摘要目的 观察应用利托那韦强化的达诺瑞韦(Ritonavir-boosted danoprevir,DNVr)联合盐酸达拉他韦( Daclatasvir,DCV)治疗1b型慢性丙型肝炎(CHC)患者的疗效和安全性.方法 收集2018年8月至2019年2月就诊于南昌大学第一附属医院感染科收治的33例基因1b型CHC患者,使用DNVr+DCV抗病毒治疗.分别于治疗前,治疗第2、4、12周,以及停药后第12周检测HCV RNA水平,观察患者肝肾功能等指标以及不良反应.采用重复测量的方差分析对数据进行分析.结果33例患者治疗前HCV RNA载量为1.12×104 ～1.76×107 IU／mL,治疗第2周时所有患者病毒载量均低于检测值下限(HCV RNA＜500 IU／mL),治疗结束后第12周持续病毒学应答率达到100%,血清丙氨酸转氨酶、天冬氨酸转氨酶、总胆红素水平均恢复正常(F＝58.26、14.49和20.16,P＜0.05).治疗中3例患者发生轻微不良反应.结论 DNVr联合DCV治疗基因1b型CHC患者可取得快速、强效病毒性应答,且具有良好的安全性.

abstractsObjective To evaluate the clinical efficacy and safety of ritonavir-boosted danoprevir (DNVr) combined with daclatasvir (DCV) in the treatment of patients with genotype 1b chronic hepatitis C (CHC).Methods Thirty-three patients with genotype 1b CHC admitted in the Department of Infectious Diseases of the First Affiliated Hospital of Nanchang University from August 2018 to February 2019 were enrolled.All the patients received DNVr +DCV antiviral treatment.HCV RNA levels were detected before and 2, 4, 12 weeks after treatment, and after drug withdrawal , respectively.Indicators of liver and kidney function and adverse events were observed.ANOVAV of repeated measurement was used to analyze the data. Results The baseline viral loads of 33 patients ranged from 1.12×104 to 1.76×107 IU／mL.Two weeks after treatment the viral loads of all patients were down to the lowest limit of detection (＜500 IU／mL). Serum ALT, AST and TBil levels returned to norml ( F＝58.26, 14.49 and 20.16, all P＜0.05) and sustained virologic response reached 100%12 weeks after drug withdrawal.Three cases had minor adverse reactions during the treatment.Conclusion DNVr combined with DCV can achieve a rapid and strong virological response in the treatment of patients with genotype 1b CHC with good safety.