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Current international guidelines for the management of patients with chronic viral hepatitis C

https://doi.org/10.21518/2079-701X-2020-15-72-77

Abstract

The new American Association for the Study of Liver Diseases and Infectious Diseases Society of America recommendations for the management of hepatitis C patients are analyzed. To screen for viral hepatitis C, it is recommended that antibodies to the hepatitis C virus and RNA be detected in individuals with increased risk of infection. Patients with an increased risk of infection include people who inject narcotic drugs; patients with prolonged hemodialysis; health workers after contact with the blood or mucous membranes of a patient with viral hepatitis C; persons who received blood transfusions or blood components before 1987. In most patients, non-invasive tests can be used to diagnose liver fibrosis, which include physical examination, determination of serum fibrosis markers, including the FIB-4 index, ultrasound or computed tomography of the liver and liver elastography. The introduction of direct antiviral drug regimens significantly facilitated the treatment of viral hepatitis C and significantly increased the frequency of response to antiviral treatment. The development of combined pathogenetic regimens with a relatively short duration of treatment has become an important step in the management of patients with viral hepatitis C. New American recommendations suggest the use of pangenotypic regimens in patients with viral hepatitis C without fibrosis or with compensated liver cirrhosis: glecaprevir (300 mg)/pibrentasvir (120 mg) 3 pills per day within 8 weeks or the combination of sofosbuvir (400 mg)/velpatasvir (100 mg) 1 pill per day for 12 weeks with the expected response to therapy in 95–100% of patients. Review authors note a number of rational aspects of the new American recommendations, but consider that experienced and qualified specialists should treat patients with chronic viral hepatitis C in Russia.

About the Authors

Ju. L. Tonkikh
Scientific Research Institute of medical problems of the North
Russian Federation

Julia L. Tonkikh, Cand. of Sci. (Med.), Leading Researcher of the Clinical Department of Adult and Child Digestive System Pathology, Federal State Budget Scientific Institution “Federal Research Center “Krasnoyarsk Science Center” of the Siberian Branch of the Russian Academy of Sciences”, Separate Subdivision “Scientific Research Institute of medical problems of the North” of the Ministry of Science and Higher Education of the Russian Federation

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022



A. V. Vasyutin
Scientific Research Institute of medical problems of the North
Russian Federation

Aleksandr V. Vasyutin, Cand. of Sci. (Med.), Senior Researcher of the Clinical Department of Adult and Child Digestive System Pathology, Federal State Budget Scientific Institution “Federal Research Center “Krasnoyarsk Science Center” of the Siberian Branch of the Russian Academy of Sciences”, Separate Subdivision “Scientific Research Institute of medical problems of the North” of the Ministry of Science and Higher Education of the Russian Federation

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022



V. V. Tsukanov
Scientific Research Institute of medical problems of the North
Russian Federation

Vladislav V. Tsukanov, Dr. of Sci. (Med.), Professor, Head of the Clinical Department of Adult and Child Digestive System Pathology, Federal State Budget Scientific Institution “Federal Research Center “Krasnoyarsk Science Center” of the Siberian Branch of the Russian Academy of Sciences”, Separate Subdivision “Scientific Research Institute of medical problems of the North” of the Ministry of Science and Higher Education of the Russian Federation

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022



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Review

For citations:


Tonkikh JL, Vasyutin AV, Tsukanov VV. Current international guidelines for the management of patients with chronic viral hepatitis C. Meditsinskiy sovet = Medical Council. 2020;(15):72-77. (In Russ.) https://doi.org/10.21518/2079-701X-2020-15-72-77

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