Features of clinical, biochemical, and sonographic parameters in patients with chronic viral hepatitis C with concomitant non-alcoholic fatty liver disease

Abstract

Difficulties encountered in treating patients with chronic viral hepatitis C (CHC) are associated with the presence of concomitant liver pathology, namely, fatty degeneration which contributes to the progression of HCV infection. The above circumstances prompted the authorsled to thoroughly examine this category of patients for further development of a new pathogenetically directed course of treatment. Objective. The aim of the study was to investigate the clinical, biochemical, and instrumental features of the course of liver disease in CHC patients with concomitant non-alcoholic fatty liver disease (NAFLD). Materials and method. The study included 339 patients with chronic hepatitis C with concomitant NAFLD, and 175 patients with СНС. Methodology: anamnestic, anthropometric and clinical, general clinical, biochemical, serological, and molecular genetic (markers of hepatitis C virus, HCV RNA PCR (qualitative and quantitative determination, genotyping), enzyme-linked immunosorbent assay, ultrasonographic examination of digestive organs, and statistical methods were used. Results. The clinical, instrumental, and laboratory studies showed that CHC patients with concomitant NAFLD are characterized by various disorders – a violation of the functional state of the liver, a violation of carbohydrate and lipid metabolism, an imbalance of the cytokine system, as well as the presence of histological and non-inflammatory activity in the liver. Conclusions. The presence of concomitant NAFLD in patients with CHC aggravates the clinical picture, manifesting itself in a significant lipid metabolism disorder that provokes the rapid formation of liver fibrosis. An additional complicating factor is the development of insulin resistance, leading to persistent morphological changes in the liver parenchyma.