Chronic hepatitis С and non-alcoholic fatty liver disease. Main aspects of pathogenesis

Жданов, К. В.; Karyakin, S. S.; Козлов, К. В.; Гусев, Д. А.; Сукачев, В. С.; Saulevich, A V; Yaremenko, M V; Кижло, С. Н.; Shahmanov, D M; Lobzin, D. Yu.; Куртуков, М. В.; Dzheriev, M A

doi:10.17816/brmma12326

Cited by 3 publications

(2 citation statements)

References 36 publications

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“…В настоящее время более 350 миллионов человек хронически инфицированы вирусом гепатита B и около 1 миллиона людей ежегодно умирает от последствий вирусного гепатита В, приблизительно 130-170 миллионов в мире инфицированы вирусом гепатита С [3,6].В Российской Федерации гемоконтактные вирусные гепатиты В и С широко распространены, общее число больных ХГВ и носителей HBsAg составляет около 5 млн, число больных хроническим гепатитом С и носителей вируса гепатита С -не менее 2 млн человек [3].…”

Section: Introductionunclassified

“…Результаты проведенных исследований свидетельствуют о важном значении передачи HBV в условиях семьи: суммарное количество лиц с маркерами HBV-инфекции составило 57,8 %. Наши данные о высокой эпидемиологической опасности больных хроническим ГВ в целом согласуются с результатами авторов, проводивших аналогичные исследования [3,7].…”

Section: Introductionunclassified

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Медико-Социальный Мониторинг Населения По Парентеральным Вирусным Гепатитам Как Основа Для Создания Организационной Модели Профилактики И Лечения Вирусных Гепатитов И Первичного Рака Печени В Якутии

СЛЕПЦОВА¹,

МИХАЙЛОВ²,

ЕФИМОВ³

et al. 2018

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The Republic of Sakha (Yakutia) is considered one of the most unfavorable territories of the Russian Federation for the prevalence of hemocontact viral hepatitis B, C and D, and their adverse outcomes -cirrhosis and primary liver cancer [1,4,5]. According to official statistics, in 2017, only 328 cases of chronic hepatitis B (CHB), (34.2 per 100,000 cases) and 501 cases of chronic hepatitis C (CHC) were registered (52.1 per 100,000 cases). In the structure of chronic viral hepatitis, the proportion of chronic hepatitis B and chronic hepatitis C in 2017 was 39.5 % and 60.5 %, respectively.In different parts of the republic, the incidence rates of viral hepatitis are unevenly distributed, which is related to the conditions of everyday life of the population and the remoteness of residents of the regions from the large settlements of the republic, provided with all kinds of medical and social assistance, including modern laboratories, so necessary for hard-to-reach areas of the RS(Y).Of great interest is the intrafamilial spread of viral hepatitis. In families of patients with chronic hepatitis B, the prevalence of infection was higher (77.6 %) than in the acute viral hepatitis B (39.7 %). And the risk of infection in family hearth with active replication of the hepatitis B virus was 1.5 times higher than in hearth without replication of the virus at the source of the infection.The intrafamilial distribution of HCV-infection was less intense. Most often, markers of viral hepatitis C were detected among the spouses of infected (in 35.1 ± 7.9 % of cases).It is necessary to further modernize the system of providing the population with quality medical care, the implementation of national programs and directions for vaccination of the population against viral hepatitis B, early detection and timely antiviral treatment of patients with chronic viral hepatitis B, C and D for the prevention of cirrhosis and liver cancer, improving epidemiological surveillance for parenteral viral hepatitis in the region and dynamic monitoring of patients and their families.

