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Chapter 5. RESEARCH of EFFICIENCY of ANTIVIRAL THERAPY of CHRONIC HEPATITISES At CHILDREN And TEENAGERS

Criteria of selection in group for carrying out of antiviral therapy
(PVT) served: proved viremija (double positive take PTSR about definition of a virus load), the age is more senior 3 years, absence of contraindications, the consent of parents to long therapy.

Before beginning PVT to the child a number of researches for revealing of possible contraindications, specifications of activity of process, expression of a fibrosis, the immune status of the patient was prescribed. Into the list of researches entered:

1. Allocation genoma a virus method PTSR

2. Genotype definition.

3. Definition of a virus load

4. Definition of markers: HGV (HBsAg, a-HBs, a-HBcor IgM, a-HBcor IgG, HBeAg, a-HBe IgM, a-HBe IgG); HGS (a-HCV cor, a-NS)

5. A biochemical blood analysis (ALT, nuclear heating plant, GGTP, SHF, O fiber, an albumin, O bilirubin, Cholesterol, v-lipoproteidy, triglycerides, the Glucose)

6. The general analysis of blood

7. Thyroid gland hormones (Т4, TTG, antibodies to TPO)

8. PTI

9. An immunogram

10. The general analysis of urine

11. Ultrasonic of organs of an abdominal cavity

12. Thyroid gland ultrasonic

13. Elastometrija/a liver puncture biopsy

14. EEG

15. Consultations of experts: the Neurologist, the Endocrinologist.

Efficiency of therapy was estimated by results of PTSR which spent to terms 4, 12, 24, 48 weeks. On 4 week was considered, that the fast virologic answer (BVO) will reach, if depression of a virus load on 2 log (in 100 times) or full absence replikatsii is noted. BVO was not an occasion to therapy correction, but it was regarded as positive prediktor success of therapy. On 12 week the early virologic answer was estimated
(RVO) by the same criteria. If RVO has not been reached, the question on correction of therapy or treatment cancellation was surveyed. On 24 week therapy was considered unsuccessful if method PTSR has been allocated by a virus gene. Therapy considered effective if at the patient the proof virologic answer (SVO) was observed, i.e. absence genoma a virus in blood within 6 or 12 months after the treatment termination.

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Scientific source Dmitriev Tatyana Gennadevna. CHRONIC VIRUS HEPATITISES At CHILDREN And TEENAGERS In REGION GIPERENDEMICHNOM. The PROGRAM of PERFECTION of RENDERING of the MEDIKO-SOCIAL HELP. The dissertation on competition of a scientific degree of the doctor of medical sciences. Yakutsk - 2014. 2014

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