Medication for hepatitis C in adults. Drugs for viral hepatitis B and C

Medical approaches to hepatitis C treatment are changing as new drugs are invented that can help the patient more effectively and in a short time. The usual interferon therapy with its side effects, complications and effectiveness below 60% is already receding. Now patients who need drug therapy have the opportunity to use the latest drugs for the treatment of hepatitis C.

A modern and effective treatment regimen!

For a long time, drugs for hepatitis C were interferon and ribavirin - it was a combination of these two drugs in different ratios and according to different schemes that were used in the treatment of patients with this ailment. During the year, patients had to take these drugs, but positive results were achieved only in half of the cases.

The pharmaceutical industry has made great strides and today patients can use a new drug for hepatitis C that has a stronger effect in treating the disease. In addition, the new drugs have other positive qualities that interferon therapy did not give, namely:

have an insignificant list side effects;
well tolerated by patients, so they are prescribed even to older people;
increase the effectiveness of therapy for the disease, which reduces the duration of treatment by several times;
can be used to treat patients suffering from human immunodeficiency virus;
make it possible to abandon interferon therapy.

The main means of treating the disease

Among the best drugs for the treatment of the disease are Sofosbuvir, Daklatasvir and Ledipasvir. Each of these medicines has its own characteristics, therefore, most often, doctors do not prescribe monotherapy, but draw up a treatment regimen with these drugs. The combinations are individual in each case, since medications can affect.

Sofosbuvir is a new effective drug tested in the United States in 2013 and approved for the treatment of patients with this disease, after which the results have been confirmed by a number of European health organizations.

The essence of the new drugs is that they suppress the copying of its own ribonucleic acids by the virus, as a result of which the virus becomes unviable and stops multiplying and developing. Studies have shown that Sofosbuvir combined with Daklatasvir and Ledipasvir cured 98 percent of patients who were tested. This is a giant leap forward in the treatment of hepatitis C, which was previously cured in only half of patients.

To find your way around the whole variety of drugs and their therapeutic combinations, you can see their list. Here is the approximate cost of the drug, both original and generic and their combinations. Some drugs in Russia are not yet certified, so the price will be indicated in foreign currency, and drugs that can be purchased in Russia are presented in rubles.

It should be noted right away that the drugs produced in the USA and India do not differ in effectiveness, and the difference in price is very significant.

Drug name or combination	Manufacturer country	Package or course cost
Daclatasvir	USA	$ 63,000 per course
Sofosbuvir	USA	$ 84,000 per course
Sofosbuvir + Ledipasvir	USA	$ 90,000 per course
Simeprevir	USA	$ 70,500 per course
Sofosbuvir	India	$ 360 per course
Sofosbuvir + Ledipasvir	India	$ 555 per course
Sofosbuvir + Veltapasvir	India	$ 850 per course
Sofosbuvir + Veltapasvir	Bangladesh	$ 840 per course
Daclatasvir	India	$ 195 per course
Hepcinate (Sofosbuvir + Ledipasvir)	India	18,000 - 20,000 rubles. for 28 tab.
Sofab (sofosbuvir + ledipasvir)	India	$ 565 per course
Sophokem	India	14,000 - 18,000 rubles. per pack.
Gratisovir	Egypt	$ 150 for 28 tab.
Ducklin's	USA	RUB 390,000 per course
Daklavirocyrl (daclatasvir)	Egypt	$ 50 for 28 tab.
Sofosbuvir + Daclatasvir	Egypt	$ 500 per course
Heterosofir Plus (sofosbuvir + ledipasvir)	Egypt	$ 180 for 28 tab.
Gratesiano	Egypt	$ 150 for 28 tab.
	Egypt	$ 180 for 28 tab.

The data given above allow the patient to navigate the price, and together with the doctor, choose a treatment regimen with one or another means.

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Treatment regimens and their effectiveness

Treatment of the hepatitis C virus long-term drugs for hepatitis are recommended to be taken for at least three months. For clarity of existing combinations and approximate costs of hepatitis treatment, you can use the table below.

