摘要
目的对比研究干扰素联合利巴韦林与直接作用抗病毒药物(DAAs)治疗人类免疫缺陷病毒(HIV)感染合并丙型肝炎患者的疗效和安全性。方法筛选2015年11月1日至2018年4月15日到昆明市第三人民医院就诊且有治疗意愿的HIV合并HCV感染的患者,一组使用聚乙二醇干扰素α-2a或重组人工干扰素α-2b联合利巴韦林治疗,另一组用DAAs抗病毒治疗,观察2组治疗前后丙型肝炎病毒(HCV)RNA、肝功能、血常规、天冬氨酸氨基转移酶和血小板比率指数(aspartate aminotransferase-to-platelet ratio index,APRI)及不良反应。结果干扰素联合利巴韦林组28例完成疗程,DAAs组86例完成疗程及观察。疗程结束时DAAs组患者100%获得病毒学应答,干扰素组67.8%患者获得病毒学应答。DAAs组的SVR24(89.5%)显著优于干扰素组(60.7%)(P < 0.001)。2组患者抗丙肝治疗结束后AST、ALT、TBIL、A/G及APRI相比差异无统计学意义(P > 0.05)。干扰素组治疗过程中出现白细胞下降、血红蛋白下降、血小板下降的比例(46.2%、23.1%、34.6%)显著高于DAAs治疗组(4.7%、3.5%、1.2%)(P<0.05)。结论 DAAs治疗HIV合并丙型肝炎患者的病毒学疗效和安全性优于干扰素联合利巴韦林。
Objective To investigate the clinical efficacy and safety of interferon combined with ribavirin(RBV) and direct-acting antiviral agents(DAAs) in patients with HIV/HCV co-infection.Methods The patients infected with HIV/HCV co-infection who were willed to treat HCV infection and in Kunming 3rd People's Hospital from November1st2015toApril15,2018were recruited.All recruited patients were divided into two groups.One group received Peg-INFα-2aorinterferon α-2b plus RBV therapy and the other group received DAAs.The HCV RNA, liver function, blood routine examination APRI and adverse reactions were observed before and after treatment,respectively.Results 28 cases finished the treatment and observation in the group of interferon and 86 cases in the group of DAAs.The ratio of ETVR rate(100%) and SVR24 rate(89.5%) in the group of DAAs was higher than the group of interferon(ETVR67.8%,SVR2460.7%)(P < 0.001).There was no significant difference in the alanine aminotransferase(ALT),aspartateaminotransferase(AST),Serum total bilirubin(TBIL),albumin/ globulin(A/G) and APRIafter treatment in two groups(P > 0.05).During the treatment,the incidence rate of the decrease of the white cell(WBC)(46.2%),hemoglobin(HB)(23.1%) and platelet(PLT)(34.6%) in the group of interferon were higher than that in the the group of DAAs respectively(4.7%、3.5%、1.2%)(P<0.05).Conclusions The efficacy and safety in patients coinfected with HIV-1 and HCV treated with DAAs is better than that of treated with interferon plus ribavirin。
作者
李重熙
白劲松
田波
周文劲
刘俊
LI Chong-xi;BAI Jing-song;TIAN Bo;ZHOU Wen-jing;LIU Jun(Dept.of Infectious Disease,The Third People’s Hospital of Kunming,Kunming Yunnan 650041,China)
出处
《昆明医科大学学报》
CAS
2019年第7期100-105,共6页
Journal of Kunming Medical University
基金
云南省教育厅科学研究基金资助项目(2017ZDX011)
