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丙肝 代偿期 与 失代偿期 肝硬化 新药 转阴率(SVR12) [复制链接]

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发表于 2015-4-17 16:27 |只看该作者 |倒序浏览 |打印
原文:A Matter of Compensation: HCV and Cirrhosis (发表于2015年2月)

图表数据采集自原文:
A study conducted by Bourliere and colleagues included 154 cirrhotic patients with genotype 1 disease who had previously failed pegylated interferon-containing regimens. Seventy-seven patients treated with an all-oral formulation of ledipasvir/sofosbuvir (Harvoni, Gilead) plus ribavirin for 12 weeks reached an SVR12 rate of 96%. The SVR12 rate for 77 patients treated with just ledipasvir/sofosbuvir for 24 weeks was 97%.
Other novel DAA regimens are showing similar results in compensated cirrhotics. Fried and colleagues found that ritonavir-boosted triple therapy with paritaprevir, ombitasvir and dasabuvir (Viekira Pak, AbbVie), known as the “3D” regimen, plus ribavirin yielded a 91.6% SVR12 rate among cirrhotics with genotype 1a disease. The SVR12 rate for the genotype 1b cohort treated with this regimen was 99.2%. The researchers added, however, that genotype 1a disease, along with prior null response to PEG-IFN and ribavirin and IL28B TT genotype, was associated with poorer outcomes.

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发表于 2015-4-17 16:28 |只看该作者

转阴后,白蛋白上升、胆红素下降,血小板上升
“Albumin went up; bilirubin went down; platelets went up. They saw clinical improvements, as well. This is a huge advance in HCV among decompensated cirrhotics.”

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发表于 2015-4-17 16:28 |只看该作者
一个用艾伯维方案后1-3周化验报告:
Hello everybody. I'm here to share my father's experience with Viekira Pak.
He's 72 yo, geno 1b with cirrhosis and he failed all the previous therapies with Interferon and Riba but he didn't try neither Telaprevir nor Boceprevir.
He is on 12 week of Viekira plus weight-based RBV (1000 mg [<75 kg], so he takes 9 pills a day with food. (3 pills of Viekira + 2 Riba in the morning and 1 Viekira + 3 Riba in the evening)
These are his blood work results.

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发表于 2015-4-17 16:29 |只看该作者
另一位肝硬化患者使用HARVONI 6周后化验报告,化验项目简写大家都看得懂,不翻译了,
harvoni用药后4周病毒未检测到,即高精阴。最新情况帖主未更新


Got my 6 week blood test results from 1/5/15 back.
Platelets after being in the 70's through most of 2014 was 93,000!
Alk Phos continues to rise 153
Alt continues to drop 31
Ast also continues to drop 23
Billirubin total is up 1.1
All others are within normal range.

__________________
61 y/o F Genotype 1b for 40+ years cirrhosis Started Harvoni on 11/23 for 12 weeks UND 12/22/2014 Ended treatment on Feb 15th.

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发表于 2015-4-17 16:30 |只看该作者
一个代偿期肝硬化案例
女性 Gender: Female
身高体重 Ht/Wt: 5'9", 165
基因分型 1a
治疗前RNA计数: 348,000
治疗经过:Incivek, interferon 24 weeks, relapsed at first blood draw;
现用治疗方案:SOVALDI+OLYSIO(simeprevir)
治疗时间,12周+2周,医生建议治疗24周
当前病毒检测:未检测到,即高精阴 SVR or Relapse: Currently UND
肝脏状态:失代偿期肝硬化 腹水 Decompensated cirrhosis
其他检查信息没写


见过另一个欧美失代偿期案例:病毒转阴后,ast, alt 恢复正常,其他不记得

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发表于 2015-4-17 16:31 |只看该作者
以上三个案例来自国外三个论坛,
只是告诉 代偿和失代偿期 肝硬化患者:要对新药有信心!呵呵!

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发表于 2015-5-11 10:35 |只看该作者
肝硬化确定要用12周还是 24周?  1型的,用harvoni.
为老妈祈福!

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发表于 2015-5-11 10:35 |只看该作者
是否一旦转阴 就不会反弹呢?还是非得吃够疗程
为老妈祈福!
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