Antsyferova N. Diagnostics and pharmacological correction of metabolic disorders and liver fibrosis in patients with chronic hepatitis C

Data of the clinical course features of chronic hepatitis C were presented in thesis. Place of extrahepatic manifestations of the disease at the modern stage was determined. Marker functions of matrix metalloproteinase-1 (MMP-1), transforming growth factor-beta 1(TGF-beta 1) and haptoglobin (HG) relative to liver fibrosis were identified. Correlation relations between the above parameters and F, defined by the system FibroMax (FibroTest) were established. The new approach to consideration of MMP-1, TGF-beta 1 and HG as a single unbroken interconnected system of indicators of hepatic fibrosis was obtained. Diagnostic criteria of the degree of morphological changes in the liver have been developed on the basis of the correlation analysis. Noninvasive method for estimating F in patients with CHC by determining of MMP-1, TGF-beta-1, HG levels in serum and calculation PFI with formula DFI = MMP-1/TFR-beta 1 x HG has been proposed. In the absence of fibrosis (F 0) DFI is greater than 10 (10 < DFI), at F 1 DFI – from 4 to 9 (4<DFI<9), F 2 – from 3 tо 4 (3<DFI<4), F 3 – from 1 tо 3 (1<DFI<3), F 4 – always less than 1 (DFI<1). (Patent № 77104). Disturbance of lipid metabolism in serum (TG, HDL, LDL, VLDL) against the CHC has been shown. Lack of correlation between the above parameters and F, determined by the system FibroMax (FibroTest) was proved. Evaluated the influence of combination antiviral therapy and drugs ursodeoxycholic acid when combined and separate use of clinical indicators, the state of lipid metabolism and liver fibrosis in patients with chronic hepatitis C.