Daclatasvir와 Asunaprevir병합 24주 요법에 의한 만성 C형 간염 치료효과 모니터링

Abstract

South Korea chronic treatment of hepatitis C tends to convert to direct acting drug from ribavirin and peg-interferon merged therapy that has kept the digits of the standard therapy of greater than or equal to about 15 years (direct-acting agent : DAA). DAA therapy was too expensive for patient and the patient's access, however, starting from April 2015, Daclatasvir and Asunaprevir combined 24 weeks therapy that makes patients who are HCV 1b type and Baseline NS5A (L31 and Y93) resistant mutation negative reduces patient's burden. And there were some the reports about cases that gain of SVR (Sustained virological response : cases that have acquired a sustained viral response) have been reported, Present study the Daclatasvir and Asunaprevir merged 24 weeks of therapy SVR image gain rate has monitored. From January to December 2015, by examing 35 patients who visited B hospital in Busan, they verified patient's suitability by Resistance mutation test and examined SVR gain rate by Daclatasvir and Asunaprevir merged 24week therapy. Among the patients who are 1b type, and interrelation between RVR(Rapid virological response : rapid virus reaction) SVR, effects of EVR(Early virological response : early virus reaction) to SVR, and changes of liver somatic index between before and after they get SVR. Also, examined for the presence and specificity change to confirm the nucleotide sequence of a virus isolated from patients with the viral breakthrough phenomenon. From August to December in 2015, among the eleven patients who were checked to be Negative in NS5A therapy, seven patients started the therapy. Four patients got therapy successfully, two patients quit the therapy during the investigation, one patient has broken though the virus. They got 80% of SVR earning rate in this inquiry. All the four patients who got successful therapy got RVR, and there were a significant amount of interrelationship. For the viral breakthrough patient, EVR result before treatment enforcement, 3.53 × 10⁶ IU/ml for HCV RNA was detected, but the treatment reduced it in week 5, after the enforcement 1.65 × 10² IU/ml of 4 Log or more, increased to 2.27 x 10⁶ IU/ml in the test who underwent week 12 did. These are the result that proves the amount of interrelationship that there should be EVR to reach SVR. Also, There were no significant changes in liver somatic index between before and after they got SVR, and even after they got SVR, ALT rates get much more effects on patient’s lifestyle. In patients with viral breakthrough, no mutations were found in L31 and Y93, but mutations in Q30 and F37 were observed in the NS5A resistance mutation test. Expansion of RAV was also confirmed for L28 and Q30, It seems appropriate.