EFFICIENCY VARIOUS SCHEMES OF ANTIVIRAL THERAPY IN PATIENTS WITH CHRONIC HEPATITIS C INFECTED WITH VIRUS GENOTYPE 1
DOI:
https://doi.org/10.11603/1681-2727.2019.2.10321Keywords:
chronic hepatitis C, antiviral treatment, sofosbuvir, ombitasvir, paritaprevir, dasabuvirAbstract
The aim of the work – to analyze the effectiveness of various schemes of antiviral treatment of patients with CHC infected with genotype 1 of HCV virus by the results of the implementation of the State Target Program in Zaporizhzhia Region.
Materials and methods. 113 patients with CHC infected with genotype 1 of the virus were studied, who were treated according to different regimens of AVT using antiviral drugs with a direct mechanism of action.
Results and discussion. The formation of a SVR 12 was found in most patients: in 86.5 % of patients after treatment with peg-IFN+SOF+RBV and 93.4 % after treatment with OBV/PTV/r+DSV±RBV, thus the frequency of achieving a SVR 12 did not depend on the degree of expressiveness of the fibrosis of the liver. It was established that the dynamics of ALT activity had certain features depending on the treatment scheme. The use of 3D regimen resulted in the normalization of ALT at the time of treatment completion in 91.8 % of patients, after which this figure remained unchanged. Treatment of patients with the peg-IFN+SOF+RBV scheme results in the normalization of ALT activity at the time of AVT completion in only 65.4 % of patients, which is lower (p<0.0001) than with the application of the 3D regimen. However, after 24 weeks after peg-IFN+SOF+RBV antiviral therapy, the ALT activity continued to decrease compared with the completion of antiviral therapy (p<0.01), and in the end period of observation, there was no statistically significant difference between patients in both groups (p>0,05). AVT according to the peg-IFN+SOF+RBV scheme compared with the 3D regimen was more often accompanied by the development of side effects (76.9 % vs. 42.6 %, p=0.0002) due to interferon-induced flu-like syndrome (65.4 %) and neutropenia (53.8 %), ribavirin-induced anemia (46.2 %). The incidence of thrombocytopenia (44.2 % and 37.7 %) and itchy skin (9.6 % and 3.3 %) did not differ statistically between patients in the studied groups (p>0.05). After the completion of treatment with the OBV/PTV/r+DSV+RBV regimen in some patients with F4 liver fibrosis, after the stable negativization of HCV-RNA in the blood, the appearance of ascites was recorded.
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