直接抗病毒治疗肾移植术后丙肝患者的疗效和安全性  

Efficacy and safety of direct-acting antiviral therapy for hepatitis C after renal transplantation

作　　者：卯怡杰 张旭峰[1] 刘双德[1] 刘晓立[1] 焉杰克[1] 徐东升[1] 潘稳固 田川[1] MAO Yijie;ZHANG Xufeng;LIU Shuangde;LIU Xiaoli;YAN Jieke;XU Dongsheng;PAN Wengu;TIAN Chuan(Department of Kidney Transplantation,Second Hospital of Shandong University,Jinan 250033,Shandong,China)

机构地区：[1]山东大学第二医院肾移植科,山东济南250033

出　　处：《山东大学学报（医学版）》2019年第1期75-80,共6页Journal of Shandong University:Health Sciences

基　　金：山东省科技发展计划(2014GSF121019);山东省自然科学基金(ZR2017PH058)

摘　　要：目的评估肾移植术后丙肝患者直接抗病毒治疗的疗效和安全性。方法回顾分析7例肾移植术后感染丙型肝炎病毒(HCV)且采用了直接抗病毒治疗患者的相关资料,统计分析患者在抗病毒治疗前,治疗2、4、12周,治疗结束后12、24、48周时的丙型肝炎病毒RNA复制量(HCV RNA)、丙氨酸氨基转移酶(ALT)、肾小球滤过率(e GFR)以及血肌酐水平等相关数据来评估直接抗病毒治疗的疗效和安全性,并分析了治疗后1年时的生存情况。结果纳入研究的7例患者经为期12周的直接抗病毒治疗后,所有患者HCV RNA转为阴性,其血清学检测快速病毒学应答(RVR)为100%(7/7),SVR12、SVR24为100%; ALT在抗病毒治疗2周时与治疗前相比具有明显变化,此后ALT水平保持稳定;整个研究期间e GFR、血肌酐水平保持稳定。结论肾移植术后丙肝患者给予直接抗病毒治疗的疗效和安全性是可靠的,研究期间移植肾功能稳定。Objective To assess the efficacy and safety of direct-acting antiviral(DAA)therapy for hepatitis C after renal transplantation. Methods By a retrospective analysis, we recruited seven patients who were infected with hepatitis C virus(HCV RNA)and treated with direct-acting antiviral agents therapy after kidney transplantation in our transplantation department. Serum HCV RNA, alanine transaminase(ALT), estimate glomerular filtration rate(eGFR)and serum creatinine level were measured at baseline, 2nd, 4th, 12th week of treatment, and 12th, 24th, 48th week after the treatment. Survival rate of these patients at 1 year post-therapy was analyzed. Results Seven kidney graft recipients infected with HCV were enrolled in our study. All these patients were given DAA therapy for 12 weeks. At the end of therapy, HCV RNA was negative in all patients. The serological test had a rapid virologic response(RVR)of 100%(7/7), SVR12, SVR24 were 100%, and ALT at 2th week of treatment had improvement compared with that before treatment. ALT levels remained stable thereafter;eGFR and blood muscle levels remained stable throughout the study period. Conclusion During the 1 year follow-up period, the therapy for patients infected with hepatitis C virus after kidney transplantation is safe and effective, and kidney function after transplantation was relatively stable during the research period.

关 键 词：肾移植 慢性丙型肝炎 直接抗病毒治疗 病毒学应答 

分 类 号：R692[医药卫生—泌尿科学]