The effectiveness of oral antiviral (Sofosbuvir/Ledipasvir) in treating children with HCV infection
The effectiveness of oral antiviral (Sofosbuvir/Ledipasvir) in treating children with HCV infection
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DOI：
10.12669/pjms.346.15722
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发表时间：
2018-11-01
影响因子：
2.2
通讯作者：
Al-Ethawi, Abd El-Salam
中科院分区：
文献类型：
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作者：
Al-Kaaby, Ban Adil;Al-Ethawi, Abd El-Salam
目的：确定（索非布韦/ledipasvir）治疗儿童HCV感染的疗效。方法：本研究于2017年4月至2018年1月在巴格达/伊拉克的胃肠病学、肝病中心/儿科和中央儿童教学医院进行。HCV PCR阳性患者，年龄7至18岁。进行病史、临床检查和研究。进行HCV基因分型（如果负担得起）。Sofosbuvir/Ledipasvir给所有患者每日一次。对于INF患者或已确诊肝硬化的患者，加用利巴韦林。随访肝功能和肾功能，并在12周（治疗结束）时进行PCR;然后在治疗后12周（SVR 12）后进行PCR。总治疗时间为12周，在肝硬化病例中延长至24周。结果：22例患者中，男14例（63.6%），女8例（36.4%），平均年龄12.5岁。基因1型占优势（75%）。SVR 12者20例（90.9%），部分应答者2例（9.1%）。在5例病例中发现了HBV合并感染;在治疗过程中，他们继续使用恩替卡韦。所有患者均达到HCV的SVR 12，HBV滴度降低。即使有INF经历的患者（7例患者31.8%）也对SVR 12有反应。结论：索非布韦/雷迪帕韦治疗儿童丙型肝炎有效，耐受性好。
Objectives: To determine the efficacy of (Sofosbuvir/ledipasvir) in treating children with HCV infection.Methods: This study was conducted at Gastroenterology, Hepatology Center /Pediatrics department and the Central Child Teaching Hospital, Baghdad / Iraq from April 2017 to January 2018. Patients with positive HCV PCR, aged 7 to 18 years were enrolled. History, clinical examinations and investigations were conducted. HCV genotyping was done (if affordable). Sofosbuvir/Ledipasvir was given to all patients once daily. Ribavirin was added for INF-experienced patients or with established cirrhosis. Follow up with liver function and renal function and PCR was done at 12 weeks (end of treatment); then after 12 weeks post treatment (SVR12). Total duration of therapy was 12 weeks, extended to 24 in cases with established cirrhosis. Computer program SPSS version 20 was used for data analysis.Results: The number of patients was 22, with mean age of 12.5 years, 14 boys (63.6%), and 8 girls (36.4%). Genotype 1 was the dominant type (75%). SVR 12 was achieved in 20 patients (90.9%), the remaining two (9.1%) had partial virological response. HBV co-infection was found in five cases; they were kept on Entecavir during the course of treatment. All achieved SVR12 for HCV with decrease in titer of HBV. Even INF-experienced patients (7 patients 31.8%) were responsive with SVR12. The treatment was well tolerated.Conclusion: Sofosbuvir/ledipasvir is effective in treating HCV in children, and is well tolerated.