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J Viral Hepat:直接抗病毒药物可有效治疗老年人丙型肝炎病毒感染

2022-07-27 sunshine MedSci原创

直接作用药物(DAAs)开创了丙型肝炎病毒(HCV)治疗的新时代。由于老年人在HCV感染者中占了很大比例,DAAs在老年人中的有效性和安全性受到了关注。

丙型肝炎病毒(HCV)感染是一个普遍的医疗问题,全球有1亿人感染。直接抗病毒药物(DAAs)开创了HCV治疗的新时代。由于老年人在HCV感染者中占了很大比例,DAAs在老年人中的有效性和安全性受到了关注。近日,发表于J Viral Hepat的一项荟萃分析旨在评估DAAs在老年患者中的疗效和安全性。

研究人员在PubMed(MEDLINE)、Embase、OVID MEDLINE、Cochrane图书馆和其他数据库中进行系统搜索后,两名研究人员审查了相关摘要,并选择了手稿进行研究。使用随机效应模型计算持续病毒学反应(SVR)和不良事件(AE)率。

结果,研究人员选择了90项评估老年患者(≥65岁)接受DAAs的SVR率的研究。分析结果显示,老年患者的DAAs表现出明显的SVR率为96%(95%置信区间[CI]:95%-97%),同时在亚组分析中也有类似的比率。老年患者和非老年患者的SVR率比较表明没有明显差异(几率[OR]1.01,95%CI:1.00-1.01)。AEs的总事件率为45%(95%CI:31%-60%),但AEs率因亚组而异。此外,老年人的AEs相对来说比非老年人更频繁(OR 1.15,95% CI:1.04-1.28),特别是在利巴韦林的SAEs(OR 1.89,95% CI:1.52-2.36)和剂量减少(OR 1.90,95% CI:1.53-2.36)等亚组中。然而,在不含利巴韦林(RBV)的方案中,老年人组和非老年人组的AEs发生率没有明显差异。

综上所述,该研究结果表明,DAAs对老年患者有很高的疗效。但是还要考虑到这类易感人群的安全问题。该研究分析表明,不含RBV的治疗方案,其安全性体现在AEs发生率低,应该对老年患者给予更多考虑。有关老年HCV感染者DAA治疗的研究必须进一步进行,从而评估使用DAA的成本效益,并权衡AE的可能性和预防肝脏相关并发症。

原始出处:

Jieun Lee, et al., Efficacy and safety of direct-acting antiviral therapy for hepatitis C virus in elderly patients (≥65 years old): A systematic review and meta-analysis. J Viral Hepat. 2022 Jul;29(7):496-517. doi: 10.1111/jvh.13679.  

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    2022-07-22 yahu
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    2022-07-22 gwc384
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