Dependence of changes in hematological and integrative parameters in patients with chronic viral hepatitis C on the received antiviral therapy
Keywordschronic viral hepatitis C, clinical blood test, biochemical blood test, integrative parameters, immunity
A total of 287 patients were treated with various antiviral therapy options: group I – basic (pathogenetic and symptomatic) therapy, group II – pegylated interferon in combination with ribavirin, group III – pegylated interferon with ribavirin and sofosbuvir, group IV – direct-acting antivirals. Patients with chronic viral hepatitis C (CVHC) before the start of treatment showed a decrease in platelet counts, segmented neutrophils and an increase in level of lymphocytes, bilirubin content, alanine aminotransferase activity, aspartate, transferrinase (practice), with a comparison group (practically virus-free patients) <0.05. After 4 weeks of receiving interferon-containing therapy, a further decrease was observed: leukocyte count, erythrocyte count, platelet count; ALT, AST and gamma-glutamyltranspeptidase (GGTP) activity; increased erythrocyte sedimentation rate (ESR), bilirubin content, and bilirubin activity p< 0.05. Patients who received direct-acting antivirals (DAAs) had a decrease in: erythrocyte count, total bilirubin content, ALT activity, AST, GGTP; increase in sed rate and the AST/ALT ratio, p <0.05. After 12 weeks of treatment, patients treated with pegylated interferon were diagnosed with a decrease in platelet count, erythrocyte count, and leukocyte count (with the exception of patients with dual therapy that experienced the slight increase of the leukocytes) with hemoglobin content, p <0.05. Also, in the group II subjects compared with week 4 decreased: the content of bilirubin and creatinine, the activity of ALT, AST, GGTP, while the De Ritis ratio increased (p <0.05). Patients in group III had lower GGTP activity than at 4 weeks and lower ALT and AST values compared with the onset of antiviral therapy (p <0.05). Patients receiving DAAs experienced a decrease in hemoglobin content; no changes in biochemical parameters at this stage compared with the previous one were established.
The investigated integrative indicators suggest changes in the immune system of patients, in particular the prevalence of cellular immunity over the humoral link and the predominance of the autoimmune component. Patients with dual and triple PVT regimens had more pronounced changes compared to patients receiving DAAs.
Hepatitis C [Electronic resource] // World Health Organization. - 2019. - Resource Access Mode: https://www.who.int/en/news-room/fact-sheets/detail/hepatitis-c
McCarthy J. J. Replicated association between an IL28B gene variant and a sustained response to pegylated interferon and ribavirin / J. J. McCarthy, J. H. Li, A. Thompson [et al.] // J. Gastroenterology. – 2010. – №6. – P. 2307–2314.
Pawlotsky, Jean-Micheletal. EASL Recommendations onTreatment of Hepatitis C 2018. Journal of Hepatology, Volume 69, Issue 2, 461 – 511.
Estes C, Abdel-Kareem M, Abdel-Razek W, etal. Economic burden of hepatitis C in Egypt: the future impact of highly effective therapies. Aliment Pharmacol Ther 2015;42(6):696–706.
Wittenborn J, Brady J, Dougherty M, etal. Potential epidemiologic, economic, and budgetary impacts of current rates of hepatitis C treatment in Medicare and non-Medicare populations. Hepatol Commun 2017;1(2):99–109.
VanderMeer AJ, Veldt BJ, Feld JJ, Wedemeyer H, Dufour JF, Lammert F, etal. Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis. JAMA 2012;308:2584–2593.
Bruno S, DiMarco V, Iavarone M, Roffi L, Crosignani A, Calvaruso V, etal. Survival of patients with HCV cirrhosis and sustained virologic response is similar to the general population. J Hepatol 2016;64:1217–1223
Nahon P, Bourcier V, Layese R, Audureau E, Cagnot C, Marcellin P, etal. Eradication of hepatitis C virus in fection in patients with cirrhos is reduces risk of liver and non-liver complications. Gastroenterology 2017;152:142–156, e2
Salomone F, Catania M, Montineri A, Bertino G, Godos J, Rizzo L, Magrì G, LiVolti G. Hepatitis C viruse radication by direct antiviral agents improves glucose tolerance and reduces post-load insulin resistance in nondiabetic patients with genotype 1. Liver Int [Internet]. 2018;38(7):1206-11. Available from: www.scopus.com
Vukovic VR, Baskic D, Mijailovic Z, Djurdjevic P, Jovanovic D, Mitrovic S, Popovic S, Popovski-Jovicic B. Hepatitis C therapy-related haematological side effects are associated with treatment outcome. Serb J Exp Clin Res [Internet]. 2016;17(1):9-14. Available from: www.scopus.com
Sulkowski MS, Wasserman R, Brooks L etal. Changes in hemoglobin during interferon alfa-2b plus ribavirin combination therapy for chronic hepatitis C virus infection. J Viral Hepat 2004; 11: 243-50.
Sulkowski M. Management of the hematologic complications of hepatitis C therapy. Clin Liver Dis 2005; 9:601-16.
Soza A, Everhart JE, Ghany MG etal. Neutropenia during combination therapy of interferon alpha and ribavirin for chronic hepatitis C. Hepatology 2002; 36: 1273-9.
Elsharkawy A, Eletreby R, Fouad R, Soliman Z, Abdallah M, Negm M, Mohey M, Esmat G. Impact of differents of osbuvirbased treatment regimens on the biochemical profile of chronic hepatitis C genotype 4 patients. Expert Rev Gastroenterol Hepatol [Internet]. 2017;11(8):773-8. Available from: www.scopus.com
Hodlevsyi A.A., Savoliuk S.I. Diagnostica ta moniyoring endotoksikosu u khirurgichnikh khvorikh : monografia [Diagnostics of endotoxicosis in surgical patients]. – Vinnitsa : Nova Knyha, 2015. – 232 p.
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