关键词:

索磷布韦/维帕他韦, 格卡瑞韦, 基因3型慢性丙型肝炎, 肝硬化, 疗效

Abstract:

Objective　To evaluate the efficacy of sofosbuvir/velpatasvir (SOF/VEL) with or without glecaprevir in the treatment of genotype 3 chronic hepatitis C (CHC). Methods　A total of 236 patients with genotype 3 CHC who were treated at the First Hospital of Yulin from June 2019 to December 2021 were selected, including 121 males and 115 females, with an age of (56.93±19.11) years old, 155 cases of CHC and 81 cases of hepatitis C virus compensated cirrhosis (HCV-CLC). All patients were treated with SOF/VEL (400 mg SOF/100 mg VEL once daily) with or without glecaprevir (100 mg once daily) for 12 consecutive weeks. The changes in the examination indicators were compared between the two groups at baseline, the 4th week of treatment, the 12th week of treatment, and the 12th week after drug withdrawal. Statistical analysis was conducted using independent sample t test, paired t test, Mann-Whitney U test, and χ² test. Results　The response rates of the CHC group at the 4th week of treatment, the 12th week of treatment, and the 12th week after drug withdrawal were 36.13% (56/155), 87.10% (135/155), and 94.84% (147/155), and those of the HCV-CLC group were 13.58% (11/81), 44.44% (36/81), and 67.90% (55/81), with statistically significant differences (all P<0.05). In the CHC group, the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) at the 4th week of treatment, the 12th week of treatment, and the 12th week after drug withdrawal were 35 (31, 55) U/L, 57 (30, 78) U/L, 123 (109, 166) U/L, 27 (23, 50) U/L, 37 (25, 45) U/L, 84 (50, 115) U/L, 15 (11, 33) U/L, 18 (10, 36) U/L, and 43 (45, 76) U/L, and there were statistically significant differences compared with those at baseline [75 (40, 100) U/L, 84 (63, 111) U/L, and 196 (144, 238) U/L] (all P<0.05). In the HCV-CLC group, the levels of ALT, AST, and ALP at the 4th week of treatment, the 12th week of treatment, and the 12th week after drug withdrawal were 42 (22, 50) U/L, 56 (46, 67) U/L, 147 (120, 160) U/L, 27 (20, 41) U/L, 33 (16, 40) U/L, 82 (70, 125) U/L, 21 (15, 23) U/L, 18 (13, 25) U/L, and 60 (44, 77) U/L, and there were statistically significant differences compared with those at baseline [73 (42, 110) U/L, 87 (57, 106) U/L, and 196 (155, 257) U/L] (all P<0.05). The liver stiffness values of the CHC group at the 4th week of treatment, the 12th week of treatment, and the 12th week after drug withdrawal were (8.87±1.52) kPa, (5.52±1.72) kPa, and (5.10±1.64) kPa, and there were statistically significant differences compared with that at baseline [(12.70±2.94) kPa] (all P<0.05). The liver stiffness values of the HCV-CLC group at the 4th week of treatment, the 12th week of treatment, and the 12th week after drug withdrawal were (14.62±4.57) kPa, (8.86±2.75) kPa, and (5.46±1.81) kPa, and there were statistically significant differences compared with that at baseline [(25.61±6.46) kPa] (all P<0.05). The liver stiffness value in the CHC group was lower than that in the HCV-CLC group at baseline, the 4th week of treatment, and the 12th week of treatment (all P<0.05), but there was no statistically significant difference in the liver stiffness value between the two groups at the 12th week after drug withdrawal (P>0.05). Conclusion　SOF/VEL with or without glecaprevir has significant efficacy in the treatment of CHC patients.

Key words:

Sofosbuvir/velpatasvir, Glecaprevir, Genotype 3 chronic hepatitis C, Liver cirrhosis, Curative effect