Koval T. HIV infection and chronic hepatitis C in coinfected patients: clinical-epidemiological description and optimization of therapeutic and diagnostic tactics

The dissertation considers the search for potentialities to increase the efficacy of the diagnosis and treatment of chronic hepatitis C and HIV-infection in coinfected patients considering the degree of immune suppression, TLR4 gene Asp299Gly and TLR7 gene Gln11Leu polymorphism, HCV genotype on the basis of comprehensive assessment of clinical-laboratory course, detection of the predictors of the HIV-infection and liver fibrosis progression, as well as improving the system of epidemiological surveillance in HIV/HCV coinfection. The prognosis of the of HIV-infection and chronic hepatitis C epidemy in the Poltava region up to 2020 has been developed and approaches to the improvement of the system of epidemiological surveillance for HIV/HCV coinfection have been suggested. The prevalence of the carriage of the TLR4 gene 299Gly and TLR7 gene 11Leu polymorphic alleles among HIV-infected people with chronic hepatitis C and their impact on the progress of coinfection has been studied. The comprehensive study of the clinical and laboratory characteristics and the rate of HCV-related fibrosis progression in HIV-infected individuals with regard of the degree of immune suppression, TLR4 gene Asp299Gly and TLR7 gene Gln11Leu polymorphism, HCV genotype have been performed. Clinical-genetic risk factors of rapidly progressive HCV-related liver fibrosis in HIV-infected people have been identified. The efficacy of antiviral therapy of chronic hepatitis C in HIV patients with interferon schemes has been evaluated and clinical-genetic predictors of its low effectiveness have been defined. The clinical and laboratory characteristics of HIV infection depending on the presence of HCV-coinfection and TLR4 gene Asp299Gly and TLR7 gene Gln11Leu polymorphism have been analyzed. The clinical-genetic predictors of rapid progression of HIV infection to clinical stage IV and the efficacy of ART have been elucidated.