medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2017-4-36-41medsovet-1849Research ArticleГЕПАТИТЫГЕПАТИТЫЛЕЧЕНИЕ HCV-ИНФЕКЦИИ КОМБИНАЦИЕЙ СОФОСБУВИРА И ДАКЛАТАСВИРАTREATMENT OF HCV INFECTION BY A COMBINATION OF SOFOSBUVIR AND DACLATASVIRШУЛЬПЕКОВАЮ. О.SHULPEKOVAY. O.

к.м.н.

PhD in medicine

ШУЛЬПЕКОВАН. В.SHULPEKOVAN. V.СЕМЕНИСТАЯМ. Ч.SEMENISTAYAM. C.УСАНОВАА. А.USANOVAA. A.ПАВЛОВЧ. С.PAVLOVC. S.

д.м.н., профессор

MD, Professor

Первый Московский государственный медицинский университет им. И.М. СеченоваРоссияSechenov First Moscow State Mdical UniversityRussian FederationНациональный исследовательский Мордовский государственный университет им. Н.П. ОгареваРоссияOgarev National Research Mordovian State UniversityRussian Federation201726052017043641Copyright © ШУЛЬПЕКОВА Ю.О., ШУЛЬПЕКОВА Н.В., СЕМЕНИСТАЯ М.Ч., УСАНОВА А.А., ПАВЛОВ Ч.С., 20172017ШУЛЬПЕКОВА Ю.О., ШУЛЬПЕКОВА Н.В., СЕМЕНИСТАЯ М.Ч., УСАНОВА А.А., ПАВЛОВ Ч.С.SHULPEKOVA Y.O., SHULPEKOVA N.V., SEMENISTAYA M.C., USANOVA A.A., PAVLOV C.S.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/1849Цель обзора

Цель обзора: оценить эффективность и безопасность применения пангенотипической комбинации «софосбувир/даклатасвир» — препаратов прямого противовирусного действия в терапии хронической HCV-инфекции на различных стадиях поражения печени.

Основные положения

Основные положения: софосбувир — антисмысловой нуклеотид, угнетающий РНК-зависимую РНК-полимеразу NS5B, этот препарат заслужил репутацию одного из сильнейших антирепликативных средств, в том числе при резистентности к интерферону. Даклатасвир — мощный ненуклеотидный ингибитор NS5А-белка, катализирующего образование репликативных комплексов. Оба компонента обладают доказанным эффектом в отношении 1-6 генотипов HCV. Их сочетание обеспечивает пангенотипическую активность, а взаимное усиление эффекта уменьшает риск развития лекарственной устойчивости. Показаниями к назначению комбинации «софосбувир/даклатасвир» являются: лечение HCV-инфекции на стадии острого гепатита (при 1—6 генотипах вируса), лечение HCV-инфекции на стадии хронического гепатита (при 1—6 генотипах вируса), лечение HCV-инфекции при ко-инфекции ВИЧ, лечение HCV-инфекции на стадии цирроза печени, лечение рецидива HCV-инфекции после трансплантации печени, лечение HCV-инфекции с иммунокомплексными проявлениями.

Заключение

Заключение: для комбинации «софосбувир/даклатасвир» показана высокая эффективность в лечении HCV-инфекции 1—6 генотипов с частотой достижения УВО 93—97% на стадии гепатита и 88—95% — на стадии цирроза. Хорошая переносимость и высокая эффективность обусловили активное применение этой комбинации на стадии цирроза печени. Данная комбинация с успехом применяется для лечения рецидива HCV-инфекции в трансплантате печени, в том числе при ко-инфекции ВИЧ.

The purpose of the review is to evaluate the efficacy and safety of using pangenotypic combination «of Sofosbuvir/Daclatasvir» — the direct action antiviral drugs in the treatment of chronic HCV infection at different stages of liver damage.

Main provisions

Main provisions: Sofosbuvir is the antisense nucleotide, inhibiting RNA-dependent RNA-polymerase NS5B, this drug has earned a reputation as one of the strongest anti-replication drugs, including when there is interferon resistance. Daclatasvir is a powerful non-nucleotide inhibitor of NS5А protein, catalyzing formation of replicative complexes. Both components are proven to be effect against HCV genotypes 1-6. Their combination provides pangenotypic activity, and the mutual strengthening effect diminishes the risk of development of drug resistance. Indications for the administration of a combination «Sofosbuvir/Daclatasvi» are: treatment of HCV infection at the stage of acute hepatitis (for genotypes 1–6 of the virus), treatment for HCV infection at the stage of chronic hepatitis (for genotypes 1–6 of the virus), treatment of HCV infection in co-infection with HIV, treatment of HCV infection at the stage of liver cirrhosis, treatment of recurrent HCV infection after liver transplantation, treatment of HCV infection with immune manifestations.

Conclusion

Conclusion: the combination «Sofosbuvir/Daclatasvir» is shown to be highly effective in the treatment of HCV infection of genotypes 1-6 with a frequency of SVR 93—97% at the stage of the hepatitis and 88—95% — at the stage of cirrhosis. Good tolerance and high efficiency has led to active use of this combination фе the stage of cirrhosis. This combination has been successfully used for the treatment of recurrence of HCV infection in the liver graft, including co-infection with HIV.

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