CLINICAL AND LABORATORY FEATURES OF THE COURSE OF CHRONIC VIRAL HEPATITIS B AND C IN CHILDREN OF PODILSKY REGION: POSSIBILITY FOR MODERN MONITORING

Abstract

Introduction. In modern hepatology, a special place is occupied by chronic viral hepatitis, including B and C, because today they occupy the leading positions due to their high prevalence, the possibility of severe complications, and also they could lead to death in both adults and children. Specialists should have a comprehensive understanding of the clinical course and laboratory diagnosis of viral hepatitis to facilitate timely diagnosis and effective management of this condition.
 The aim: to evaluate the clinical and laboratory features of the course of chronic viral hepatitis B and C in children by determining patterns between parametric indexes characterizing the processes of liver fibrosis.
 Materials and methods. In the process of scientific research, 49 children were examined, including 29 children with diagnosed chronic viral hepatitis B and C (group I) and 20 almost healthy children (group II). The diagnoses of CHB and CHC were confirmed by the PCR method and specific markers detected by ELISA. All examined patients underwent anamnesis collection, general clinical examination, laboratory examination, calculation of CDS, Lok, GUCI, APRI, FIB-4 and "Fibrotest" diagnostic indexes. Statistical data analysis was carried out with "R-Studio" and "Statistica 10.0" software, using the methods of descriptive statistics, correlation analysis. Significance was considered significant at p<0.05. The study was conducted in compliance with the principles of the Declaration of Helsinki.
 Results. It was established that the levels of ALT, AST, GGT, ALP, indirect bilirubin, international normalized ratio (INR) were significantly higher in the examined patients of the I group. The level of the CDS index was significantly higher in the examined patients of the I group (5,97±0,30), compared with the patients of the II group (4,35±0,28) (p<0,001). A similar trend was noted with the Lok index and FIB-4 (p<0,001). The GUCI and APRI indices were significantly higher in patients of the I group (1,02±0,22; 0,73±0,04), compared to the examined patients of the II group (0,27±0,02; 0,23±0,02) (p<0,01).
 Conclusions. Implementation of non-invasive indices into clinical practice for the management of children with chronic hepatitis B and C will allow for dynamic monitoring of liver fibrogenesis processes.