Background and Aims: Ravidasvir (RDV) is a new generation pangenotypic hepatitis C virus (HCV) NS5A inhibitor, with high barrier to baseline resistance-associated species. This is the first phase 2/3 study conducted in Mainland China confirming the efficacy and safety of RDV + ritonavir-boosted danoprevir + ribavirin for 12 weeks in treatment-naïve noncirrhotic patients with genotype 1 infection in a large population.Methods: In this multicenter, randomized, double-blinded, placebo-controlled phase 2/3 trial (NCT03362814), we enrolled 424 treatment-naïve, noncirrhotic adult HCV genotype 1 patients. All patients were randomized at 3:1 ratio to receive a combination of RDV 200mg once daily plus ritonavir-boosted danoprevir 100mg/100mg twice daily and oral ribavirin 1000/1200mg/day (body weight <75/≥75 kg) (n = 318) or placebo (n = 106) for 12 weeks. The primary end-point was the rate of sustained virologic response 12 weeks after the end of treatment, and the safety was evaluated and compared between treatment and placebo groups.Results: The overall rate of sustained virological response at 12 weeks after treatment is 99% (306/309, 95%, CI: 97%–100%) under per protocol set analysis. All patients harboring baseline NS5A resistance-associated species in the treatment group (76/76, per protocol set) achieved sustained virological response at 12 weeks after treatment. No treatment-related serious adverse events were reported. Laboratory abnormalities showed mild or moderate severity (grade 1 and grade 2) in liver function tests.Conclusions: In treatment-naïve, noncirrhotic HCV Chinese patients infected with HCV genotype 1, all-oral regimen of RDV + ritonavir-boosted danoprevir + ribavirin for 12 weeks was highly efficacious, safe, and well tolerated.
Triclosan (TCS) exists ubiquitously in the environment. Several in vitro and in vivo studies have demonstrated that TCS exerts endocrine disruptive effects on reproduction, but data from human populations are limited and conflicting. The objective of our study was to investigate whether high urinary TCS concentration is adversely associated with early reproductive outcomes in women undergoing in vitro fertilization-embryo transfer (IVF-ET). This prospective cohort study was conducted from September 2015 to June 2016, including 156 infertile women undergoing their first IVF-ET cycle. Two spot urine samples were collected prior to oocyte retrieval for TCS detection using solid-phase extraction (SPE) and liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). Linear regression model and binary logistic regression model were used to evaluate the association between urinary TCS concentrations and IVF outcomes. The intake of aquaculture food may have positive influences on urinary TCS concentrations. After adjustment for age, body mass index (BMI), baseline follicle-stimulating hormone (FSH), antral follicle count (AFC) and smoking status, a significant decrease of top quality embryo formation and implantation rate was observed in patients with urinary TCS concentration greater than or equal to the median level (0.045 μmol/mol Cr). We concluded that TCS exposure may exert negative effects during early stages of human reproduction.
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