Current issues of application of anti-viral drugs in hematological patients with hepatitis C virus
Objective. To analyze the effectivity of the use of antiviral drugs Sovaldi 400 mg and Harvoni 90/400 mg in hematological patients.
Materials and methods. Under our supervision there were 68 patients: 43 (63 %) male and 25 (37 %) female, age from 23 to 80 years, who were treated with antiviral medications intended to hepatitis C virus (HCV). The drugs had prescribed depending on the genotype of the virus; the degree of liver damage; factors that aggravate the course of the disease and the treatment process; responses and adverse reactions that may occur during the process of taking the drug and the timing of use. The 26 patients with genotypes 1 (3), 1c (4), 2 (4), 3a (14) and 1 patient with atypical genotype Sovaldi 400 mg received. Harvoni 90/400 mg was used for treatment HCV 1b genotype in 41 patients and in 1 patient with an atypical genotype. To all patients were investigation according to the algorithm for the diagnosis and treatment of HCV: general clinical (biochemical and hematological) studies and examinations to determine the genotype of the virus, viral load, the degree of liver fibrosis.
Results and discussion. Given the high infection rate of hematological patients with HCV, which does not allow full treatment, including surgery and chemotherapy, under the program “Treatment of patients with viral hepatitis” antiviral drugs were purchased and treatment was performed in groups of hematological patients. In particular, in patients with the following diagnoses: non-Hodgkin lymphoma (5); myelodysplastic syndromes (1); Hodgkin lymphoma (1); haemophilia A (13) and B (3); leukopenia (3); disaggregation thrombocytopathy (16); immune thrombocytopenic purpura (13); secondary erythrocytosis (5); iron deficiency anemia (5); polycythemia vera (2); chronic lymphocytic leukemia (1). Antiviral therapy was performed according to the clinical protocol for the treatment of viral hepatitis B and C in hematological patients under the supervision of an infectious disease specialist and hematologist. Most patients tolerated treatment satisfactorily and without complications.
Conclusions. In the last years, direct-acting antiviral drugs become the standard of treatment in hematological patients. For today, HCV should not hinder on the basic of full treatment in the hematological patients as most infected patients may receive antiviral therapy.
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