Introduction and objective:
Introduction. Difficulties encountered in treating patients with chronic viral hepatitis C (CHC) are associated with the presence of concomitant liver pathology, namely fatty degeneration, which contributes to the progression of HCV infection. The above circumstances prompted the authorsled to thoroughly examine of this category of patients for further development of a new pathogenetically directed course of treatment. Objective. To study clinical, biochemical, and instrumental features of the course of liver disease in CHC patients with concomitant non-alcoholic fatty liver disease (NAFLD).

Material and methods:
Tested 339 patients with chronic hepatitis C with concomitant NAFLD; and 175 patients with СНС. Methodology: anamnestic, anthropometric and clinical, general clinical, biochemical, serological, and molecular genetic (markers of hepatitis C virus, HCV RNA PCR (qualitative and quantitative determination, genotyping), enzyme-linked immunosorbent assay, ultrasonographic examination of digestive organs, statistical methods.

Conducted clinical, instrumental, and laboratory studies have shown that CHC patients with concomitant NAFLD are characterized by various disorders - a violation of the functional state of the liver, a violation of carbohydrate and lipid metabolism, an imbalance of the cytokine system, the presence of histological and non-inflammatory activity in the liver.

The presence of concomitant NAFLD in patients with CHC aggravates the clinical picture, manifesting itself in a significant lipid metabolism disorder that provokes the rapid formation of liver fibrosis. An additional complicating factor is the development of insulin resistance, leading to persistent morphological changes in the liver parenchyma.

