Viral hepatitis with

HCV( Hepatitis C) is a viral disease that most often occurs in the form of posttransfusion hepatitis with a predominance of anicteric and mild forms and is prone to process chronicization. The causative agent is the hepatitis C virus( HCV), contains RNA.Based on the phylogenetic analysis, 6 HCV genotypes and more than 80 subtypes have been isolated. Genotype 1 is the most common genotype in the whole world( 40-80% of isolates).Genotype 1a is a predominant subtype for the United States, and 1b predominates in Western Europe and South Asia. Genotype 2 is common throughout the world, but occurs at a lower frequency than genotype 1( 10-40%).Genotype 3 is typical for India, Pakistan, Australia and Scotland. Genotype 4 is prevalent mainly in Central Asia and Egypt, genotype 5 in South Africa, and genotype 6 in Hong Kong and Macau.

Months after infection

Years after infection

Fig. Dynamics of blood markers in chronic viral hepatitis In

In 40-75% of patients register an asymptomatic form of the disease, in 50-75% of patients with acute HCV, chronic hepatitis forms, in 20% of them cirrhosis develops. An important role of HCV is assigned to the etiology of hepatocellular carcinoma.

The HCV genome is a single-stranded positively charged RNA that encodes 3 structural nucleocapsid core proteins and N-leoprotein E1-E2 envelopes and 5 structural( NSp NS2, NS3, NS4, NS5) proteins. To each of these proteins, ATs found in the blood of HCV patients are synthesized.

A distinctive feature of HCV is the undulating course of the disease, in which three phases are distinguished: acute, latent and reactive phase.

■ The acute phase is characterized by an increase in the activity of hepatic enzymes in the blood serum, the content of ATM classes IgM and IgG( to the nucleocapsid core protein) to HCV with the growth of titers, as well as HCV RNA.

■ The latent phase is characterized by the absence of clinical manifestations, the presence in blood of the AT-class IgG( to the nucleocapsid core protein and unstructured NS3-NS5 proteins) to HCV in high titers, the absence of ATM class IgM and RNA HCV, or their presence in low concentrations against a slight increaseactivity of liver enzymes during periods of exacerbation.

■ For the reactivation phase, the appearance of clinical signs, an increase in the activity of liver enzymes, the presence of an AT class of IgG( to nucleocapsid core and unstructured NS proteins) in high titres, the presence of HCV RNA and the growth of ATM class titers to HCV in dynamics are characteristic.