中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

Clinical effect of elbasvir/grazoprevir in treatment of chronic hepatitis C in the real world

DOI: 10.3969/j.issn.1001-5256.2020.10.010
  • Received Date: 2020-03-18
  • Published Date: 2020-10-20
  • Objective To investigate the clinical effect of elbasvir/grazoprevir in the treatment of patients with genotype 1 b chronic hepatitis C( CHC). Methods A total of 99 patients with genotype 1 b CHC and compensated cirrhosis who received elbasvir/grazoprevir treatment for 12 weeks and completed treatment and follow-up for 12 weeks after drug withdrawal in Tianjin Third Central Hospital from December2018 to October 2019 were enrolled. Related clinical data,serological markers,virological indices,and liver stiffness measurement were collected at baseline,at the end of treatment,and at week 12 after drug withdrawal,and virologic response was observed. The Friedman test and Wilcoxon signed rank sum test were used to observe virologic response rate and the changes in liver function and liver stiffness measurement at the end of treatment and at week 12 after drug withdrawal,and the safety of elbasvir/grazoprevir was evaluated. Results For the 99 patients treated with elbasvir/grazoprevir for 12 weeks,the proportion of patients with HCV RNA below the lower limit of detection was100% at the end of treatment and 99% at week 12 after drug withdrawal. There were significant reductions in alanine aminotransferase( ALT) and aspartate aminotransferase( AST) from baseline to the end of treatment( Z =-5. 857 and-5. 941,both P < 0. 05). Liver stiffness measurement decreased from 10. 5 kPa at baseline to 8. 0 kPa at week 12 after drug withdrawal( Z =-4. 036,P < 0. 05). Among the 99 patients,24 patients with compensatory cirrhosis reached a virologic response rate of 100% at the end of treatment and at week 12 after drug withdrawal,as well as significant reductions in ALT and AST from baseline( both P < 0. 05),and liver stiffness measurement decreased from 21. 1 kPa at baseline to 17. 5 k Pa at the end of treatment( Z =-1. 832,P = 0. 067) and 13. 6 k Pa at week 12 after drug withdrawal( Z =-3. 182,P = 0. 001). Compared with the non-liver cirrhosis group,the liver cirrhosis group had significantly greater reductions in liver stiffness measurement( P < 0. 05). The patients had good tolerance throughout the treatment,and 4 patients reported mild adverse events during the treatment. Conclusion Patients with genotype 1 b CHC have a high virologic response rate to elbasvir/grazoprevir in the real world,with significant improvements in liver function and liver stiffness measurement and good tolerance.

     

  • [1] MAO XR,ZHANG LT,JIANG N,et al. Distribution of HCV genotypes in Chinese Han population with chronic hepatitis C[J]. J Zhejiang Univ(Med Sci),2015,44(4):417-422.(in Chinese)毛小荣,张立婷,蒋妮,等.丙型肝炎病毒基因型在中国大陆汉族慢性丙型肝炎患者中的分布特征[J].浙江大学学报医学版,2015,44(4):417-422.
    [2] JU W,YANG S,FENG S,et al. Hepatitis C virus genotype and subtype distribution in Chinese chronic hepatitis C patients:Nationwide spread of HCV genotypes 3 and 6[J]. Virol J,2015,12:109.
    [3] WEI L,JIA JD,WANG FS,et al. Efficacy and safety of elbasvir/grazoprevir in participants with hepatitis C virus genotype1,4,or 6 infection from the Asia-Pacific region and Russia:Final results from the randomized C-CORAL study[J]. J Gastroenterol Hepatol,2019,34(1):12-21.
    [4] JACOBSON IM,LAWITZ E,KWO PY,et al. Safety and efficacy of Elbasvir/Grazoprevir in patients with hepatitis C virus infection and compensated cirrhosis:An integrated analysis[J]. Gastroenterology,2017,152(6):1372-1382. e2.
