NON-INVASIVE METHODS FOR DETERMINING THE DEGREE OF LIVER DAMAGE IN PATIENTS WITH TORCH INFECTIONS
DOI:
https://doi.org/10.11603/1811-2471.2022.v.i4.13511Keywords:
non-alcoholic fatty liver disease (NAFLD), TORCH infection, diagnosticsAbstract
SUMMARY. Nowadays a new non-invasive, highly informative research methods to determine the stage of damage and the functional state of the liver, especially in patients with combined pathology, namely, non-alcoholic fatty liver disease (NAFLD) and infection with pathogens of the TORCH group are actively being searched.
The aim – to research the effectiveness of using various non-invasive diagnostic methods to determine the degree of liver damage in patients with NAFLD infected with TORCH infection.
Material and Methods. There were examined 72 patients with NAFLD. The patients were divided into two groups: the first group was included the patients with NAFLD who have detected antibodies of the IgG class to TORCH infections group (n=40); the II group was consisted of patients on NAFLD, who has had the test negative for infections of the TORCH group (n=32). All examined patients were undertaken general clinical examinations, as well as determination of the state of the autonomic nervous system.
Results. Strongly marked growth in indicators of the functional state of the liver, as well as cholestatic syndrome, was established in patients of the 1st group. In the examined patients of both groups, hyperinsulinemia and insulin resistance were found, with maximum marked changes in the examined patients with NAFLD in combination with TORCH infection. In patients of group I, the results of the Fibrotest (which were calculated online) and the commercial FibroMax test indicate the F2-F3 stage of fibrosis according to METAVIR, while in patients of group II was only the initial stage of F2.The obtained results also confirm the presence of steatohepatitis in the examined patients (SteatoTest – 0.66±0.08 – p<0.01; NashTest – 0.78±0.05 – p<0.01 in patients of the I group and 0.59± 0.04 and 0.69±0.09 – p<0.01, respectively, in patients of the II group).
Conclusions. Patients with NAFLD infected with TORCH infection have more pronounced laboratory signs of cytolytic and cholestatic syndromes, as well as hyperinsulinemia and insulin resistance. The use of non-invasive methods (elastometry of the liver, online Fibrotest based on surrogate markers of liver fibrosis, commercial test FibroMax) are effective and informative methods for determining the stage of fibrosis in patients with NAFLD infected with TORCH infection.
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