Mostovenko R. Pathogenic role of iron metabolism in the progression of chronic hepatitis C in children.

The thesis covers the issues of the improvement of treatment of chronic hepatitis C in children by examining the impact of iron metabolism on the progression of the pathological process in the liver and the effectiveness of antiviral therapy. It is established that HCV in children is mainly oligosymptomatic, of a subclinical course and is accompanied by active fibrogenesis. The peculiarities of iron metabolism in children with HCV are analysed and it is determined that more than one third of patients suffer from iron overload syndrome and isolated hyperferritinemia, not connected with the mutation of inherited hemochromatosis gene. The morphological peculiarities of iron storage in liver tissue and its impact on the hepatitis activity and degree of fibrosis are studied. Ultrasound markers of fibrosis in children with HCV are determined, as well as the dependence of their number and activity on the peculiarities of ferrokinetics and the duration of the disease. The peculiarities of oxidative stress in children with chronic hepatitis C are specified in terms of indices of oxide modification of proteins and their dependence on disorders of iron metabolism is determined. A method of noninvasive diagnostics of advanced fibrosis in children with chronic hepatitis C by determining the parameter PAC is offered. The influence of iron metabolism on the effectiveness of antiviral therapy in children with CHC is studied. The algorithm for diagnostics of iron overload syndrome and antiviral therapy tactics based on the presence or absence of this syndrome is elaborated, which will improve the effectiveness of treatment of chronic hepatitis C in children.