    [5] KWO P,GANE EJ,PENG CY,et al. Effectiveness of Elbasvir and Grazoprevir combination,with or without Ribavirin, for treatment-experienced patients with chronic hepatitis C infection[J]. Gastroenterology,2017,152(1):164-175. e4.
    [6] KRAMER J,PUENPATOM A,ERICKSON K,et al. Real world experience with elbasvir/grazoprevir in the Veterans Affairs healthcare system[J]. J Hepatol,2017,66:Abstract PS-095.
    [7] Chinese Society of Hepatology and Chinese Society of Infectious Diseases,Chinese Medical Association. The guideline of prevention and treatment for hepatitis C:A 2015 update[J]. J Clin Hepatol,2015,31(12):1961-1979.(in Chinese)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(2015年更新版)[J].临床肝胆病杂志,2015,31(12):1961-1979.
    [8] LEE MH,YANG HI,LU SN,et al. Hepatitis C virus seromarkers and subsequent risk of hepatocellular carcinoma:Longterm predictors from a community-based cohort study[J]. J Clin Oncol,2010,28(30):4587-4593.
    [9] LEE MH,YANG HI,LU SN,et al. Hepatitis C virus genotype1b increases cumulative lifetime risk of hepatocellular carcinoma[J]. Int J Cancer,2014,135(5):1119-1126.
    [10] WEI L,KUMADA H,PERUMALSWAMI PV,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.
    [11] KUMADA H,SUZUKI Y,KARINO Y,et al. The combination of elbasvir and grazoprevir for the treatment of chronic HCV infection in Japanese patients:A randomized phase II/III study[J]. J Gastroenterol,2017,52(4):520-533.
    [12] OMRAN D,ZAYED RA,NABEEL MM,et al. Evaluating diagnostic accuracy of noninvasive tests in assessment of significant liver fibrosis in chronic hepatitis C egyptian patients[J].Viral Immunol,2018,31(4):315-320.
    [13] MUELLER S,ENGLERT S,SEITZ HK,et al. Inflammationadapted liver stiffness values for improved fibrosis staging in patients with hepatitis C virus and alcoholic liver disease[J].Liver Int,2015,35(12):2514-2521.
    [14] PONS M,SANTOS B,SIMN-TALERO M,et al. Rapid liver and spleen stiffness improvement in compensated advanced chronic liver disease patients treated with oral antivirals[J].Therap Adv Gastroenterol,2017,10(8):619-629.
    [15] KNOP V,MAUSS S,GOESER T,et al. Dynamics of liver stiffness by transient elastography in patients with chronic hepatitis C virus infection receiving direct-acting antiviral therapy-Results from the German Hepatitis C-Registry[J]. J Viral Hepat,2020,27(7):690-698.
    [16] KOHLA M,FAYOUMI AE,AKL M,et al. Early fibrosis regression by shear wave elastography after successful direct-acting antiHCV therapy[J]. Clin Exp Med,2020,20(1):143-148.
    [17] ATTIA D,DETERDING K,CORNBERG J,et al. Different kinetics of liver stiffness using shear wave elastography in patients with chronic hepatitis C infection treated with interferon-free regimens[J]. Eur J Gastroenterol Hepatol,2019,31(1):67-74.
    [18] TADA T,KUMADA T,TOYODA H,et al. Improvement of liver stiffness in patients with hepatitis C virus infection who received direct-acting antiviral therapy and achieved sustained virological response[J]. J Gastroenterol Hepatol,2017,32(12):1982-1988.
    [19] KANDA T,LAU G,WEI L,et al. APASL clinical practice recommendation:How to treat HCV-infected patients with renal impairment?[J]. Hepatol Int,2019,13(2):103-109.
    [20] LENS S,RODRIGUEZ S,LLOVET L,et al. Treating hepatitis C in patients with renal failure[J]. Dig Dis,2017,35:339-346.
