关键词: 丙型肝炎, 直接抗病毒药物, 超快速病毒学应答

Abstract: Objective To evaluate the clinical efficacy and safety of direct-acting antiviral agents (DAAs) in patients with chronic hepatitis C.Methods A total of 106 patients with chronic hepatitis C were enrolled in this study. Age of the patients were from 29 to 74 years old with a median age of 56. Hepatitis C virus (HCV) RNA was detected in all patients, with the viral load ranging from 5.955e × 104 to 1.688e × 108 IU/ml. Among the 106 patients, 62 were genotype 1b and 44 were genotype 2a. Moreover, 11 patients with decompensated cirrhosis were all infected with HCV genotype 1b. All patients were treated with sofosbuvir (SOF) and daclatasvir (DCV) for 12 weeks, and ribavirin was added in patients with HCV genotype 1b and cirrhosis. Patients with HCV genotype 1b and decompensated liver cirrhosis could not tolerate ribavirin, so their treatment was extended to 24 weeks. HCV RNA, liver function, safety and adverse events were observed during and after treatment. Results Of all the patients, 58.5% achieved super-rapid virological response at week 1 of treatment, 99% achieved complete virological response at weeks 4 of treatment, and 99% achieved viral response at the end of treatment. After treatment, levels of alanine aminotransferase and aspartate aminotransferase were normalized (P<0.05). Level of albumin was increased in cirrhosis group (P<0.05), while level of total bilirubin showed no statistical difference (P>0.05). The rate of sustained virological response (SVR) at weeks 12 and week 24 after treatment was high ( both were 99%). Only slight adverse effects appeared such as gastrointestinal discomfort (2 cases), headache (5 cases), and fatigue with bloating (10 cases).Conclusion Combined therapy of SOF and DCV for patients with HCV is safe and effective. However, the long-term therapeutic efficacy needs to be further investigated.

Key words: HCV, Direct-acting antiviral agents, Sper-rapid virological response