RU2180862C2 - Method to treat chronic viral hepatitis - Google Patents

Abstract

FIELD: medicine, hepatology, gastroenterology, clinical lymphology. SUBSTANCE: interferon is injected by traditional course during the first 2 wk via catheter in hepatic round ligament. Catheter is introduced and installed by laparoscopic technique, treatment course is repeated 3 times at 3 months interval. EFFECT: higher efficiency of antiviral therapy at applying moderate doses of interferon. 1 ex

Description

 The invention relates to medicine, in particular gastroenterology, hepatology and clinical lymphology.

 Currently, various treatment regimens are used to treat chronic viral hepatitis, involving the use of different doses of interferon preparations (from 1 to 10 million units), multiplicity (1-3 times a week) and duration of treatment (from 3 months to 2 years). The main disadvantage of existing methods of treatment is their low efficiency (less than 50%). Closest to the proposed is a method of treating chronic viral hepatitis, involving the introduction of interferon preparations intramuscularly or subcutaneously at a dose of 3 million units 3 times a week. The mechanism of the antiviral action of interferon manifests itself in its interaction with cells and consists in suppressing viral replication, stimulating the production of endogenous interferon and the immunomodulating effect (Sorinson S.N., 1998).

 We propose a method consisting in the introduction of the drug interferon at a dose of 3 million units every other day in a round ligament of the liver.

 The technical result when applying the proposed method is to increase the effectiveness of antiviral therapy using moderate doses of interferon using indirect lymphotropic therapy.

 The method is as follows. A catheter is inserted into the round ligament of the liver and fixed in it using laparoscopic techniques under video control. The preparation of interferon (reaferon or roferon A or intron A) is dissolved in the appropriate solvent and introduced into the catheter at a dose of 3 million units every other day with an infusomat at a rate of 2-5 ml per hour. Interferon infusion is preceded by the introduction of 5 ml of a 0.25% solution of novocaine at a rate of 2-5 ml per hour. On days when interferon is not used, the catheter is washed with 5-10 ml of a 0.25% solution of novocaine, which is also injected with an infusomat at the same rate. Treatment in this mode lasts 14 days, then the catheter is removed, and the patient switches to the traditional treatment regimen at 3 million units intramuscularly (subcutaneously) 3 times a week. Catheterization of the round ligament of the liver and indirect lymphotropic administration of the drug interferon is repeated after 3 and 6 months. The total duration of treatment with interferon is 1 year.

 We observed 12 patients with chronic viral active hepatitis (6 with hepatitis C, 3 with hepatitis B, 3 with hepatitis B + C). The diagnosis of chronic viral hepatitis was verified by laboratory, histopathological, serological data, as well as PCR analysis. Patients underwent indirect lymphotropic therapy with one of the preparations of interferon at a dose of 3 million units every other day by introducing into the round ligament of the liver for 2 weeks. Compared with the initial parameters, after 2 weeks of treatment, patients showed a decrease in plasma transaminases activity by 1.3-1.5 times. Further treatment for 3 months, patients received in the form of intramuscular injections of the drug interferon at a dose of 3 million units 3 times a week. After 3 and 6 months from the start of therapy, the patients were given a repeated course of introducing interferon into the round ligament of the liver according to the same scheme. After 6 months from the start of treatment, a biochemical blood test revealed persistent normalization of transaminase activity and signs of seroconversion, and after 1 year - persistent seroconversion, normal transaminase activity, the disappearance of intralobular infiltrates and necrosis, that is, the transition of hepatitis to the inactive phase. 6 months after the end of treatment, only 1 out of 12 patients (a patient with chronic hepatitis B + C) showed signs of exacerbation of the disease.

 Clinical example.

 Patient T., 44 years old, was admitted to the hospital with a diagnosis of chronic hepatitis C, activity II. The patient was prescribed therapy with roferon A at a dose of 3 million units every other day with the introduction of the drug into the round ligament of the liver. Conducted 3 courses of indirect lymphotropic therapy with interferon in the round ligament of the liver. The total duration of treatment was 1 year. Examination after 1 year of treatment showed no signs of active inflammation in the liver, serological markers of hepatitis C virus replication were also negative. During the follow-up examination six months and a year after the end of the treatment with interferon, there was no exacerbation of the disease, the activity of transaminases was stably normal, there were no signs of hepatitis C virus replication, and no morphological examination of necrosis and inflammatory infiltrates was found in the liver parenchyma.

 Literature.

 Sorinson S.N. Viral hepatitis St. Petersburg: TEZA, 1998 .-- 325 p.

Claims (1)

 A method for the treatment of chronic viral hepatitis, including the introduction of interferon preparations according to the traditional course and characterized in that the interferon preparations are administered for the first two weeks through a catheter in the round ligament of the liver, which is introduced and established using laparoscopic technique, the treatment is repeated 3 times at intervals of 3 months.