    [21] ATSUKAWA M,TSUBOTA A,TOYODA H,et al. Efficacy and safety of elbasvir/grazoprevir for Japanese patients with genotype 1b chronic hepatitis C complicated by chronic kidney disease,including those undergoing hemodialysis:A post hoc analysis of a multicenter study[J]. J Gastroenterol Hepatol,2019,34(2):364-369.
  • Relative Articles

    [1]Lixian WU, Weiqiang ZHENG, Huanqin HAN. Effect of different antiviral drugs in reducing the risk of hepatitis B virus-related hepatocellular carcinoma[J]. Journal of Clinical Hepatology, 2022, 38(5): 1165-1168. doi: 10.3969/j.issn.1001-5256.2022.05.040
    [2]Mingyang FENG, Hui WANG. Selection of antiviral drugs for patients with hepatitis B virus-associated hepatocellular carcinoma[J]. Journal of Clinical Hepatology, 2022, 38(11): 2452-2456. doi: 10.3969/j.issn.1001-5256.2022.11.004
    [3]Hongyu CHEN, Qian KANG, Hao LUO, Ning TAN, Jiali PAN, Ran CHENG, Yifan HAN, Yuqing YANG, Dan LIU, Hongli XI, Min YU, Xiaoyuan XU. Virological response to direct-acting antiviral therapy and changes in liver fibrosis indices in chronic hepatitis C patients with different alanine aminotransferase and aspartate aminotransferase levels in a real-world setting[J]. Journal of Clinical Hepatology, 2021, 37(2): 314-317. doi: 10.3969/j.issn.1001-5256.2021.02.014
    [4]XIA Yang, HUANG Jing, WU ShuDuo, LI JianPing, CHEN WenLi, XIE ZhiWei, GUAN YuJuan. Efficacy of elbasvir/grazoprevir in treatment of genotype 1 chronic hepatitis C: A real-world study[J]. Journal of Clinical Hepatology, 2020, 36(12): 2700-2704. doi: 10.3969/j.issn.1001-5256.2020.12.012
    [5]Hou YiHui, Liu TengFei, Zhao XiaoQing, Zhang LiaoYun. Effect of different direct-acting antivirals on the clinical outcome of genotype 1b chronic hepatitis C and compensated hepatitis C cirrhosis[J]. Journal of Clinical Hepatology, 2020, 36(1): 84-87. doi: 10.3969/j.issn.1001-5256.2020.01.019
    [6]Liang Jing, Zhang YaPing, Liu Fang, Xiang HuiLing, Lu: HongMin, Han Tao. Efficacy of direct-acting antiviral agents in treatment of chronic hepatitis C and its effect on liver stiffness and aspartate aminotransferase-to-platelet ratio index[J]. Journal of Clinical Hepatology, 2020, 36(6): 1263-1267. doi: 10.3969/j.issn.1001-5256.2020.06.015
    [7]Ning HuiBin, Liu JunPing, Jin HuiMing, Li Kuan, Xiao ErHui, Shang Jia. Direct-acting antiviral durgs for hepatitis C in children: A case report[J]. Journal of Clinical Hepatology, 2019, 35(1): 164-165. doi: 10.3969/j.issn.1001-5256.2019.01.032
    [8]You GuoQiong, Wang Li, Duan Meng, Zhu Peng. Research advances in direct-acting antiviral agents in the treatment of hepatitis C virus-related liver cirrhosis[J]. Journal of Clinical Hepatology, 2019, 35(1): 187-190. doi: 10.3969/j.issn.1001-5256.2019.01.041
    [9]Zhang JieBing, Guo HongHua. Research advances in hepatitis B cirrhosis with renal injury and the application of antiviral drugs[J]. Journal of Clinical Hepatology, 2019, 35(1): 191-196. doi: 10.3969/j.issn.1001-5256.2019.01.042
