Клинические рекомендации Российского общества по изучению печени, Российской гастроэнтерологической ассоциации, Национального научного общества инфекционистов по диагностике и лечению хронического вирусного гепатита С

Цель исследования: в клинических рекомендациях, предназначенных для врачей-терапевтов, врачей общей практики, гастроэнтерологов, инфекционистов, представлены современные положения по диагностике и лечению хронического гепатита С.

Основное содержание. Хронический вирусный гепатит С — социально значимая инфекция, заболеваемость которой в Российской федерации остается высокой. За последние 10 лет достигнуты большие успехи в лечении гепатита С — появились препараты с прямым противовирусным действием. Спектр их эффективности позволяет достичь устойчивого вирусологического ответа более чем в 90 % случаев, даже в группах, которые ранее не рассматривались как кандидаты на терапию или были трудными для излечения: пациенты, получающие заместительную почечную терапию, после трансплантации печени и других органов, на стадии декомпенсированного цирроза печени, с коинфекцией ВИЧ и др. Из рекомендаций исключены препараты интерферонов ввиду их низкой эффективности и широкого спектра нежелательных явлений. Расширены показания к назначению лечения, а именно — факт подтверждения репликации вируса. Сокращены сроки диспансерного наблюдения пациентов без цирроза печени (до 12 недель после окончания терапии). Также в данных рекомендациях представлены подходы к активному скринингу гепатита в группах риска, профилактические и реабилитационные мероприятия после окончания лечения.

Заключение. Достигнуты большие успехи в лечении хронического вирусного гепатита С. В большинстве случаев эрадикация вирусной HCV-инфекции — реальная задача даже у пациентов на стадии цирроза печени, с нарушением функции почек, коинфекцией ВИЧ, после трансплантации печени и других органов.

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