疾病复发;1例患者发生再感染。单独使用daclatasvir治疗、daclatasvir联合干扰素治疗的复发率分别是3/842 (0.4%)和9/487 (2%)。15例CHC患者发生肝脏疾病进展;23例CHC患者新发肝细胞癌。在非应答者,27/157 (17%)和35/47 (74%)的患者的非结构蛋白-5A(NS5A)和非结构蛋白-3(NS3)被野生型序列所取代。

总之,研究表明,daclatasvir治疗后,99%的患者达到的可持续病毒学应答状态能够持续。肝脏疾病进展和新发肝细胞癌的病例少见。NS5A替换在非应答患者中的持续时间超过NS3替换。

原始出处:

Reddy KR, Pol S, Thuluvath PJ, et al. Long-Term Follow-Up of Clinical Trial Patients Treated for Chronic HCV Infection with Daclatasvir-Based Regimens. Liver Int, 2017, Sep 21. doi: 10.1111/liv.13596.

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    2017-09-30 bbjsj_1981
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    2017-09-30 zhouqu_8
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