Analysis of long-term results of effective etiotropic therapy of chronic hepatitis C


DOI: https://dx.doi.org/10.18565/therapy.2022.3.50-58

Esaulenko E.V., Dzemova A.A., Novak K.E., Bushmanova A.D., Ostankova Yu.V., Valutite D.E., Chernoguz Yu.A., Zueva E.B., Yushina E.Yu., Tyurenkova N.V.

1) Saint Petersburg State Pediatric Medical University of the Ministry of Healthcare of Russia; 2) Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology of Rospotrebnadzor; 3) S.P. Botkin Clinical Infectious Hospital, Saint Petersburg
Abstract. The existence of occult hepatitis C virus (HCV) infection in the general population and in selected clinical groups is covered in the literature, but its consequences in various clinical situations require further study.
The aim of the study was to evaluate the long-term outcomes of chronic hepatitis C after successful antiviral therapy.
Material and methods. In patients with chronic hepatitis C (n=182), clinical and laboratory parameters and liver density were compared at the start of therapy and at the end point of follow-up (median follow-up of 99 weeks), were tested for occult HCV infection (n=109).
Results. The proportion of patients with liver cirrhosis and severe fibrosis decreased from 47% to 36%. A regression of cirrhosis occurred in 12 (24%) patients with Child–Pugh class A. A significant decrease in the FIB4 and APRI indices was recorded (p<0,05). In 27 (14%) patients, negative dynamics was observed (progression of fibrosis, n=17; decompensation of the cirrhosis, n=3; portal vein thrombosis, n=2; development of hepatocellular carcinoma, n=5) associated with higher AFP, FIB4, comorbidity index level. Occult HCV infection was detected in 5,5%.
Conclusion. In patients with severe fibrosis and liver cirrhosis, the risk of fibrosis progression, decompensation of the cirrhosis and the development of HCC after the eradication of hepatitis C virus remains. Further studies on risk stratification are required to optimize dispensary follow-up after antiviral therapy.
Keywords: occult HCV infection, long-term outcomes, chronic hepatitis C, antiviral therapy
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About the Autors

Elena V. Esaulenko, Dr. med. habil., professor, head of the Department of infectious diseases in adults and epidemiology, Saint Petersburg State Pediatric Medical University of the Ministry of Healthcare of Russia, head of the laboratory «Viral hepatitis» at Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology of Rospotrebnadzor. Address: 197101, Saint Petersburg, 14 Mira Str. E-mail: eve-gpmu@mail.ru. ORCID: https://orcid.org/0000-0003-3669-1993
Alexandra A. Dzemova, postgraduate student at Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology of Rospotrebnadzor, assistant at the Department of infectious diseases in adults and epidemiology, Saint Petersburg State Pediatric Medical University of the Ministry of Healthcare of Russia, head of the laboratory «Viral hepatitis» at Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology of Rospotrebnadzor. Address: 194100, Saint Petersburg, 2 Litovskaya Str. E-mail: dzemovaalexandra@mail.ru.
ORCID: https://orcid.org/0000-0002-3683-7860
Kseniya E. Novak, PhD in Medicine, associate professor of the Department of infectious diseases in adults and epidemiology, Saint Petersburg State Pediatric Medical University of the Ministry of Healthcare of Russia. Address: 194100, Saint Petersburg, 2 Litovskaya Str. E-mail: kseniya.novak@mail.ru.
ORCID: https://orcid.org/0000-0001-9633-4328
Anastasia D. Bushmanova, PhD in Medicine, assistant at the Department of infectious diseases in adults and epidemiology, Saint Petersburg State Pediatric Medical University of the Ministry of Healthcare of Russia, infectious diseases specialist at the Department of diagnosis and prevention of viral hepatitis, Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology of Rospotrebnadzor. Address: 197101, Saint Petersburg, 14 Mira Str. E-mail: nastya1089@mail.ru
Yulia V. Ostankova, PhD in Biology, head of Laboratory of virology and immunology of HIV infection, Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology of Rospotrebnadzor. Address: 197101, Saint Petersburg, 14 Mira Str. E-mail: shenna1@yandex.ru. ORCID: https://orcid.org/0000-0003-2270-8897
Diana E. Valutite, doctor of clinical laboratory diagnostics at the Department for diagnosing HIV infection and AIDS-related diseases, Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology of Rospotrebnadzor. Address: 197101, Saint Petersburg, 14 Mira Str. E-mail: dianavalutite008@gmail.com.
ORCID: https://orcid.org/0000-0002-0931-102X
Yulia A. Chernoguz, biologist at the Department for diagnosing HIV infection and AIDS-related diseases, Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology of Rospotrebnadzor. Address: 197101, Saint Petersburg, 14 Mira Str
Elena B. Zueva, PhD in Biology, senior researcher at the Laboratory of experimental virology, Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology of Rospotrebnadzor. Address: 197101, Saint Petersburg, 14 Mira Str. ORCID: https://orcid.org/0000-0002-0579-110X
Elena Yu. Yushina infectious disease specialist, head of the Day Hospital Department, S.P. Botkin Clinical Infectious Hospital. Address: 195067, Saint Petersburg, 49 Piskarevskiy Drive. E-mail: yushinaeu1976@mail.ru
Natalia V. Tyurenkova, PhD in Medicine, infectious disease specialist, head of the Department of diagnostic observation, S.P. Botkin Clinical Infectious Hospital. Address: 195067, Saint Petersburg, 49 Piskarevskiy Drive. E-mail: natal4ik_74@mail.ru


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