The Kinetics of Virological and Biochemical Responses in the Treatment of Chronic Hepatitis C by Dual Antiviral Therapy

Introduction: Infection with hepatitis C is often manifested by a mild clinicalcourse, and in many patients it is revealed incidentally, during routine laboratorytests. Progression of the disease often takes 10-20 years with specified high risk offibrosis and hepatocellular carcinoma. Material and methods: The group of subjectswith chronic liver disease of viral C etiology was consisted of 50 patients of both sexes,38 (75%) were male and 13 (25%) females, aged 20-65 years. Patients were selectedaccording to genotype hepatitis C viral infection and subsequently treated accordingto two current therapeutic protocols. All patients had prior therapy and after completionof treatment using standard methods of laboratory tests were done the following:functional hepatic tests, serological analysis, nucleic acid detection of hepatitis C viruspolymerase chain reaction (PCR), quantitatively and qualitatively with the genotypingof the virus C, which determines the length of therapy. In determining the stage ofchronic liver disease, histopathological examination of liver tissue samples obtainedby biopsy of the liver was done and we analyzed the fibrosis and architectural changes.Results: By analyzing the HCV RNA PCR values at the beginning and end of treatmentwe tested the effect of treatment on PCR with paired samples t-test logarithmvalues of the PCR and came to the conclusion that the values after treatment aresignificantly lower with threshold of significance of 0.01. The results showed that thevalue of PCR before and after therapy, or achieved a response at the end of therapy,which achieved 77% of patients. The values of ALT in the group of patients with CHCwere significantly higher than the values in the group of patients after the therapy.AST values in the patients with CHC were significantly higher than the values in thegroup of patients after therapy. There was a moderate correlation between ALT valuesat baseline and ALT values upon completion of treatment (0.5061). There was nocorrelation between HCV RNA PCR and ALT and AST. Conclusion: Upon completionof antiviral treatment response at the end of treatment achieved 77% of patients,regardless of the genotype of the virus. Also, regardless of the genotype of the virusantiviral therapy led to statistically significant reduction of AST and ALT, indicatinga direct effect of combination therapy on virological and biochemical response withno significant link between these two studied parameters.