Potii V. Natural history and possible strategies of the elimination of hepatitis C virus

The dissertation is devoted to the investigation of the natural history and the development of strategies for the elimination of hepatitis C virus (HCV) infection in Ukraine.Epidemiological features of acute hepatitis B (AGB) and C (AGC) were studied in 4358 patients, natural history of CHC in 1654 patients including 142 patients with LC. 987 patients were determined the stage of fibrosis and hepatitis activity by non-invasive methods of the examination or biopsy, genotyping of HCV was performed in 667 patients. It has been established that the main components of the burden of HCV in Ukraine are a large number of infected people (1.3 million according to the data of epidemiological studies), 33 % of them have severe forms of fibrosis or cirrhosis, there is a high level of mortality (30 to 100 000 population). Predicted unfavorable population factors include the prevalence among infected men (61 %), infection with chronic hepatitis at a young age (in 63.3 % that occurs at the age of 16 to 30 years), early formation of severe forms of fibrosis / cirrhosis (31 % of patients compose the people who are younger than 60 years). The most significant factors that influence the progression of fibrosis were age (r = 0.37, p < 0,05), sex (p < 0,05) and hepatitis activity (r = 0.6, p <0,05). The logistic regression equation that connects these indicators can be used to predict the dynamics of fibrosis and to determine the patient’s position in the waiting list for antiviral therapy.