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索磷布韦在合并终末期肾病行血液透析的HCV感染者中的应用
DOI: 10.3969/j.issn.1001-5256.2021.05.045
利益冲突声明：所有作者均声明不存在利益冲突。
作者贡献声明：余祖江、张野、连建奇负责设计综述方案，资料收集与遴选，文章起草、审阅、修订与定稿。
Application of sofosbuvir in HCV-infected patients with end-stage renal disease undergoing hemodialysis
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摘要: 对于慢性丙型肝炎合并终末期肾病行血液透析的患者，指南多建议以含蛋白酶抑制剂(PI)的直接抗病毒药物方案进行治疗，但临床中常有透析患者因合并严重肝损伤禁忌使用PI类药物。简述了行透析丙型肝炎患者中未满足的治疗需求，回顾了在此类患者中应用基于索磷布韦(SOF)的无PI抗病毒方案的临床试验及真实世界研究进展，探讨了基于SOF的方案在中国透析患者中的应用价值及有待进一步研究的问题。提示，基于全剂量SOF的方案在透析患者中的疗效、耐受性及安全性良好，为此类患者中合并中、重度肝损伤者提供了更多安全有效的抗病毒治疗选择。Abstract: For chronic hepatitis C patents with end-stage renal disease (ESRD) undergoing hemodialysis, most guidelines recommend the use of direct-acting antivirals containing protease inhibitor (PI), yet dialysis patients with severe liver injury are often unable to receive such treatment due to contraindications to PIs. This article briefly introduces the unmet treatment needs in hepatitis C patients with ESRD undergoing dialysis, reviews the data from clinical trials and real-world studies investigating the use of PI-free sofosbuvir (SOF)-based regimens in such patients, and explores the value of SOF-based regimens in the treatment of dialysis patients in China and issues requiring further research. It is pointed out that full-dose SOF-based regimens have good clinical effect, tolerability, and safety in dialysis patients and thus provide additional safe and effective treatment options for such patients with moderate or severe liver injury.
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Key words:
- Hepatitis C /
- Antiviral Agents /
- Nephrosis /
- Renal Dialysis /
- Kidney Failure, Chronic
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