[Effect of hepatitis C virus genotype on viral load and clinical-laboratory characteristics of liver disease].
2010
UNLABELLED: Aim of the work was to examine the influence of HCV genotype on the clinical features of chronic hepatitis and cirrhosis. MATERIALS AND METHODS: Were examined 9.715 patients under treatment in hospital gastroenterological for the presence of hepatitis C virus. In 365 patients was found HCV RNA. At 210 patients was performed genotyping. Was performed a quantitative analysis of 193 patients. There were determined cytolytic syndrome (ALT, AST), cholestatic (alkaline phosphatase, bilirubin), the activity of GGT in the blood of patients by biochemical markers. RESULTS AND DISCUSSION: The frequency of virus infection, confirmed by PCR analysis of data from this group of patients was 3.7% (95% CI 3.3-4.1). Occurrence of genotypes of hepatitis C was for 1 genotype 61.4% (54.7-68.1, 95% CI) for the 2-th genotype--10.9% (6.7-15.2; 95% CI) and the third genotype--at 27.6% (21.5-33.7, 95% CI). Viral load was significantly higher (p < 0.05) at 3-m type of HCV and was amounted to 8.08 +/- 15.6 million IU, compared with patients with 1st and 2nd genotype: 4.5 +/- 11.3 and 3.7 +/- 10.3 MIU. Also among patients with genotype 3 HCV viral load was (more than 800 thousand IU/ml) significantly more frequent in 50% of patients, whereas among patients with genotype 1 HCV, such patients was 22% and from 2 th HCV genotype--26% (chi2 = 13.0, p = 0.001). Significantly more frequent among patients with viral load more than 2.5 million IU/l at men (Fisher's test p = 0.03), as men often had the third genotype of hepatitis C (p < 0.005). Genotype was not significantly affected the performance of cytolytic and cholestatic syndromes. In patients with low viral load (less than 800 thousand IU/ml) was significantly less pronounced cytolytic syndrome, ALT was significantly lower (p < 0.05), the AST activity of reliable statistical difference was noted. Also significantly under high viral load (more than 800 thousand IU/ml) was higher than the activity of GGT (p < 0.05). CONCLUSIONS: Thus, our data showed that among the patients in our hospital were more prevalent third genotype of hepatitis C virus than among the population of the Russian Federation. Gender particular occurrence of the third genotype require further study to clarify the role of gender or other factors, concomitant increase in its prevalence. The presence of the third genotype of hepatitis C virus was accompanied by a high viral load, and probably an additional toxic effect on hepatocytes.
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