medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2016-14-75-79medsovet-1467Research ArticleЗАБОЛЕВАНИЯ ПЕЧЕНИLIVER DISEASEСофосбувир в лечении хронической HCV-инфекцииSofosbuvir in therapy of chronic HCV-infectionПавловЧ. С.PavlovC. S.

д.м.н., профессор

MD, Prof.

ШульпековаЮ. О.ShulpekovaY. O.

к.м.н.

PhD in medicine

ШульпековаН. В.ShulpekovaN. V.СеменистаяМ. Ч.SemenistayaM. C.УсановаА. А.UsanovaA. A.Первый Московский государственный медицинский университет им. И.М. СеченоваРоссияSechenov First Moscow State Medical UniversityRussian FederationЦИОП «Медицина будущего» Первого Московского государственного медицинского университета им. И.М. СеченоваРоссияCenter of Innovative Educational Programs Medicine of the Future of Sechenov First Moscow State Medical UniversityRussian FederationЦИОП «Медицина будущего» Первого Московского государственного медицинского университета им. И.М. СеченоваРоссияOgarev National Research Mordovksy State UniversityRussian Federation2016301220160147579Copyright © Павлов Ч.С., Шульпекова Ю.О., Шульпекова Н.В., Семенистая М.Ч., Усанова А.А., 20162016Павлов Ч.С., Шульпекова Ю.О., Шульпекова Н.В., Семенистая М.Ч., Усанова А.А.Pavlov C.S., Shulpekova Y.O., Shulpekova N.V., Semenistaya M.C., Usanova A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/1467Цель обзора

Цель обзора: представить новые подходы к терапии больных с хронической HCV-инфекцией, основанные на клиническом применении препарата прямого противовирусного действия Софосбувир.

Основные положения

Основные положения: до недавнего времени стандартным подходом к лечению HCV-инфекции оставалось назначение схем на основе пегилированного интерферона (ПЭГ-ИФН) в комбинации с рибавирином. В последние годы препаратами выбора становятся средства узконаправленного воздействия на функциональные белки самого вируса – препараты прямого противовирусного действия, что значительно повышает эффективность и безопасность лечения. Препараты прямого противовирусного действия классифицируют по типу вирусных белков, которые служат мишенью их действия: ингибиторы протеаз (наименования препаратов оканчиваются на «-превир»), ингибиторы полимеразы (наименования препаратов оканчиваются на «-бувир»), ингибиторы NS5A (наименования препаратов оканчиваются на «-асвир»).

Препарат Софосбувир – аналог уридинового нуклеотида, мощный ингибитор NS5B – ключевого фермента репликации HCV-РНК, широко применяется в различных схемах противовирусной терапии.

Заключение

Заключение: Софосбувир – один из наиболее многообещающих препаратов для лечения хронической HCV-инфекции. Его бесспорные преимущества: можно применять при различных генотипах вируса, декомпенсированной функции печени. Софосбувир отличается очень хорошей переносимостью и низкой вероятностью развития вирусной резистентности. 

Objective of review

Objective of review: to present new approaches to therapy of patients with chronic NCV-infection based on the clinical use of the direct antiviral action drug Sofosbuvir.

Major provisions

Major provisions: until recently a standard approach to therapy of HCV-infection included prescription of schemes on the basis of the pegylated interferons (PEG-IFN) in combination with Ribavirin. Drugs of focused action at functional proteins of the virus – direct antiviral drugs – have become drugs of choice, which significantly increases effectiveness and safety of treatment. Drugs of direct antiviral action are classified by the type of viral proteins that serve as the target of their action: protease inhibitors (names of the drugs end with - previr), polymerase inhibitors (names of the drugs end with –buvir), NS5A inhibitors (names of the drugs end with – asvir).

Sofosbuvir is an analogue of the uridine nucleotide, a powerful NS5B inhibitor, a key enzyme of HCV-RNA replication, it is widely used in various scheme of antiviral therapy.

Conclusion

Conclusion: Sofosbuvir is one of the most promising drugs for therapy of chronic NCV-infection. Its indisputable advantages: it can be used at various viral genotypes, decompensated liver function. Sofosbuvir stands out for its good tolerability and low possibility of development of viral resistance. 

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The authors declare that there are no conflicts of interest present.