Clinical effect of elbasvir/grazoprevir in treatment of chronic hepatitis C in the real world

Objective To investigate the clinical effect of elbasvir/grazoprevir in the treatment of patients with genotype 1 b chronic hepatitis C( CHC). Methods A total of 99 patients with genotype 1 b CHC and compensated cirrhosis who received elbasvir/grazoprevir treatment for 12 weeks and completed treatment and follow-up for 12 weeks after drug withdrawal in Tianjin Third Central Hospital from December2018 to October 2019 were enrolled. Related clinical data,serological markers,virological indices,and liver stiffness measurement were collected at baseline,at the end of treatment,and at week 12 after drug withdrawal,and virologic response was observed. The Friedman test and Wilcoxon signed rank sum test were used to observe virologic response rate and the changes in liver function and liver stiffness measurement at the end of treatment and at week 12 after drug withdrawal,and the safety of elbasvir/grazoprevir was evaluated. Results For the 99 patients treated with elbasvir/grazoprevir for 12 weeks,the proportion of patients with HCV RNA below the lower limit of detection was100% at the end of treatment and 99% at week 12 after drug withdrawal. There were significant reductions in alanine aminotransferase( ALT) and aspartate aminotransferase( AST) from baseline to the end of treatment( Z =-5. 857 and-5. 941,both P < 0. 05). Liver stiffness measurement decreased from 10. 5 kPa at baseline to 8. 0 kPa at week 12 after drug withdrawal( Z =-4. 036,P < 0. 05). Among the 99 patients,24 patients with compensatory cirrhosis reached a virologic response rate of 100% at the end of treatment and at week 12 after drug withdrawal,as well as significant reductions in ALT and AST from baseline( both P < 0. 05),and liver stiffness measurement decreased from 21. 1 kPa at baseline to 17. 5 k Pa at the end of treatment( Z =-1. 832,P = 0. 067) and 13. 6 k Pa at week 12 after drug withdrawal( Z =-3. 182,P = 0. 001). Compared with the non-liver cirrhosis group,the liver cirrhosis group had significantly greater reductions in liver stiffness measurement( P < 0. 05). The patients had good tolerance throughout the treatment,and 4 patients reported mild adverse events during the treatment. Conclusion Patients with genotype 1 b CHC have a high virologic response rate to elbasvir/grazoprevir in the real world,with significant improvements in liver function and liver stiffness measurement and good tolerance.