METABOLISM FEATURES OF HAPTOGLOBIN AS INFLAMMATION ACUTE PHASE PROTEIN IN PATIENTS WITH CHRONIC HCV INFECTION

Abstract

Modern advances in hepatology are characterized by the introduction into practice of interferon−free therapy of chronic hepatitis C, as well as the expansion of the arsenal of methods for non−invasive or minimally invasive diagnosis of morphological changes in the liver. The ineffectiveness of therapy is stipulated by, in particular, the amino acid polymorphism of viral proteins, which determines the resistance of certain variants of HCV to directly acting antiviral drugs. In order to assess the content of haptoglobin in the serum of patients with chronic hepatitis C depending on the activity of cytolytic enzymes in the serum, the degree of inflammatory−necrotic activity of the process, stage of liver fibrosis, virus genotype, viral load, age and sex of patients, prior to, on the background and after antiviral therapy, 215 patients were examined. The results showed that in most patients the content of haptoglobin in the serum was within normal limits. It correlated with the degree of inflammatory−necrotic activity of hepatitis, the stage of liver fibrosis and did not depend on the biochemical activity of the process, virus genotype, viral load, age and sex of the patient. Determining the content of this protein in the serum before the start of combination antiviral therapy, provided that other factors, leading to hypogaptoglobinemia, with a high probability allowed to diagnose severe fibrosis (cirrhosis) of the liver or its absence, and to predict the absence of its effect. On the background of a combined antiviral therapy with ribavirin, there was a decrease in serum haptoglobin, enabling the use of this index to monitor the activity of drug hemolysis and was a reason not to recommend assessment of liver fibrosis by FibroTest during and after treatment, if its protocol included "antiviral Ribavirin". Key words: HCV infection, morphological changes in liver, liver biopsy, non−invasive diagnosis of fibrosis, antiviral therapy, predictors for treatment outcome, haptoglobin.