Interrelation between endogenous intoxication indicators and nitric oxide metabolites in the infectious process in chronic viral hepatitis C

Aim. To study dynamics and interrelation between final nitric oxide metabolites (nitrites) and endogenous intoxication index (medium mass molecules) in patients with chronic hepatitis C with the effect of antiviral therapy on them.

Methods. The study included 99 patients with chronic hepatitis C. The combination therapy for 48 weeks in patients with genotype 1 chronic hepatitis C with pegylated interferon (peginterferon alfa-2a and alfa-2b) in combination with ribavirin and for 24 weeks with daily standard interferon alfa-2b administration in patients with virus genotypes 2 and 3 was conducted. The nitric oxide level was estimated by the content of the nearest metabolite (nitrite) in blood serum using the P.P. Golikov method. Medium mass molecules in the blood serum were determined by the N.I. Gabrielyan method.

Results.In patients with chronic hepatitis C high values of nitrogen oxide metabolites and the medium mass molecules in the blood serum were revealed, whereas the level of nitroxidemia and endogenous intoxication by the values of medium mass molecules was associated with the viral replicative capacity value and alanine aminotransferase serum levels. Amid the combination antiviral therapy the nature of nitroxidergy changed with the normalization of nitrogen oxide indicators by 24 weeks and an increase to 48 weeks of treatment. There were significantly positive correlative relations between pronouncement of levels of nitric oxide metabolites and the medium mass molecules before the start of antiviral therapy (R=0.292629, p

Conclusion. Chronic hepatitis C promotes increase in nitrite ion content and medium mass molecules in the blood serum, their level is associated with virus replication activity and cytolysis severity; antiviral therapy has an effect on the level of endogenous intoxication with the normalization of content of the nitrite ions and medium mass molecules in blood serum by 24th week of treatment.