使用直接作用抗病毒药物治疗慢性丙型肝炎血友病患者

D. Danilau
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摘要

背景。在世界范围内,1990年以前,大量血友病患者由于替代治疗而感染丙型肝炎病毒。丙型肝炎和血友病患者的慢性肝病和HCC死亡率明显高于一般人群。目标。目的:评价血友病合并慢性丙型肝炎患者直接抗病毒治疗的效果。评估DAA治疗后持续病毒学应答率以及抗病毒治疗期间临床和实验室参数的动态。结果。治疗12 / 24周后,14例患者均获得持续的病毒学应答。在抗病毒治疗期间,部分患者出现血尿素氮升高,白细胞计数下降,ALT活性升高。所有这些现象都是可逆的,都是自发解决的。结论。白俄罗斯现有的DAA方案对血友病患者的慢性丙型肝炎治疗非常有效。这些方案不会显著影响血液学参数,耐受性良好,具有可接受的安全性。
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THE USE OF DIRECT-ACTING ANTIVIRALS FOR THE TREATMENT OF CHRONIC HEPATITIS C IN PATIENTS WITH HEMOPHILIA
Background. Worldwide, prior to 1990, a large number of patients with hemophilia were infected with the hepatitis C virus due to substitution therapy. The mortality rate from chronic liver disease and HCC in patients with HCV and hemophilia is signifcantly higher than in general population. Objective. To assess the results of direct-acting antiviral therapy in patients with hemophilia and chronic hepatitis C. Material and methods. The rate of sustained virologic response after DAA treatment and the dynamics of clinical and laboratory parameters during antiviral treatment were evaluated. Results. All 14 patients achieved sustained virological response after 12 / 24 weeks of treatment. During antiviral treatment, some patients showed an increase in blood urea nitrogen, a decrease in leukocyte count, and increase of ALT activity. All these phenomena were reversible and resolved spontaneously. Conclusion. The DAA regimens available in Belarus are highly effective for the treatment of chronic hepatitis C in patients with hemophilia. These regimens do not signifcantly affect hematological parameters, are well tolerated, and have acceptable safety profle.
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