Частота виявлення різних генотипів вірусу гепатиту С серед хворих у м. Дніпро

Abstract

При обстеженні методом ПЛР біологічного матеріалу на наявність генетичних маркерів вірусу гепатиту С від осіб з підозрою на гепатит визначено позитивну відповідь у 616 випадках (53%) серед усіх позитивних результатів виявлення гепатитів. Домінуючими генотипами гепатиту С серед населення м. Дніпро є 1в і 3а (41,7% і 33,4% відповідно). Мікст-генотипи найчастіше представлені комбінацією 1в+3а (6,8%); При обследовании методом ПЦР биологического материала на наличие генетических маркеров вируса гепатита С от лиц с подозрением на гепатит определен положительный ответ в 616 случаях (53%) среди всех положительных результатов выявления гепатитов. Доминирующими генотипами гепатита С среди населения г. Днепр являются 1в и 3а (41,7% и 33,4% соответственно). Микст генотипы чаще всего представлены комбинацией 1в+3а (6,8%); Viral hepatitis with parenteral mechanism of transmission of pathogens, one of which is hepatitis C, are an important problem of modern medical science and health practitioners around the world. This is due to the widespread, high morbidity, expressed polymorphism of clinical manifestations, the multiplicity of ways and factors of transmission and extremely adverse effects, which can cause hepatitis – forming the entire spectrum of chronic liver disease, including cirrhosis and hepatocellular carcinoma. In recent years a marked trend towards an increased incidence of chronic disease was fixed. According to data of WHO experts chronic hepatitis C affected about 150 mln. people and 350 thousand die each year as a result of liver disease hepatitis C virus incidence and mortality due to hepatitis C is increasing progressively in the world and, according to experts, will double till 2020. For the degree of negative impact on human health and the extent of the incidence of viral hepatitis dominant place in the structure of infectious diseases parallel with influenza and acute infectious diseases of the upper respiratory tract. The aim of research was to determine the incidence of different genotypes of HCV among the population of Dnipro city. The research was made at the laboratory «Synevo» in Dnipro city. The presence of hepatitis B virus markers in obtained blood samples from individuals (n=2510), which applied to the laboratory by a doctor direction or at own will with suspected hepatitis. The material for the research was the samples of venous blood of 616 patients with manifestation of chronic hepatitis C. All patients were directed to screening for hepatitis C in clinical indications. The age of patients ranged from 21 to 57 years. The study was made by polymerase chain reaction (PCR) in real time using a kit «AmplySens® HCV-genotype-FL» (LLC «YnterLabServys», RF), which can detect a number of subtypes of virus. Extraction RNA from clinical material carried by a kit of «RIBO-sorb» (OOO «YnterLabServys», RF) according to the instructions. From total contingent of the patients (n=2510) obtained during the second half of 2016 presence of viral hepatitis was confirmed in 1163 persons (46.3%). Of these, for 616 people (53%) the chronic hepatitis C was confirmed. A study of 616 samples of plasma often met genotypes 1b – in 257 (41.7%) cases and 3a – in 206 (33.4%) cases. Genotype 1a and 2 were confirmed in 18 cases (2.9%) and 43 (7%) relatively. The genotype 4 found in 6 people (1%), 5 and 6 genotypes did not register at all. Among mixed genotypes largest number of cases – 42 fell to the lot mixed 3a+1c (6.8%) and 1a+1c, which is registered in 38 cases (6.2%), and mixed 1b+2 found only 6 people (1%). Information about genotype is very important because it allows you to predict the response to treatment duration and dose chosen to recommend the drug. There are at least 6 HCV genotypes and many subtypes that have different sensitivity to interferon. Hepatitis C is very difficult to treat compared with hepatitis B. From the literature it is known that genotype 1b better than others to treatment with modern drugs. In contrast, genotype 1b, a positive result from treatment known for hepatitis C caused by genotypes 2 and 3 is 80%. Conclusions: study of samples on the basis of «Synevo» laboratory in Dnipro city of biological material by PCR for the presence of genetic markers identified HCV positive response in 616 cases (53%) of all positive results for hepatitis research; dominant genotypes of hepatitis C among population of Dnipro city were 1c and 3a (41.7% and 33.4% respectively). Mixed genotypes often presented combination 3a+1c (6.8%). Prospects for further research: the spread of viral hepatitis is a significant medical and social problem for Ukraine, especially for hepatitis C and important area of research is the establishment of infections virus genotypes, allowing correct therapeutic scheme for each individual patient. Research genotypes of HCV to determine prognosis and options research its distribution among the population, which in the future will develop highly effective preventive measures.