Опыт противовирусной терапии хронического гепатита D в Кабардино-Балкарской Республике

Abstract

Objective. To study the results of the application of an innovative strategy for antiviral therapy of chronic hepatitis D (CHD) in real practice. Patients and methods. Evaluation of the efficacy and tolerability of bulevirtide, HBV and HDV entry inhibitor, in 8 patients with CHD: in monotherapy in 3 patients, combined therapy with peginterferon alfa in 5 patients. Results. High virological efficacy of both treatment regimens was demonstrated for 48 weeks: all patients on monotherapy, 4 of 5 patients on combination therapy achieved a virological response. The maximum decline in viral load was 5.8 log10 from baseline with monotherapy, 6.6 log10 with combination therapy. HDV RNA undetectable level was observed in all patients on combination therapy (in 2 patients – by week 12, in 1 – by week 24, in 1 – by week 36) and in 1 patient on monotherapy (by week 24). In 2 patients with undetectable HDV RNA level, the resumption of viremia was noted after interruptions in treatment, which emphasizes the need for adherence to treatment for the formation of a stable virological response. The tolerability of treatment was good, no serious adverse events, cases of withdrawal of treatment, deterioration of liver function in cirrhosis were reported. The number of white blood cells remained stable (3.2–3.4 × 109/l), the number of platelets decreased by week 24 from 104 to 83 thousand cells × 109/l, followed by self-recovery to the baseline by week 48. Conclusion. The data obtained confirm the validity of the choice of an innovative strategy for antiviral therapy of HCD in real practice, indicate the high efficacy and good tolerability of bulevirtide in monotherapy and combination therapy in patients with CHD, including with compensated cirrhosis. Key words: bulevirtide, chronic hepatitis D, combination therapy, monotherapy, peginterferon, real practice