Younoss Z, Papatheodoridis G, Cacoub ?, et al. The comprehensive outcomes of hepatitis C virus infection: A multi-faceted chronic disease. J Viral Hepat. 2018; 25(Suppl. 3): 6–14.
Sierpińska L, Jaworski S. Hepatocellular carcinoma inpatients with chronic hepatitisC–casestudy. J Educ Healthand Sport. 2022;12(3):229–237.
WHO. World Hepatitis Day 2019. News bulletin. July 2019.
Adinolfi LE, Rinaldi L, Guerrera B, et al. NAFLD and NASH in HCV Infection: Prevalence and Significance in Hepatic and Extrahepatic Manifestations. Inter J Molecular Sci. 2016;6(17):803.
Kralj D, Jukić LV, Ljević SS, et al. Hepatitis C Virus, Insulin Resistance, and Steatosis. J Clin Transl hepatol. 2016;4(1):66–75.
Mangia A, Ripoli M. Insulin resistance, steatosis and hepatitis C virus. Hepatol Int. 2013;7:782–789.
Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease. Metaanalytic assessment of prevalence,incsdence, and outcomes. Hepatol. 2016;64:73–84.
Patil R, Sood GK. Non-alcoholic fatty liver disease and cardiovascular risk. World J Gastrointestinal Pathofhysiol. 2017;8(2):51–58.
Hartleb M, Mastalerz-Migas A, Kowalski P, Okopień B, Popovic B, Proga K, Cywińska-Durczak B. Healthcare practitioners’ diagnostic and treatment practice patterns of nonalcoholic fatty liver disease in Poland: a cross-sectional survey. Eur J Gastroenterol Hepatol. 2022;34(4):426–434.
Zemlyanitsyna OV, Dunaeva IP, Savenko VI, et al. Non-alcoholic fatty liver disease: prevalence, etiology and pathogenesis, areas of diagnosis and therapy (literature review and own data). Inter J Endocrinol. 2018;14(7):54–63.
Benedict M, Zhang X. Non-alcoholic fatty liver disease: An expanded review. World J Hepatol. 2017;9(16):715–732. v9. i16.715.
Huber Y, Boyle H, Hallsworth K, et al. Health-related Quality of Life in Nonalcoholic Fatty Liver Disease Associates With Hepatic Inflammation. Clin Gastroenterol Hepatol. 2019;17(10):2085–2092.
EASL-EASD-EASO. Clinical Practice Guidelines for the Management of Non-Alcoholic Fatty Liver Disease. Obes Facts. 2016;9(2):65–90.
Goryachkovsky AM. Clinical biochemistry in laboratory diagnostics. Odessa: Ecology; 2005. p. 616.
Handbook of laboratory diagnostics Sinevo. Kyiv: Doctor-Media; 2011.
Ciećko-Michalska I, Szczepanek M, Wierzbicka-Tutka I, Zahradnik-Bilska J, Mach T. Non-invasive diagnosis of steatosis, inflammatory changes and liver fibrosis in patients with non-alcoholic fatty liver diseases. Pilot study. Arch Med Sci Atheroscler Dis. 2018 Dec;28(3):e179-e183.
Martinou E, Pericleous M, Stefanova. Kaur V, Angelidi AM. Diagnostic Modalities of Non-Alcoholic Fatty Liver Disease: From Biochemical Biomarkers to Multi-Omics Non-Invasive Approaches. Diagnostics. 2022;12:407. 12020407.
Chaudhari R, Fouda S, Sainu A, et al. Metabolic complications of hepatitis C virus infection. World J Gastroenterol. 2021;27(13):1267–1282.
Shawky MA, Mohammed AQ, Hassan AM, et al. Insulin resistance in nondiabetic Egyptian patients with chronic hepatitis C virus. Rev Gastroenterol de Mex. 2020;85(2):173–179.
Mishra PR, Bharti A, Arora R, et al. Increased insulin resistance in hepatitis-C infection-association with altered hepatic function testing. Pathophysiol. 2022;29(3):326–332. 29030024.
Zabolotna IB, Gushcha SG, Mikhailenko VL. Non-alcoholic fatty liver disease and mineral waters of Ukraine – opportunities of application (experimental-clinical studies). Balneo Res J. 2018;9(3):270–276.
Tkach S, Chereda ?. Non-alcoholic fatty liver disease: incidence, natural history, new approaches to diagnostic and treatment. Clin Endocrinol Endocrine Surgery. 2016;1(53):60–71.
Komshilova KA, Troshina EA. Obesity and non-alcoholic fatty liver disease: metabolic risks and their correction. Obesity Metabol. 2015;12(2):35–39.
Yagmur VB, Kislova RM, Klenina IA, et al. Indicators of carbohydrate and fat metabolism in patientswith various degrees of fatty liver dystrophy. Gastroenterologia. 2022;56(1):29–33.
Miyauchi S, Miyake T, Miyazak M, et al. Insulin-like growth factor-1 is inversely associated with liver fibrotic markers in patients with type 2 diabetes mellitus. J Diabetes Investig. 2019;10(4):1083–1091.
Nakahara T, Hyogo H, Yoneda M, et al. Type 2 diabetes mellitus is associated with the fibrosis severity in patients with nonalcoholic fatty liver disease in a large retrospective cohort of Japanese patients. J Gastroenterol. 2014;49(11):1477–1484.
Paradis V, Perlemuter G, Bonvoust F, et al. High glucose and hyper-insulinemia stimulate connective tissue growth factor expression: a potential mechanism involved in progression to fibrosis in nonalcoholic steatohepatitis. Hepatology. 2001;34(4):738–744.
Yoon IC, Eun JR. Pharmacologic therapy for nonalcoholic steatohepatitis focusing on pathophysiology. Yeungnam Univ J Med. 2019 May;36 (2):67–77.
Persico M, Masarone M, La Mura V, et al. Clinical expression of insulin resistance in hepatitis C and B virus-related chronic hepatitis: Differences and similarities. World J Gastroenterol. 2009;15(4):462–466.
Negro F, Alaei M. Hepatitis C virus and type 2 diabetes. World J Gastroenterol. 2009;15(13):1537–1547.
Hui JM, Sud A, Farrell GC, et al. Insulin resistance is associated with chronic hepatitis C and virus infection fibrosis progression. Gastroenterology. 2003;125:1695–1704.
Munteanu M, Pais R, Peta V, et al. Long-term prognostic value of the FibroTest in patients with non-alcoholic fatty liver disease, compared to chronic hepatitis C, B, and alcoholic liver disease. Alimentary Pharmacol Therapeutics. 2018;48(10):1117–1127.
Tacke F, Weiskirchen R. Non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH)-related liver fibrosis: mechanisms, treatment and prevention. Annals of Translational Medicine. 2021;9(8):729.
Mirandola S, Bowman D, Hussain M, et al. Hepatic steatosis in hepatitis C is a storage disease due to HCV interaction with microsomal triglyceride transfer protein (MTP) Nutrition Metabol. 2010;7:13.
Maqsood H, Chughtai T, Khan AB, et al. Association of Lipid and Body Mass Index Profile With Chronic Hepatitis C Infection Stratified by Age and Gender. Cureus. 2021 Dec;13(12):e20665.
González-Aldaco K, Torres-Reyes LA, Ojeda-Granados C, et al. Immunometabolic effect of cholesterol in hepatitis C infection: implications in clinical management and antiviral therapy. Ann Hepatol. 2018;17:908–919.
Kralja D, Jukić LV, Stojsavljević S, et al. Hepatitis C virus, insulin resistance, and steatosis. J Clin Translat Hepatol. 2016;4(1):66–75.
Van Iderstine MG, Uhanova J, Minuk GY. Liver enzymes and fibrosis markers in patients with non-alcoholic fatty liver disease and concomitant chronic viral hepatitis. Canadian Liver J. 2021;4(3):317–321.
Solomennyk AO. Complex blood lipids in patients with chronic hepatitis C. Exp Clin Med. 2013;3(60):99–104. (In Ukraine).
Wang CC, Cheng PN, Kao JH. Systematic review: chronic viral hepatitis and metabolic derangement. Alimentary Pharmacol Therapeutics. 2020;51(2):216–230.
Yanavich C, Pacheco AG, Cardoso SW, et al. Diagnostic value of serological biomarkers for detection of non-alcoholic fatty liver disease (NAFLD) and/or advanced liver fibrosis in people living with HIV. Hiv Med. 2021;22(6):445–456.
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