vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2018-4-61-68vtio-951Research ArticleАктуальная проблема. Лечение гепатита С у реципиентов донорских органовIssue of the day. Treatment of hepatitis C in donor organ recipientsЭффективность и безопасность препаратов прямого противовирусного действия у реципиентов печени с рецидивом хронического гепатита С 1-го генотипа после трансплантацииThe efficacy and safety of antiviral drugs of direct action in liver recipients with recurrence of chronic hepatitis C genotype 1 after transplantationЦирульниковаО. М.TsiroulnikovaО. M.

Москва

Moscow

УмрикД. В.UmrikD. V.

123182, Москва, ул. Щукинская, д. 1. Тел. (926) 434-16-24.

1, Shchukinskaya str., Moscow, 123182. Tel. (926) 434-16-24.

d_ipatova@mail.ruМилосердовИ. А.MiloserdovI. A.

Москва

Moscow

ЕгороваЕ. Т.EgorovaЕ. Т.

Москва

Moscow

ЛатыповР. А.LatypovR. A.

Москва

Moscow

ФГБУ «Национальный медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава России; ФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Минздрава России (Сеченовский университет)РоссияV.I. Shumakov National Medical Research Center of Transplantology and Artificial Organs of the Ministry of Healthcare of the Russian Federation; I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of the Russian Federation (Sechenovsky University)Russian FederationФГБУ «Национальный медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава РоссииРоссияV.I. Shumakov National Medical Research Center of Transplantology and Artificial Organs of the Ministry of Healthcare of the Russian FederationRussian Federation2018300120192046168Copyright © Цирульникова О.М., Умрик Д.В., Милосердов И.А., Егорова Е.Т., Латыпов Р.А., 20192019Цирульникова О.М., Умрик Д.В., Милосердов И.А., Егорова Е.Т., Латыпов Р.А.Tsiroulnikova О.M., Umrik D.V., Miloserdov I.A., Egorova Е.Т., Latypov R.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/951Цель

Цель. Изучить эффективность и безопасность применения паритапревира, ритонавира, омбитасвира и дасабувира в сочетании или без рибавирина у реципиентов печени с рецидивом HCV 1-го генотипа после трансплантации.

Материалы и методы

Материалы и методы. В исследование включено 46 пациентов после ортотопической трансплантации печени с рецидивом HCV 1-го генотипа; 37 пациентов завершили полный 24-недельный курс противовирусной терапии, включающей паритапревир, ритонавир, омбитасвир и дасабувир в сочетании или без рибавирина. Эффективность терапии рассчитывалась как доля пациентов, достигших авиремии через 12 недель после окончания курса лечения. Безопасность терапии оценивалась по количеству нежелательных явлений, возникших во время курса противовирусной терапии.

Результаты

Результаты. Устойчивого вирусологического ответа через 12 недель после окончания курса противовирусной терапии, включающей паритапревир, ритонавир, омбитасвир и дасабувир, достигли 100% реципиентов печени. Снижение интенсивности цитолитического и холестатического синдромов отмечалось на 4-й неделе терапии. Нежелательные явления были зарегистрированы у 56,7% исследуемых, в основном они были нетяжелыми и купировались самостоятельно. Острое клеточное отторжение трансплантата развилось у 1 пациента (2,7%). Не было зарегистрировано случаев необратимой дисфункции трансплантата печени или смерти реципиента.

Заключение

Заключение. Применение паритапревира, ритонавира, омбитасвира и дасабувира безопасно и эффективно при лечении рецидива HCV-инфекции 1-го генотипа после трансплантации печени.

Aim

Aim. To study the efficacy and safety of the use of paritaprevir, ritonavir, ombitasvir and dasabuvir in combination or without ribavirin in liver recipients with recurrence of HCV 1 genotype after transplantation.

Materials and methods

Materials and methods. The study included 46 patients after orthotopic liver transplantation with recurrence of HCV 1 genotype. 37 patients completed a 24-week course of antiviral therapy, including paritaprevir, ritonavir, ombitasvir and dasabuvir in combination or without ribavirin. The effectiveness of the therapy was calculated as the proportion of patients who achieved aviremia 12 weeks after the end of the course of treatment. The safety of therapy was assessed by the number of adverse events that occurred during the course of antiviral therapy.

Results

Results. A sustained virologic response at 12 weeks after the end of the course of antiviral therapy, including paritaprevir, ritonavir, ombitasvir and dasabuvir, reached 100% of the recipients of the liver. Reduction in the intensity of cytolytic and cholestatic syndromes was noted at week 4 of therapy. Adverse events were recorded in 56.7% of the subjects, mostly they were not severe and were stopped on their own. Acute cellular rejection of the transplant developed in 1 patient (2.7%). There have been no cases of irreversible liver transplant dysfunction or death of the recipient.

The conclusion

The conclusion. The use of paritaprevir, ritonavir, ombitasvir and dasabuvir is safe and effective in the treatment of relapse of HCV infection of 1 genotype after liver transplantation.

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