20222024年云南省德宏州应用直接抗病毒药物联合方案治疗不同基因型丙型肝炎的疗效

Efficacy of direct-acting antiviral agents combined regimens for hepatitis C virus with different genotypes in Dehong Prefecture, Yunnan Province from 2022 to 2024

  • 摘要:
    目的 了解2022—2024年德宏州不同基因型丙型肝炎病毒(HCV)感染患者采用直接抗病毒药物(DAAs)联合方案的治疗效果,并分析治疗失败患者特征,为发现更有效的治疗方案提供依据。
    方法 通过下载中国疾病预防控制信息系统德宏州HCV综合防治信息,共纳入617例HCV抗病毒治疗患者,使用差异性检验分析不同基因型患者变量特征之间的差异,包括社会人口学基本特征、生化检测、既往治疗和现在治疗信息,比较不同特征HCV患者的治愈率,探讨治疗失败的潜在原因。
    结果 HCV治愈率达96.8%,不同HCV基因型患者的天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)指标以及既往抗病毒治疗情况、开始治疗方案的差异均有统计学意义(均P<0.05)。多型联合用药方案中,索磷布韦(SOF)为主的方案治愈率达97.00%,维帕他韦(VEL)为主的方案治愈率达95.45%,其他治疗方案,包括利巴韦林(RIB)介入方案的治愈率达93.10%。治疗失败患者中,45.00%基因型为3型,40.00%腹部超声检查结果异常,基线AST检测结果全部异常。
    结论 HCV患者的临床治疗应考虑其基因型和生化检测结果的差异,应用DAAs联合方案治疗HCV已在德宏州实现高治愈率,能适用于多种临床特征不同的HCV患者,为在更大范围推广应用提供了可能的研究依据。

     

    Abstract:
    Objective To investigate the therapeutic effects of direct-acting antiviral agents (DAAs) combined regimens for hepatitis C virus (HCV) patients in Dehong Prefecture, Yunnan Province from 2022 to 2024, to analyze the characteristics of treatment failure patients, so as to provide a basis for discovering more effective treatment regimens in the future.
    Methods Data on HCV prevention and treatment in Dehong Prefecture was extracted from the China Disease Control and Prevention Information System. A total of 617 patients with HCV antiviral therapy were included, and the differences in variable characteristics among patients with different genotypes were analyzed using comparative statistical tests, including basic socio-demographic characteristics, biochemical testing indicators, and information on previous treatment and current treatment. In addition, the cure rate of HCV patients with diverse characteristics was compared, and the potential causes of treatment failure were explored simultaneously.
    Results The cure rate of HCV was 96.8%, and statistically significant differences were observed in aspartate transaminase (AST) and alanine transaminase (ALT) levels, previous antiviral therapy history and initial treatment regimens among patients with different HCV genotypes (all P<0.05). Among the multi-type combination regimens, the cure rate of sofosbuvir (SOF)-containing regimens was 97.00%, that of velpatasvir (VEL)-containing regimens was 95.45%, and the cure rate of other treatment regimens, including the regimens with ribavirin (RIB) intervention, was 93.10%. Among the patients with treatment failure, 45.00% had genotype 3, 40.00% had abnormal abdominal ultrasound results, and all presented with elevated baseline AST test levels.
    Conclusion The clinical treatment of HCV patients should consider the differences in genotype and biochemical test results. DAAs combined regimens for HCV have achieved a high cure rate in Dehong Prefecture and are applicable to HCV patients with diverse clinical characteristics, providing research evidence for wider application.

     

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