An analysis on the clinical efficacies of different antiviral treatment approaches for chronic hepatitis C patients with hepatitis C virus genotype 1b infection

Abstract

Abstract: Objective To investigate the efficacy and safety of different antiviral treatment regimens for chronic hepatitis C (CHC) patients with hepatitis C virus (HCV) genotype 1b infection. Methods A retrospective analysis was conducted on the clinical data of 155 CHC patients with HCV genotype 1b infection admitted to Sanya People′s Hospital from January 2021 to December 2024. All patients were divided into three groups based on different treatment regimens they received: a ledipasvir/sofosbuvir (LDV/SOF) group, a sofosbuvir/velpatasvir (SOF/VEL) group, and a peginterferon α-2b injection/ribavirin (PR) group. The levels of serological liver function and blood routine test indicators were compared before and after treatment in each group, and the virological response rates at 4 weeks, 12 weeks, and 12 weeks after the end of treatment were also compared between the two groups. Results After treatment, the levels of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the LDV/SOF and SOF/VEL groups were [(34.9±6.7)U/L, (31.6±5.9)U/L] and [(35.1±6.3)U/L, (32.7±4.2)U/L], respectively, which were significantly lower than those in the PR group [(48.4±5.9)U/L, (44.7±4.8)U/L] (both P<0.05). The white blood cell (WBC) and platelet count (PLT) levels in the LDV/SOF and SOF/VEL groups were [(6.4±1.2)×10⁹/L, (206.5±30.1)×10⁹/L] and [(6.3±1.4)×10⁹/L, (208.7±32.7)×10⁹/L], respectively, which were significantly higher than those in the PR group [(3.6±1.1)×10⁹/L, (135.4±35.2)×10⁹/L] (both P<0.05). The virological response rates at 4 weeks, 12 weeks, and 12 weeks after the end of treatment in the LDV/SOF and SOF/VEL groups were 87.30%, 95.24%, and 93.65%, respectively, which were significantly higher than those in the PR group (63.16%, 73.68%, and 71.05%, respectively) (both P<0.05). During treatment, the adverse reaction rates in the LDV/SOF and SOF/VEL groups were 15.87% and 14.81%, respectively, which were significantly lower than that in the PR group (63.16%) (both P<0.05). Conclusion The application of direct antiviral drug regimens according to the condition of CHC patients with HCV genotype 1b infection results in high virological response rates, good efficacy, significant improvement in liver function, and good safety.

Key words: Chronic hepatitis C, Genotype 1b, Direct-acting antiviral drugs, Efficacy

HUANG Hui, PENG Yu-feng. An analysis on the clinical efficacies of different antiviral treatment approaches for chronic hepatitis C patients with hepatitis C virus genotype 1b infection[J]. Chinese Hepatolgy, 2026, 31(5): 639-642.

References

[1] Abu-Freha N, Mathew Jacob B, Elhoashla A, et al. Chronic hepatitis C:diagnosis and treatment made easy[J]. Eur J Gen Pract, 2022, 28(1):102-108.
[2] Guntipalli P, Pakala R, Kumari Gara S, et al. Worldwide prevalence, genotype distribution and management of hepatitis C[J]. Acta Gastroenterol Belg, 2021, 84(4):637-656.
[3] Rao H,Wei L,Lopez-Talavera J C,et al. Distribution and clinical correlates of viral and host genotypes in Chinese patients with chronic hepatitis C virus infection[J]. J Gastroenterol Hepatol,2014,29(3):545-553.
[4] 陈卫兵,王小红, 刘芳. 基因1b型不同准种株丙型肝炎病毒核心蛋白对HepG2 细胞生物学行为的影响[J]. 实用肝脏病杂志, 2022,25(1):13-17.
[5] 任姗, 金怡, 柳雅立, 等. 聚乙二醇干扰素联合利巴韦林治疗对基因1b型慢性丙型肝炎患者预存耐药相关替代的差异性分析[J]. 北京医学, 2020, 42(6):479-484+488.
[6] 中华医学会肝病学分会, 中华医学会感染病学分会. 丙型肝炎防治指南(2019年版)[J]. 中华传染病杂志, 2020, 38(1):9-28.
[7] 庄立伟, 纪世博, 张雨, 等. Sofosbuvir联合Velpatasvir治疗1～6基因型慢性丙型肝炎和丙型肝炎肝硬化患者疗效及安全性Meta分析[J]. 中国肝脏病杂志(电子版), 2019, 11(2):30-36.
[8] 谢志伟,章红艳,陆霭琪,等.奥比帕利联合达塞布韦治疗基因 1b 型慢性丙型病毒性肝炎患者的疗效与安全性分析.中华生物医学工程杂志,2021,27(4):380-385.
[9] 胡春霞,杨娇楠,张丰晓,等.格卡瑞韦/哌仑他韦治疗基因1b型慢性丙型肝炎患者疗效及安全性分析[J].实用肝脏病杂志,2022,25(3):359-362.
[10] Damiani G, Franchi C, Pigatto P, et al. Outcomes assessment of hepatitis C virus-positive psoriatic patients treated using pegylated interferon in combination with ribavirin compared to new direct-acting antiviral agents[J]. World J Hepatol, 2018, 10(2):329-336.
[11] 陈海艳, 李晓峰, 童照威. 来迪派韦/索磷布韦对比艾尔巴韦/格拉瑞韦治疗基因1b型慢性丙型肝炎疗效分析[J]. 中华临床感染病杂志, 2022, 15(2):119-124.
[12] Wei L, Kumada H, Perumalswami P V, et al. Safety and efficacy of elbasvir/grazoprevir in Asian participants with hepatitis C virus genotypes 1 and 4 infection[J]. J Gastroenterol Hepatol, 2019, 34(9):1597-1603.
[13] Johnson P J, Berhane S, Walker A J, et al. Impact of direct-acting antiviral agents on liver function in patients with chronic hepatitis C virus infection[J]. J Viral Hepat, 2021,28(1):168-176.
[14] Tacke F,Boeker K H W,Klinker H,et al.Baseline risk factors de termine lack of biochemical response after SVR in chronic hepatitis C patients treated with DAAs[J].Liver Int,2020,40(3):539-548.
[15] 韩宏艳, 潘娟, 蒋文平, 等. 3D方案治疗基因1b型低病毒载量慢性丙型肝炎患者应答疗效研究[J]. 实用肝脏病杂志, 2021, 24(5):689-692.
[16] 侯艺辉,刘腾飞,赵晓青,等. 不同直接抗病毒药物方案对基因1b型慢性丙型肝炎及代偿期丙型肝炎肝硬化临床结局的影响[J]. 临床肝胆病杂志,2020,36(1):84-87.
[17] 王奕璇,王建军,闫涛,等. 直接抗病毒药物治疗基因1b型慢性丙型肝炎病毒感染的真实世界临床研究[J]. 军事医学,2020,44(7):534-540.