索磷布韦和维帕他韦联合利巴韦林治疗基因2、3型慢性丙型肝炎患者近期疗效和耐受性观察*

目的 研究应用索磷布韦/维帕他韦联合利巴韦林治疗基因2、3型慢性丙型肝炎(CHC)患者的近期疗效及耐受性。方法 2018年6月～2019年4月收治的58例基因2、3型CHC患者,采用抽签随机法分为两组,每组29例。给予对照组利巴韦林联合干扰素α-2b治疗,观察组接受索磷布韦/维帕他韦联合利巴韦林治疗,两组均持续治疗3个月。采用实时荧光定量聚合酶链反应法检测血清HCV RNA载量,采用基因芯片法检测HCV基因分型。结果 观察组快速病毒学应答(RVR)和早期病毒学应答(EVR)率分别为72.4%和89.7%,显著高于对照组的44.8%和65.5%(P＜0.05);在治疗4周末,观察组外周血白细胞计数为(5.8±2.1)×10⁹/L,显著高于对照组【(3.7±1.9)×10⁹/L,P＜0.05】;在治疗12周结束时,观察组外周血白细胞和血小板计数分别为(3.4±0.4)×10⁹/L和(99.60±24.2)×10⁹/L,均显著高于对照组【分别为(2.9±0.9)×10⁹/L和(82.01±14.8)×10⁹/L,P＜0.05】;两组不良反应发生率比较差异无统计学意义(P＞0.05),均未出现终止治疗情况。结论 应用索磷布韦/维帕他韦联合利巴韦林治疗基因2、3型CHC患者近期临床疗效确切,安全性较好,值得进一步观察。

Short-term efficacy and tolerance ofsofosbuvir/velpatasvir and ribavirin combination in the treatment of hepatitis C patients with genotype 2 or 3 infection

Objective The aim of this study was to investigate the short-term efficacy and tolerance of sofosbuvir/velpatasvir and ribavirin combination in the treatment of hepatitis C patients with genotype 2 or 3 infection.Methods 58 patients with chronic hepatitis C(CHC)and genotype 2 or 3 infection were enrolled in our hospitals from June 2018 through April 2019,and were randomly divided into two groups,29 in each group.The patients in control group were treated with ribavirin combined with interferonα-2b,and those in the observation group were treated withsofosbuvir/velpatasvir and ribavirin combination.The regimen in the two groups lasted for three months.Serum HCV RNA was detected by RT-PCR,and the viral genotypes was determined by genetic chip sequencing.Results The rapid viralogical response and early viralogical response rates in the observation group were 72.4%and 89.7%,significantly higher than 44.8%and 65.5%(P<0.05)in the control;at the end of four week treatment,the white blood cell counts in the observation was(5.8±2.1)×109/L,significantly higher than(3.7±1.9)×10^9/L,P<0.05]in the control group;at the end of 12 week treatment,the white blood cell count and platelet count were(3.4±0.4)×10^9/L and(99.60±24.2)×10^9/L,both significantly higher than(2.9±0.9)×10^9/L and(82.01±14.8)×10^9/L,respectively,P<0.05]in the control group;there was no significantly differences as compared to the side effects in the two groups,and no discontinuation because of severe untoward reactions happened in the two groups.Conclusion The application of sofosbuvir/velpatasvir and bibavirin combination therapyin the treatment of CHC patients with genotype 2 or 3 infection has a good short-term efficacy,which warrants further investigation.