Drug name and active ingredient, country of origin	Application features (if any)	Activity against hepatitis virus genotype	Treatment regimen	Cost per course
Ducklinza + Sophokem	without adding ribavirin to the scheme		12 weeks of therapy with compensated liver disease allowed to give positive results in 90% of cases, if the patient had cirrhosis of the liver - in 63% of cases	approx RUB 450,000
Viropack (sofosbuvir + ledipasvir)	with cirrhosis of the liver, the course of treatment is doubled, does not require the appointment of ribavirin and interferon	1st, 4th genotype, with 2nd and 4th genotypes, a combination with ribavirin is recommended	effectiveness with the standard course was proven in 96%, with a complicated course of the disease, the effectiveness was 63%	$ 540 / $ 1080 (double rate)
Daklinza + Sovaldi (daclatasvir + sofosbuvir) (made in the USA)	with compensated cirrhosis	1.4th genotype	duration of therapy 12 weeks, a positive effect in 95%	$ 19,500 per course
Harvoni (sofosbuvir + ledipasvir), made in the USA	the ability to use in HIV-infected	all genotypes	100% effect in most uncomplicated hepatitis, about 90-94% in hepatitis with cirrhosis and 86% in the presence of HIV infection	$ 25,700 for 28 tab.
Copegus (ribavirin) (Switzerland)	possible as a component in a complicated course of the disease	all genotypes	efficiency depends on additional components, mainly ranges from 90% and more	$ 500 for 168 tab.
Viktrelis (boceprevir), manufacturer Switzerland	recommended for hepatitis with liver cirrhosis	all genotypes	used three times a day for three months, the remedy enhances the effect of other drugs against hepatitis with cirrhosis	$ 4,000 for 336 capsules (full course)
Ducklinza (daclatasvir), USA	monotherapy	all genotypes	efficiency with monotherapy about 90%	$ 28,000 per treatment course
Wikirakis (USA)	possible combination with ribavirin, no side effects with monotherapy		efficacy in uncomplicated hepatitis 98%	$ 19,000 for 14 tab.
Olisio (simeprevir), Belgium	prescribed for chronic hepatitis, if the liver is affected by cirrhosis	1st genotype	the course of treatment is three months, after which it is necessary to take the same amount of peginterferon and ribavirin	$ 39,000 for a course of treatment.
Sunvepra (asunaprevir) (USA)	possible appointment with daclatasvir, ribavirin and peginterferon	1-a, 1-b genotype	take three months twice a day	$ 12,000 per course
Gratesiano (sofosbuvir), Egypt	successful in treating coinfections and in HIV-infected patients, works well with daclatasvir	all genotypes of hepatitis C	the course of treatment is three months, high efficiency - 100% can be cured for hepatitis with cirrhosis and type 3 hepatitis, 94% for type 1 hepatitis	$ 450 per course

Patients treated with new drugs for hepatitis C, note the absence of severe side effects. The same good result was obtained in the treatment with ribavirin - the drug gives high efficiency, less negative impact. If the liver is affected by cirrhosis, the effectiveness of therapy in many cases does not decrease, but remains at the level of 95-98%. This is a good indicator for such a serious complication, since the treatment of hepatitis previously could not have such good results.

Direct-acting drugs

The pharmaceutical market has recently been enriched by another group of drugs - direct-acting drugs. These drugs include funds:

Vikeira Pak;
Ducklinz;
Dasabuvir;
Ombitasvir;
Ritonavir;
Simeprevir;
Sunvepra.

These antiviral drugs act directly on the sites of the hepatitis C virus, which makes it possible to achieve high efficiency in the treatment of the disease. After the virus stops multiplying and growing, it weakens and is completely eliminated from the body.

The action of the representatives of this group is complicated by the fact that they must be applied in a complex manner, following a clear scheme developed by the doctor. Also, the reaction of each organism to the combination is very individual. medicines - they can cause serious adverse reactions that patients may not get rid of for the rest of their lives. Therefore, doctors are very responsible in choosing drugs and drawing up a treatment regimen with them. The nutritional regimen during therapy is clearly prescribed, factors dangerous for the patient are eliminated, etc.

The scheme of the most successful treatment depends not only on the efforts of doctors and the patient, the genotype of the hepatitis C virus plays a huge role in this issue, therefore, before starting therapy, patients need to pass a number of tests to specify the causative agent of the disease.

As mentioned earlier, modern hepatitis drugs are quite expensive. Taking into account all the necessary drugs that the patient needs to take during the course, the amount is quite high. Naturally, the pharmaceutical industry began to look for ways to reduce the cost of drugs, therefore analogues of direct-acting drugs, the so-called. generics. Their cost is much lower, so most of the patients can be covered by such therapy. Indian pharmaceutical companies have mastered the production of generics. Generics by their own medicinal properties are similar to the original drugs, but they are produced under a special license, which makes them cheaper to manufacture.

Don't think that a generic is a fake. Generics undergo strict certification, they comply with the main ratio of the components of the product, the production of drugs complies with international standards, and the absorption rates do not differ from the "native" drugs. The average price of a full course of generics is about $ 1000, the most famous names generics:

Ledifos;
Harvoni;
Hepsinat;
Mikhep;
Ducklinz;
Lipasvir;
Lezovir.

Interferons

Interferon therapy is used to treat mainly chronic forms of the disease, since long-term use of antiviral drugs causes serious side effects - reduced immunity, allergies, accumulation of toxins in liver cells. This not only lengthens the patient's recovery process, but also jeopardizes the achieved effect, because when monotherapy with antiviral drugs is stopped, the pathogen reappears in the blood after three months. To improve the results of treatment, interferon was added to the antiviral drugs. Drugs for the liver in hepatitis C based on ribavirin and interferon prevent the multiplication of the virus, which allows you to stop the pathological process and save hepatocytes from the development of carcinoma. The goal of interferon therapy is as follows:

stopping replication of the pathogen;
normalization of serum blood counts;
reduction of the inflammatory process in the liver parenchyma;
slowing the progression of the disease.

Treatment with interferon therapy can lead to the following outcomes:

a persistent result of the absence of the virus for six months;
a transient response, in which the virus ceases to be detected, but when therapy is canceled, the symptoms return;
complete lack of response to treatment with interferon therapy.

Interferon therapy is not prescribed for severe lesions of the heart and blood vessels, autoimmune hepatitis, decompensated cirrhosis, thyroiditis. When choosing a dose of a drug, there is always a question of its tolerability, therefore, the treatment regimen is drawn up very correctly, after a complete picture of all diagnostic measures. Among the interferons used in the treatment of the disease, doctors prescribe Laferon, Reaferon, Layfferon, Interal, Realdiron, Roferon, Alvir and other drugs. They are produced both in Russia (Reaferon-EU, Altevir, Interal, Layfferon), and in Israel, Switzerland, USA, Ukraine, Lithuania.

