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J Hepatol:DAA对NS5A治疗失败的HCV患者再治疗,显示出良好效果

2017-11-23 MedSci MedSci原创

基于以上研究结果,在一线NS5A方案治疗失败后对患者进行重新治疗是有效的(96% SVR)。在未来,双重或三重治疗方案可能有类似的结果,治疗时间可能更短。

研究背景:本研究的目的是对基线采用非结构蛋白5A(NS5A)抑制剂进行治疗,导致患者发生耐药相关突变(RASs),再使用直接抗病毒药物对患者进行再治疗后的效果评估。

研究方法:2014年1月至2016年3月,在法国6家肝脏转诊中心,2995例HCV感染患者采用NS5A抑制剂进行治疗,80例(2.7%)患者发生突变。真实世界的研究纳入24例(24/80)患者,这些患者在NS5A治疗方案下,并未获得持续病毒学应答(SVR)。这24例患者采用不同的组合方案进行再治疗。采用治疗后第4周和第12周的可持续病毒学应答(SVR4, SVR12)作为评价抗病毒疗效的主要研究终点。

研究结果:在治疗基线的20例(80%)患者中发现了NS5A耐药相关突变/多态性。治疗结束后,所有患者获得了可持续病毒学应答(SVR),HCV RNA低于检测下限(<15 IU/mL)。23/24(96%)患者在第4周和第12周获得可持续病毒学应答,其余1例患者在治疗4周内复发。

研究结论:基于以上研究结果,在一线NS5A方案治疗失败后对患者进行重新治疗是有效的(96% SVR)。在未来,双重或三重治疗方案可能有类似的结果,治疗时间可能更短。

原始出处:

Halfon P, Scholtes C, Izopet J, et al. Retreatment with direct-acting antivirals of genotypes 1-3-4 hepatitis C patients who failed an anti-NS5A regimen in real world. J Hepatol, 2017, Oct 4. pii: S0168-8278(17)32333-4. doi: 10.1016/j.jhep.2017.09.019.

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    2017-11-25 ymljack
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    2017-11-25 qingting
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    2017-11-25 gwc384
  5. [GetPortalCommentsPageByObjectIdResponse(id=1717270, encodeId=8fab1e1727020, content=<a href='/topic/show?id=e3436460313' target=_blank style='color:#2F92EE;'>#治疗失败#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64603, encryptionId=e3436460313, topicName=治疗失败)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b1c332383811, createdName=ligang4450, createdTime=Sun Dec 10 11:51:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257688, encodeId=ee98125e6883e, content=<a href='/topic/show?id=774e856e22' target=_blank style='color:#2F92EE;'>#HCV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8567, encryptionId=774e856e22, topicName=HCV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=460849, createdName=ymljack, createdTime=Sat Nov 25 12:51:00 CST 2017, time=2017-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1361827, encodeId=a565136182e0e, content=<a href='/topic/show?id=a88b564ea6' target=_blank style='color:#2F92EE;'>#DAA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5647, encryptionId=a88b564ea6, topicName=DAA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Sat Nov 25 12:51:00 CST 2017, time=2017-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426902, encodeId=e8a11426902c2, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=142, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Sat Nov 25 12:51:00 CST 2017, time=2017-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564164, encodeId=883c15641640a, content=<a href='/topic/show?id=c80d30641d1' target=_blank style='color:#2F92EE;'>#再治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30641, encryptionId=c80d30641d1, topicName=再治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fd4415287515, createdName=whmdzju, createdTime=Sat Nov 25 12:51:00 CST 2017, time=2017-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263865, encodeId=7db926386534, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Fri Nov 24 08:16:55 CST 2017, time=2017-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263747, encodeId=de7c263e4704, content=学习学习.了解了解额, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Thu Nov 23 23:41:15 CST 2017, time=2017-11-23, status=1, ipAttribution=)]
    2017-11-25 whmdzju
  6. [GetPortalCommentsPageByObjectIdResponse(id=1717270, encodeId=8fab1e1727020, content=<a href='/topic/show?id=e3436460313' target=_blank style='color:#2F92EE;'>#治疗失败#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64603, encryptionId=e3436460313, topicName=治疗失败)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b1c332383811, createdName=ligang4450, createdTime=Sun Dec 10 11:51:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257688, encodeId=ee98125e6883e, content=<a href='/topic/show?id=774e856e22' target=_blank style='color:#2F92EE;'>#HCV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8567, encryptionId=774e856e22, topicName=HCV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=460849, createdName=ymljack, createdTime=Sat Nov 25 12:51:00 CST 2017, time=2017-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1361827, encodeId=a565136182e0e, content=<a href='/topic/show?id=a88b564ea6' target=_blank style='color:#2F92EE;'>#DAA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5647, encryptionId=a88b564ea6, topicName=DAA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Sat Nov 25 12:51:00 CST 2017, time=2017-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426902, encodeId=e8a11426902c2, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=142, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Sat Nov 25 12:51:00 CST 2017, time=2017-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564164, encodeId=883c15641640a, content=<a href='/topic/show?id=c80d30641d1' target=_blank style='color:#2F92EE;'>#再治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30641, encryptionId=c80d30641d1, topicName=再治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fd4415287515, createdName=whmdzju, createdTime=Sat Nov 25 12:51:00 CST 2017, time=2017-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263865, encodeId=7db926386534, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Fri Nov 24 08:16:55 CST 2017, time=2017-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263747, encodeId=de7c263e4704, content=学习学习.了解了解额, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Thu Nov 23 23:41:15 CST 2017, time=2017-11-23, status=1, ipAttribution=)]
    2017-11-24 天涯183

    非常好的文章.学习了

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1717270, encodeId=8fab1e1727020, content=<a href='/topic/show?id=e3436460313' target=_blank style='color:#2F92EE;'>#治疗失败#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64603, encryptionId=e3436460313, topicName=治疗失败)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b1c332383811, createdName=ligang4450, createdTime=Sun Dec 10 11:51:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257688, encodeId=ee98125e6883e, content=<a href='/topic/show?id=774e856e22' target=_blank style='color:#2F92EE;'>#HCV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8567, encryptionId=774e856e22, topicName=HCV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=460849, createdName=ymljack, createdTime=Sat Nov 25 12:51:00 CST 2017, time=2017-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1361827, encodeId=a565136182e0e, content=<a href='/topic/show?id=a88b564ea6' target=_blank style='color:#2F92EE;'>#DAA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5647, encryptionId=a88b564ea6, topicName=DAA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Sat Nov 25 12:51:00 CST 2017, time=2017-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426902, encodeId=e8a11426902c2, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=142, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Sat Nov 25 12:51:00 CST 2017, time=2017-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564164, encodeId=883c15641640a, content=<a href='/topic/show?id=c80d30641d1' target=_blank style='color:#2F92EE;'>#再治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30641, encryptionId=c80d30641d1, topicName=再治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fd4415287515, createdName=whmdzju, createdTime=Sat Nov 25 12:51:00 CST 2017, time=2017-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263865, encodeId=7db926386534, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Fri Nov 24 08:16:55 CST 2017, time=2017-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263747, encodeId=de7c263e4704, content=学习学习.了解了解额, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Thu Nov 23 23:41:15 CST 2017, time=2017-11-23, status=1, ipAttribution=)]
    2017-11-23 1dd8c52fm63(暂无匿称)

    学习学习.了解了解额

    0

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