Tsarova O. Clinical and diagnostic criteria of chronic viral hepatitis B and C progression in children.

The thesis is devoted to improving the efficiency of diagnostics of liver fibrosis in children with chronic hepatitis B (CHB) and C (CHC) by investigating the characteristics of their progression depending on the etiology, duration of illness, viral load, hepatitis activity and polymorphism of the gene IL-28B. It was established that genotype 1 of the virus and duration of disease in children with CHC influence the process of fibrosis in liver, and HBeAg negative status and the activity of the inflammatory process contributes to the progression of fibrosis in liver in children with CHB. The genotype TT and CT (rs12979860), TG/GG (rs8099917) of the gene IL-28B are unfavorable in terms of the progression of fibrosis in patients with CHC. In patients with CHB the more active fibrogenesis occurred in patients with genotype CT/TT (rs12979860) of the gene IL-28B only in immunoactive phase and in the phase of avoiding the immune response. The diagnostic criteria and predictors of the progressive course of CHB and CHC in children were established. The algorithms of diagnostic measures were developed which allow to diagnose expressive fibrosis without a biopsy in children with CHC and B and to determine the need of antiviral therapy.