gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLCgastro-j-1332Research ArticleГЕПАТОЛОГИЯHEPATOLOGYДва пути к одной цели: новые стратегии противовирусной терапии хронического гепатита СTwo ways to one goal: new strategy of antiviral therapy for chronic hepatitis CБацкихC. Н.BatskikhS. N.ФБУН «Центральный НИИ эпидемиологии Роспотребнадзора»РоссияFederal Budget Institution of Science «Central Research Institute of Epidemiology» of the Federal Service on Customers' Rights Protection and Human Well-being SurveillanceRussian Federation2012011120122262226Copyright © Бацких C.Н., 20122012Бацких C.Н.Batskikh S.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/1332

Цель обзора. Проанализировать данные клинических исследований, посвященных лечению хронического гепатита С (ХГС) с использованием новых схем комбинированной терапии, включающих в себя селективный ингибитор вирусной протеазы.Основные положения. Новые схемы противовирусной терапии как у не леченных, так и безуспешно леченных ранее больных, инфицированных 1-м генотипом вируса, подразумевают наличие или отсутствие так называемой «вводной фазы», суть которой заключается в применении на начальном этапе лечения комбинации только двух препаратов (пегилированного интерферона-α и рибавирина) с последующим добавлением третьего компонента терапии (прямого противовирусного агента). Стратегию тройной терапии с вводной фазой предлагается использовать в случае применения в качестве третьего агента препарата боцепревир. Другой противовирусный препарат прямого действия – телапревир рекомендуется назначать с первого дня лечения.Заключение. Учитывая очевидный положительный эффект от вводной фазы для трехкомпонентных схем с боцепревиром и отсутствие доказательств ее необходимости при использовании телапревира, оправданным является применение в клинической практике обеих новых стратегий противовирусной терапии у больных ХГС.

The aim of review

The aim of review. To analyze data of the clinical studies on chronic hepatitis C (CHC) treatment with application of new modes of combined therapy, including selective inhibitor of viral protease.

Key points

Key points. New algorithms of antiviral therapy for patients infected by the 1-st virus genotype not treated earlier, and after treatment failure, implicate presence or absence of so-called «induction phase», the kernel of which is application of pegilated interferon-α and ribavirin combination at the beginning of treatment with subsequent addition of the third agent (the direct action antiviral agent). Triple therapy with induction phase strategy is recommended at application of boceprevir as the third agent. Another antiviral drug with direct action – telaprevir is recommended for prescription from first day of treatment.

Conclusion

Conclusion. Taking into account an apparent positive effect of induction phase for boceprevir modes of treatment and absence of that evidence for telaprevir application, both new antiviral strategies are justified for clinical application in CHC patients.

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