American Journal Of Biomedical Science & Pharmaceutical Innovation
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VOLUME
Vol.05 Issue04 2025
PAGE NO.
43-46
10.37547/ajbspi/Volume05Issue04-10
Diagnostic Significance of Clinical and Objective Signs
in Chronic Viral Hepatitis C
Khayrullaeva D.Kh.
Tashkent Medical Academy, Tashkent city, Uzbekistan
Mamatyusupov M.Kh.
Tashkent Medical Academy, Tashkent city, Uzbekistan
Received:
26 February 2025;
Accepted:
22 March 2025;
Published:
25 April 2025
Abstract:
This article describes the prevalence and clinical features of 105 patients with chronic hepatitis. As a
result of the study, it was found that the disease is more common in women and the different picture of subjective
or objective symptoms is higher in patients.
Keywords:
Chronic hepatitis, liver, virus, subjective sign, objective sign.
Introduction:
Relevance and importance of the topic
.
According to the World Health Organization (WHO), 3%
of the world's population, or approximately 170 million
people, are infected with the hepatitis C virus (HCV).
According to the researched scientific analysis, the
wide distribution of liver tissue damage caused by the
virus, the high percentage of it becoming chronic and
liver cirrhosis and liver tumor indicate that the disease
is not only a medical, but also a social problem
[1,2,5,8,9]. The disease in 80% of cases becomes
chronic and undergoes constant mutations, the
difficulties in creating a vaccine and the high cost of
treatment make the disease a pressing problem in
modern therapy and infectious diseases. Acute and
chronic forms of viral hepatitis are often asymptomatic,
and laboratory tests are also observed in borderline
values [2,3,4,5,10,11]. Currently, much attention is
being paid to the systematic study of the clinical and
laboratory features of chronic viral hepatitis. However,
the number of studies that can confirm this idea is
extremely small, and the data they contain are
unreliable. Based on these considerations, the aim of
our work is to assess liver function in patients with
chronic viral hepatitis by determining clinical and
laboratory markers and biochemical parameters.
Viral hepatitis C continues to be the most important
medical and social problem worldwide. This is due to
high morbidity, especially among young people, the
severity of complications and the degree of chronicity.
Viral hepatitis C is the most common cause of
hepatocellular carcinoma. Chronic viral hepatitis C is
one of the socially significant infectious diseases. The
importance of this disease is determined by the high
proportion of chronicity of acute hepatitis (up to 80%
of cases), the ability of the hepatitis C virus to
constantly mutate and the associated difficulties in
creating a vaccine, the high cost of treatment [5, 7, 11].
In 2019, according to the World Health Organization
(WHO), 71 million people worldwide were infected
with the hepatitis C virus, and 350,000 to 500,000
people die each year. Chronic viral hepatitis C is
considered one of the leading causes of liver cirrhosis
and the development of hepatocellular carcinoma. It is
the clinical outcomes of hepatitis C that more often
than other etiological factors lead to transplantation.
According to various authors, 250-400 million people
chronically infected with the hepatitis C virus are
registered in the world. The relevance of the problem
is also associated with the possible consequences of
chronic viral hepatitis. It has now been proven that
chronic HCV infection leads to progressive liver
inflammation; in 20-30%, progression of liver cirrhosis
with subsequent decompensation or formation of
hepatocellular carcinoma is observed [3]. It has been
established that in patients with hepatitis B, in 70-90%
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American Journal of Applied Science and Technology (ISSN: 2771-2745)
of cases, hepatocellular carcinoma may develop at
stages up to the development of liver cirrhosis [2]. The
study of the mechanisms of pathogenesis of chronic
viral liver diseases against the background of the
growth of this pathology in the world is an urgent task
of hepatology. The basis of liver damage in HCV
infection is a combination of direct cytopathic and
immune-mediated cellular damage induced by the
virus [1]. It is believed that disruption of the liver
structure with the development of necrotic and fibrotic
changes in it is associated with the level of production
of proinflammatory cytokines - interleukin-6 and tumor
necrosis factor alpha (TNF-a) [4].
It is known that TNF'α is involved in tissue destruction
and reparation processes against the background of
inflammation, and its elevated level is observed in viral
and bacterial infections, oncological diseases and many
inflammatory reactions. During an exacerbation of
gastrointestinal diseases, the concentration of TNF'α in
the blood serum exceeds the norm by an average of 10
times, and in some patients by 75
–
80 times [2,8].
