[Efficacy of the infusion hepatotropic drug remaxol in the pathogenetic therapy for cirrhotic stage chronic viral hepatitides]. / Effektivnost' infuzionnogo gepatotropnogo preparata remaksol v patogeneticheskoi terapii khronicheskikh virusnykh gepatitov na tsirroticheskoi stadii.

AIM: To investigate the impact of therapy with the infusion hepatoprotector remaxol on liver function in cirrhosis in the outcome of chronic viral hepatitides (CVH): HCV, HBV, HCV+HBV, and HBV+HDV. SUBJECTS AND METHODS: Sixty-five patients aged 26 to 76 years, who had been diagnosed as having liver cirrhosis (LC) in the outcome of CVH: HCV, HBV, HCV+HBV, and HBV+HDV were examined. During infusion therapy, every day 32 cirrhotic patients in the outcome of CVH B or C received intravenous remaxol 400 ml in a jetwise manner once daily for 11 days. A comparison group comprised 33 patients with the similar condition who had intravenous ademetionine 400 mg in a jetwise fashion during infusion therapy with crystalloids (400 ml of isotonic sodium chloride solution, Ringer's solution) for 11 days. RESULTS: After an infusion therapy cycle, the study group patients were recorded to have more significantly reduced cytolytic and cholestatic parameters. The pronounced hepatotropic effect of the drug was confirmed by the rate of a decline in the average concentrations of alanine aminotransferase, aspartate aminotransferase, and total bilirubin. In the study group patients, the relative values of a decrease in the levels of these biochemical parameters were 29, 29, and 40% versus 15, 20, and 9% in the control patients. CONCLUSION: Infusion therapy with remaxol in the combination treatment of the patients with viral LC not only improves liver function (reduces the degree of cytolysis, cholestasis), but also exerts a cytoprotective effect on peripheral blood cells (leukocytes, lymphocytes, platelets).

[Pulmonary vasculitis as a clinical mask of HCV infection: efficiency of interferon-free antiviral therapy].

The paper describes a clinical case of pulmonary vasculitis caused by hepatitis C virus (HCV). Its diagnosis was established on the basis of in-depth laboratory testing and an investigation of the molecular biological markers of viremia (polymerase chain reaction--PCR--HCV RNA) in peripheral blood mononuclear cells. By taking into account of extrahepatic HCV replication and contraindications to interferon therapy, the female patient was given an interferon-free antiviral therapy cycle using an interferonogenic inductor in combination with ribavirin. Pathogenic therapy (methylpred and ursodeoxycholic acid) was additionally performed. An interferon-free regimen of cycloferon + ribavirin led to sustained remission of HCV infection running with its systemic manifestations. The therapy could improve the function of not only the liver, but also the lung. In suspected extrahepatic HCV infections, an investigation of molecular biological markers for viremia (HCV RNA PCR) in the peripheral blood mononuclear cells is an essential diagnostic technique. Interferonogenic inductors, cycloferon in particular, should be used in combination with ribavirin when a chronic hepatitis C patient with the extrahepatic manifestations of HCV infection has contraindications to conventional therapy with recombinant interferon-α.