In some patients, hepatitis C medication can cause fever, chills, tiredness, and headache. In this case, simple interferons can be replaced with pegylated ones, which are stronger. Among side effects depression, hair loss, leukopenia, and thrombocytopenia have also been reported.

Ribavirins

In order to suppress the virus, the active ingredient ribavirin is used. It was synthesized in the 70s of the last century and was actively used to treat viral diseases, including hepatitis C. Ribavirin can reduce the amount of hepatitis viruses in the blood, the effectiveness of treatment with ribavirin drugs is about 85 percent. The disadvantage of the drug is that the effect is observed only while taking the drug. After the abolition of ribavirin, the increase in the amount of viral elements in the blood increases after six months without medication. Tablets for hepatitis C with ribavirin have long been the main medicine for the disease. In combination with interferon, they were prescribed for all genotypes of the hepatitis virus. In connection with what drugs for hepatitis C are being treated now, ribavirin fades into the background. Tablets are prescribed only as an additional drug to maintain the therapeutic effect of other drugs. The drug itself has a number of contraindications, so it cannot be used in every patient with hepatitis C - this is the main disadvantage of this drug. Since new drugs are not always available to patients, ribavirin has not yet disappeared from the prescriptions of the attending physician, and patients have to fight not only with hepatitis C, but also with the side effects of drugs. Among the drugs based on ribavirin, which are used for treatment, one can mention such names - Rebetol, Trivorin, Ribavirin, Arviron, Ribapeg and others. Ribavirins are produced by both domestic firs and foreign companies (USA, Mexico, India, Germany).

Other drugs

Since hepatitis C in itself is a serious illness, and therapy for hepatitis does not have the best effect on the patient's health, therefore, people taking drugs for hepatitis C are also given rehabilitation therapy. There are a number of drugs that are recommended for administration - Riboflavin, Pyridoxine, Rutin, Gerimaks. In most cases, these are vitamins that support the body during recovery.

Hepatoprotectors, which restore liver cells affected by the virus, are also mandatory. Among these drugs, doctors recommend taking Heptral, Phosphogliv and Ursofalk. These medicines have detoxifying and regenerating properties. With their use, metabolic processes in the liver parenchyma improve, the elasticity of hepatocytes increases, and bile acids are detoxified. The drug Phosphogliv has an antiviral effect, it is also able to prevent cirrhotic changes in the liver. Ursofalk is famous for its immunomodulatory effect, which facilitates the work of the liver by normalizing the composition of bile. Also, to reduce side effects, patients are prescribed intramuscular injections with Derinat, Neupogen and Recormon, Revolide tablets are recommended.

Contraindications

Hepatitis C is treated mainly for all patients, except for those who have contraindications. They are approved by the American Hepatological Association based on the observation of patients taking the latest drugs. Such contraindications include:

severe depressive conditions;
autoimmune hepatitis;
the presence of organ transplants;
thyrotoxicosis, not amenable to therapy;
allergic reactions to the components of the product;
pregnancy;
ischemic heart disease in a severe stage;
diabetes.

When treating hepatitis C, patients have the opportunity to try an effective course of treatment, which gives hope for recovery to almost all patients. The choice of drugs, which will best affect a given genotype of the virus, is carried out by the doctor, he also prescribes the treatment regimen.

The drugs with the best results in the treatment of hepatitis C successfully help to save many patients from developing severe consequences: cirrhosis and liver cancer. However, in some cases, the desired result cannot be achieved. Viral disease is difficult to treat. It is especially difficult to cure patients with obesity, immunosuppression of various origins and high blood concentration of HCV RNA. People who are infected cannot get rid of the disease. different kinds hepatitis viruses, as well as patients suffering from a chronic form of pathology for more than 2 years. New types of drugs increase their chances of recovery.

The main group of antiviral drugs - Interferons alpha

The main drug that has proven to be effective in hepatitis C is Interferon alpha (IF alpha). Interferons are protein substances that are produced in the body during viral lesions. In the treatment of viral hepatitis, the following are used:

Intron A;
Interal;
Alfaferon;
Viferon;
Reaferon;
Roferon-A.

IF alpha is administered subcutaneously or intramuscularly for 3 months. In 10-15% of cases, drug monotherapy gives a stable positive result. If laboratory tests by PCR did not reveal the RNA of the causative agents of the disease, therapy continues for another 9 months. When viruses are found in the patient's biomaterial, the treatment regimen is changed.

To increase the effectiveness of the hepatitis C drug, it is combined with polyethylene glycol (PEG). The molecule of polyethylene glycol makes the molecule of pegylated IF alpha (Pegasys) extremely resistant to the action of the proteolytic enzyme peptidase. It binds several water molecules and creates a kind of water cloud around the chemical unit of Pegasis. It delays the dissolution of the drug without impairing its antiviral properties.

Thanks to the PEG molecule, Pegasis is able to inhibit the reproduction of viruses for a longer time. Therefore, it is used once a week. Pegasis can significantly improve the patient's quality of life. A modern drug does not require dosage adjustment when treating patients with concomitant chronic renal failure.

To increase the duration of action of IF alpha, it is combined with human albumin. Albumin is a substance that has a long half-life. IF alpha in combination with Albumin (Albumin-interferon) retains antiviral activity longer than Pegasis. Therefore, it is used once every 2-4 weeks.

