PECULIARITIES OF TREATMENT AND PREVENTION OF INFECTION CAUSED BY HEPATITIS C VIRUS. Review

T. Hrydina
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Abstract

Relevance. The goal of the WHO Global Strategy on Hepatitis Agents, in particular hepatitis C virus, is to identify infected people early for treatment and prevention of chronic infection. Early detection and treatment of this infection with direct antiviral drugs significantly reduces the incidence of liver cirrhosis and subsequent deaths. Development of an effective hepatitis C vaccine that can primarily protect at-risk individuals is ongoing. Objective: to determine the main approaches for the treatment and prevention of hepatitis C, proposed by WHO, which can lead to the prevention of the formation of chronic forms of the disease and the development of hepatocarcinoma. Methods. Analysis of publications from scientometric databases PubMed, Google Scolar, Cohrane Database by keywords. Search depth is 10 years (2011–2021). Results. Analysis of literature sources about the peculiarities of the treatment of C viral hepatitis showed the feasibility of using drugs with direct antiviral action. Selection of such drugs in order the structural features of the pathogen and specificity of inhibition of the stages of viral reproduction process is discussed and justified. The specificity of the action of these drugs and the main targets of their application are considered. Today, WHO recommends the using of thirteen antiviral drugs with direct action. Two preparations are inhibitors of viral polymerase and the other eleven drugs inhibit of the viral proteases activity. Two direct-acting drugs with a different mechanism of activity are used in the therapeutic schemes. The genotype of the virus, the age and state of health of the patients, especially liver state, have to be considered during the treatment process. This treatment allows to get a positive result without using of interferon, which can cause some complication. Prospects with using new technologies for the creation of effective drugs for the specific prevention of hepatitis C, such as recombinant vaccines, nanovaccines, mRNA containing modified vaccines are considered. Such vaccines will allow to provide specific prophylaxis, especially among people from risk groups, including those with immunodeficiency states. Conclusions. The application of the global strategy proposed by WHO such as early detection and treatment of acute hepatitis C for prevention of the development of chronic forms will lead to a decrease in the incidence of hepatitis in the world.
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丙型肝炎病毒感染的治疗和预防特点。审查
的相关性。世卫组织关于肝炎病原体,特别是丙型肝炎病毒的全球战略的目标是及早发现感染者,以便治疗和预防慢性感染。早期发现和使用直接抗病毒药物治疗这种感染可显著降低肝硬化的发生率和随后的死亡。目前正在开发一种有效的丙型肝炎疫苗,主要用于保护高危人群。目的:确定世界卫生组织提出的治疗和预防丙型肝炎的主要途径,这些途径可以预防丙型肝炎慢性形式的形成和肝癌的发展。方法。PubMed、b谷歌、Scolar、Cohrane等科学计量数据库中论文的关键词分析。搜索深度为10年(2011-2021年)。结果。对丙型肝炎治疗特点的文献资料分析表明,使用具有直接抗病毒作用的药物是可行的。根据病原体的结构特征和抑制病毒繁殖过程各阶段的特异性来选择这些药物,并进行了讨论和论证。讨论了这些药物的作用特异性及其应用的主要靶点。今天,世卫组织建议使用13种直接作用抗病毒药物。两种制剂是病毒聚合酶抑制剂,其余11种药物是抑制病毒蛋白酶活性的药物。治疗方案中使用了两种具有不同活性机制的直接作用药物。在治疗过程中,必须考虑病毒的基因型、患者的年龄和健康状况,特别是肝脏状况。这种治疗可以在不使用干扰素的情况下获得阳性结果,干扰素会导致一些并发症。考虑了利用新技术生产专门预防丙型肝炎的有效药物的前景,如重组疫苗、纳米疫苗、含mRNA的改性疫苗。这种疫苗将能够提供特定的预防,特别是对来自危险群体的人,包括免疫缺陷状态的人。结论。实施世卫组织提出的全球战略,如早期发现和治疗急性丙型肝炎以预防慢性形式的发展,将导致世界肝炎发病率的下降。
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