    [10]Zhang YaoDi, Zhang YueRong, Wang Hui, Lin Yan, Zhou Ning, Wu LiYang, Wei ShiFang, Li XiangLin. Clinical features of hepatitis C patients with failure or recurrence after treatment with pegylated interferon-α combined with ribavirin and the clinical effect of direct-acting antiviral agents[J]. Journal of Clinical Hepatology, 2019, 35(11): 2456-2460. doi: 10.3969/j.issn.1001-5256.2019.11.014
    [11]An ZiYing, Ding Yang, Dou XiaoGuang. Selection and evaluation of treatment regimens with direct-acting antiviral agents for patients with chronic hepatitis C in the real world in China[J]. Journal of Clinical Hepatology, 2018, 34(2): 233-237. doi: 10.3969/j.issn.1001-5256.2018.02.003
    [12]Wang MengLan, Tang Hong. Drug-drug interaction of direct-acting antivirals in treatment of chronic hepatitis C[J]. Journal of Clinical Hepatology, 2018, 34(2): 229-232. doi: 10.3969/j.issn.1001-5256.2018.02.002
    [13]Zhang Xi, Li YongGuo. Current status of the application of direct-acting antiviral agents in treatment of chronic hepatitis C and existing problems[J]. Journal of Clinical Hepatology, 2018, 34(4): 853-857. doi: 10.3969/j.issn.1001-5256.2018.04.034
    [14]Chen XinYue, Liu YaLi, Ren Shan. Value of direct-acting antivirals combined with PR regimen (PEG-IFN combined with ribavirin) in the new era of antiviral therapy for hepatitis C[J]. Journal of Clinical Hepatology, 2017, 33(6): 1063-1066. doi: 10.3969/j.issn.1001-5256.2017.06.009
    [15]Bian DanDan, Zheng SuJun. Influencing factors for the therapeutic effect of direct-acting antiviral agents in hepatitis C[J]. Journal of Clinical Hepatology, 2017, 33(11): 2205-2208. doi: 10.3969/j.issn.1001-5256.2017.11.034
    [16]Ceng Qun, Jie ShengHua. Research advances in antiviral drugs and their treatment regimens in chronic hepatitis C[J]. Journal of Clinical Hepatology, 2017, 33(11): 2200-2204. doi: 10.3969/j.issn.1001-5256.2017.11.033
    [17]Wen XiaoYu, Niu JunQi. Mechanism of action of direct-acting antiviral agents in treatment of chronic hepatitis C[J]. Journal of Clinical Hepatology, 2016, 32(9): 1699-1705. doi: 10.3969/j.issn.1001-5256.2016.09.013
    [18]Zhang Jing, Liu XueMin, Liu ZhengWen, Lu: Yi. Application of direct-acting antiviral agents in perioperative period of liver transplantation for patients with hepatitis C[J]. Journal of Clinical Hepatology, 2015, 31(12): 2084-2087. doi: 10.3969/j.issn.1001-5256.2015.12.023
    [19]Ren Shan, Chen XinYue. Current research on hepatitis C virus resistance to direct-acting antiviral agents[J]. Journal of Clinical Hepatology, 2015, 31(11): 1807-1812. doi: 10.3969/j.issn.1001-5256.2015.11.010
    [20]Chen XiaoYun, Zhang YongHong, Ma LiNa, Jin Yi, Yu HaiBin, Zheng YanHong, Liu Ning, Liu JinHua, Wang Jian, Chen XinYue. Changes in NK cells and regulatory T cells among patients with refractory chronic hepatitis C during antiviral treatment[J]. Journal of Clinical Hepatology, 2014, 30(6): 508-513. doi: 10.3969/j.issn.1001-5256.2014.06.008
  • Cited by

    Periodical cited type(5)

    1. 陶西磊. 艾尔巴韦格拉瑞韦片治疗基因1b型丙型肝炎的临床效果. 临床合理用药. 2023(01): 76-78 .
