Clinical and laboratory characteristics of liver cirrhosis in the outcome of chronic hepatitis C at the modern viewpoint

Chronic hepatitis C (CHC) remains a pressing healthcare problem, including due to the high risk of developing liver cirrhosis (LC), which is associated with high mortality from complications and leads to the need for liver transplantation.

The aim: to present the current clinical and laboratory characteristics of LC as a result of CHC and to analyze them depending on the degree of compensation of the pathological process.

Material and methods. Data from 65 patients with LC in the outcome of CHC, divided into classes according to the Child – Pugh scale, were analyzed. All participants underwent a comprehensive examination. Obtained data were compared between the groups and with a group of apparently healthy individuals.

Results. Almost half of the patients (44.6%) had decompensated LC (class C). Males predominated among all examined persons (61.5%), and genotype 1 of the hepatitis C virus (HCV) was the most common (55.6%). A high frequency of comorbidities (87.7%) was fixed in the observed patients, as well as a statistically significant increase in the proportion of gastrointestinal and cardiovascular diseases in case of decompensated liver cirrhosis. With the progression of cirrhosis from class A to class C, the frequency of the absence of specific complaints and clinical symptoms significantly decreased, while the prevalence of abdominal pain, jaundice, urine discoloration, peripheral edema, and ascites significantly increased. According to laboratory data, the highest levels of alanine aminotransferase and aspartate aminotransferase were characteristic of class A cirrhosis, while bilirubin concentrations, its fractions, and the international normalized ratio increased significantly with disease progression, while albumin levels and the prothrombin index decreased with the transition to class C.

Conclusion. Clinical picture and laboratory indexes are directly depending on the class of liver cirrhosis. Compensated cirrhosis is often asymptomatic, so laboratory tests play a key role in its diagnosis. In decompensated cirrhosis, symptoms associated with hepatocellular insufficiency and portal hypertension are predominating. Regular monitoring of clinical and laboratory changes allows for an objective assessment of the severity of patients’ condition, promptly identifying the development of liver cirrhosis decompensation, and timely initiating treatment.