达诺瑞韦/利托那韦联合拉维达韦治疗HIV合并慢性丙型肝炎的真实世界研究

肝脏 ›› 2026, Vol. 31 ›› Issue (1): 44-48.

达诺瑞韦/利托那韦联合拉维达韦治疗HIV合并慢性丙型肝炎的真实世界研究

吴桂芳, 魏振华, 严亚军, 杨威, 万竹青, 许璐, 王瑶芬, 余文俊, 龚晓明, 冯玲, 杨蓉蓉, 蒋洪林, 梁科, 高世成, 柯亨宁

430071 武汉武汉大学中南医院(吴桂芳,严亚军,冯玲,杨蓉蓉,梁科,高世成,柯亨宁);441322 随州随州市均川镇卫生院(魏振华);441309 随州随县疾病预防控制中心(杨威); 432599 孝感云梦县人民医院(万竹青);432599 孝感云梦疾病预防控制中心(许璐);437100 咸宁湖北科技学院附属第二医院(王瑶芬);430312 武汉武汉市第一医院(余文俊);437100 咸宁咸宁市中心医院(龚晓明);430079 武汉湖北省疾病预防控制中心(蒋洪林)

收稿日期:2025-01-04 出版日期:2026-01-31 发布日期:2026-03-30

A real-world study of Danorevir/Ritonavir combined with Ravidavir in the treatment of HIV with chronic hepatitis C

WU Gui-fang¹, WEI Zhen-hua², YAN Ya-jun¹, YANG Wei³, WAN Zhu-qing⁴, XU Lu⁵, WANG Yao-fen⁶, YU Wen-jun⁷, GONG Xiao-ming⁸, FENG Ling¹, YANG Rong-rong¹, JIANG Hong-lin⁹, LIANG Ke¹, GAO Shi-cheng¹, KE Heng-ning¹

1. Zhongnan Hospital of Wuhan University,Wuhan 730071, China;
2. Hubei Province Suizhou City Junchuan Town Health Center, Suizhou 441322, China;
3. Suixian Center for Disease Control and Prevention, Suizhou 441309, China;
4. Yunmeng County People′s Hospital, Xiaogan 432599, China;
5. Yunmeng Center for Disease Control and Prevention, Xiaogan 432599, China;
6. The Second Affiliated Hospital of Hubei University of Science and Technology, Xianning 437100, China;
7. Wuhan First Hospital, Wuhan 430312, China;
8. Xianning Central Hospital,Xianning 437100, China;
9. Hubei Provincial Center for Disease Control and Prevention,Wuhan 730079, China

Received:2025-01-04 Online:2026-01-31 Published:2026-03-30

摘要/Abstract

摘要： 目的评估达诺瑞韦/利托那韦联合拉维达韦治疗HCV感染及HIV/HCV合并感染的疗效和安全性。方法于2023年7月～2024年3月在中国湖北某地区开展一项前瞻性、多中心研究,研究对象为HCV感染及HIV/HCV合并感染者。在基线、治疗第4周、随访12周时分别检测HCV病毒载量、肝功能、肾功能等。观察治疗过程中的不良反应和实验室检测指标。统计学分析方法采用t检验、Friedman检验和χ²检验。采用单因素和多因素非条件logistic回归分析持续病毒学应答(SVR)的影响因素。结果研究共入组87例患者,其中66例患者完成随访。HCV感染者15例,HCV/HIV合并感染者51例。HCV感染者SVR率为73.33%,HCV/HIV合并感染者SVR率为74.50%,两者差异无统计学意义(P=1.000)。多因素logistic回归分析显示HCV基因分型(OR=4.589,95%CI: 1.272~16.558,P=0.020)是持续病毒学应答12周(SVR12)的独立影响因素。66例患者中有34例(51.52%)发生不良事件,其中HIV/HCV组中有27例(52.94%),HCV组中有7例(46.67%),所有不良反应在对症支持治疗后均消失。结论达诺瑞韦/利托那韦联合拉维达韦治疗HCV具有次优的抗病毒疗效,HCV基因2a型是SVR的独立影响因素。对于基因2a型患者,可能需要选择其他治疗方案来提高SVR率。

关键词: 丙型肝炎病毒, 艾滋病, 共感染, 直接抗病毒药物, 安全性

Abstract: Objective To evaluate the efficacy and safety of Danorevir/Ritonavir combined with ravidavir in the treatment of HCV infection and HIV with HCV infection. Methods A prospective, multicenter study of HCV infection and HIV/HCV co-infected persons in a region of Hubei, China, from July 2023 to March 2024. HCV viral load, liver function, and renal function were measured at baseline, at the 4th week of treatment, at the end of treatment, and at the 12 week follow-up. The adverse reactions and laboratory test indexes were observed during the treatment. t test, Friedman test and χ² test were used for statistical analysis. Univariate and multivariate logistic regression were used to analyze the influencing factors of sustained virological response (SVR). Results A total of 87 patients were enrolled in the study, 66 of whom completed follow-up. There were 15 patients with HCV infection and 51 patients with HCV/HIV co-infection. The rate of SVR in HCV-infected patients was 73.33%, and that in HCV/HIV co-infected individuals was 74.50%, with no significant difference (P=1.000). Multivariate logistic regression analysis showed that the genotype of hepatitis C (OR=4.589,95%CI: 1.272~16.558, P=0.020) was an independent influencing factor for SVR. Adverse events occurred in 34 (51.52%) of 68 patients, including 27 (52.94%) in the HIV/HCV group and 7 (46.67%) in the HCV group, all of which disappeared after symptomatic supportive treatment. Conclusion Danorevir/Ritonavir combined with Ravidavir has a suboptimal antiviral efficacy in the treatment of HCV. HCV genotype 2a is an independent influencing factor for SVR. For patients with genotype 2a, other treatment regimens may need to be selected to increase the SVR rate.

Key words: Hepatitis C virus, AIDS, Co-infection, Direct antiviral drugs, Security

吴桂芳, 魏振华, 严亚军, 杨威, 万竹青, 许璐, 王瑶芬, 余文俊, 龚晓明, 冯玲, 杨蓉蓉, 蒋洪林, 梁科, 高世成, 柯亨宁. 达诺瑞韦/利托那韦联合拉维达韦治疗HIV合并慢性丙型肝炎的真实世界研究[J]. 肝脏, 2026, 31(1): 44-48.

WU Gui-fang, WEI Zhen-hua, YAN Ya-jun, YANG Wei, WAN Zhu-qing, XU Lu, WANG Yao-fen, YU Wen-jun, GONG Xiao-ming, FENG Ling, YANG Rong-rong, JIANG Hong-lin, LIANG Ke, GAO Shi-cheng, KE Heng-ning. A real-world study of Danorevir/Ritonavir combined with Ravidavir in the treatment of HIV with chronic hepatitis C[J]. Chinese Hepatolgy, 2026, 31(1): 44-48.

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