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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">nid</journal-id><journal-title-group><journal-title xml:lang="ru">Нефрология и диализ</journal-title><trans-title-group xml:lang="en"><trans-title>Nephrology and Dialysis</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1680-4422</issn><issn pub-type="epub">2618-9801</issn><publisher><publisher-name>Российское диализное общество</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.28996/2618-9801-2021-1-49-56</article-id><article-id custom-type="elpub" pub-id-type="custom">nid-7</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group></article-categories><title-group><article-title>Возможности современных пангенотипных противовирусных препаратов для лечения хронического гепатита C у больных, получающих лечение гемодиализом</article-title><trans-title-group xml:lang="en"><trans-title>Possibilities of modern pangenotypic antiviral drugs for the treatment of chronic hepatitis C in patients on hemodialysis</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зубкин</surname><given-names>М. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Zubkin</surname><given-names>M. .</given-names></name></name-alternatives><email xlink:type="simple">m-zubkin@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Балкарова</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Balkarova</surname><given-names>O. .</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Богомолов</surname><given-names>П. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Bogomolov</surname><given-names>P. .</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гольбрайх</surname><given-names>Р. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Golbraikh</surname><given-names>R. .</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Нуриахметов</surname><given-names>Р. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Nuriakhmetov</surname><given-names>R. .</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Орлова</surname><given-names>А. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Orlova</surname><given-names>A. .</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-6"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Русейкина О</surname><given-names>О. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Ruseykina</surname><given-names>O. .</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-7"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Стребкова</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Strebkova</surname><given-names>E. .</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-8"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Семененко</surname><given-names>Т. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Semenenko</surname><given-names>T. .</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-9"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Крюков</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kryukov</surname><given-names>E. .</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-10"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФБУН «Московский НИИ эпидемиологии и микробиологии им. Г.Н. Габричевского Роспотребнадзора»; Военно-медицинская академия им. С.М. Кирова; ФГБУ Главный военный клинический госпиталь им. Н.Н. Бурденко</institution><country>Россия</country></aff><aff xml:lang="en"><institution>G.N. Gabrichevsky Research Institute for Epidemiology and Microbiology; Branch of the S.M. Kirov Military Medical Academy; N.N. Burdenko Main Military Clinical Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ГБУЗ «ГКБ 24 Департамента здравоохранения г. Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>City Hospital № 24</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ГБУЗ МО «Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>M.F. Vladimirsky Moscow Regional Research Сlinical Institute</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>ГБУЗ «Пермская краевая клиническая инфекционная больница»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Сlinical Infectious Hospital of Perm’ Region</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>ГБУЗ «РКБ им. Г.Г. Куватова»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>G.G. Kuvatov Republican Clinical Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru"><institution>ГБУЗ «ГКБ № 52 Департамента здравоохранения г. Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>City Hospital № 52</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-7"><aff xml:lang="ru"><institution>ФБУН «Московский НИИ эпидемиологии и микробиологии им. Г.Н. Габричевского Роспотребнадзора»; ФГБУ Главный военный клинический госпиталь им. Н.Н. Бурденко</institution><country>Россия</country></aff><aff xml:lang="en"><institution>G.N. Gabrichevsky Research Institute for Epidemiology and Microbiology; N.N. Burdenko Main Military Clinical Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-8"><aff xml:lang="ru"><institution>ФГБОУ ВО «Самарский государственный медицинский университет»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Samara State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-9"><aff xml:lang="ru"><institution>ФГБУ «Национальный исследовательский центр эпидемиологии и микробиологии имени почётного академика Н.