Long-acting IF alpha has been shown to be highly effective in clinical trials. Among the patients who were prescribed long-acting drug treatment, there were much more recovered than among patients receiving traditional short-acting IF alpha drugs.

Reverse transcriptase inhibitors

In the treatment of hepatitis C, reverse transcriptase inhibitors, namely nucleoside analogs, are successfully used:

Lamivudine;
Acyclovir;
Ribavirin.

They block the production of viral RNA and prevent the virus from multiplying. As recommended by doctors European Association according to the study of the liver, people who have been diagnosed with chronic hepatitis C are prescribed IF alpha together with reverse transcriptase inhibitors.

The list of the most effective drugs for hepatitis C includes the reverse transcriptase inhibitor Ribavirin (Vero-Ribavirin, Copegus). This drug has a pronounced antiviral effect. It inhibits the synthesis of RNA of HCV viruses and prevents them from multiplying. Ribavirin acts more actively together with IF alpha preparations. In case of virus genotypes C 2 and 3, in addition, with a small concentration of viruses of genotype 1 in a patient, the course of combined treatment is 6 months. If the patient's blood contains a large number of microorganisms, therapy is extended for another six months. It gives a stable positive result in 40-60% of cases.

Good results are demonstrated by treatment with the long-acting IF alpha drug Pegasis in combination with Ribavirin. It allows you to achieve a cure even in "difficult" patients with pronounced signs of liver cirrhosis and a high concentration of HCV genotype 1 viruses. The percentage of successful cure among this group of patients reaches 40%. Patients with a more favorable course of the disease are cured in 75% of cases.

Interferonogenesis inducers

Despite the high rates of effectiveness, interferon therapy in some cases does not give the desired result. The most difficult to treat exacerbation of hepatitis C in patients who previously took - pegylated IF alfa and Ribavirin. In these patients, further progression of liver fibrosis is likely to be observed. The lowest cure rate (less than 10%) is observed in patients diagnosed with HCV genotype 1.

In such cases, interferonogenesis inducers are used:

Cycloferon;
Amiksin;
Neovir.

They stimulate the production of its own interferons in the patient's body and allow him to heal himself at the expense of internal reserves. Endogenous interferons (intrinsic) do not possess antigenicity and do not cause side reactions, as drugs administered from outside. The production of its own interferons is strictly controlled by the body, so their excess is impossible. Interferonogenesis inducers enhance the action of recombinant IF alpha.

Among the inducers of interferonogenesis, the most effective drug for hepatitis C is Cycloferon. It stimulates the production of interferons in the liver and spleen. The drug reaches its maximum concentration in the blood after 2 hours. After a day, it is almost completely eliminated, however, the reaction to its introduction is observed for another 24 hours.

Immunomodulators with the ability to induce interferons

Remantadine tablets may be included in the therapy regimen. They are used as an alternative to Ribavirin if the patient has an intolerance to reverse transcriptase inhibitors. Remantadine is less effective, but causes fewer side reactions.

Currently, in a number of European countries, triple therapy regimens for hepatitis C are successfully used. Together with IF alpha and reverse transcriptase inhibitors, patients are prescribed drugs of the amantadine group:

Remantadine;
PC-Merz;
Midantan;
Amantadine.

Triple therapy makes it possible to achieve recovery in 60–70% of cases. Positive dynamics is observed even in patients with HCV 1b genotype, who experienced an exacerbation after successfully applied monotherapy with IF alpha. The triple regimen helps people who do not respond to traditional hepatitis C drugs.

Interleukins (IL) help to get rid of viral hepatitis. Interleukin-1 beta (Betaleukin) demonstrates high efficiency. It rebuilds the lymphocyte differentiation system (immunopoiesis), stimulates the blood supply to the bone marrow and the neuroendocrine system, enhancing the body's immune response. Betaleukin is usually used in combination with IF alpha and reverse transcriptase inhibitors.

Hepatoprotectors

The hepatitis C therapy regimens include hepatoprotectors. They help to restore the destroyed structure of the liver and restore its functions. For the treatment of people suffering from hepatitis C, it is better to use ursodeoxycholic acid. The drug has a pronounced anticholestatic and hepatoprotective effect. Ursodeoxycholic acid lowers cholesterol saturation in bile. It prevents the absorption of cholesterol by the intestinal walls, suppresses its production in the liver and reduces its secretion into bile. Hepaprotective drugs not only stimulate the recovery of hepatocytes, but also reduce the toxicity of antiviral agents.

According to the Russian Consensus on Hepatitis C, ursodeoxycholic acid is an adjunctive treatment for hepatitis caused by HCV pathogens. It cannot replace basic therapy.

In the treatment of hepatitis C, Chinese capsules Hugan Pian are used. They are of plant origin. The drug has a pronounced hepatoprotective effect. It is effective in the chronic form of pathology, as well as on initial stage cirrhosis of the liver.

New drugs

Treatment of a viral disease with IF alpha drugs is associated with a high risk of adverse reactions (more than 72%). Most often, a flu-like syndrome develops, gastrointestinal and psychiatric symptoms appear. Patients experience dysfunction of the thyroid and parathyroid glands, the content of leukocytes and platelets in the blood decreases (myelosuppression). Artificially administered IF alpha sometimes provokes an autoimmune reaction that accelerates the destruction of liver tissue.

