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Том 18 №4 2016 год - Нефрология и диализ

Хроническая HCV-инфекция в условиях заместительной почечной терапии

Зубкин М.Л. Червинко В.И. Крюков Е.В. Фролова Н.Ф. Ушакова А.И. Логунов О.В. Котенко О.Н.

Аннотация: Несмотря на значительное снижение распространенности хронической HCV-инфекции среди больных, получающих заместительную почечную терапию, проблема сохраняет свою актуальность в первую очередь для тех, кому планируется или была выполнена пересадка почки, поскольку инфицирование вирусом гепатита С неблагоприятно влияет как на выживаемость реципиентов, так и на сроки функционирования трансплантатов. Применение противовирусной терапии интерфероном ограничивалось значительным числом серьезных нежелательных явлений в диализной популяции и было противопоказано для реципиентов почечного трансплантаа ввиду высокого риска развития необратимых кризов отторжения. Назначение рибавирина, напротив, считалось недопустимым у больных, получающих лечение гемодиализом, в связи с возможностью усугубления нефрогенной анемии. Внедрение в клиническую практику современных препаратов прямого противовирусного действия радикально повысило эффективность и безопасность лечения хронической HCV-инфекции. Однако применение этих препаратов при тяжелой почечной дисфункции имеет ряд важных особенностей, в первую очередь, в связи с возможностью неблагоприятных межлекарственных взаиодействий с иммуносупрессантами, назначаемыми после трансплантации почки. В настоящем обзоре рассматриваются характер течения и прогноз хронической HCV-инфекции у больных на заместительной почечной терапии, а также возможности, условия и тактика применения новых противовирусных препаратов в этой популяции.

Для цитирования: Зубкин М.Л., Червинко В.И., Крюков Е.В., Фролова Н.Ф., Ушакова А.И., Логунов О.В., Котенко О.Н. Хроническая HCV-инфекция в условиях заместительной почечной терапии. Нефрология и диализ. 2016. 18(4):374-386. doi:

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Ключевые слова: хроническая HCV-инфекция, заместительная почечная терапия, препараты прямого противовирусного действия, chronic hepatitis C virus infection, renal replacement therapy direct-acting antiviral agents

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