METHODS
The study included data on the results of clinical,
laboratory and instrumental examinations of 105
patients diagnosed with chronic viral hepatitis. 67
(64.1%) of the patients were female, 38 (35.8%) were
male, and their age ranged from 20 to 75 (mean
44.2±3.2) years. The results of the examination were
assessed
using
a
clinical-reference
card
(questionnaire). The study was approved by the
members of the ethics committee established under
the auspices of the Bukhara Medical Institute. Inclusion
criteria for the study: patients with chronic hepatitis
aged 20-75 years; persons who provided written
consent for clinical, laboratory and instrumental
examinations. Exclusion criteria: alcohol or drug
addiction, toxic hepatitis, alcoholic hepatitis, serious
illnesses (uncontrolled arterial hypertension, type 2
diabetes mellitus in the decompensation stage, chronic
heart failure III-IV functional class, patients with
myocardial infarction and stroke), pregnant and
lactating women. To rule out alcoholic liver disease, a
history (absence of regular alcohol consumption) was
collected and screened using a special CAGE
questionnaire [4]. During the study, a comparative
assessment was performed with 60 healthy subjects
(aged 20-65). In the process of diagnosing patients,
anamnesis data were collected, laboratory and
ultrasound examinations were used. Abdominal
ultrasound examination (assessing the size of the liver
and spleen, the condition of the parenchyma, the
extrahepatic bile ducts, the vascular pattern of the
liver, identifying signs of portal hypertension: the
presence of ascites, the diameter of the splenic vein >
10 mm, portal vein > 13 mm, splenomegaly, re-
drainage of the umbilical vein was determined by
parameters and the following symptoms were noted:
liver enlargement, increased echogenicity, relatively
decreased liver density compared to the spleen (liver-
spleen index less than 1), decreased sound
conductivity, poor visualization of the portal and
hepatic veins.
Ultrasound elastography was performed in 105
patients to rule out fibrosis in liver parenchyma.
Biochemical tests of blood: alanine aminotransferase
(ALT) and aspartate aminotransferase (AST), γ
-
glutamyltranspeptidase (GGTP), alkaline phosphatase
(IF), total bilirubin, total protein and its fractions, blood
clotting system activity were studied.
The obtained data were statistically processed using
the Student's t-test, and the difference in results with
P<0.05 was considered reliable
RESULTS
The ratio of women to men in our study was 1.3:1. The
prevalence of chronic hepatitis by age is shown in Table
1.
Table 1.
Description of the examined group of patients
Indicators
Main group
n =105
Control group
n=60
Men
N
38
25
%
35,8
41,6
Woman
N
67
35
%
64,1
58,3
Average age of patients
44,2±3,2
44,2±3,2
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American Journal of Applied Science and Technology (ISSN: 2771-2745)
As can be seen from Table 1, when analyzed by gender,
the results of the analysis showed that SG is more
common in women, and is observed mainly in the
working-age population.
To assess the characteristics of clinical manifestations,
the first task was to determine the range of leading
symptoms that make up the essence of the disease.
After that, each clinical and objective sign was
analyzed. The frequency and incidence of clinical signs
in SG were analyzed in detail.
Table 2.
The rate of meeting subjective and objective symptoms in chronic hepatitis
Indicators
Asymptomatic
Occurrence
Subjective or
objective signs
Occurrence of
subjective and
objective signs
Asthenovegetative
syndrome
-
weakness, reduced work capacity,
sleep disorders, agitation, low mood,
headache, weight loss
26 (25%)
55 (45,8%)
35 (29%)
Dyspeptic
syndrome
– biliary
dyspepsia with a bitter taste in the
mouth, nausea, belching,
Intestinal dyspepsia – flatulence,
persistent diarrhea
27 (25,8%)
61 (50,8%)
28 (23,3%)
Pain syndrome - pain under the right
rib, a feeling of heaviness
24 (23,3%)
59 (49,1%)
33 (27,5%)
Cholestatic syndrome - yellowing of
the skin, sclera, mucous membranes
28 (26,6%)
58 (48,3%)
2828 (23,3%)
The main set of clinical symptoms characteristic of
chronic hepatitis is as follows: weakness, reduced work
capacity, sleep disorders, irritability, low mood,
headache, weight loss, heaviness and discomfort under
the right rib, flatulence, constipation, flatulence,
yellowing of the skin and sclera.
As can be seen from the data presented in the table,
the frequency of symptoms in CKD varies and depends
on the stage of the disease.
It was observed that 25% of patients had no symptoms
of asthenovegetative symptoms, 45.8% of patients had
only one of the subjective or objective symptoms, and
29% of patients had only one of the subjective or
objective symptoms.
Among the dyspeptic symptoms, 50.8% of patients had
a full sensation of bitterness in the mouth, nausea,
while dyspeptic syndrome was observed in 23.3% of
patients, and 25.8% of patients had no symptoms. Pain
under the right rib, a feeling of heaviness, subjective
and objective signs were found in 49.1% of patients,
and objective signs were found separately in 27.5% of
patients
Cholestatic syndrome - yellowing of the skin, sclera,
mucous membranes was not observed in 28.3% of
patients, subjective and objective symptoms were
observed in 48.3% of patients, and only one symptom
was observed in 23.3% of patients.
In conclusion, it was found that chronic hepatitis is
more common in women than in men. The clinical
picture often shows a combination of subjective and
objective signs.
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