Клиническая характеристика и частота фиброза печени у больных с хроническим вирусным гепатитом C или с инвазией Opisthorchis felineus

Abstract

Study Objective: To study the clinical symptoms and prevalence of hepatic fibrosis in patients with chronic virus hepatitis C (CVHC), genotype 1, or Opisthorchis felineus invasion. Study Design: Cross-sectional comparative study of random groups of inpatient or outpatient patients. Material and Methods. We examined 297 patients with CVHC, genotype 1, and 214 patients with chronic opisthorchiasis. CVHC was diagnosed in accordance with the guidelines of the European Association for the Study of the Liver. Opisthorchiasis was diagnosed when eggs or mature parasites were found in duodenal content and/or faeces of the patient. Hepatic fibrosis was assessed with shear wave elastography using the METAVIR scale. Study Results. We have found differences in clinical symptoms: prevailing cytolytic syndrome (82.8% vs 9.8%; p < 0.001), hepatomegaly (20.9% vs 10.3%; p = 0.002), and stage F3-F4 hepatic fibrosis (METAVIR) (20.5% vs 8.4%; p < 0.001) in patients with CVHC and higher prevalence of cholestatic syndrome (14.5% vs 0.3%; p < 0.001), chronic cholecystitis (18.2% vs 8.8%; р = 0.002), gallstones (4.7% vs 0.7%; р = 0.008) in patients with opisthorchiasis. Conclusion. Highly significant is frequently diagnosed F2, F3 and F4 hepatic fibrosis (METAVIR) in patients with opisthorchiasis (20.5%). These evidences point out that O. felineus invasion is a hepatic pre-cancer condition. Taking into account the high prevalence of O. felineus invasion in some regions of Siberia, the available data show that opisthorchiasis is a relevant medical and social issue which must be addressed. Keywords: virus hepatitis С, Opisthorchis felineus, hepatic fibrosis.