Aim. To study the clinical and immunological features of the course of chronic hepatitis C (CHC) in patients with an unfavorable comorbid background. Materials and methods. The study included 700 patients with CHC, followed up in the period from 2013 to 2019 in Botkin Clinical Infectious Diseases Hospital (St. Petersburg). A comparison of immunological features in 79 patients was carried out, depending on the presence or absence of comorbidity, the immunological profile (the concentrations of cytokines/chemokines were determined: tumor necrosis factor α, interferon γ, CCL20/MIP-3α, CXCL9/MIG, CXCL10/IP-10, CXCL11/ITAC in blood plasma by multiplex analysis) was specifically studied in persons with diseases of the gastrointestinal tract and pancreas, pathology of the cardiovascular system and endocrine diseases, compared with the indicators of a group of conventionally healthy individuals. Results. Comorbidity was present in 63% of patients with CHC, among whom multimorbidity was found in 79.4%. The most common comorbidities were diseases of the gastrointestinal tract and pancreas – 49% of cases, diseases of the circulatory system – 15.4%, and pathology of the endocrine system and metabolism – 13.9%. In the group of patients with comorbidity, the concentrations of the chemokines CXCL9/MIG and CCL20/MIP-3α were determined, which were 2 and 1.6 times higher than those in the group without concomitant diseases (p=0.017). Also, both of these indicators significantly exceeded normal values (p<0.05). When analyzing the chemokine profile in patients in various subgroups, a significant excess of CCL20/MIP-3α concentration was revealed in the subgroup with endocrine diseases (p<0.05). Conclusion. Patients with CHC have a high prevalence of comorbidity and multimorbidity. The cytokine profile showed high concentrations of CCL20/MIP-3α and CXCL9/MIG chemokines in the group of patients with concomitant pathology in comparison with patients without it, and a predominance of the CCL20/MIP-3α chemokine concentration in patients with endocrine pathology, including diabetes 1 and 2 type.
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