在患有并发性疾病的儿童中治疗型肝炎病毒感染的挑战
Engy Adel Mogahed1,2, Nevian Nabil3, Haytham Ghita3
1Pediatric Hepatology Unit, Department of Pediatrics, Cairo University, Cairo, Egypt. engy.mogahed@kasralainy.edu.eg.
European journal of pediatrics
|March 10, 2025
概括
直接作用抗病毒药物 (DAA) 为患有型肝炎病毒 (HCV) 感染的儿童提供安全有效的治疗方法,即使是患有并发症的儿童. 这些治疗方法可以实现高持续性病毒学反应率,并具有最小的,短暂的副作用.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 儿童传染病 儿童传染病
- 药理学 药理学是指药理学的学科.
背景情况:
- 直接作用抗病毒药物 (DAA) 改变了型肝炎病毒 (HCV) 治疗方法,扩大了以前无法接受基于干扰素的治疗的患者的选择.
- 关于DAA在儿科患者群体的疗效和安全性的数据有限,特别是那些患有并存疾病的人群.
研究的目的:
- 评估口服DAA在被诊断患有HCV的6-18岁儿童的疗效和安全性.
- 为了比较患有HCV单一感染的儿童和患有相关并发症的儿童的治疗结果.
主要方法:
- 一项分析性回顾性研究涉及187名患有HCV感染的儿童.
- 将患者分为单一感染HCV和携带并发性疾病的HCV组.
- 评估基线临床参数,持续病毒学反应 (SVR) 和治疗出现的不良事件.
主要成果:
- 114名患者 (61%) 呈现并发症,最常见的是血液学,脏和心脏疾病.
- 在患有并发症的患者中观察到肝酶和胆红素的显著升高.
- 持续病毒学响应 (SVR) 率很高:单一感染儿童的100%,并发病症儿童的98.2%.
- 最常见的不良事件 (头痛,喘息,易怒) 是轻微的和短暂的,不需要停止治疗.
结论:
- 口服的DAA在治疗儿童的HCV中非常有效和安全,包括那些患有并发症的儿童,达到优异的SVR率.
- 索福斯布维尔/莱迪帕斯维尔在患有并发症的儿科患者中显示出98.9%的SVR.
- 在儿童中,DAA治疗耐受性良好,具有可管理和暂时的副作用,支持其在减少HCV感染池中的作用.
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