Modern principles of anti-viral therapy of hepatitis C

Kuznetsov, N. A.; Ильич, Кузнецов Николай; Romanova, Elena S.; Сергеевна, Романова Елена; Startseva, Galina Yu.; Юрьевна, Старцева Галина

doi:10.17816/rfd2018323-27

Rossiĭskiĭ semeĭnyĭ vrach

2018

DOI: 10.17816/rfd2018323-27

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Modern principles of anti-viral therapy of hepatitis C

N. A. Kuznetsov

Кузнецов Николай Ильич²,

Elena S. Romanova

et al.

Abstract: The article presents the basic principles of antiviral therapy for hepatitis C. The main objectives and importance of antiviral therapy for hepatitis C are considered. The concept of a sustained virological response is given. The necessity of determining the causal relationship between infection with the hepatitis C virus and liver damage is substantiated. The article discusses the principles of antiviral therapy using interferon and interferon-free therapy with direct-acting antiviral drugs in both patients w… Show more

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Cited by 3 publications

References 8 publications

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Development of approaches to the evaluation of pharmacotherapy effectiveness for chronic hepatitis C

Narkevich,

Tsitlionok

2023

Farmakoèkonomika

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Objective: to analyse the consumption pattern of antiviral therapy (AVT) for chronic hepatitis C on the example of an infectious hospital.Material and methods. The study was based on data from 380 discharge summaries of an infectious diseases hospital for 2011–2019. The criterion of sampling was the established diagnosis of chronic hepatitis C. The first line therapy regimens were analyzed and compared; the calculations were based on direct treatment costs of the study sample. The pharmacoeconomic effectiveness of therapy was assessed by calculating the cost-effectiveness ratio (CER).Results. A retrospective analysis of patients’ sampling allowed to establish a general profile: a 40-year-old man with hepatitis C virus genotype 1 and a mild degree of liver fibrosis. A total of 18 international nonproprietary names (17 trade names) were used for AVT. The pattern of drugs prescribed correlated with the clinical guidelines for the studied period and allowed to distinguish the beginning of the transition from interferon-based regimens to direct-acting antivirals (DAAs). The change in the treatment paradigm was associated not only with increased efficacy in achieving a sustained virological response, but also with minimization of side effects. The high frequency of prescribing interferon regimens as AVT was accompanied by low rates of achieving virus elimination (63.69%), high frequency of relapses (12.88%), as well as the lack of response to pharmacological correction (21.32%) and premature discontinuation of therapy due to adverse events (2.11%). A total of 142,450,414.91 rubles was spent on the first line pharmacotherapy in the study cohort during the study period. Costs per 1 patient with the diagnosis “chronic hepatitis C” and F0–F3 fibroses according to METAVIR were 372,847.07 rubles with achieving sustained virologic response without relapse in 66% of cases, costs per patient with F4 liver lesion were 398,464.73 rubles (45,16%, respectively).Conclusion. The findings allow us to note the transition from interferon-, nucleoside- and nucleotide-based drugs to DAAs, which can be associated with an increase in therapy effectiveness and proportion of cases with sustained virologic response achieved along with a decrease in the number of adverse events. The results of the study have practical implications for building a strategy for hepatitis C virus elimination in terms of choosing effective pharmacotherapy while reducing the economic burden.

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Development of approaches to the evaluation of pharmacotherapy effectiveness for chronic hepatitis C

Narkevich,

Tsitlionok

2023

Farmakoèkonomika

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Clinical-epidemiological and pathogenetic features of viral hepatitis C in the hemodialysis departments

Акалаев¹,

Aripxodjaeva²,

Рашидова³

et al. 2019

Transplantologiâ (Mosk.)

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Background. Today, the programmed hemodialysis belongs to the clinical medicine area where patients are at a constant risk of viral hepatitis infection. This is associated with surgical interventions on the vessels, fairly frequent transfusions of blood components, and regular hemodialysis procedures. But in recent years, the ratio of reported cases of viral hepatitis B and C in patients on programmed hemodialysis has changed significantly. With an abrupt increase in the incidence of viral hepatitis C, there is a decrease in the number of registered viral hepatitis B cases.The aim. To study the clinical, epidemiological and pathogenetic features of viral hepatitis C in hemodialysis units.Material and methods. A multicenter study was conducted that enrolled the patients from the Programmed Hemodialysis Units in Tashkent and the regional departments of the Republic of Uzbekistan. The study involved 395 patients on programmed hemodialysis for 7.5 ± 0.7 years. The age of patients was 43.5 ± 0.91 years. The diagnosis of chronic viral hepatitis C was made on the basis of medical history, clinical and laboratory data, and detection of anti-HCV IgG and RNA-HCV in blood.Results. When analyzing the clinical examination and laboratory test results of 395 patients, the parenteral viral infection markers were detected in 181 patients (45.8%). The analysis of the overall incidence of viral hepatitis showed that chronic viral hepatitis C had the highest rates and was found in 125 patients (31.6%). The analysis of the chronic viral hepatitis C course in the presence of the end-stage chronic renal disease showed that in 11 (34%) of 32 patients of the Main group the disease proceeded as a fulminant form of chronic renal-hepatic failure with the development of adverse outcomes. Twenty seven patients (84%) in this group developed progressive anemia. In 16 patients (50%), persistent polyserositis developed in the form of hydrothorax, ascites, and pericarditis, which reflected the aggravating effect of chronic viral hepatitis C on the course of chronic renal disease.Conclusions. In Hemodialysis Units, both in the city of Tashkent, and in the regional departments of the Republic of Uzbekistan, the incidence of chronic viral hepatitis C prevails, having the form of a pathological process with a minimally low activity. Chronic viral hepatitis C has an aggravating effect on the course of the underlying disease with the development of adverse outcomes.

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Peculiarities of the Clinical Course of Chronic Viral Hepatitis C in the Background of End-Stage Chronic Renal Insufficiency

Aripkhodjayeva¹,

Akalayev²,

Рашидова³

et al. 2020

Exp Clin Transplant

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Modern principles of anti-viral therapy of hepatitis C

Cited by 3 publications

References 8 publications

Development of approaches to the evaluation of pharmacotherapy effectiveness for chronic hepatitis C

Development of approaches to the evaluation of pharmacotherapy effectiveness for chronic hepatitis C

Clinical-epidemiological and pathogenetic features of viral hepatitis C in the hemodialysis departments

Peculiarities of the Clinical Course of Chronic Viral Hepatitis C in the Background of End-Stage Chronic Renal Insufficiency

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