Analysis of long-term results of effective etiotropic therapy of chronic hepatitis C


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Resumo

The existence of occult hepatitis C virus (HCV) infection in the general population and in selected clinical groups is covered in the literature, but its consequences in various clinical situations require further study. The aim of the study was to evaluate the long-term outcomes of chronic hepatitis C after successful antiviral therapy. Material and methods. In patients with chronic hepatitis C (n=182), clinical and laboratory parameters and liver density were compared at the start of therapy and at the end point of follow-up (median follow-up of 99 weeks), were tested for occult HCV infection (n=109). Results. The proportion of patients with liver cirrhosis and severe fibrosis decreased from 47% to 36%. A regression of cirrhosis occurred in 12 (24%) patients with Child-Pugh class A. A significant decrease in the FIB4 and APRI indices was recorded (p<0,05). In 27 (14%) patients, negative dynamics was observed (progression of fibrosis, n=17; decompensation of the cirrhosis, n=3; portal vein thrombosis, n=2; development of hepatocellular carcinoma, n=5) associated with higher AFP, FIB4, comorbidity index level. Occult HCV infection was detected in 5,5%. Conclusion. In patients with severe fibrosis and liver cirrhosis, the risk of fibrosis progression, decompensation of the cirrhosis and the development of HCC after the eradication of hepatitis C virus remains. Further studies on risk stratification are required to optimize dispensary follow-up after antiviral therapy.

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Sobre autores

Elena Esaulenko

Saint Petersburg State Pediatric Medical University of the Ministry of Healthcare of Russia; Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology of Rospotrebnadzor

Email: eve-gpmu@mail.ru
Dr. med. habil., professor, head of the Department of infectious diseases of adults and epidemiology

Alexandra Dzemova

Saint Petersburg State Pediatric Medical University of the Ministry of Healthcare of Russia; Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology of Rospotrebnadzor

postgraduate student at Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology of Rospotrebnadzor, assistant at the Department of infectious diseases in adults and epidemiology

Kseniya Novak

Saint Petersburg State Pediatric Medical University of the Ministry of Healthcare of Russia

PhD in Medicine, associate professor of the Department of infectious diseases in adults and epidemiology

Anastasia Bushmanova

Saint Petersburg State Pediatric Medical University of the Ministry of Healthcare of Russia; Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology of Rospotrebnadzor

PhD in Medicine, assistant at the Department of infectious diseases in adults and epidemiology

Yulia Ostankova

Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology of Rospotrebnadzor

PhD in Biology, head of Laboratory of virology and immunology of HIV infection

Diana Valutite

Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology of Rospotrebnadzor

doctor of clinical laboratory diagnostics at the Department for diagnosing HIV infection and AIDS-related diseases

Yulia Chernoguz

Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology of Rospotrebnadzor

biologist at the Department for diagnosing HIV infection and AIDS-related diseases

Elena Zueva

Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology of Rospotrebnadzor

PhD in Biology, senior researcher at the Laboratory of experimental virology

Elena Yushina

S.P. Botkin Clinical Infectious Hospital

infectious disease specialist, head of the Day Hospital Department

Natalia Tyurenkova

S.P. Botkin Clinical Infectious Hospital

PhD in Medicine, infectious disease specialist, head of the Department of diagnostic observation

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