СОСТОЯНИЕ ИММУНИТЕТА У ВИЧ-ИНФИЦИРОВАННЫХ ПАЦИЕНТОВ, КОИНФИЦИРОВАННЫХ ВИРУСОМ ГЕПАТИТА C
https://doi.org/10.22328/2077-9828-2018-10-4-25-36
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Полный текст:
Аннотация
Среди коинфекций, сопутствующих ВИЧ-инфекции, чаще всего встречается вирусный гепатит С. В России более половины ВИЧ-инфицированных пациентов коинфицировано ВГС. Обе инфекции могут оказывать взаимное отрицательное влияние, что отражается в увеличении заболеваемости и смертности коинфицированных пациентов по сравнению с моноинфицированными. Негативная роль ВИЧ-инфекции в развитии гепатита C проявляется ускорением процесса фиброзирования и формирования цирроза печени, а также частого возникновения гепатоцеллюлярной карциномы. Менее изучены эффекты ВГС-инфекции на течение ВИЧ-инфекции. Известно, что гепатит может замедлять восстановление иммунитета на фоне получения антиретровирусной терапии. Кроме того, нарушение печеночного барьера для продуктов, поступающих из кишечника, по-видимому, способно приводить к дополнительной активации иммунитета, углублению иммунодефицита, усилению системного воспаления и развитию СПИД-неассоциированных заболеваний, в первую очередь болезней сердечно-сосудистой системы. Решение проблемы большинство исследователей видит в раннем начале антиретровирусной терапии, а также в переходе от интерферонотерапии к назначению препаратов прямого действия при лечении ВГС-инфекции.
Ключевые слова
ВИЧ-инфекция,
коинфекция вирусом гепатита C,
фиброз и цирроз печени,
антиретровирусная терапия,
микробная транслокация,
системное воспаление,
СПИД-неассоциированные заболевания
При поддержке: Работа выполнена при поддержке гранта РФФИ № 17-54-30006.
Об авторах
К. В. Шмагель
Институт экологии и генетики микроорганизмов — филиал ФГБУН «Пермский федеральный исследовательский центр» УрО РАН
Россия
Россия
Шмагель Константин Владимирович — д.м.н., зав. лабораторией экологической иммунологии
614990, Пермь, ул. Ленина, 13А
В. А. Черешнев
Институт экологии и генетики микроорганизмов — филиал ФГБУН «Пермский федеральный исследовательский центр» УрО РАН;
ФГБУН «Институт иммунологии и физиологии» УрО РАН
Россия
Россия
Черешнев Валерий Александрович
академик РАН, д.м.н., г.н.с. лаборатории экологической иммунологии
г.н.с.
620041, Екатеринбург, ул. Первомайская, 106
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Рецензия
Для цитирования:
Шмагель К.В., Черешнев В.А. СОСТОЯНИЕ ИММУНИТЕТА У ВИЧ-ИНФИЦИРОВАННЫХ ПАЦИЕНТОВ, КОИНФИЦИРОВАННЫХ ВИРУСОМ ГЕПАТИТА C. ВИЧ-инфекция и иммуносупрессии. 2018;10(4):25-36. https://doi.org/10.22328/2077-9828-2018-10-4-25-36
For citation:
Shmagel K.V., Chereshnev V.A. IMMUNE STATUS IN HIV-INFECTED PATIENTS COINFECTED WITH HEPАTITIS C VIRUS (HCV). HIV Infection and Immunosuppressive Disorders. 2018;10(4):25-36. (In Russ.) https://doi.org/10.22328/2077-9828-2018-10-4-25-36
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