Changes in clinical, biochemical, immunological and integrative parameters in patients with chronic hepatitis C virus infection according to the virus genotype and the grade of activity

Abstract

The aim of this study is to determine the features of the course of chronic hepatitis C virus (CHCV) infection and the dependence of changes in integrative indicators of endogenous intoxication, nonspecific immunoreactivity and inflammation on the virus genotype and the grade of activity. Materials and methods. In total, 287 CHCV patients were examined and their inpatient and outpatient medical cards were analyzed. The study included 55 healthy individuals. In addition to the general group, which included all the patients, the examined people were divided into groups, depending on the grade of activity (minimal activity – 210 people, moderate – 68, expressed – 9) and the virus genotype (1b – 150 people, 2 – 19, 3a – 102). Clinical and laboratory examination was performed according to the protocol. The integrative indices of severity, nonspecific reactivity, indices of inflammation and intoxication activity were also calculated. The statistical processing of the obtained results was carried out by Microsoft Office Excel 2010 and IBM SPSS Statistic 23 computer software. Results. The groups were sex- and age-representative. The 1b genotype (52.30 %), moderate liver fibrosis (F2 – 31.25 %) and minimal activity (73.17 %) were the most frequently encountered in patients with CHCV. The most frequent clinical manifestations were asthenovegetative syndrome (81.88 %) and heaviness in the right hypochondrium (64.76 %). Patients with CHCV caused by different virus genotypes had evenly distributed clinical data (P > 0.05), with the exception of the 1b genotype patients who were diagnosed with telangiectasia 1.3 times more frequently than in the total sample; and liver enlargement were 1.5 times (P 0.05); IIS with genotype 3a was 1.7 times lower compared with all patients (P < 0.05). The ELR indicator did not change in all grades of activity and did not differ from those of healthy individuals. In patients with moderate activity, IA was higher than in the comparison group and NI was lower than in the total group (P < 0.05). Abdominal ultrasound, regardless of the group, most frequently revealed liver enlargement (76.26% of persons) and an increase in its echogenicity (82.35 %). Conclusions. Chronic hepatitis C virus patients were dominated by asthenovegetative syndrome, feeling of heaviness in the right hypochondrium, liver enlargement, increase in lymphocyte count, ESR, transaminase activity. Telangiectasia in genotype 1b and liver enlargement in genotype 2 were less frequent. Laboratory changes were accompanied by leukocytopenia, erythrocytopenia, anemia and thrombocytopenia, an increase in total protein content, ALT, AST and GGT activity. In chronic hepatitis C virus, the entropy indexes of leukocyte formula, RC, Ilimph, AI, ILG and IL ESR were increased. Positive ANAs were significantly more frequently identified than AMAs.