Хронический вирусный гепатит С: эволюция научных взглядов

Abstract

The problem of infection with viral hepatitis C is relevant nowadays. Despite the fact that scientists are still searching for new methods of treating this infectious disease, the main problems are complications that develop over the years in patients with hepatitis C. Fibrosis, cirrhosis, portal hypertension, liver failure, hepatocellular carcinoma, and different extrahepatic manifestations are the main causes of death. Even complete elimination of the virus after direct antiviral therapy does not stop developing of complications which effect on life expectancy. We cannot speak about morbidity because of the fact that viral hepatitis C is most often diagnosed at the stage of complications. All this is due to the asymptomatic, chronic development of this disease. We still diagnose complications from viral hepatitis C, but the infection could have happened 10 years ago. Human immunodeficiency virus is frequently found in patients with viral hepatitis C, which is most often directly related to the features of the mechanism of infection and transmission routes. The presence of untreated human immunodeficiency virus is a poor prognostic sign. This co-infection can affect the rate of development of complications and the general severity of the disease. Prevalence rate are still high, despite the development of various preventive measures to reduce infection with the listed above viruses, such as the free distribution of disposable syringes, barrier contraceptives, widespread promotion of a healthy lifestyle, informing the population about the danger of infection, etc. The lack of reliable and high-quality statistical information on the prevalence of viral hepatitis, both monoinfection and in association with human immunodeficiency virus is very important issue in Ukraine. There is also a small amount of data about the dominance of certain genotypes in different parts of our country. This absence information interferes with a clear understanding of the leading routes of transmission of infection and a targeted impact on them. There are also no clear screening programs for groups of risk. There are problems with clear control over patients, especially over those who have successfully completed antiviral therapy. This category of patients disappears from the control of medical workers. They often do not know that the absence of the virus in the blood still leaves a high risk of developing cirrhosis of the liver and other complications, because the liver was previously compromised. This once again proves the importance of dispensary observation of all treated patients, not depending on their response to therapy