Therefore, recently, NS3 / 4A protease inhibitors have been used to treat patients with hepatitis C. Telaprevir, Boceprevir are introduced into clinical practice, in addition, modern drugs of a new generation Simeprevir and Sofosbuvir. They are used to treat patients in whom standard therapy with IF alpha and Ribavirin causes serious adverse reactions.

NS3 / 4A protease inhibitors are used alone as monotherapy or in combination with Ribavirin if the patient is well tolerated.

Most effective drugs the new generation can also be used in combination with pegylated interferon and Ribavirin, if patients do not experience adverse reactions when taking IF alpha drugs.

The triple regimen allows for progress in the treatment of “difficult” patients who are not helped by standard therapy.

Alternative treatment

Successful treatment of hepatitis C requires an individualized approach. The course of the pathological process depends on the age of the patient, the duration of the disease, the genotype of the infection, the level of viral load, individual drug tolerance and the patient's financial capabilities. Therefore, only a doctor should treat hepatitis C. He will select the most effective and safe medicines.

Recently, alternative drugs that have antiviral effect have been used. They are used to replace antiviral drugs in the treatment of patients with intolerance to standard therapy. Medicines containing glycyrrhizic acid salts (, Viusid) have an antiviral effect. They are obtained from licorice root.

To date, the drug Heptozyme is undergoing clinical trials. When it was created, a fundamentally new approach to the treatment of hepatitis C was used. The target of the drug's effect is the stable part of the virus genome - Core-protein (“ribosomal scissors” technology, Pipe-line).

In some cases, antiviral drugs are not used. Contraindication is the presence of autoimmune diseases and diseases of the hematopoietic system, in addition, alcoholism, pregnancy and lactation.

Before using any drugs consultation of the attending physician is necessary.

Hepatitis is a disease of the liver, which is characterized by the presence of an inflammatory process in its cells of various etiologies. With improper treatment or its absence, dangerous consequences arise - cirrhosis or liver cancer, which often lead to the death of a sick person.

Today, there are many drugs that can effectively fight pathology. With early diagnosis of the disease and properly selected treatment, in most cases, the patient recovers completely (except for hepatitis B, which cannot be completely cured). In this article, we will try to answer the main concerns of the drug treatment of hepatitis.

Among hepatitis of various genesis, viral hepatitis most often occurs. In this case, inflammation in the liver develops against the background of viruses entering the body. They have several types (A, B, C, D, G, E, F), depending on which specific therapy is prescribed.

The disease proceeds in 2 forms, which have their own characteristics:

Determining the form of pathology is critical when prescribing treatment. So, for example, acute hepatitis A and B most often require only supportive treatment, while chronic hepatitis B requires hospitalization and treatment with antiviral drugs in a hospital setting.

Depending on the reasons that led to liver damage, in addition to viral forms, several more types of hepatitis are distinguished:

The highest efficiency in the treatment of hepatitis is drug therapy. This is especially true of treatment viral hepatitis... Moreover, for different forms different medications are used for diseases.

Medication for hepatitis A and E

Virus A infects liver cells most often. It enters the human body along with food and water. The carriers of the viral infection are flies, some insects and molluscs. The virus is transmitted from person to person by the oral-fecal route. Hepatitis A has an acute course and ends mainly in self-healing. Some particularly severe cases may require medical attention. In addition, the patient is prescribed bed rest and a special diet.

Hepatitis A is not a serious illness and is rarely treated in a hospital setting. As a rule, patients are allowed to go home, where they are shown bed rest, as well as a special diet. The body itself is able to overcome the virus. But if this does not happen, drug therapy is prescribed. Among the drugs in especially severe cases are prescribed:

For emergency detoxification, infusion therapy is used. Intravenous administration of rheopolyglucin 5%, glucose solution and polyionic buffer solutions is prescribed. They also use powerful means Sovaldi, Hepsinat. But such therapy has a number of contraindications (pregnancy, lactation, childhood), as well as side effects.

Vitamin complexes are used as an auxiliary therapy. These are B vitamins, vitamin C, PP, retinol and tocopherol. They are taken in a course for 2 weeks. They should be drunk only with the recommendation of the attending physician and under his supervision, since, in addition to their benefits, they can harm, causing a serious allergic reaction.

Hepatitis E has a lot in common with hepatitis A, but the onset is less dramatic. As a rule, it does not lead to dangerous consequences (only in pregnant women it can provoke some complications). When infected with the hepatitis E virus, the body is able to fight it itself, but sometimes symptomatic therapy is required, similar to that used for form A.

How to deal with hepatitis B and D?

The B form virus enters the human body in several ways:

Ways of acquiring hepatitis

through the blood;
as a result of unprotected sex;
from mother to her child.

In the case of an acute course, the pathology often goes away on its own. However, sometimes such a disease occurs in a chronic form and in this case it is difficult to treat. As a rule, complete recovery does not occur with the chronicity of the pathological process.

Note! The main principle of treatment is antiviral therapy using interferons. The treatment takes a long time, sometimes throughout life.

In order to alleviate the patient's condition, hepatoprotectors are additionally prescribed, dieting, physiotherapy procedures.

