doiSerbia

Association between risk factors, basal viral load, virus genotype and the degree of liver fibrosis with the response to the therapy in patients with chronic hepatitis C virus infection

Vuković Vuk R. (Garrison Clinic, Kragujevac)
Baskić Dejan (Faculty of Medicinal Sciences, Center for Molecular Medicine and Stem Cell Research, Kragujevac + Public Health Institute of Kragujevac, Kragujevac)
Mijailović Željko (Clinical Center of Kragujevac, Department of Infectious Diseases, Kragujevac)
Đurđević Predrag (Clinical Center of Kragujevac, Department of Hematology, Kragujevac)
Jovanović Danijela (Clinical Center of Kragujevac, Department of Hematology, Kragujevac)
Mitrović Slobodanka (Faculty of Medicinal Sciences, Center for Pathological Anatomy, Kragujevac)
Popović Suzana (Faculty of Medicinal Sciences, Center for Molecular Medicine and Stem Cell Research, Kragujevac)

Background/Aim. Hepatitis C is an important sociomedical problem worldwide due to frequent progression to chronic disease, occurrence of liver cirrhosis and hepatocellular carcinoma. Standard pegylated interferon alfa 2a plus ribavirin therapy results in resolution of infection only in 50% of patients. The aim of this study was to determine the association of various factors with response to the therapy in patients with chronic hepatitis C virus (HCV) infection. Age and sex of patients, inoculation risk factors, histopathological changes in the liver, viral load and HCV genotype were analyzed. Methods. The study included a group of 121 patients with chronic HCV infection. The treatment was carried out 24 weeks for virus genotype 2 and 3, and 48 weeks for genotype 1 and 4. The degree of histopathological changes in the liver was determined by hematoxylin and eosin staining, whereas polimerase chain reaction was used for HCV genotyping. Results. In the group of non-responding patients genotype 1 was represented with 100%, while in the other groups, although predominantly present, its percentage was lower. Unresponsiveness to therapy and relapse of disease were associated with higher viral load and advanced fibrosis. Intravenous use of psychoactive substances, as a risk factor, was present in a high percentage in the group of patients with sustained response, while blood transfusion and dialysis were leading risk factors in the group of relapse responders and non-responders. Conclusion. The results of our study showed that the treatment outcome of chronic HCV infection was associated with baseline HCV ribonucleic acid, HCV genotype, route of infection and the degree of histopathological changes in the liver.

Keywords: hepatitis C, hepatitis, chronic, treatment outcome, risk factors, genotype, histological techniques, disease transmission, infections

Projekat Ministarstva nauke Republike Srbije, br. III41010