Репозиторий Университета

© 2018 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd. Chronic viral infections including those by hepatitis B (CHB) virus and hepatitis C (CHC) virus have been reported to be comorbidities of chronic spontaneous urticaria (CSU). Here, we performed the first comprehensive review of the peer-reviewed literature (PubMed, Web of Science and Google Scholar) on the prevalence of CHB and CHC in patients with CSU and vice versa. The prevalence of CHB and CHC in CSU does not appear to be increased. Less than 5% and 2% of patients with CSU have markers of CHB and CHC, respectively, according to most of the 32 studies reviewed. Urticarial rash including CSU occurs in ≤3% of patients with CHC as reported by most of 20 studies analysed. Very few patients have been assessed for the effects of antiviral hepatitis treatment on their CSU, and two but not all reportedly showed improvement. Hepatitis B/C infections appear unlikely to be linked to CSU. We suggest that routine screening for these infections in patients with CSU is not relevant or cost-effective and should not be performed unless liver function tests are abnormal, risk factors or symptoms of viral hepatitis are present, or urticarial vasculitis is suspected.

© 2018 Media Sphera Publishing Group. All rights reserved. Systemic vasculitis is a heterogeneous group of inflammatory diseases, which are classified according to the diameter of the affected vessels. The treatment of systemic vasculitis is no longer empirical, because of increasing number of randomized clinical trials in this field. In recent years, there was a trend to limit the cumulative dose of glucocorticosteroids and immunosuppressive drugs, partially through biological drugs usage. However, biologic therapy is not always superior to combination of glucocorticosteroids and cytotoxic drugs. The efficacy of different biologic drugs varies in patients with different forms of systemic vasculitis, which creates the ground for personalized therapy of these diseases. Another serious problem is the absence of strict criteria to immunosuppressive therapy intensification, especially in vasculitis, affecting large vessels, due to the lack of reliable laboratory markers of disease activity. The article reviews modern approaches to the treatment of some types of systemic vasculitis, including ANCA-associated vasculitides, giant cell arteritis, Takayasu`s arteritis and cryoglobulinemic vasculitis.

© 2018 Media Sphera Publishing Group.All Rights Reserved. In the article we present three clinical observations demonstrating that HCV infection in patients with remission of Wilson disease causes an recrudescence of the disease, in one of the observations - decompensation of liver cirrhosis. In this study we first describe on the successful treatment of HCV infection with direct antiviral drugs in patients with Wilson disease. Establishment of all factors of liver damage and successful treatment (elimination of the virus, adequate lifelong medical treatment) allow to expect a favorable prognosis in patients with a combination of Wilson disease and HCV infection.

Рассмотрены особенности поражения почек, развивающиеся при хронической инфекции, вызванной вирусом гепатита С (HCV-инфекции), а также современные возможности лечения. Подробно освещены клинические и морфологические проявления криоглобулинемического гломерулонефрита, ассоциированного с HCV-инфекцией, критерии его диагностики, прогноза. Обсуждены новые подходы к лечению (особенно тяжелых форм криоглобулинемического васкулита с поражением почек) — сочетание противовирусной терапии (пегилированный α-интерферон/рибаверин) с биологическими препаратами (моноклональные антитела к СD20 В-лимфоцитов, в частности ритуксимаб) с целью достижения клинической, вирусологической, иммунологической ремиссии, а также ответа на молекулярном уровне — устранения олиго- и моноклональной пролиферации В-лимфоцитов.

Рассмотрены особенности поражения почек, развивающиеся при хронической инфекции, вызванной вирусом гепатита С (HCV-инфекции), а также современные возможности лечения. Подробно освещены клинические и морфологические проявления криоглобулинемического гломерулонефрита, ассоциированного с HCV-инфекцией, критерии его диагностики, прогноза. Обсуждены новые подходы к лечению (особенно тяжелых форм криоглобулинемического васкулита с поражением почек) — сочетание противовирусной терапии (пегилированный α-интерферон/рибаверин) с биологическими препаратами (моноклональные антитела к СD20 В-лимфоцитов, в частности ритуксимаб) с целью достижения клинической, вирусологической, иммунологической ремиссии, а также ответа на молекулярном уровне — устранения олиго- и моноклональной пролиферации В-лимфоцитов.