Hepatitis B is difficult to treat. It is impossible to kill a virus completely, especially if it has been in the body for a long time. Therefore, the therapy for this pathology is very long and complex. It can drag on for several years or last a lifetime. First of all, the use of antiviral drugs is shown. Among them:

Also, as additional agents, drugs are prescribed that protect the liver from the harmful effects of viruses - hepatoprotectors. For example, Livolin Forte, which contains phospholipids that replenish the missing elements in the liver cells. This medicine has practically no contraindications and has a beneficial effect on the liver.

A properly selected drug can suppress the activity of the virus in a year. But this does not guarantee a complete recovery.

Important! In addition to taking medications, a patient with this form of the disease must constantly adhere to a strict diet so as not to burden the affected liver, and also take measures to increase his immunity.

Hepatitis D develops only in conjunction with hepatitis B. It significantly aggravates the course of the latter, therefore it is treated in a hospital setting. There, the patient is given basic and symptomatic therapy, similar to that used for chronic hepatitis B.

Hepatitis C therapy

Hepatitis C has much in common with hepatitis B (the same routes of infection, the risk of complications in the form of cirrhosis or liver cancer), but its treatment is more successful and in most cases ends with a complete recovery of the patient. Hepatitis C is treated with interferon with Ribavirin; there are also new drugs that have proven themselves well (direct antiviral drugs). Additionally, a course of hepatoprotectors and vitamins is prescribed.

The virus of this disease is diagnosed in more than 80% of cases of infection. At the same time, hepatitis C often occurs in a chronic form, when the patient at an early stage does not even know about the presence of the disease. When complications occur in the form of cirrhosis or liver cancer, the treatment is ineffective. Therefore, the earlier it is possible to diagnose a pathology, the more favorable the prognosis of its treatment.

Basic therapy regimens

For hepatitis C, there are several treatment regimens that are used depending on the complexity of the disease, as well as the material condition of the patient:

Interferon-free therapy

The refusal of interferons in the treatment of hepatitis C is practiced more and more often, so it is worth dwelling on this issue in more detail. In the treatment of viral pathology, direct-acting drugs are used:

The choice of drugs for the treatment of hepatitis C is quite wide. In addition to expensive original products, more affordable Indian generics, which may well cope with the virus, are also highly effective.

Toxic and autoimmune liver damage

Toxic hepatitis is a liver disease in which it has been poisoned by substances of natural or chemical origin. This pathology requires complex treatment, which is aimed at:

Important! In case of poisoning with any toxic substances (including alcohol), you must seek help from a medical institution.

First of all, procedures are carried out to terminate the action of poisons. For this purpose, the stomach is washed or the blood is purified by introducing glucose-sodium solutions.

hepatoprotective agents (Essentialle, Hepatosan, Gepadif), which protect and restore liver cells;
choleretic agents (Holnezim, Allohol), which remove toxins from the body along with bile;
drugs that improve the functioning of the gastrointestinal tract (Mezim, Festal).
to increase immunity, take vitamin complexes (group B, vitamins A, E, C).

If the body temperature rises with toxic hepatitis, then the usual antipyretic drugs should be abandoned, since they can aggravate liver poisoning. Rehabilitation therapy lasts from several weeks to several months.

Therapeutic measures for autoimmune hepatitis are aimed at suppressing the immune system, which destroys cells in your liver. In this case, complex treatment is carried out, including the intake of such groups of drugs:

Antibiotics for hepatitis

We should also dwell on the use of antibiotics for hepatitis. As a rule, these drugs are indispensable for bacterial lesions or for their prevention. However, it is also known that antibiotics have an extremely negative effect on the liver. They are especially dangerous for an organ affected by the development of any form of hepatitis.

Antibacterial drugs do not act on viruses, so their use in the case of viral hepatitis is not practiced.

But there are situations when, simultaneously with hepatitis, the patient becomes infected with a bacterial infection (respiratory tract diseases, intestinal dysbiosis, etc.), in which antibiotics cannot be dispensed with.

Therefore, you need to know which of them are the most dangerous for the liver. The wrong selection of drugs in this group can lead to an exacerbation of viral or toxic damage to the organ, as well as a violation of bile outflow and stagnation of secretions in the liver. Such processes lead to a significant deterioration in the patient's condition, the progression of hepatitis, and hence, even greater destruction of the liver.

For hepatitis of any nature, such antibiotics are prohibited:

All tetracyclines.
Antibiotics for tuberculosis.
Levomycetin.

If antibiotic therapy is necessary, in this case, the specialist prescribes drugs that are less toxic to the liver (fluoroquinolones, penicillins), and the treatment is necessarily accompanied by the intake of hepatoprotectors:

Essentiale.
Phosphogliv.
Carsil.
Ursosan.
Heptral.

As already mentioned, hepatitis itself cannot be treated with antibiotics, however, with some of its complications, they are necessarily prescribed. The main ones are:

sepsis;
ascites;
peritonitis;
hepatic encephalopathy.

In the case of the development of such pathologies in hepatitis, drugs are prescribed that are characterized by a less damaging effect on the liver:

Fluoroquinolones (Ciprofloxacin; Norfloxacin).
3rd generation cephalosporins (Ceftriaxone, Cefotaxime).
Penicillins (Augmentin, Amoxiclav).
Aminoglycosides (Neomycin).
Glycopeptides (Vancomycin).
Nitroimidazoles (Metronidazole.)

The effectiveness of treatment for any type of hepatitis depends on its severity and the presence of complications. Therefore, early diagnosis of the disease, as a rule, guarantees a complete recovery with the right treatment.

