transplantologiyaТрансплантологияTransplantologiya. The Russian Journal of Transplantation2074-05062542-0909IPO Association of Transplantologiststransplantologiya-10Research ArticleАКТУАЛЬНЫЕ ВОПРОСЫ ТРАНСПЛАНТОЛОГИИACTUAL ISSUES OF TRANSPLANTATIONЛечение гепатита С у реципиентов печени в Московском центре трансплантации печени в течение 10 летTreatment of hepatitis C in liver transplant recipients in the Moscow Center for Liver Transplantation within 10 yearsХубутияМ. Ш.KhubutiaM. Sh.СюткинВ. Е.SjutkinV. E.СалиенкоА. А.SalienkoA. A.salienko@pochta.ruКарандашоваИ. В.KarandashovaI. V.ДолгинВ. А.DolginV. A.ЧулановВ. П.ChulanovV. P.НоврузбековМ. С.NovruzbekovM. S.ГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского» ДЗ МосквыРоссияSklifosovsky Research Institute for Emergency Medicine, MoscowRussian FederationФБУН «Центральный НИИ эпидемиологии» Роспотребнадзора, РоссияРоссияFederal Budget Institution of Science «Central Research Institute of Epidemiology» of The Federal Service on Customers’ Rights Protection and Human Well-being Surveillance, RussiaRussian Federation20132601201602Трансплантология512Copyright © Хубутия М.Ш., Сюткин В.Е., Салиенко А.А., Карандашова И.В., Долгин В.А., Чуланов В.П., Новрузбеков М.С., 20162016Хубутия М.Ш., Сюткин В.Е., Салиенко А.А., Карандашова И.В., Долгин В.А., Чуланов В.П., Новрузбеков М.С.Khubutia M.S., Sjutkin V.E., Salienko A.A., Karandashova I.V., Dolgin V.A., Chulanov V.P., Novruzbekov M.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jtransplantologiya.ru/jour/article/view/10

Проанализирован опыт Московского центра трансплантации печени в области противовирусной терапии гепатита С, развившегося у реципиентов печени. С 2002 по 2012 г. были инициированы 49 курсов лечения у 42 больных. Эрадикация инфекции, вызванной вирусом гепатита С (HCV), достигнута у 42% пациентов, получивших не менее одной дозы препаратов, и у 56% больных, получивших не менее 80% доз препаратов при более чем 80% запланированной продолжительности терапии. Скорость снижения виремии HCV на фоне противовирусной терапии у реципиентов печени более медленная, чем у  иммунокомпетентных пациентов, что обосновывает необходимость более продолжительного лечения. Учет фармакогенетических показателей до начала противовирусной терапии позволяет прогнозировать скорость снижения виремии HCV. Основным осложнением противовирусной терапии после трансплантации печени являются цитопении. Применение эритропоэтина и филграстима на протяжении всей терапии позволило поддерживать терапевтические дозы противовирусных препаратов и не приводило к развитию серьезных нежелательных явлений.

 

An experience of the Moscow Center for Liver Transplantation in the field of antiviral therapy of hepatitis C in recipients of liver grafts has been analyzed. From 2002 to 2012 forty nine courses of treatment were  initiated in 42 patients. Eradication of infection caused by the hepatitis C virus (HCV) was achieved in 42% patients who received at least one dose of drugs, and in 56% patients who received at least 80% of doses of drugs for more than 80% of the planned duration of therapy. The rate of decrease of HCV viremia during antiviral therapy in liver transplant recipients is slower than in immunocompetent patients, and this fact justifies the need for a more long-term treatment. Accounting for pharmacogenetic indicators prior to antiviral therapy is able to predict the rate of decline in viremia HCV. The main complication of antiviral therapy after liver transplantation was cytopenia. The use of erythropoietin and filgrastim throughout the whole course of therapy allowed to maintain therapeutic doses of antiviral drugs and did not lead to serious adverse events.

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