International Medical Journal, Vol. 25., Iss. 1, 2019, P. 80−85.
LOW-INVASIVE DIAGNOSIS OF SEVERITY OF LIVER FIBROSIS CHANGES IN PATIENTS WITH CHRONIC HEPATITIS C
Kharkiv National Medical University, Ukraine
One of the important tasks of modern hepatology is the timely determining the presence of fibrosis and clarification of its stage in the patients with chronic hepatitis C. Liver fibrosis is a consequence of an excessive deposition and accumulation of extracellular matrix components in it as a result of the activation of stellate cells. Early qualitative and quantitative diagnosis of the severity of fibrotic changes in the patients is needed not only to decide on the feasibility and duration of etiotropic therapy, assess its effectiveness, but also to establish the overall prognosis. Despite the fact that needle biopsy is still the "gold standard" for diagnosing morphological changes in liver, serological markers of fibrosis are more accessible and popular in practical use. By their origin, they are divided into direct, directly related to metabolism of extracellular matrix, and indirect, i.e. laboratory indices, reflecting the functional state of liver. The first ones include hyaluronic acid, cytokeratin−18, procollagen peptides, collagens, matrix metalloproteinases and their tissue inhibitors, laminin, and the second includes transferases, blood clotting factors, cytokines, etc. A number of tests based on direct (MP3, ELF), indirect (APRI, AAR, Model 3, FibroTest, etc.) markers of fibrosis and their combination (SHASTA, FIBROSpect, Zeng's score, Hepascore, Fibrometer) has been developed. Each of them has a different diagnostic value. Despite the variety of methods for non−invasive diagnosis of fibrosis in the patients with chronic hepatitis C, each of them, along with the advantages, has certain disadvantages, which dictates the need to continue the further search for biochemical equivalents of the severity of fibrotic changes of liver in such patients.
Key words: chronic hepatitis C, fibrogenesis, liver fibrosis, liver biopsy, biochemical diagnosis, transforming growth factor beta 1, sex hormones.