Yields best drug treatment viral hepatitis, because antiviral therapy allows you to get rid of the cause (viruses). This immediately relieves the patient's condition. However, some complicated forms of hepatitis (chronic course B and C) are not completely cured. Although, with appropriate supportive therapy, it is possible to significantly facilitate the patient's life with such forms of pathology.

Hepatitis C is asymptomatic in 80 out of 100 people infected. This is the danger of illness. Patients are often diagnosed at a later stage, when cirrhosis or liver cancer has developed. Every person has a risk of getting sick, but there is no vaccine yet. Antiviral drugs are the mainstay of therapy for hepatitis C. The latest generation drugs have made a complete cure possible. It can be helped by folk remedies for the liver with hepatitis C.

The virus enters the body through the blood, gets to the liver cells, where it begins to reproduce. Substances produced by the pathogen provoke an immune response and the development of inflammation of the liver parenchyma. With hepatitis C, this organ grows early, but practically does not hurt, which causes a long asymptomatic course of the pathology. How much tissue is destroyed is found out during ultrasound (ultrasound), CT (computed tomography) or biopsy.

To assume how far the inflammatory process has gone, the change in indicators in the biochemical blood test allows.

For instance:

increased content of total bilirubin;
an increase in the activity of liver enzymes, mainly ALT (alanine aminotransferase);
decreased albumin levels.

In 20 out of 100 patients with chronic hepatitis Fibrosis develops, which progresses and can lead to cirrhosis, carcinoma.

As you accumulate connective tissue at the site of dead hepatocytes, liver functions begin to weaken, and with cirrhosis they are completely lost. This is why it is so important to decide on a therapy. It will help restore the damaged liver.

Comprehensive treatment for liver inflammation includes:

Preparations to eliminate the causes of the disease. These are Interferons, as well as new drugs that have a direct effect on the virus - Sofosbuvir and its analogues. They are often used in combination with each other. Special schemes have been developed for different genotypes of HCV (hepatitis C virus) and stages of liver damage.
Preparations for restoring the structure and functions of hepatocytes. This is an extensive group of synthetic and natural hepatoprotectors. The first includes Essentiale N, Geptral, Phosphogliv, Ursosan. On a natural basis, make Gepabene, Karsil, Hofitol, Sirepar, Prohepar. They are made from plant or animal raw materials.
Vitamin complexes and biologically active additives (dietary supplements). They are a source of vitamins, trace elements and active substances necessary for the restoration of the liver. Supplements most often have a vegetable composition. Examples are Gepar Active, Gepagard Active, Legalon.
Folk recipes. Various herbal teas, herbal teas, bee products in the form of mixtures, infusions and tinctures - all this helps to maintain liver function, improve immunity, and suppress viral activity.
Diet therapy and proper lifestyle. They are designed to unload the affected organ as much as possible, help get rid of the virus faster, and reduce the side effects of drugs.

In addition to fighting the pathogen, official medicine insists on the use of hepatoprotectors, which can improve the condition of the cells of the inflamed organ.

Patients, depending on the severity of the course of the disease, may be prescribed different drugs that help restore the functionality of hepatocytes. Some of the drugs are synthetic.

essential phospholipids;
detoxification drugs;
amino acid-based products;
antioxidants;
lipotropic substances;
derivatives of ursodeoxycholic acid;
medicines with cysteine \u200b\u200band ornithine.

The most popular group is essential phospholipids.

They are represented by:

Essentiale N.
Essliver forte.
Cut.
Phosphogliv.

Phospholipids are the main building blocks of the hepatic cell walls. To achieve the effect, it is necessary to take drugs from 3 months to six months. With a severe degree of liver damage, drugs are administered intravenously.

It has been proven that drugs in this category improve the result of Interferon therapy and reduce the number of relapses.

Detoxifying agents include substances such as:

Magnesium sulfate.
Sodium bicarbonate.
Vitamin C
Reamberin.

Amino acids include:

L-methionine.
Ademetionine.
Acetylcysteine.
Heptral.

The last drug is the most famous. Its domestic counterpart is Heptor. The active ingredient in both drugs is called ademetionine.

In addition to hepatotropic, agents with amino acids have an antidepressant effect. With mild degrees of severity of hepatitis C, pills are used, with an acute process, intravenous drip administration is practiced.

Antioxidants inactivate free radical molecules in liver cells.

Vitamins C, A, E.
Lipoic acid
Ubiquinone.
Mexidol.
Berlition.

Lipotropic drugs include those that prevent liver obesity.

Recommended:

Alpha Lipoic Acid.

Ursodeoxycholic acid preparations bind to cholesterol molecules, dissolve soft stones in the gallbladder.

Usually appoint:

Ursosan.
Urdox.

Ursodeoxycholic acid is used to restore the functioning of the entire biliary system.

Cysteines are made on the basis of N-acetylcysteine, which promotes the synthesis of the antioxidant substance glutathione.

Ornithine-containing preparations include Hepa-Merz.

Other medicines:

vegetable;
animal origin.

Natural animal-type preparations contain liver cells of pigs or cows. The first category includes Hepatosan.

Cow cells are present in:

Hepatamine.
Prohepare.
Sirepare. It also includes cyanocobalamin (vitamin B12).

Means remove toxic metabolites from the body, restore damaged liver cells. In addition, the drugs improve the indicators of hepatic function, therefore they are prescribed as part of the complex therapy of the chronic form of hepatitis C. In the acute stage, category agents cannot be used, since the pathological process may worsen.