    2. 赵静雯,王溶,杨隽芃. 艾尔巴韦格拉瑞韦片治疗继发性丙型肝炎病毒感染的效果观察. 中国处方药. 2023(04): 97-99 .
    3. 孙皆齐,姜绍文,汪铮. 应用艾尔巴韦/格拉瑞韦治疗基因1b型慢性丙型肝炎初治和经治患者效果对比研究. 实用肝脏病杂志. 2022(02): 195-198 .
    4. 仲小强,陈海燕. 艾尔巴韦格拉瑞韦片治疗尿毒症血液透析患者丙型肝炎病毒感染的临床疗效及对不良反应的影响. 智慧健康. 2022(04): 130-132 .
    5. 赵夏平,刘凯,武淑芳. 艾尔巴韦/格拉瑞韦对初治和经治基因1b型CHC患者的效果分析. 华夏医学. 2022(06): 64-68 .

    Other cited types(1)

  • 加载中
    Created with Highcharts 5.0.7Chart context menuAccess Class DistributionFULLTEXT: 1.5 %FULLTEXT: 1.5 %META: 95.4 %META: 95.4 %PDF: 3.1 %PDF: 3.1 %FULLTEXTMETAPDF
    Created with Highcharts 5.0.7Chart context menuAccess Area Distribution其他: 4.1 %其他: 4.1 %其他: 0.6 %其他: 0.6 %Australia: 0.1 %Australia: 0.1 %Central District: 0.1 %Central District: 0.1 %China: 0.8 %China: 0.8 %India: 0.1 %India: 0.1 %Netherlands: 0.1 %Netherlands: 0.1 %Reynoldsburg: 0.1 %Reynoldsburg: 0.1 %Russian Federation: 0.1 %Russian Federation: 0.1 %Sweden: 0.2 %Sweden: 0.2 %United Kingdom: 0.3 %United Kingdom: 0.3 %United States: 0.2 %United States: 0.2 %上海: 2.4 %上海: 2.4 %东营: 0.1 %东营: 0.1 %中卫: 2.6 %中卫: 2.6 %临汾: 0.3 %临汾: 0.3 %丹东: 0.1 %丹东: 0.1 %乌海: 0.1 %乌海: 0.1 %伊犁: 0.1 %伊犁: 0.1 %佛山: 0.1 %佛山: 0.1 %保定: 0.1 %保定: 0.1 %北京: 16.6 %北京: 16.6 %华盛顿州: 0.1 %华盛顿州: 0.1 %南京: 0.3 %南京: 0.3 %南宁: 0.1 %南宁: 0.1 %厦门: 0.1 %厦门: 0.1 %台州: 0.9 %台州: 0.9 %吉林: 0.6 %吉林: 0.6 %吴忠: 0.1 %吴忠: 0.1 %呼和浩特: 0.1 %呼和浩特: 0.1 %和田: 0.1 %和田: 0.1 %商丘: 0.3 %商丘: 0.3 %喀什: 0.1 %喀什: 0.1 %嘉兴: 0.1 %嘉兴: 0.1 %天津: 0.8 %天津: 0.8 %太原: 0.2 %太原: 0.2 %宜宾: 0.1 %宜宾: 0.1 %宜春: 0.1 %宜春: 0.1 %宣城: 0.5 %宣城: 0.5 %巴彦淖尔: 0.1 %巴彦淖尔: 0.1 %巴音郭楞: 0.1 %巴音郭楞: 0.1 %常州: 0.1 %常州: 0.1 %广州: 0.3 %广州: 0.3 %廊坊: 0.2 %廊坊: 0.2 %张家口: 3.1 %张家口: 3.1 %徐州: 