Clinical and laboratory characteristics of liver cirrhosis in the outcome of chronic hepatitis C at the modern viewpoint
Abstract. Chronic hepatitis C (CHC) remains a pressing healthcare problem, including due to the high risk of developing liver cirrhosis (LC), which is associated with high mortality from complications and leads to the need for liver transplantation.Tereshkin N.A., Makashova V.V., Ponezheva Zh.B., Omarova Kh.G., Gorelov A.V.
The aim: to present the current clinical and laboratory characteristics of LC as a result of CHC and to analyze them depending on the degree of compensation of the pathological process.
Material and methods. Data from 65 patients with LC in the outcome of CHC, divided into classes according to the Child – Pugh scale, were analyzed. All participants underwent a comprehensive examination. Obtained data were compared between the groups and with a group of apparently healthy individuals.
Results. Almost half of the patients (44.6%) had decompensated LC (class C). Males predominated among all examined persons (61.5%), and genotype 1 of the hepatitis C virus (HCV) was the most common (55.6%). A high frequency of comorbidities (87.7%) was fixed in the observed patients, as well as a statistically significant increase in the proportion of gastrointestinal and cardiovascular diseases in case of decompensated liver cirrhosis. With the progression of cirrhosis from class A to class C, the frequency of the absence of specific complaints and clinical symptoms significantly decreased, while the prevalence of abdominal pain, jaundice, urine discoloration, peripheral edema, and ascites significantly increased. According to laboratory data, the highest levels of alanine aminotransferase and aspartate aminotransferase were characteristic of class A cirrhosis, while bilirubin concentrations, its fractions, and the international normalized ratio increased significantly with disease progression, while albumin levels and the prothrombin index decreased with the transition to class C.
Conclusion. Clinical picture and laboratory indexes are directly depending on the class of liver cirrhosis. Compensated cirrhosis is often asymptomatic, so laboratory tests play a key role in its diagnosis. In decompensated cirrhosis, symptoms associated with hepatocellular insufficiency and portal hypertension are predominating. Regular monitoring of clinical and laboratory changes allows for an objective assessment of the severity of patients’ condition, promptly identifying the development of liver cirrhosis decompensation, and timely initiating treatment.
Keywords
chronic hepatitis C
liver cirrhosis
clinical picture of liver cirrhosis
laboratory indexes
cirrhosis class
Child – Pugh scale
References
1. Hall EW, Bradley H, Barker LK, Lewis KC, Shealey J, Valverde E et al. Estimating hepatitis C prevalence in the United States, 2017–2020. Hepatology. 2025;81(2):625–36.
PMID: 38739849. PMCID: PMC11557732. https://doi.org/10.1097/HEP.0000000000000927
2. Sallam M, Khalil R. Contemporary insights into hepatitis C virus: A comprehensive review. Microorganisms. 2024;12(6):1035.
PMID: 38930417. PMCID: PMC11205832. https://doi.org/10.3390/microorganisms12061035
3. Stroffolini T, Stroffolini G. Prevalence and modes of transmission of hepatitis C virus infection: A historical worldwide review. Viruses. 2024;16(7):1115.
PMID: 39066277. PMCID: PMC11281430. https://doi.org/10.3390/v16071115
4. Roudot-Thoraval F. Epidemiology of hepatitis C virus infection. Clin Res Hepatol Gastroenterol. 2021;45(3):101596.
PMID: 33610022. https://doi.org/10.1016/j.clinre.2020.101596
5. Tapper EB, Parikh ND. Diagnosis and management of cirrhosis and its complications: A review. JAMA. 2023;329(18):1589–602.
