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目的探讨以索非布韦为主的新型抗病毒药物治疗肾移植术后丙型病毒性肝炎(丙肝)的疗效与安全性。方法回顾性分析1例患有丙肝的二次肾移植受者应用索非布韦为主新方案治疗丙肝的诊疗过程,并进行经验总结。结果单用索非布韦方案治疗12周,随访至停药第12周复查发现该受体丙型肝炎病毒(HCV)RNA为5.82×10~4 IU/ml,未能实现持续病毒学应答(SVR)。采用索非布韦+雷迪帕韦+利巴韦林复合治疗方案后实现SVR。两种方案治疗期间患者均未出现不良反应,移植肾和肝功能良好。截至投稿日已术后1年余,患者肝、肾功能以及免疫抑制剂血药浓度稳定。结论单用索非布韦治疗肾移植术后丙肝疗效可能欠佳,复合治疗方案疗效相对稳定且安全。
Objective To investigate the efficacy and safety of a novel antiviral drug mainly consisting of orbofovir in the treatment of hepatitis C virus (HCV) after renal transplantation. Methods Retrospective analysis of 1 case of secondary renal transplant recipients with HCV treated with sofosbuvir-based new treatment of hepatitis C treatment process, and to sum up the experience. Results Single treatment with sofosbuvir regimen for 12 weeks followed up until the 12th week of drug withdrawal and found that the HCV RNA of this recipient was 5.82 × 10 ~ 4 IU / ml, which failed to achieve sustained virological response SVR). SVR was achieved with a combination of sofosbuvir + radipavir plus ribavirin. No adverse reactions were observed in both regimens during the treatment period, with good graft and liver function. As of submission date has been more than 1 year after surgery, patients with liver and kidney function and immunosuppressive agents plasma concentration stability. Conclusions The treatment of HCV with single-agent sofosbuvir may not be effective after renal transplantation, and the efficacy of combination therapy is relatively stable and safe.