EVALUATION OF PREDICTORS OF INEFFECTIVENESS OF ANTIVIRAL THERAPY FOR CHRONIC HEPATITIS C IN THE REPUBLIC OF KAZAKHSTAN: A MATCHED CASE-CONTROL STUDY.

This study aims to identify the predictors of ineffectiveness in antiviral therapy for chronic hepatitis C (CHC) in Kazakhstan. The rising prevalence and mortality rates associated with CHC globally and within Kazakhstan underscore the need for effective antiviral treatment strategies. Despite the introduction of direct-acting antiviral agents (DAAs) with high cure rates, a subset of patients fails to achieve a sustained virological response (SVR).

Regression of Liver Steatosis Following Phosphatidylcholine Administration: A Review of Molecular and Metabolic Pathways Involved.

Liver steatosis is a key pathology in non-alcoholic or metabolic associated fatty liver disease. Though largely ignored for decades it is currently becoming the focus of research in hepatology. It is important to consider its origin and current opportunities in terms of pharmacotherapy.

Neurological disorders in vitamin B12 deficiency.

The review discusses thesteps of vitamin B12 metabolism and its role in maintaining of neurological functions. The term "vitamin B12 (cobalamin)" refers to several substances (cobalamins) of a very similar structure. Cobalamin enters the body with animal products.

[Elastography in the diagnosis of portal hypertension in patients with liver cirrhosis].

Aim: To establish the diagnostic accuracy of liver and spleen density (LD and SD) measurements in patients with compensated alcoholic liver cirrhosis (LC) in the diagnosis of portal hypertension.

Subjects And Methods: The investigation enrolled 83 patients with compensated alcoholic and viral (hepatitis C virus) LC. All the patients underwent LD and SD determinations, abdominal ultrasonography, and endoscopy to detect esophageal varices (EV), as well as examination of blood indices.

[Pharmacotherapy of portal hypertension and its complications: analysis of efficacy of preparations for clinical practice and discussion of promising methods of treatment].

Bleeding from oesophageal varicose veins is the terminal stage of a sequence of complications of liver cirrhosis caused by progressive fibrosis, circulation blockade, and development of portal hypertension syndrome followed by collateral shunt. It leads to progressive vein dilation and their rupture. The main issue of today is to prevent the development of successive stages of portal hypertension, to search for therapeutic and surgical methods for marked reduction of pressure in the portal system, and to prevent the risk of hemorrhage from varicose veins.

[The prevalence of liver and gallbladder pathologies in overweight and obese patients].

This paper reports data on the prevalence of liver and gallbladder pathologies in ovenrweight and obese patients based on the examination of 1506 subjects (684 men, 820 women) aged 25-65 years. Changes in the liver and gall bladder constituted principal pathology of the gastrointestinal tract associated with excessive body mass and obesity. Body mass index (BMI) positively correlated with triglyceride, VLDLP and HDLP cholesterol levels (p = 0.

[Serological tests of functional activity of the digestive system (gastrin, pepsinogen-I, trypsin), general IgE and serum cortisol levels in children with hepatitis A and B].

The mild form of hepatitis A and B with children is attended by a functional activity of pancreatic gland (tripsin), mucous coats of stomach and duodenum (gastrin) which permits to consider them as a factor of the risk of digestive organs combined pathology starting with the disease acuity. Differences in gastrin levels with children depending on hepatitis etiology were specified. Highest levels of gastrin were observed with persons suffering from hepatitis B.

[Portal hypertension as a clinical manifestation of hepatic lesions in sarcoidosis].

The paper is devoted to differential diagnostics of portal hypertension (PH) in view of frequent diagnostic mistakes (10-15%) associated with this pathology. PH syndrome is usually interpreted by practitioners as a clinical manifestation of liver cirrhosis even if it is not necessarily related to the involvement of this organ. In patients with hepatic pathology, PH is likely to develop not only in case of fibrotic transformation and false lobule formation but also in case of disturbed blood flow in the portal vein, e.

[The scope of clinical applications of noninvasive methods for the assessment of liver fibrosis results of orginial studies in a multi-field hospital].

Potential and limitations of non-invasive methods for the evaluation of hepatic fibrosis are discussed (hepatic elastography, fibrotest, ultrasound dopplerography of portal vessels). Each non-invasive method was assessed in terms of threshold values it provides for the characteristic of successive stages ofhepatic fibrosis. The data obtained were used to develop the optimal algorithm for the diagnosis of hepatic fibrosis in patients with chronic viral liver infection.

[Chronic hepatitis B, hemosiderosis, and hepatic fibrosis in a renal graft recipient].

Chronic hepatitis B is a frequent concomitant disease in recipients of a renal graft that worsens results of kidney transplantation due to renal and extrarenal complications. Much rarer hemochromatosis either has genetic roots (hereditary hemochromatosis) or results from multiple blood transfusions and hemolysis during treatment by hemodialysis (secondary hemochromatosis). Combination of chronic hepatitis B and hemochromatosis increases the risk of chronic liver disease leading to cirrhosis and hepatocellular carcinoma.

[The place of the biopsy and morphological study of hepatic tissue in children and adults in the clinician's practice].

The authors analyze their own (more than 2500 manipulations in children and adults) and foreign experience in hepatic biopsy, and describe the most wide-spread techniques of puncture biopsy, paying special attention to complications of the manipulation and ways of their prevention. Indications and contra-indications to biopsy in children and adults are defined; the role of morphological studies in diagnostics of chronic hepatic diseases is discussed.

[Methods of early diagnostics of hepatic fibrosis and cirrhosis].

The article covers the functional and clinical importance of hepatic fibrosis. Contemporary principles of invasive and non-invasive diagnostics of fibrotic changes are described. The article deals with the main types of fibrosis, chronic hepatic diseases in which they develop, and the most wide-spread systems of semiquantitative evaluation of fibrotic process' morphologic signs.

[Current methods of early diagnosis of hepatic fibrosis].

The article covers the functional and clinical significance of hepatic fibrosis. Contemporary principles of invasive and non-invasive methods of diagnostics of fibrotic alterations are described. The article also covers the main forms of fibrosis, chronic hepatic diseases in which they are found, and the most wide-spread systems of half-quantitative evaluation of morphological signs of the fibrotic process.

[Spontaneous bacterial peritonitis: a clinical variant of ascites-peritonitis: diagnosis and treatment].

The lecture deals with diagnosis, prevention and treatment of spontaneous bacterial peritonitis (SBP). The choice of treatment groups is described according to recommendations of the International Ascitis Club (IAC). Algorithm of SBP examination for different SBP forms, the disease course characteristics and factors of prognosis are provided.

[Hematological syndromes in patients with chronic hepatitis C].

Aim: To examine hemopoiesis and to estimate proinflammatory cytokines in blood serum from 42 patients with chronic viral hepatitis (CVH) associated with 1-3 lineage cytopenia in the blood.

Material And Methods: 42 patients with diagnostically complicated hematological picture suggestive of hemoblastosis were examined using standard tests, bone marrow puncture and trepanobiopsy, laparoscopy with biopsy of the liver and spleen, transcutaneous puncture biopsy of the liver under ultrasonic control, explorative laparotomy with splenectomy and liver biopsy and, on demand, laboratory tests for hemolysis, presence of antithrombocytic and antileukocytic antibodies, iron metabolism, karyological analysis of bone marrow cells was also made.

Results: The majority of the patients were diagnosed to have chronic hepatitis C with low activity of hepatic inflammation and frequent (55%) absence of the diagnostic antibodies to hepatitis C virus in the serum.