Range of extrahepatic implications in patients with chronic hepatitis c depending on the infection with different genotypes of the virus and the virus load
DOI:
https://doi.org/10.14739/2310-1237.2013.2.17799Keywords:
chronic hepatitis C, extrahepatic implications, HCV genotype, virus loadAbstract
The HCV-infection possesses a special role in the development of extrahepatic lesions which not only mask a liver lesion, but also can define the disease forecast. Data of modern literature on the role of HCV genotype and virus level in formation of extrahepatic implications of the disease is very inconsistent.
The aim of this work: to analyze the range of extrahepatic implications in patients with chronic hepatitis C depending on the infection with different genotypes of HCV and level of the virus load.
216 patients with chronic hepatitis C aged from 18 till 69 years were included into research. Men – 122, women – 94. Patients were included into research on a casual sign and existence of the informed agreement. In all the patients, except traditional clinic-biochemical researches, concentration of cryoglobulins in blood serum was determined by a spectrophotometer method. Virologic researches included definition of HCV genotype and the virus load with the method of polymerase chain reaction. The obtained data was processed by the method of variation statistics.
Results of the conducted researches showed that infection with the 1st and the 3rd genotype of the virus, which identification frequency was 54,2% and 39,8% respectively, prevailed in patients with chronic hepatitis C. The analysis of the range of extrahepatic implications of chronic hepatitis C showed that most often the admixed cryoglobulinemia which emergence was accompanied by the development of the cryoglobulinemia syndrome was found in patients irrespective of HCV genotype. However it is necessary to notice that emergence of laboratory signs of the lesion of a thyroid gland wasn't always combined with the admixed cryoglobulinemia. Such extrahepatic implications as a sensory polyneuropathy, B-cellular non-Hodgkin's lymphoma, pulmonary fibrosis were registered in isolated cases only against clinically demonstrative cryoglobulinema syndrome. Statistical differences in the frequency of formation of extrahepatic implications when infected with different genotypes aren't recorded.
The index of the virus load in patients with chronic hepatitis C fluctuated from 4,9x103 IU/ml to 6,2x107 IU/ml. The analysis of level of the virus load showed that the low virus load (73,5 %), below level of 2x106 IU/ml, is registered most often. The high virus load, higher than 2x106 IU/ml, is recorded in every fourth patient. Comparison of frequency of formation of extrahepatic implications in patients with chronic hepatitis C with different level of the virus load didn't identify statistically significant differences.
Conclusions. In patients with chronic hepatitis C the infection with 1st genotype (54,2 %) prevails over the 3rd genotype of a virus (39,8 %). Irrespective of HCV genotype most often there are the admixed cryoglobulinemia and the lesion of a thyroid gland in patients. In patients with chronic hepatitis C the low virus load is registered more often (73,5 %). Development of separate extrahepatic implications doesn't depend on level of the virus load.
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