Bondaruk I. Effectiveness of antiviral therapy in patients with chronic viral hepatitis C (CHC) taking into account the markers of fibrosis

The dissertation is devoted to the research of the predictors of the effectiveness of treatment of patients with CHC on the dynamics of direct and indirect markers of fibrosis. In the dissertation the frequency of persistent virological response (PVR) in patients with CHC is established depending on age, sex, duration of disease, viral load. Clinical and laboratory features of the course of CHC depending on the response to antiviral therapy (AVT) are determined. The diagnostic role of hyaluronic acid (HA) content in serum, as a marker of liver fibrosis, in patients with CHC, was investigated. A comparative evaluation of the effectiveness of methods of diagnosis of fibrosis in patients with CHC. We also found changes in the level of HA in serum in patients with chronic hepatitis C with the 1st genotype of the virus during the AVT and at the stage of subsequent observation. A decrease in the level of HA in serum was found to be 1.06 times at the end of treatment and 1.09 times after 24 weeks of observation. An increase in the number of non-responders by 4.2 times among patients with chronic hepatitis C with a level of HA in serum> 70 ng / ml proves the effect of the level of HA in serum from patients with chronic hepatitis C on the results of triple AVT. It was found that there is a direct strong correlation between the value of HA level (according to the degree of liver fibrosis) and the stage of triple AVT (r = 0.92; p <0.05).It was determined that in patients with CHC with no or initial signs of liver fibrosis (F0 - F2) the diagnostic efficiency of the method for determining the level of HA in serum is higher than the method of FEG (AUC = 0.914 against AUC = 0.817 (p<0.05)).