Effectiveness and safety of community-based treatment with sofosbuvir plus ribavirin for elderly patients with genotype 2 chronic hepatitis C
Effectiveness and safety of community-based treatment with sofosbuvir plus ribavirin for elderly patients with genotype 2 chronic hepatitis C
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DOI：
10.1016/j.dld.2017.04.012
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发表时间：
2017-09-01
影响因子：
4.5
通讯作者：
Iwakiri, Katsuhiko
中科院分区：
文献类型：
--
作者：
Atsukawa, Masanori;Tsubota, Akihito;Iwakiri, Katsuhiko
背景资料：本研究的目的是阐明sofosbuvir/利巴韦林治疗基因型2感染的慢性丙型肝炎（CHC）在Japanes.Methods的老年患者的有效性和安全性：一项多中心，回顾性研究评估sofosbuvir/利巴韦林的有效性和安全性的基础上，真实世界的临床data.Results：受试者包括270例患者，其中47.0%的人年龄≥ 65岁。≥ 65岁患者的持续病毒学应答率< 65 and >分别为98.6%和95.3%。由于利巴韦林相关的溶血，血红蛋白水平在治疗期间降低，并且在所有时间点，年龄> 65岁的患者的血红蛋白水平均显著低于年龄< 65岁的患者。在血红蛋白水平< 13.0 g/dL的患者中，31.0%（26/84）的患者和70.7%（39/127）的年龄> 65岁的患者需要减少利巴韦林剂量。虽然最常见的不良事件是贫血，但没有患者停止使用利巴韦林或索非布韦。年龄>= 65岁的患者中利巴韦林相关性贫血的发生率为34.6%，显著高于年龄< 65岁的患者（2.8%）。结论：索非布韦/利巴韦林治疗基因2型感染的CHC即使对老年患者也是有效和安全的，尽管包括利巴韦林相关性贫血在内的不良事件的发生率相对较高。(C)2017 Editrice Gastroenterologica Italiana S.r.l.由爱思唯尔有限公司出版。保留所有权利。
Background: The aim of this study was to clarify the effectiveness and safety of sofosbuvir/ribavirin therapy for elderly patients with genotype 2-infected chronic hepatitis C (CHC) in Japan.Methods: A multicenter, retrospective study evaluated the effectiveness and safety of sofosbuvir/ribavirin based on real-world clinical data.Results: The subjects consisted of 270 patients, 47.0% of whom were aged >= 65 years. The sustained virological response rates in patients aged < 65 and >= 65 years were 98.6% and 95.3%, respectively. Hemoglobin levels decreased during treatment due to ribavirin-related hemolysis, and were significantly lower in patients aged > 65 years than those aged < 65 years at all time-points. A reduction in ribavirin dose was necessary in 31.0% (26/84) of patients with hemoglobin levels < 13.0 g/dL and in 70.7% (39/127) of those aged > 65 years. Although the most frequent adverse event was anemia, no patients discontinued the use of either ribavirin or sofosbuvir. The incidence of ribavirin-related anemia in patients aged >= 65 years was 34.6% and significantly higher compared with that in patients aged < 65 years (2.8%).Conclusions: Treatment with sofosbuvir/ribavirin for genotype 2-infected CHC was effective and safe even for elderly patients, although the incidence of adverse events including ribavirin-related anemia was relatively high. (C) 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.