Ф. Гамалеи» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>N.F. Gamaleya National Research Centre for Epidemiology and Microbiology</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-10"><aff xml:lang="ru"><institution>ФГБУ Главный военный клинический госпиталь им. Н.Н. Бурденко</institution><country>Россия</country></aff><aff xml:lang="en"><institution>N.N. Burdenko Main Military Clinical Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>21</day><month>06</month><year>2024</year></pub-date><volume>23</volume><issue>1</issue><fpage>49</fpage><lpage>56</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Зубкин М.Л., Балкарова О.В., Богомолов П.О., Гольбрайх Р.Б., Нуриахметов Р.Р., Орлова А.Д., Русейкина О О.М., Стребкова Е.А., Семененко Т.А., Крюков Е.В., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Зубкин М.Л., Балкарова О.В., Богомолов П.О., Гольбрайх Р.Б., Нуриахметов Р.Р., Орлова А.Д., Русейкина О О.М., Стребкова Е.А., Семененко Т.А., Крюков Е.В.</copyright-holder><copyright-holder xml:lang="en">Zubkin M..., Balkarova O..., Bogomolov P..., Golbraikh R..., Nuriakhmetov R..., Orlova A..., Ruseykina O..., Strebkova E..., Semenenko T..., Kryukov E...</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://journal.nephro.ru/jour/article/view/7">https://journal.nephro.ru/jour/article/view/7</self-uri><abstract><p>Больные, получающие лечение гемодиализом (ГД), являются одной из наиболее перспективных групп для реализации программы ВОЗ по элиминации HCV-инфекции. До недавнего времени основным препятствием к этому являлось отсутствие противовирусных препаратов для лечения хронического гепатита С (ХГС) у пациентов с низкой скоростью клубочковой фильтрацией, инфицированных 2 и 3 генотипами вируса. Новые возможности открывает внедрение в клиническую практику комбинации препаратов прямого противовирусного действия (ПППД) глекапревира и пибрентасвира (GLE/PIB). Восемнадцать диализных пациентов с ХГС (средний возраст 49,4±12,4 года, продолжительность ГД 100,9±70,1 мес.) получали лечение GLE/PIB. У 13 (72,2%) из них определялся 3 генотип вируса, у 4 (22,2%) - генотип 2 (один с рекомбинантным вариантом 2k/1b) и у 1 (5,6%) - генотип 1b. Устойчивый вирусологический ответ на 12-й и 24-й неделях после окончания лечения был достигнут у всех пациентов при ограниченном количестве нежелательных явлений. У 17 из 18 больных после окончания противовирусной терапии отмечалась положительная динамика показателей транзиентной эластографии печени, выраженность которой наблюдалась в большей степени у больных с исходно повышенной активностью аланиновой аминотрансферазы. Таким образом, применение пангенотипной комбинации GLE/PIB оказалось высокоэффективным и безопасным у пациентов на гемодиализе со 2-м или 3-м генотипами вируса гепатита С (HCV), включая химерный вариант 2k/1b. Для уточнения возможности и степени уменьшения выраженности фиброза после снижения активности воспаления в печени требуется дальнейший анализ на большей выборке больных с более длительным сроком наблюдения.</p></abstract><trans-abstract xml:lang="en"><p>Patients receiving hemodialysis (HD) treatment are one of the most promising groups for implementing the WHO HCV Infection Elimination Program. Until recently an obstacle to its elimination was the lack of antiviral drugs for the treatment of chronic hepatitis C in HCV genotypes 2 and 3 patients with low glomerular filtration rate. New opportunities have emerged with the introduction into clinical practice of direct antiviral drugs combination - glecaprevir and pibrentasvir (GLE/PIB). Eighteen dialysis patients with HCV (average age 49.4±12.4 years, HD duration 100.9±70.1 months) were treated with GLE/PIB. Thirteen (72.2%) of them had genotype 3 HCV, 4 (22.2%) had genotype 2, (one with the recombinant 2k/1b subtype) and 1 (5.6%) had genotype 1b. A sustained virological response was achieved at 12 and 24 weeks in all patients with a limited number of adverse events. In 17 of 18 patients after completion of antiviral therapy, there was a positive dynamics of transient liver elastography indicators, expressed to a greater extent in patients with initially increased activity of alanine aminotransferase. Thus, the use of the GLE/PIB pangenotype combination proved to be highly effective and safe in hemodialysis patients with HCV 2 or 3 genotypes, including the 2K/1b chimeric variant. Further analysis on a larger sample of patients with a longer follow-up period is required to clarify the possibility and degree of reduction of fibrosis severity after decreased inflammation activity in the liver.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>хронический гепатит С</kwd><kwd>препараты прямого противовирусного действия</kwd><kwd>гемодиализ</kwd><kwd>chronic hepatitis C</kwd><kwd>direct acting antiviral agents</kwd><kwd>hemodialysis</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Glassock R., D. Warnock, P. Delanave. The global burden of chronic kidney disease: estimates, variability and pitfalls. 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