| Popis: |
The review deals with the stages of antiviral therapy of chronic viral hepatitis C. Using different schemes of combined treatment with genetically engineered interferon drugs with ribavirin that makes the treatment so expensive, we observed the successes and failures in the effectiveness of the antiviral therapy, especially in patients with genotype 1 of C virus. The dependence of the efficiency of virologic response on many factors - liver fibrosis and cirrhosis, C virus genotype, ethnicity, as well as the genotype of the IL 28B gene and its loci – has been found out. Therapy with interferon drugs was carried out parenterally for 24 to 48 weeks and longer. In 2012–2014 direct-acting antiviral drugs (DAAs) – NS3/4A protease inhibitors boceprevir and telaprevir – came into use, followed by simeprevir, in combination with pegylated interferon-α and ribavirin for the treatment of patients with chronic viral hepatitis C with 1B and 1A virus genotype. In 2015, the Ministry of Health of the Russian Federation registered the first fully interferon-free combination for the treatment of genotype 1 chronic viral hepatitis, with the trade name of Viekira Pak consisting of 3 direct-acting antiviral drugs: dasabuvir, ombitasvir, paritaprevir, and pharmacological booster ritonavir. Such therapy has shown high efficiency, safety, convenience of use of tablet formulations, a short course of treatment, which contributed to a greater commitment of patients to treatment. Later, registered direct-acting antiviral drugs – daclatasvir and asunaprevir - found their use. The prospects are obvious, although there is still a lot of work to be done in selecting the best approaches to the treatment of all categories of patients with chronic viral hepatitis C. Key words: chronic viral hepatitis C, interferon therapy, direct-acting antiviral drugs, interferon-free therapy. |