PMID: 37159031. PMCID: PMC10843851. https://doi.org/10.1001/jama.2023.5997
6. Wilson R, Williams DM. Cirrhosis. Med Clin North Am. 2022;106(3):437–46.
PMID: 35491064. https://doi.org/10.1016/j.mcna.2021.12.001
7. Авдеева М.Г., Кулбужева М.И., Ганжа А.А., Запашняя О.В., Черникова Н.В., Колодько Е.И. с соавт. Клинико-эпидемиологическая характеристика цирроза печени HCV-этиологии на ранних стадиях его формирования. Эпидемиология и инфекционные болезни. 2019;24(5–6):220–228. (Avdeeva MG, Kulbuzheva MI, Ganzha AА, Zapashnaya OV, Chernikova NV, Kolodko EI et al. Clinical and epidemiological characteristics of hepatic cirrhosis of hepatitis C virus etiology in the early stages of its formation. Epidemiologiya i infektsionnyye bolezni = Epidemiology and Infectious Diseases. 2019;24(5–6):220–228 (In Russ.)).
EDN: SOUQSR. https://doi.org/10.17816/EID34792
8. Ranjitha E, Parekar V, Rani CS. Clinico-pathological correlation of hematological and biochemical profiles in patients with chronic liver disease: A cross-sectional analysis. Int J Med Public Health. 2025;15(2):835.
https://doi.org/10.70034/ijmedph.2025.2.150
9. Эсауленко Е.В., Новак К.Е., Дземова А.А., Лялина Л.В., Цинзерлинг В.А., Федуняк И.П. Вирусные циррозы печени: клинический профиль современного пациента, танатогенез и патоморфология. Инфекционные болезни. 2023;21(1):70–79. (Esaulenko EV, Novak KE, Dzemova AA, Lyalina LV, Tsinzerling VA, Fedunyak IP. Virus-related liver cirrhosis: Clinical profile of a patient, thanatogenesis, and pathomorphology. Infektsionnyye bolezni = Infectious Diseases. 2023;21(1):70–79 (In Russ.)).
EDN: PRIQKN. https://doi.org/10.20953/1729-9225-2023-1-70-78
About the Authors
Nikita A. Tereshkin, MD, postgraduate student at the Central Research Institute of Epidemiology of Rospotrebnadzor, assistant at the Department of infectious diseases and epidemiology of the Institute of Clinical Medicine at N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia (Pirogov University). Address: 111123, Moscow, 3A Novogireevskaya St.E-mail: nteryoshkin@gmail.com
ORCID: https://orcid.org/0009-0002-3541-4150
Vera V. Makashova, MD, Dr. Sci. (Medicine), professor, leading researcher at the Clinical Department of infectious pathology, Central Research Institute of Epidemiology of Rospotrebnadzor. Address: 111123, Moscow, 3A Novogireevskaya St.
E-mail: veramakashova@yandex.ru
ORCID: https://orcid.org/0000-0002-0982-3527
Zhanna B. Ponezheva, MD, Dr. Sci. (Medicine), head of the Clinical Department of infectious pathology, Central Research Institute of Epidemiology of Rospotrebnadzor. Address: 111123, Moscow, 3A Novogireevskaya St.
E-mail: doktorim@mail.ru
ORCID: https://orcid.org/0000-0002-6539-4878
Khadizhat G. Omarova, MD, PhD (Medicine), head of the Clinical Research Department, Central Research Institute of Epidemiology of Rospotrebnadzor. Address: 111123, Moscow, 3A Novogireevskaya St.
E-mail: omarova@cmd.su
ORCID: https://orcid.org/0000-0002-9682-2230
Alexander V. Gorelov, MD, Dr. Sci. (Medicine), professor, academician of RAS, deputy director for research work, Central Research Institute of Epidemiology of Rospotrebnadzor, head of the Department of infectious diseases and epidemiology, Russian University of Medicine of the Ministry of Healthcare of Russia, professor of the Department of pediatric diseases of N.F. Filatov Clinical Institute of Child Health, I.M. Sechenov First Moscow State University of the Ministry of Healthcare of Russia (Sechenov University). Address: 111123, Moscow, 3A Novogireevskaya St.
E-mail: agorelov_05@mail.ru
ORCID: https://orcid.org/0000-0001-9257-0171
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