[CLINICAL AND LABORATORY FEATURES OF CHRONIC HEPATITIS C IN PATIENTS WITH HELICOBACTERIOSIS]
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Published on: November 1, 2024
M Derbak1, E Dankanich1, I Pushkash1
1SEI "Uzhgorod National University", Faculty of Medicine, Ukraine.
Insights
Helicobacter pylori (Hp) infection significantly worsens chronic hepatitis C (CHC) clinical and biochemical outcomes. Hp-positive CHC patients exhibit more severe symptoms, cholestasis, and elevated liver enzymes, indicating a need for integrated Hp eradication therapy.
Area of Science:
- Hepatology
- Gastroenterology
- Infectious Diseases
Background:
- Chronic hepatitis C (CHC) is a significant global health concern.
- The role of co-infection with Helicobacter pylori (Hp) in CHC progression is not fully understood.
- Understanding co-infection's impact is crucial for optimizing CHC management.
Purpose of the Study:
- To investigate the influence of Hp infection on the clinical and biochemical course of CHC.
- To compare clinical symptoms, liver function tests, and inflammatory markers in CHC patients with and without Hp.
- To identify specific markers associated with Hp co-infection in CHC.
Main Methods:
- Study included 150 CHC patients not receiving antiviral therapy.
- Hp infection diagnosed via urease (CLO-test) and coprological tests.
- Interleukin (IL)-1β, IL-6, tumor necrosis factor α (TNF-α), and neopterin levels measured by ELISA.
- Patients categorized into two groups: CHC with Hp (n=52) and CHC without Hp (n=98).
Main Results:
- Hp-positive CHC patients showed significantly higher prevalence of dyspeptic syndrome (94.2% vs 52.0%), right hypochondrium pain (65.4% vs 20.4%), and skin itching (57.7% vs 12.4%).
- Elevated levels of total bilirubin, alkaline phosphatase, and gammaglutamyltranspeptidase (indicating cholestasis) were observed in Hp-positive CHC patients.
- Significantly higher hepatic enzyme activity (AlAT, AsAT) and increased pro-inflammatory cytokines (IL-1β, IL-6, TNF-α, neopterin) were noted in the Hp co-infected group.
Conclusions:
- Hp co-infection exacerbates CHC, leading to more severe clinical symptoms and biochemical abnormalities.
- Cholestasis and heightened liver enzyme activity are characteristic of CHC combined with Hp infection.
- Comprehensive eradication therapy for Hp should be considered in CHC patients, tailored to clinical and laboratory findings.
Abstract:
The aim of the study was to investigate the influence of Hp on clinical and biochemical course of chronic hepatitis C (CHC). The study included 150 patients with a confirmed diagnosis of chronic hepatitis C, who for various reasons did not receive specific antiviral therapy. Helicobacter pylori (Нр) was determined using a quick urease test (CLO-test) and a coprological test (CITO TEST, manufactured by Pharmasco LLC), interleukin (IL) levels: IL-1β, IL-6, tumor necrosis factor α (TNF-α) and neopterin by ELISA. Two groups were formed: the 1st (n=52) - patients with chronic hepatitis C infected with Hp and the 2nd (n=98) - patients with chronic hepatitis C without Hp. It was found that in patients with chronic hepatitis C infected with HP, dyspeptic syndrome (94.2% versus 52.0%, p<0.05), pain and severity in the right hypochondrium (65.4% versus 20.4%, p<0.05); and periodic itching of the skin (57.7% versus 12.4%, p<0.05) were significantly more often recorded, compared with patients with chronic hepatitis C without HP. Levels of total bilirubin, alkaline phosphatase and gammaglutamyltranspeptidase are significantly higher in patients with chronic hepatitis C combined with Hp, compared with patients without Hp (p<0.05), which indicates the predominance of cholestasis syndrome in them. Also, in patients with chronic hepatitis C combined with Hp, higher levels of hepatic enzyme activity (AlAT, AsAT) were detected compared with patients with chronic hepatitis C without Hp (82.3% versus 22.9%, respectively; p<0.001). More pronounced disregulatory changes in the cytokine link of the immune system, characterized by an increase in the levels of proinflammatory cytokines: IL-1β, IL-6, TNF-α and neopterin were registered in patients with chronic hepatitis C infected with Hp, than in patients without Hp. High levels of hepatic enzyme activity (AlAT, AsAT, GGTP), as well as the predominance of cholestasis syndrome in patients with chronic hepatitis C combined with Hp, require the development of a comprehensive eradication therapy of Hp considering the results of clinical and laboratory features of the course of CHC.
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