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Section: Introductionunclassified

Медико-Социальный Мониторинг Населения По Парентеральным Вирусным Гепатитам Как Основа Для Создания Организационной Модели Профилактики И Лечения Вирусных Гепатитов И Первичного Рака Печени В Якутии

СЛЕПЦОВА¹,

МИХАЙЛОВ²,

ЕФИМОВ³

et al. 2018

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Extrahepatic manifestations of chronic viral hepatitis C

Kryukov

Черкашин

Салухов

et al. 2022

Bulletin of the Russian Military Medical Academy

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Chronic viral diseases of the liver are frequently characterized by clinical signs of intrahepatic complications. Infection caused by the hepatitis C virus should be considered as a systemic disorder associated with the frequent development of various extrahepatic complications, such as cryoglobulinemia, glomerulopathy, lymphoproliferative diseases, seronegative arthritis, type 2 diabetes mellitus, lichen planus, and late cutaneous porphyria. Often, extrahepatic complications become the main features of the clinical disease picture, forcing patients to seek medical help from various specialists and delaying diagnosis. In some cases, the treatment of extrahepatic manifestations becomes an independent, complex task, surpassing the actual treatment of chronic hepatitis C. The relationship between hepatic and extrahepatic complications of viral hepatitis C is not linear; rather, extrahepatic manifestations often outstrip the development of liver damage. The effects of hepatitis C virus on the organs and systems of the body are caused by the direct action of the virus, pathogenetically induced by the development of steatosis/steatohepatitis, and by the disruption of system regulation of hepatokines and cytokines. Treatment of chronic hepatitis C virus infection should be comprehensive and should include antiviral therapy, treatment of metabolic-associated fatty liver disease and treatment of hepatic-related disorders. Antiviral therapy with preparations of direct antiviral action allows the prevention of not only liver complications but also of many extrahepatic complications of hepatitis C virus. Comorbid states significantly increase the natural progression of chronic hepatitis C infection and vice versa: the hepatitis C virus increases the clinical manifestations of co-pathology. In the age of direct antiviral drugs, it is possible to eliminate the hepatitis C virus, but in some cases, elimination alone does not arrest the progression of liver disease.

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Assessment of body mass index in patients with chronic hepatitis C who received an effective antiviral therapy

Dudina,

Belyy,

Maev

et al. 2023

Terapevticheskii arkhiv

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Aim. To evaluate the body mass index (BMI) in patients with chronic hepatitis C (CHC) with different stages of liver fibrosis and steatosis who received effective antiviral therapy (AVT). Materials and methods. The study included 278 CHC patients with a sustained virologic response (SVR) at the end of treatment. In addition to assessing the investigational data to determine the clinical status of the patient, we calculated BMI (following the World Health Organization guidelines) and determined the severity of liver fibrosis (F) and steatosis (S) using transient elastography. The patients were assessed at the start of antiviral therapy, after 6 months from the moment SVR was confirmed, and then every 12 to 24 months. Results. By the end of the study, the mean patient age was 49 years, 53% of them were men, and 34% of the patients were obese. Excessive weight gain was registered in 17% (n=48) of the cases, with 60% newly diagnosed with Class 1 to 2 obesity. Both before the start of AVT and years after reaching SVR, the mean BMI corresponded to the reference pre-obesity values, the liver steatosis was significantly more often absent in normal BMI; on the contrary, fatty liver (predominantly S2 to S3) was registered in individuals with elevated BMI (p0.0001). After the long-term period following a successful therapy, Stage F4 liver fibrosis patients were mainly diagnosed with obesity (80% versus 44% before AVT; p=0.0010). Conclusion. The high proportion of patients with elevated BMI and liver steatosis seen years after a successful CHC therapy indicates a continued risk of progression of chronic liver disease. Such patients should be advised on how important it is to change their lifestyle to reduce overweight and prevent weight gain. We also need long-term assessments of how liver steatosis changes over time and what are the outcomes associated with post-SVR increase in BMI.

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Chronic hepatitis С and non-alcoholic fatty liver disease. Main aspects of pathogenesis

Cited by 3 publications

References 36 publications

Extrahepatic manifestations of chronic viral hepatitis C

Assessment of body mass index in patients with chronic hepatitis C who received an effective antiviral therapy

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