Herbal hepatoprotectors are created from herbal extracts:

milk thistle;
artichoke;
thorny capers.

Many drugs include the active substance silymarin. It is obtained from thistle. This plant is rich in flavonoids. They improve blood circulation in hepatocytes, stimulate regeneration processes and rapidly remove toxins from the body. In addition, flavonoids effectively slow down the rate of fibrous degeneration of liver tissue.

Group drugs:

Carsil.
Hepabene.
Silimar.
Legalon.
Milk thistle meal.
Cynarix.
Hofitol.

The last 2 preparations are made from artichoke.

Hepatoprotectors should be used in the complex therapy of hepatitis C along with antiviral agents. Without them, drugs will not lead to recovery, since they do not act on the pathogen.

Folk recipes

Alternative therapy is used as an adjunct to mainstream treatment, designed to support both the liver with hepatitis C and the body's defenses. The recipes use different medicinal herbs, bee products, fruits and berries, vegetables, juices.

Suitable for the treatment of hepatitis C:

Tea made from a tablespoon of rowan leaves and 0.5 liters of boiling water. Drink after insisting 1 glass a day. You can keep the rest in the refrigerator.
Tea from the collection of St. John's wort, mint leaves, chamomile flowers, rose hips, wormwood herb. Herbs are taken in equal parts.
Broth of unpeeled oats.
Carrot, beet or cabbage juice.
Propolis tincture. The latter is taken 20 grams for 2 shots of vodka. You need to drink 20 drops in half a cup of milk before eating.

When choosing a recipe for traditional medicine, it is worth enlisting the support of a doctor. Self-medication can worsen your health.

Proven to be effective in hepatitis C nutritional supplements based on the seeds of milk thistle (dry thistle), oats and rose hips. These plants quickly remove harmful metabolic products from the liver.

Dietary supplements start the process of natural regeneration of damaged tissues. For this, Ovesol, Hepatrin, LIV-52 can be used. In case of viral liver damage, it is important to increase the effectiveness of all links of the immune system. For this purpose, you can use Uncaria.

To maintain liver cells in working order, you can recommend:

Hepatocholan plus. Contains silymarin, beetroot beetroot, hill hodgepodge, dandelion, wax bark. The drug has a positive effect on all digestive organs, promotes the regeneration of damaged hepatocytes and restores them after hepatitis C.
Indol Active. Contains chemical substancesas well as artichoke, broccoli powder. The drug enhances immune capabilities, restores the functional abilities of the liver and the structure of its cells, removes unnecessary substances from the body.

With the help of dietary supplements, you can increase immunity in order to effectively cope with the virus, while restoring the impaired functions of the liver parenchyma.

Does the liver hurt with hepatitis is a question that interests many who are faced with the disease. Doctors say that the body does not ache until the changes go too far. This is due to the absence of nerve endings in the liver. The rate of destruction of an organ depends not only on the genotype of the virus, but also on the nutritional load. The gland processes toxins and provides the intestines with bile, which breaks down fats.

Accordingly, in order to relieve the liver and slow the development of hepatitis C, you need to exclude from the diet:

fats of animal origin - due to a complex formula, they are difficult to digest, which creates an extra burden on the liver and pancreas;
simple carbohydrates - they increase the possibility of obesity and type 2 diabetes;
some trace elements, in particular, iron, the level of which in hepatitis must be controlled;
vegetable fiber in excess, it should be consumed a little;
animal proteins from fatty meat - leave only rabbit, turkey, fish and lean beef in the diet.

Some of the meat can be offset by nuts. But tobacco, alcohol and drugs do not imply replacement, they are definitely excluded.

A balanced diet prescribed by a doctor speeds up recovery. At the end of therapy, a return to the usual diet is allowed. If eating healthy food becomes a good habit, you can keep it.

Among the drugs and dietary supplements that have a hepatoprotective effect, the most popular among doctors and patients are:

Medicines with milk thistle - Silymarin, Silibinin, Karsil, Legalon.
Products with artichoke extract - Hofitol, Holebil.
Combined herbal preparations. Here they distinguish Gepabene, Sibektan, Gepaphor, Liv-52.
Essential phospholipids - Essentiale N, Rezalut Pro, Essliver Forte, Fosfontsiale, Phosphogliv.
Heptral (Heptor, Ademetinin).
Hepa-Merz.
Ursofalk, Ursosan.
Oatsol.
Berlition.
LIV-52.

The choice of the drug should be made by the doctor, taking into account the age, severity of the disease, the presence of concomitant pathologies and the individual characteristics of the patient's body.

There are many recipes that help maintain the functioning of liver cells in hepatitis C. Drugs help relieve stress on the organ, including in case of combined diseases, when the body is simultaneously destroyed by several ailments.

Duration of treatment by one means or another

The duration of the course of treatment is determined by the doctor specifically for each patient. Not only the state of the liver is taken into account, but also the characteristics of the drugs.

Usually, within a year after recovery or remission, it is recommended:

Sparing regime.
Diet food.
Taking vitamins and means to restore the functions of hepatocytes.

With severe fibrosis, the recovery period is longer than in its absence or mild.

During the recovery period, you must be under the supervision of your doctor. Since there is no vaccination against hepatitis C, the maximum restoration of the body and immunity is important. Otherwise, the risk of re-susceptibility to the virus increases.

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