0.1 %徐州: 0.1 %成都: 0.1 %成都: 0.1 %扬州: 0.6 %扬州: 0.6 %抚州: 0.1 %抚州: 0.1 %抚顺: 0.1 %抚顺: 0.1 %新乡: 0.2 %新乡: 0.2 %昆明: 0.3 %昆明: 0.3 %朝阳: 0.1 %朝阳: 0.1 %杭州: 0.9 %杭州: 0.9 %枣庄: 0.1 %枣庄: 0.1 %柳州: 0.3 %柳州: 0.3 %桂林: 0.1 %桂林: 0.1 %武汉: 0.8 %武汉: 0.8 %毕节: 0.1 %毕节: 0.1 %沈阳: 0.3 %沈阳: 0.3 %泉州: 0.1 %泉州: 0.1 %泰州: 0.2 %泰州: 0.2 %济南: 0.3 %济南: 0.3 %淄博: 0.1 %淄博: 0.1 %深圳: 0.2 %深圳: 0.2 %湖州: 0.5 %湖州: 0.5 %漳州: 0.1 %漳州: 0.1 %玉林: 0.1 %玉林: 0.1 %玉溪: 0.2 %玉溪: 0.2 %石嘴山: 0.1 %石嘴山: 0.1 %福州: 0.3 %福州: 0.3 %秦皇岛: 0.1 %秦皇岛: 0.1 %红河: 0.1 %红河: 0.1 %绍兴: 0.1 %绍兴: 0.1 %绥化: 0.1 %绥化: 0.1 %芒廷维尤: 26.3 %芒廷维尤: 26.3 %芝加哥: 0.3 %芝加哥: 0.3 %苏州: 0.1 %苏州: 0.1 %莫斯科: 0.8 %莫斯科: 0.8 %蚌埠: 0.2 %蚌埠: 0.2 %衡水: 0.1 %衡水: 0.1 %衢州: 0.5 %衢州: 0.5 %西宁: 18.7 %西宁: 18.7 %西安: 0.3 %西安: 0.3 %诺沃克: 0.1 %诺沃克: 0.1 %贵阳: 0.5 %贵阳: 0.5 %赤峰: 0.3 %赤峰: 0.3 %运城: 0.3 %运城: 0.3 %连云港: 0.2 %连云港: 0.2 %遵义: 0.1 %遵义: 0.1 %邯郸: 0.2 %邯郸: 0.2 %郑州: 0.2 %郑州: 0.2 %鄂州: 0.1 %鄂州: 0.1 %重庆: 0.8 %重庆: 0.8 %金华: 0.1 %金华: 0.1 %铁岭: 0.2 %铁岭: 0.2 %银川: 0.1 %银川: 0.1 %长春: 1.1 %长春: 1.1 %长沙: 0.7 %长沙: 0.7 %长治: 0.2 %长治: 0.2 %阜阳: 0.3 %阜阳: 0.3 %阿拉善盟: 0.1 %阿拉善盟: 0.1 %青岛: 0.1 %青岛: 0.1 %香港: 0.2 %香港: 0.2 %鸡西: 0.1 %鸡西: 0.1 %黄冈: 0.1 %黄冈: 0.1 %龙岩: 0.2 %龙岩: 0.2 %其他其他AustraliaCentral DistrictChinaIndiaNetherlandsReynoldsburgRussian FederationSwedenUnited KingdomUnited States上海东营中卫临汾丹东乌海伊犁佛山保定北京华盛顿州南京南宁厦门台州吉林吴忠呼和浩特和田商丘喀什嘉兴天津太原宜宾宜春宣城巴彦淖尔巴音郭楞常州广州廊坊张家口徐州成都扬州抚州抚顺新乡昆明朝阳杭州枣庄柳州桂林武汉毕节沈阳泉州泰州济南淄博深圳湖州漳州玉林玉溪石嘴山福州秦皇岛红河绍兴绥化芒廷维尤芝加哥苏州莫斯科蚌埠衡水衢州西宁西安诺沃克贵阳赤峰运城连云港遵义邯郸郑州鄂州重庆金华铁岭银川长春长沙长治阜阳阿拉善盟青岛香港鸡西黄冈龙岩

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (1383) PDF downloads(99) Cited by(6)
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return