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Версия он-лайн:
https://clck.ru/D9SCb
Версия PDF:
https://clck.ru/D9SCm
Добавлено Gudvin 04.07.2018
Русскоязычная версия, 3 Mb, PDF
download/file.php?id=103782
Что нового?
Самое главное - Из Рекомендаций исчезли схемы, содержащие даклатасвир, симепревир, рибавирин.
Для рецидивистов:
Recommendations
•Patients who failed after pegylated IFN-α and ribavirin, pegylated IFN-α, ribavirin and sofosbuvir, or sofosbuvir and ribavirin combination treatment must be retreated according to the above recommendations for “treatment-experienced” patients, by HCV genotype (A1).
•HCV resistance testing prior to retreatment in patients who failed after any of the DAA-containing treatment regimens is useful to guide retreatment by probabilities of response, according to the resistance profile observed in the context of a multidisciplinary team including experienced treaters and virologists (B2).
•Patients without cirrhosis or with compensated (Child-Pugh A) cirrhosis who failed after a DAA (protease inhibitor and/or NS5A inhibitor)-containing regimen should be retreated with the fixed-dose combination of sofosbuvir, velpatasvir and voxilaprevir for 12 weeks, ideally in the context of a multidisciplinary team including experienced treaters and virologists (A1).
•Patients without cirrhosis or with compensated (Child-Pugh A) cirrhosis who failed after a DAA (protease inhibitor and/or NS5A inhibitor)-containing regimen and have predictors of lower response (advanced liver disease, multiple courses of DAA-based treatment, complex NS5A RAS profile) can be retreated with the combination of sofosbuvir plus the fixed-dose combination of glecaprevir and pibrentasvir for 12 weeks, based on an individual decision in the context of a multidisciplinary team including experienced treaters and virologists (B2).
•In very difficult-to-cure patients (patients with NS5A RASs who failed twice to achieve SVR after a combination regimen including a protease and/or an NS5A inhibitor), the triple combination of sofosbuvir, velpatasvir and voxilaprevir, or the triple combination of sofosbuvir, glecaprevir and pibrentasvir can be administered for 12 weeks with weight-based ribavirin (1,000 or 1,200 mg in patients <75 kg or ≥75 kg, respectively) and/or treatment duration can be prolonged to 16 to 24 weeks, based on an individual decision in the context of a multidisciplinary team including experienced treaters and virologists (C2).
•Patients with decompensated (Child-Pugh B or C) cirrhosis who failed after a DAA (protease inhibitor and/or NS5A inhibitor)-containing regimen have a contraindication for the use of protease inhibitors, and should therefore be retreated with the fixed-dose combination of sofosbuvir and velpatasvir with weight-based ribavirin (1,000 or 1,200 mg in patients <75 kg or ≥75 kg, respectively) for 24 weeks, based on an individual decision in the context of a multidisciplinary team including experienced treaters and virologists (B2).
Дружно изучаем и анализируем.
Здесь же размещу рекомендации по лечению с декомпенсированным циррозом.
https://clck.ru/D9T5q
Он-лайн версии так и нет, видимо, позднее будет здесь:
https://clck.ru/D9T7t
муж
