Bondar O. Clinicomorphological Manifestations and Indices of Immune Response in Patients with HCV-infection.

The thesis is devoted to studying the clinicopathogenetic and prognostic importance of the immune response indices in HCV-infection. The results are presented of clinical, laboratory and instrumental investigation of patients with HCV-infection: acute hepatitis C, latent and manifested forms of chronic hepatitis C, mixed HBV/HCV hepatitis. We have carried out studying the content of the main sub-populations of peripheral blood lymphocytes and the level of serum IFN-alfa depending on the disease forms; the analysis of the interrelation between morphological changes in liver and immune response indices in patients with chronic hepatitis C; the comparison of the immunological investigation results with the clinical efficiency of treating the patients. The investigation has revealed the formation of secondary cellular immune deficiency in HCV-infection; the dependance of immunological disorders on disease forms; the reliable reverse relation between the activity degree histological index and the CD4+ and CD8+ lymphocyte content, the direct relation between the activity degree histological index and the IFN-alfa level, between the liver fibrosis development and the CD20+ lymphocyte content. The therapeutic effect depended on the immune response indices dynamics. As far as the development of biochemical and virological remission in patients with chronic hepatitis C is concerned the most prognostically important, on the therapy background, was the increase of the CD4+ lymphocyte content.