Dinical and immunological status of patients with chronic hepatitis С on the background of comorbidity

Cover Page

Cite item

Full Text

Abstract

Aim. To study the clinical and immunological features of the course of chronic hepatitis C (CHC) in patients with an unfavorable comorbid background. Materials and methods. The study included 700 patients with CHC, followed up in the period from 2013 to 2019 in Botkin Clinical Infectious Diseases Hospital (St. Petersburg). A comparison of immunological features in 79 patients was carried out, depending on the presence or absence of comorbidity, the immunological profile (the concentrations of cytokines/chemokines were determined: tumor necrosis factor a, interferon y, CCL20/MIP-3a, CXCL9/MIG, CXCL10/IP-10, CXCL11/ITAC in blood plasma by multiplex analysis) was specifically studied in persons with diseases of the gastrointestinal tract and pancreas, pathology of the cardiovascular system and endocrine diseases, compared with the indicators of a group of conventionally healthy individuals. Results. Comorbidity was present in 63% of patients with CHC, among whom multimorbidity was found in 79.4%. The most common comorbidities were diseases of the gastrointestinal tract and pancreas - 49% of cases, diseases of the circulatory system - 15.4%, and pathology of the endocrine system and metabolism - 13.9%. In the group of patients with comorbidity, the concentrations of the chemokines CXCL9/MIG and CCL20/MIP-3a were determined, which were 2 and 1.6 times higher than those in the group without concomitant diseases (p=0.017). Also, both of these indicators significantly exceeded normal values (p<0.05). When analyzing the chemokine profile in patients in various subgroups, a significant excess of CCL20/MIP-3a concentration was revealed in the subgroup with endocrine diseases (p<0.05). Conclusion. Patients with CHC have a high prevalence of comorbidity and multimorbidity. The cytokine profile showed high concentrations of CCL20/MIP-3a and CXCL9/MIG chemokines in the group of patients with concomitant pathology in comparison with patients without it, and a predominance of the CCL20/MIP-3a chemokine concentration in patients with endocrine pathology, including diabetes 1 and 2 type.

About the authors

Valentina V. Basina

Saint Petersburg State Pediatric Medical University

Email: v.basina@mail.ru
канд. мед. наук, ассистент каф. Saint Petersburg, Russia

Aleksandra A. Dzemova

Saint Petersburg State Pediatric Medical University; Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology

ассистент каф. Saint Petersburg, Russia

Natalya A. Arsent'eva

Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology

канд. биол. наук, ст. науч. сотр. лаб. Saint Petersburg, Russia

Kseniya E. Novak

Saint Petersburg State Pediatric Medical University

канд. мед. наук, доц. каф. Saint Petersburg, Russia

Elena V. Esaulenko

Saint Petersburg State Pediatric Medical University; Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology

