ЭТИОТРОПНАЯ ТЕРАПИЯ ЛЕКАРСТВЕННЫМИ СРЕДСТВАМИ ПРЯМОГО ПРОТИВОВИРУСНОГО ДЕЙСТВИЯ У ПАЦИЕНТОВ С ЦИРРОЗОМ ПЕЧЕНИ В ИСХОДЕ ХРОНИЧЕСКОГО ГЕПАТИТА С
Аннотация
Хронический гепатит С является проблемой здравоохранения глобального масштаба. В мире до 180 млн человек инфицированы вирусом гепатита С. Хроническая инфекция, ассоциированная с вирусом гепатита С, зачастую протекает бессимптомно до первых признаков цирроза печени, вызывая более чем 700 тысяч смертей ежегодно. В течение нескольких предшествующих лет с появлением лекарственных средств прямого противовирусного действия подходы к этиотропной терапии хронического гепатита С кардинальным образом изменились. Помимо существенного увеличения эффективности, выражающейся в большей вероятности достижения устойчивого вирусологического ответа, современные схемы противовирусной терапии относительно безопасны у пациентов с циррозом печени, в том числе декомпенсированным. Таким образом, в настоящий момент возможно проведение эффективной противовирусной терапии у наиболее нуждающейся в ней категории пациентов, и у тех, кому применение интерферон-содержащих схем зачастую противопоказано. В данном клиническом обзоре приведены актуальные сведения об этиотропной терапии лекарственными средствами прямого противовирусного действия у пациентов с циррозом печени в исходе хронического гепатита С. Показана приемлемая эффективность и относительная безопасность при циррозе печени основных лекарственных средств прямого действия, часть из которых уже доступна в Республике Беларусь, остальные же ожидаются в обозримом будущем. Указаны отдельные данные по эффективности лекарственных средств прямого действия при ряде осложнений цирроза печени, например, при прогрессирующей портальной гипертензии и гепатоцеллюлярной карциноме.Литература
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