Effect of different direct-acting antivirals on the clinical outcome of genotype 1b chronic hepatitis C and compensated hepatitis C cirrhosis

Objective To investigate the effect of different direct-acting antivirals(DAAs) on the clinical outcome of genotype 1 b chronic hepatitis C(CHC) and compensated liver cirrhosis(CLC). Methods A total of 115 patients with genotype 1 b CHC and CLC who were treated in Department of Infectious Diseases in The First Hospital of Shanxi Medical University from January to December,2018 were enrolled as subjects,among whom there were 91 patients with CHC and 24 patients with CLC. All patients were given antiviral therapy with DAAs according to their conditions. Among the patients with CHC,28 were treated with sofosbuvir and velpatasvir(SOF + VEL),21 were treated with elbasvir and grazoprevir tablets(EBR + GZR),16 were treated with ombitasvir and dasabuvir(OBV + DSV),13 were treated with sofosbuvir and daclatasvir(SOF + DCV),and 13 were treated with sofosbuvir and ribavirin(SOF + RBV); among the 24 patients with CLC,15 were treated with sofosbuvir and velpatasvir(SOF + VEL),4 were treated with elbasvir and grazoprevir tablets(EBR + GZR),and5 were treated with sofosbuvir and daclatasvir(SOF + DCV). The two groups were compared in terms of normalization rate of liver function and virologic response rate,and adverse drug reactions were observed. The t-test was used for comparison of continuous data between groups,and the chi-square test was used for comparison of categorical data between groups. Results Of all patients,90. 4% achieved super-rapid virologic response at 1 week of treatment,98. 2% achieved rapid virologic response at week 4 of treatment,100% achieved complete early virologic response at week 12 of treatment,and 100% achieved sustained virologic response at week 12 after the end of treatment.There was no significant difference in HCV RNA seroconversion rate between the patients receiving different antiviral treatment regimens at weeks 1 and 4 of treatment(χ2= 2. 83 and 0. 07,P > 0. 05). All antiviral treatment regimens significantly improved the liver function of patients,and there was no significant difference in clinical outcome between different groups(χ2= 0. 83 and 1. 23,P > 0. 05). Both groups had no significant increase or reduction in renal function parameters after 12 weeks of the treatment with DAAs(t = 1. 32 and 0. 56,P >0. 05). There was a low incidence rate of adverse events,with two cases of nausea(1. 74%) and one case each of dizziness,palpitation,rash,and hemolysis(0. 87%). Conclusion In patients with genotype 1 b disease,DAA antiviral regimens selected based on their conditions can achieve good virologic response rate,with significant improvement in liver function and a low incidence rate of adverse events.