Kalashnyk K. Interleukin gene polymorphism diagnostic significance in the development of mixed cryoglobulinemia in chronic hepatitis C and predicting the effectiveness of antiviral treatment.

To improve the early diagnosis of mixed cryoglobulinemia and predict the effectiveness of antiviral treatment (AVT), a comprehensive examination of 149 patients with chronic hepatitis C (CHC), who were registered at the hepatocenter Municipal Institution «Regional Infectious Diseases Clinical Hospital» Zaporozhye Regional Council. All patients underwent laboratory and instrumental studies according to the Unified Protocol of the Ministry of Health of Ukraine. Special studies included the determination of the IL-6 gene (rs 1800795) and IL-17 (rs 612242) single nucleotide polymorphisms (SNPs) by PCR; quantitative content of IL-6, IL-17, rheumatoid factor (total, IgM, IgA) in serum by ELISA; content of mixed cryoglobulins in blood serum by spectrophotometric method, which were carried out on the basis of the Scientific medical-laboratory center of Zaporizhzhya State Medical University. Among the examined patients with CHC were 98 (65,8 %) men and 51 (34,2 %) women. The duration of documented CHC ranged from 1 to 21 years with a median and interquartile range of 4.0 [1,0; 8,0] years. Patients with CHC were predominantly infected with 1 genotype of the virus (67,8 %) and had a high viral load (63,8 %). According to the results of the assessment of the degree of fibrotic changes in the liver, stages F2 (35,5 %) and F3 (33,6 %) prevailed. A mathematical model for predicting the success of AVT in patients with CHC (discriminant analysis) has been created. When creating the model, the five most informative laboratory indicators were identified, which are reliably associated with the success of AVT, namely the content of IL-6 and 17 in serum, rheumatoid factor IgA and rheumatoid factor IgM, the level of necrosis-inflammatory process in the liver. The proposed discriminant formula for calculating the relationship between the success of AVT completion according to the scheme peg-IFNα+RBV+SOF in patients with CHC allows to predict the probability of a SVR 24 (overall accuracy of the method – 80,0 %).