EXTRAHEPATIC MANIFESTATIONS OF VIRAL HEPATITIS C: CLINICAL FEATURES OF THE COURSE OF ASSOCIATED ARTHRITIS IN PATIENTS WITH CHRONIC VIRAL HEPATITIS AND MODERN APPROACHES TO SOLVING THE PROBLEM

Abstract

Introduction. Chronic viral hepatitis (CVH) is often accompanied by a variety of extrahepatic (systemic) manifestations, often coming to the fore in the clinical picture and, in some cases, determining the prognosis of the disease. One of the main extrahepatic manifestations of HCV is joint pathology. In this regard, various rheumatic complaints in patients may be associated with viral hepatitis infection. This study is devoted to the study of the frequency of extrahepatic manifestations in CVH C.

Materials and methods. A cross-sectional study was conducted of 52 patients (mean age 38.54 ± 6.00 years) with a diagnosis of chronic viral hepatitis C (CVHC), who underwent initial consultation with a specialized course of outpatient treatment at the arthrology center (arthSCOT) at the Tashkent Medical Academy (TMA) and received inpatient treatment in the departments of the clinic of the Research Institute of Epidemiology, Microbiology and Infectious Diseases of the Republic of Uzbekistan (RIEMID).

Results. Among 52 patients diagnosed with chronic hepatitis C (HCV), rheumatic manifestations such as arthritis were observed in 19.2%.Among patients with cryoglobulinemia (CGE), the incidence of articular manifestation was 74.3%. According to liver elastography, the examined patients with CGE had signs of liver fibrosis of the 2nd and 3rd degrees, relative to the indices of the group without CGE, where degrees 1 and 2 of fibrosis were more often observed. According to ultrasound of the joints, synovitis occurred in 46 (88.4%) patients.

Conclusion. In patients with chronic hepatitis C, the most common rheumatologic manifestation is arthralgia (92.3%). The relationship between the duration of hepatitis disease, its activity, the severity of liver fibrosis according to elastography and changes in the levels of the main biochemical and immunological parameters is established. Among patients with CGE, the incidence of articular manifestation was 74.3%, and the articular manifestations of HCV were mostly more severe.