nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-606Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESЛечение ХГС у больных на программном гемодиализе; анализ многоцентровой программы наблюдения за пациентами, получавшими пэгинтерферон альфа-2аTherapy of HCV in patients on programmed hemodialysis; analysis of multicenter observational program for patients treated with peginterferon alfa-2aКолтуновС. С.KoltunovS. S.noemail@neicon.ruЛузинаЕ. В.LuzinaE. V.noemail@neicon.ruМаловИ. В.MalovI. V.noemail@neicon.ruПироговаИ. Ю.PirogovaI. Y.noemail@neicon.ruРогачиковЮ. Е.RogachikovY. E.noemail@neicon.ruСелютинА. А.SelyutinA. A.noemail@neicon.ruЧервинкоВ. И.ChervinkoV. I.noemail@neicon.ruКокоеваФ. К.KokoevaF. K.noemail@neicon.ruРусейкинВ. М.RuseikinV. M.noemail@neicon.ruЗубкинМ. Л.ZubkinM. L.m-zubkin@yandex.ruНегосударственное учреждение здравоохранения «Дорожная клиническая больница на станции Хабаровск-1 ОАО «РЖД», г. ХабаровскРоссияNon-governmental healthcare institution «Railway clinical hospital on the station Khabarovsk-1 JSCo «RZD», KhabarovskRussian FederationГОУ ВПО «Читинская государственная медицинская академия», г. ЧитаРоссияSEI of HPT «Chita State medical Academy», ChitaRussian FederationГУЗ «Иркутский областной клинический консультативно-диагностический центр», г. ИркутскРоссияState Healthcare Institution «Irkutsk Regional Consultative-Diagnostic Center», IrkutskRussian FederationМУЗ «Городская клиническая больница № 8», г. ЧелябинскРоссияMunicipal Healthcare Institution «City Clinical Hospital № 8», ChelyabinskRussian FederationГУЗ «Краевая клиническая больница № 1 им. профессора С.И. Сергеева», г. ХабаровскРоссияState Healthcare Institution «Regional Clinical Hospital № 1 named after prof. Sergeev SI», KhabarovskRussian FederationМУЗ «Муниципальная городская клиническая больница скорой медицинской помощи № 1 г. Оренбурга», г. ОренбургРоссияMunicipal Healthcare Institution «Municipal City Clinical Hospital of Emergency Medical Services № 1», OrenburgRussian FederationИнститут усовершенствования врачей МУНКЦ им. П.В. Мандрыка МО РФ, г. МоскваРоссияInstitute for Continuous Postgraduate Medical Education, MoscowRussian FederationФБУН «Московский НИИ эпидемиологии и микробиологии им. Г.Н. Габричевского» Федеральной службы по надзору в сфере защиты прав потребителей и благополучия человека, г. МоскваРоссияG.N. Gabrichevsky research institute for epidemiology and microbiology, MoscowRussian Federation201320092024154269276Copyright © Колтунов С.С., Лузина Е.В., Малов И.В., Пирогова И.Ю., Рогачиков Ю.Е., Селютин А.А., Червинко В.И., Кокоева Ф.К., Русейкин В.М., Зубкин М.Л., 20242024Колтунов С.С., Лузина Е.В., Малов И.В., Пирогова И.Ю., Рогачиков Ю.Е., Селютин А.А., Червинко В.И., Кокоева Ф.К., Русейкин В.М., Зубкин М.Л.Koltunov S.S., Luzina E.V., Malov I.V., Pirogova I.Y., Rogachikov Y.E., Selyutin A.A., Chervinko V.I., Kokoeva F.K., Ruseikin V.M., Zubkin M.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/606

Хронический гепатит С (ХГС) остается серьезной проблемой больных с терминальной стадией хронической почечной недостаточности (тХПН), получающих заместительную почечную терапию. Однако отсутствуют единые представления о подходах к противовирусной терапии ХГС у этих пациентов. Цель исследования: изучить эффективность и безопасность монотерапии пэгинтерфероном альфа-2а (Peg-IFN-a2а) у больных ХГС, получавших лечение программным гемодиализом (ПГД). Материалы и методы: в исследование были включены 26 пациентов с ХГС (10 мужчин и 16 женщин) в возрасте от 22 до 58 лет, находившихся на лечении в 5 диализных центрах разных регионов России. Уровень вирусной нагрузки достигал 4,8 ± 1,5 log10 МЕ/мл. 1-й генотип был выявлен у 12 (48%) пациентов, не 1-й генотип – у 13 (52%). Активность АЛТ составила 29,6 ± 18,5 МЕ/л. 10 пациентам была выполнена пункционная биопсия печени. ИГА по Knodell равнялся 5,5 ± 1,4 баллов. Стадия фиброза 1 (по шкале METAVIR) определялась у 6 больных, стадия фиброза 2 – у 4. Всем пациентам было назначено лечение пэгинтерфероном-a2а в дозе 135 мкг/нед. продолжительностью 48 нед. Результаты исследования: ранний вирусологический ответ (РВО) развился у 22 из 26 (84,6%) больных. Устойчивый вирусологический ответ (УВО) был достигнут у 15 из 26 пациентов (57,7%). Подтверждена связь РВО с УВО: из 21 пациента с РВО у 13 констатирован УВО (61,9%), тогда как из 4 больных без РВО – лишь у 1 (25%) больного определялся УВО (р = 0,039). Выводы: подтверждена эффективность и безопасность монотерапии пэг-интерферона-a2а при ХГС у больных, получавших лечение ПГД.

Chronic hepatitis C (CHC) remains a serious problem for patients with the end-stage kidney disease on renal replacement therapy. However there is no uniform concept of approaches to antiviral HCV therapy in these patients. Objective of the study: to investigate the efficacy and safety of peginterferon alfa-2a (Peg-IFN-a2а) monotherapy in HCV patients on hemodialysis (HD). Materials and methods: the study included 26 patients with HCV (M: 10 and F: 16) aged 22 to 58 years treated at 5 dialysis centers in various regions of Russia. The viral load was 4,8 ± 1,5 log10 IU/ml. Genotype 1 was identified in 12 (48%) patients, non-1 genotype was identified in 13 (52%) patients. ALT activity was 29,6 ± 18,5 IU/L. Liver needle biopsy was performed in 10 patients. Knodell HAI score was 5,5 ± 1,4. Fibrosis stage 1 (by METAVIR score) was determined in 6 patients, fibrosis stage 2 was revealed in 4 patients. All patients were assigned to receive peginterferon-a2а at a dose of 135 µg/week for 48 weeks. Results of the study: early virological response (EVR) was reported in 22 out of 26 (84,6%) patients. Sustained virological response (SVR) was achieved in 15 out of 26 patients (57,7%). The correlation between EVR and SVR was confirmed: SVR was reported in 13 out of 21 patients with EVR (61,9%) whereas among 4 patients without EVR, only 1 patient (25%) had SVR (р = 0,039). Conclusions: the efficacy and safety of peginterferon-a2а monotherapy in CHC was confirmed in patients on HD.

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