д-р мед. наук, проф., зав. каф. Saint Petersburg, Russia

Areg A. Totolyan

Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology

акад. РАН, д-р мед. наук, проф., зав. лаб. Saint Petersburg, Russia

References

  1. European Association for the Study of the Liver Recommendations on Treatment of Hepatitis C 2015. J Hepatol. 2015;63:199-236.
  2. Эсауленко Е.В., Новак К.Е., Басина В.В., и др. Распространенность коморбидности при хроническом вирусном гепатите С. Мед. алфавит. 2021;1:66-70
  3. Heydtmann M, Adams DH. Chemokines in the immunopathogenesis of hepatitis C infection. Hepatology. 2009;49(2):676-88. doi: 10.1002/hep.22763
  4. Арсентьева Н.А., Семенов А.В., Любимова Н.Е., и др. Содержание цитокинов и хемокинов в плазме крови больных хроническим вирусным гепатитом С. Рос. иммунологический журн. 2015;9(18):83-92
  5. Арсентьева Н.А., Семенов А.В., Любимова Н.Е., и др. Хемокиновые рецепторы CXCR3 и CCR6 и их лиганды в печени и крови больных хроническим вирусным гепатитом C. Бюл. эксперим. биологии и медицины. 2015;160(8):218-22
  6. Larrubia J, Benito-Martinez S, Calvino M, et al. Role of chemokines and their receptors in viral persistence and liver damage during chronic hepatitis C virus infection. World J Gastroenterol. 2008;14(47):7149-59. doi: 10.3748/wjg.14.7149
  7. Cooper C, Galanakis C, Donelle J, et al. HCV-infected individuals have higher prevalence of comorbidity and multimorbidity: a retrospective cohort study. BMC Infect Dis. 2019;19:712. doi: 10.1186/s12879-019-4315-6
  8. Negro F. Facts and fictions of HCV and comorbidities: steatosis, diabetes mellitus, and cardiovascular diseases. J Hepatol. 2014;61(1):69-78. doi: 10.1016/j.jhep.2014.08.003
  9. Новак К.Е. Клинико-морфологическая характеристика субкомпенсированного и декомпенсированного цирроза печени вирусной этиологии. Педиатр. 2011;2(2):47-52
  10. Эсауленко Е.В., Сухорук А.А. Трансплантация в детском возрасте и у взрослых. Педиатр. 2015;6(3):98-103
  11. Kuna L, Jakab J, Smolic R, et al. HCV Extra hepatic manifestations. J Clin Trans Hepatol. 2019;7(2):172-82. doi: 10.14218/JCTH.2018.00049
  12. Labenz С, Huber Y, Kalliga E, et al. Predictors of advanced fibrosis in non-cirrhotic non-alcoholic fatty liver disease in Germany. Aliment Pharmacol Ther. 2018;48(10):1109-16. doi: 10.1111/apt.14976
  13. McPherson S, Gosrani S, Hogg S, et al. Increased cardiovascular risk and reduced quality of life are highly prevalent among individuals with hepatitis C. BMJ Open Gastroenterol. 2020;7(1):000470. D0I:10.1136/bmjgast-2020-000470
  14. Gonnella D. Type 1 diabetes and MIG. Clin Ther. 2019;170(6):465-71. doi: 10.7417/CT.2019.2177
  15. Antonelli А, Ferrari S, Corrado A, et al. CXCR3, CXCL10 and type 1 diabetes. Cytokine Growth Factor Rev. 2014;25(1):57-65. doi: 10.1016/j.cytogfr.2014.01.006
  16. Corrado A, Ferrari S, Ferri C, et al. Type 1 diabetes and (C-X-C motif) ligand (CXCL) 10 chemokine. Clin Ther. 2014;165(2):181-5. doi: 10.7471/CT.2014.1706
  17. Ferrari S, Ruffilli I, Colaci M, et al. CXCL10 in psoriasis. Adv Med Sci. 2015;60(2):349-54. doi: 10.1016/j.advms.2015.07.011
  18. Antonelli A, Ferrari S, Giuggioli D, et al. Chemokine (C-X-C motif) ligand (CXCL)10 in autoimmune diseases. Autoimmun Rev. 2014;13(3):272-80. doi: 10.1016/j.autrev.2013.10.010
  19. Sayed-Ahmed L, Kotb N, El-Serogy H, et al. TNF-alpha and CXCL-10 correlation with insulin resistance in patients with chronic hepatitis C virus infection. Egypt J Immunol. 2010;17(1):101-11
  20. Hung C-H, Lee C-M, Lu S-N. Hepatitis C virus-associated insulin resistance: pathogenic mechanisms and clinical implications. Expert Rev Anti Infect Ther. 2011;9(5):525-33. doi: 10.1586/eri.11.33
  21. Liu C, Feng X, Li Q, et al. TNF-a and inflammatory cytokines and risk of type 2 diabetes: A systematic review and meta-analysis. Cytokine. 2016;86:100-9. doi: 10.1016/j.cyto.2016.06.028

Copyright (c) 2021 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies