Dyachenko P. Clinical and pathogenetic features and optimization of therapy for patients with chronic hepatitis C

Dissertation for the scientific degree of Candidate of medical sciences on speciality 14.01.13 - Infectious diseases. - State establishment "L.V. Gromashevsky Memorial Institute of Epidemiology and Infectious diseases of AMS Ukraine", Kyiv, 2009. Dissertation is devoted to the problems of pathogenesis of chronic hepatitis C. It is well-proven that chronic HCV-infectious is closely associated with violation of balance of regulator cytokines, which arises up as a result of weak and uneffective immune answer of the virus specific Th1 clones of lymphocytes, that in the turn, is a result of the some reasons among which infection and defeat of major immunocytes of the first line of immune answer, virus produced inhibitors of differentiation of naive Th lymphocytes, suppression of apoptosis of the virus infected cells and his stimulation in the relation of effectors of immune answer, forming of numerous quasispecies in a that patient which results in exhaustion of the immune system and anergy. It is routinedthat expression of cytokines of both clones of Т-helpers rises at HCV. A chronic infection causes the increase of blood serum concentration of basic proinflammatory cytokines IL-1, TNF, and IL-6. Stimulation of mononuclear cells of peripheral blood (MPC) by virus specific antigens resulted only in the insignificant increase of basic cytokines synthesis in vitro, that lead to exhaustion of adaptation mechanisms of immune answer and falling of anti-virus reactivity. The analysis of possibility to use roncoleukin for treatment of CHC showed him good bearableness, absence of serious side effects, comparatively high antiviral activity. A biochemical answer was attained for all patients who got the combined therapy (IFN plus roncoleukin), an early virologic answer was attained in 70 % patients.