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首页> 外文期刊>Hepatology research: the official journal of the Japan Society of Hepatology >Influence of renal dysfunction on dose reduction and virologic efficacy of regimens combining ribavirin and all-oral direct acting antivirals in patients with chronic hepatitis C virus infection
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Influence of renal dysfunction on dose reduction and virologic efficacy of regimens combining ribavirin and all-oral direct acting antivirals in patients with chronic hepatitis C virus infection

机译：肾功能障碍对慢性丙基肝炎病毒感染患者中药物和口服直接作用抗病毒治疗中药物剂量降低和病毒疗效的影响

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Aim Several interferon (IFN)-free, all-oral regimens with direct acting antivirals (DAAs) for chronic hepatitis C virus (HCV) infection also include ribavirin (RBV). We investigated the influence of renal dysfunction on virologic efficacy and adverse effects in 189 patients with HCV genotype 2 infection who received combination RBV-DAA regimens. Methods The incidence of RBV-induced anemia, RBV dose reduction, and virologic efficacy were compared according to baseline renal function as defined by the estimated glomerular filtration rate (eGFR). Results Patients with renal dysfunction (eGFR = 30-59 mL/min/1.73 m(2)) had higher rate of RBV dose reduction and more marked decreases in hemoglobin levels. These findings were more pronounced in patients with the ITPA CC genotype, who are more sensitive to RBV-induced anemia. Although there were no statistically significant differences in sustained virologic response (SVR) rates according to renal function overall (P = 0.1650), the SVR rate was significantly lower in patients who required RBV dose reduction than in those who did not (P < 0.0001). Conclusions Baseline renal dysfunction could unfavorably affect the outcomes of RBV-DAA in patients with chronic HCV infection due to the increased risk of RBV dose reduction, even in the era of IFN-free DAA regimens.
机译：瞄准几种干扰素（IFN） - 免费，具有直接作用抗病毒（DAAs）的全口腔方案，用于慢性丙型肝炎病毒（HCV）感染还包括利巴韦林（RBV）。我们调查了肾功能障碍对189例HCV基因型2患者的病毒学疗效和不良反应的影响，接受了RBV-DAA方案的组合。方法根据估计的肾小球过滤速率（EGFR）定义，比较RBV诱导的贫血，RBV剂量降低，RBV剂量降低和病毒疗性的发生率。结果肾功能障碍患者（EGFR = 30-59ml / min / 1.73m（2））具有较高的RBV剂量降低速率，血红蛋白水平的更高率降低。这些发现在患有ITPA CC基因型的患者中更加明显，他对RBV诱导的贫血症更敏感。虽然根据肾功能总体持续的病毒学反应（SVR）率没有统计学上显着的差异（P = 0.1650），但在需要RBV剂量减少的患者中，SVR速率显着降低（P <0.0001） 。结论由于RBV剂量降低的风险增加，基线肾功能障碍可能不利地影响慢性HCV感染患者的RBV-DAA的结果，即使在无IFN的DAA方案的时代。

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