Kronik hepatit C tedavisinde ikinci kuşak direk etkili oral antivirallerin gerçek yaşam verileri: Tek merkez ve heterojen hasta grubu
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Tarih
2020
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info:eu-repo/semantics/openAccess
Özet
Kronik hepatit C enfeksiyonu karaciğer sirozu ve hepatoselüler karsinomun nedenleri arasındadır. Bu çalışmada primer olarakkronik hepatit C’li heterojen bir hasta grubunda güncel olarak kullanılanikinci kuşak direk etkili oral antivirallerin tedavi etkinliği ve yan etki profillerinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Retrospektifolan bu çalışmaya ikinci kuşak direk etkili oral antiviral tedavi alan 72hasta dahil edilmiştir. Hastalara ait klinik ve laboratuvar verileri polikliniktakip dosyalarından elde edilmiştir. Bulgular: Hastaların yaş ortalaması 58±14 olup, 39’u (%54) kadın idi. Baskın genotip 1b idi (%74.6).Non-sirotik, kompanse siroz ve dekompanse siroz hastaların sayıları sırasıyla; 56 (%77.8), 14 (%19.4) ve 2 (%2.8) idi. On sekiz hasta (%25)tedavi deneyimli idi. Paritaprevir/ritonavir/ombitasvir + dasabuvir, ledipasvir/sofosbuvir, ledipasvir/sofosbuvir + ribavirin, sofosbuvir + ribavirin, glekaprevir + pibrentasvir ve paritaprevir/ritonavir/ombitasvir +ribavirin alan hasta sayıları sırasıyla; 38 (%52.8), 13 (%18.1), 7 (%9.7),7 (%9.7), 6 (%8.3) ve 1 (%1.4) idi. Toplam 71 hasta tedaviyi tamamladıve bunların 69’unda (%97.2) kalıcı viral yanıt elde edildi. Ayrıca başlangıç aspartat aminotransferaz, alanin amimotransferaz, gama glutamiltransferaz ve alfa fetoprotein düzeylerinde tedavi ile birlikte anlamlı birdüşüş izlendi (p <0.05). Bilirübin düzeyleri ise tedavi esnasında anlamlıbir şekilde yükselmekle beraber (p <0.05), tedavinin sona ermesiyle birlikte düşüş göstermekteydi. Yan etki profilleri açısından, kullanılan tümrejimlerde gözlenen yan etkiler hafif şiddette olup, tedaviyi kesecek vasıfta değildi. Sonuç: Ülkemizde kronik hepatit C infeksiyonunda güncelolarak kullanılan ikinci kuşak direk etkili oral antiviraller yüksek etkinlikve düşük yan etki profiline sahiptirler.
Chronic hepatitis C infection is one of the causes of liver cirrhosis and hepatocellular carcinoma. The purpose of this study was primarily to examine the treatment efficacy and side effect profiles of second-generation direct-acting oral antivirals currently used in a heterogeneous patient group with chronic hepatitis C. Materials and Methods: This retrospective study included 72 patients who received second-generation direct-acting oral antiviral therapy. Clinical and laboratory data of the patients were collected from outpatient follow-up files. Results: The mean age of the patients was 58±14 years, of which 39 (54%) were women. The predominant genotype was 1b (74.6%). Patients with no cirrhosis, compensated cirrhosis, and decompensated cirrhosis were 56 (77.8%), 14 (19.4%), and 2 (2.8%), respectively. Eighteen patients (25%) were treatment experienced. On the other hand, patients treated with paritaprevir/ritonavir/ombitasvir + dasabuvir, ledipasvir/sofosbuvir, ledipasvir/sofosbuvir + ribavirin, sofosbuvir + ribavirin, glecaprevir + pibrentasvir, and paritaprevir/ritonavir/ombitasvir + ribavirin were 38 (52.8%), 13 (18.1%), 7 (9.7%), 7 (9.7%), 6 (8.3%), and 1 (1.4%), respectively. A total of 71 patients completed the treatment and 69 of them (97.2%) was obtained sustained viral response. In addition, a significant decrease was observed in the initial aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transferase, and alpha fetoprotein levels during treatment (p <0.05). Although bilirubin levels increased significantly during treatment (p <0.05), they decreased at the end of treatment. In terms of the side effect profile, side effects observed in all regimes were mild and not severe enough to discontinue treatment. Conclusion: Therefore, the second-generation direct-acting oral antivirals widely used in chronic hepatitis C infection in our country have high efficacy and low side effect profile.
Chronic hepatitis C infection is one of the causes of liver cirrhosis and hepatocellular carcinoma. The purpose of this study was primarily to examine the treatment efficacy and side effect profiles of second-generation direct-acting oral antivirals currently used in a heterogeneous patient group with chronic hepatitis C. Materials and Methods: This retrospective study included 72 patients who received second-generation direct-acting oral antiviral therapy. Clinical and laboratory data of the patients were collected from outpatient follow-up files. Results: The mean age of the patients was 58±14 years, of which 39 (54%) were women. The predominant genotype was 1b (74.6%). Patients with no cirrhosis, compensated cirrhosis, and decompensated cirrhosis were 56 (77.8%), 14 (19.4%), and 2 (2.8%), respectively. Eighteen patients (25%) were treatment experienced. On the other hand, patients treated with paritaprevir/ritonavir/ombitasvir + dasabuvir, ledipasvir/sofosbuvir, ledipasvir/sofosbuvir + ribavirin, sofosbuvir + ribavirin, glecaprevir + pibrentasvir, and paritaprevir/ritonavir/ombitasvir + ribavirin were 38 (52.8%), 13 (18.1%), 7 (9.7%), 7 (9.7%), 6 (8.3%), and 1 (1.4%), respectively. A total of 71 patients completed the treatment and 69 of them (97.2%) was obtained sustained viral response. In addition, a significant decrease was observed in the initial aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transferase, and alpha fetoprotein levels during treatment (p <0.05). Although bilirubin levels increased significantly during treatment (p <0.05), they decreased at the end of treatment. In terms of the side effect profile, side effects observed in all regimes were mild and not severe enough to discontinue treatment. Conclusion: Therefore, the second-generation direct-acting oral antivirals widely used in chronic hepatitis C infection in our country have high efficacy and low side effect profile.
Açıklama
Anahtar Kelimeler
Kaynak
Akademik Gastroenteroloji Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
19
Sayı
3
