Противовирусная терапия хронического гепатита D в Республике Крым – опыт реальной практики

Abstract

Objective. The analysis of the results of antiviral therapy of chronic hepatitis D (HDV) in real practice using bulevirtide, an inhibitor of the entry of hepatitis B and D viruses (HDV) into the hepatocyte. Patients and methods. Intermediate treatment results were studied in 6 patients with HDV, including 3 patients with compensated cirrhosis who received bulevirtide in combination with pegylated interferon-α for 48 weeks, as well as in 3 patients who continued treatment (in combination therapy or monotherapy) for up to 60–64 weeks. Results. After 48 weeks of combination therapy, the HDV RNA level decreased from 6.5 log10 to 1.0 log10 ( p = 0.015), the median decrease was 3.4 log10, the frequency of virological response was 83%, and aviremia was 50%. Virological efficacy increased with treatment. In 3 patients, an increase in the initially normal level of alanine aminotransferase (ALT) associated with the use of interferon was noted, followed by a decrease or normalization; in 2 patients with initially moderate and high liver activity, ALT levels decreased by 35 and 354 U/l, respectively. Virological and biochemical response was maintained in all 3 patients who continued treatment up to 60–64 weeks, including aviremia in 1 patient. No serious adverse events, cases of withdrawal of treatment or deterioration of liver function in cirrhosis have been reported. Conclusion. The analysis of the intermediate results of CHD treatment in real practice has demonstrated the effectiveness, safety and good tolerability of bulevirtide, including at the stage of compensated liver cirrhosis. Further study of optimal treatment regimens is needed to achieve treatment goals and improve the prognosis of the disease. Key words: bulevirtide, chronic hepatitis D