Clinical Manifestations in Patients with Genotypes 1 and 3 of Viral Hepatitis C, Depending on the Severity of Liver Fibrosis

Abstract

Aim: to compare the clinical manifestations in patients with genotypes 1 and 3 of viral hepatitis C (HCV) depending on the severity of liver fibrosis (LF). Study Design: a comparative study of randomized groups of patients treated in an inpatient or outpatient setting. Materials and methods. A total of 297 patients with HCV genotype 1 and 231 patients with HCV genotype 3 were examined. The diagnosis of chronic viral hepatitis C was established according to the recommendations of the European Association for the Study of the Liver. All patients underwent clinical and biochemical blood tests, ultrasound examination of the liver and pancreas. LF was studied by shear wave transient elastometry with METAVIR score. Results. Severe LF was associated in both groups of patients with an increase in the frequency of liver complaints, hepatomegaly and splenomegaly, an increase in the content of bilirubin and alanine aminotransferase in the blood, a decrease in the number of platelets and the concentration of albumin in the blood. Only in patients with HCV genotype 3 was an increase in viral load and a trend towards a decrease in the proportion of neutrophils in the blood in patients with stages 3–4 LF compared with 0–2 stages of LF according to METAVIR. Conclusion. We think that the explanation for the higher incidence of severe LF in patients with HCV genotype 3 is probably a more significant deformation of the immune response, leading to an increase in viral load and an aggressive course of pathology. Keywords: viral hepatitis C, virus genotype, liver fibrosis, clinical manifestations.