Clinical Observation Of Sofosbuvir+Daclatasvir In The Treatment Of Chronic HCV Infection

Objective: To observe the sustained virological response rate and adverse reactions of Sofosbuvir(SOF)+Daclatasvir(DCV)in patients with chronic HCV infection;At the same time,the effects of SOF+DCV regimen on liver function,blood routine,and renal function tests were analyzed;Preliminary study on the influencing factors of rapid virological response rate.Methods: According to the inclusion and exclusion criteria,64 patients with chronic HCV infection who received oral SOF+DCV antiviral treatment from the Department of Infectious Diseases and Inpatient Department of Yan’an University Hospital from June2015 to June 2018 were selected as subjects.Baseline data were collected for all subjects,including age,gender,marital history,drinking history,smoking history,previous antiviral treatment history,baseline hepatitis C virus load and hepatitis C virus genotype,concomitant disease and medication status;follow-up and record patient treatment Serum hepatitis C virus load,liver function,renal function,blood routine,liver hardness and other examination data during the period(treatment 4 weeks,treatment end)and after treatment(12 weeks,24 weeks,48 weeks).To observe the sustained virological response rate and adverse reactions of SOF+DCV in patients with chronic HCV infection in China,and analyze the effects of SOF+DCV antiviral therapy on laboratory tests such as liver function,blood routine and renal function,and to explore the rapid virological response rate.Influencing factors.Results: 1.At 4 weeks of treatment,the HCV RNA negative rate was 87.5%(56/64);at the end of treatment,the HCV RNA negative rate was 98.4%(63/64).2.At 4weeks of antiviral therapy,the HCV RNA conversion rate of each group,ie,the rapid virological response rate(RVR): 100% of patients with type 1b gene,82.4% of patients with type 3 gene;96.6% of female patients and 80% of male patients;96.6% of patientswith low viral load(≤8.0×105 IU/ml),high viral load(>8.0×105 IU/ml)80%;89.1% of newly diagnosed patients,77.8% of patients who failed PR treatment;no fatty liver93.0% of patients,76.2% of patients with fatty liver;66.7% of patients with hepatitis C cirrhosis,93.9% of patients with chronic hepatitis C.3.HCV RNA negative rate at 4weeks of treatment: gender group,baseline viral load group,cirrhosis and non-cirrhosis group,P value was 0.045,0.045,0.005,the difference was statistically significant(P<0.05);Gene type 1b and type 3,PR treatment failure and initial treatment group,combined with fatty liver and non-fatty liver group,the P values were 0.081,0.341,0.056,the difference was not statistically significant.(P>0.05).4.Serum HCV RNA was undetectable at 12 weeks after the end of treatment,ie,the sustained virological response rate(SVR12)was 100%.At the 24 th week after the end of treatment,serum HCV RNA was still undetectable in all patients,ie SVR24 was 100%.At the 48 th week after the end of treatment,serum HCVRAN was also undetectable in all patients,that is,SVR48 was100%.No recurrence of HCV RNA was observed during follow-up.5.At 4 weeks of treatment,ALT and AST of chronic hepatitis C were significantly lower than those at baseline,P values were 0.000 and 0.000,respectively,and the difference was statistically significant(P<0.05);ALB,TBi L,DBIL,IBi L treatment Before and after comparison P>0.05,no difference.The changes of ALT and AST in patients with hepatitis C cirrhosis were the same as those in chronic hepatitis C.The P values were 0.000 and0.000,respectively,compared with the baseline of treatment at 4 weeks of treatment.The difference was statistically significant(P<0.05);TBi L was 48 weeks after treatment.The difference was statistically significant(P = 0.023,<0.05);DBIL was compared with the treatment baseline at 4 weeks of treatment,at the end of treatment,at 12 weeks,24 weeks,and 48 weeks after treatment,the P values were 0.038,0.017,respectively.0.012,0.004,0.002,the difference was statistically significant(P<0.05).There were no differences in the baseline of HB,PLT and Cr between the observation subjects and the treatment period and after treatment(P>0.05).6.The baseline liver stiffness of patients with hepatitis C cirrhosis was compared with that of 24 weeks after treatment(P=0.000),and the difference was statistically significant(P<0.05).Conclusion: 1.SOF+DCV treatment of chronic HCV infection patients with sustained virological response rate(SVR12)up to 100%,high safety,low incidence of adverse reactions and mild,well tolerated.2.The rapid virological response of SOF+DCV in patients with chronic HCV infection may be affected by gender,baseline viral load and liver stiffness.3.SOF+DCV in patients with chronic HCV infection can rapidly reduce transaminase and reduce liver stiffness and total bilirubin in patients with hepatitis C cirrhosis.