Impact of host characteristics on liver fibrosis progression in patients with chronic hepatitis C

Smatra se da oko 200 milijuna ljudi u svijetu boluje od kroničnog hepatitisa C što predstavlja velik javnozdravstveni problem. Kronični hepatitis C je bolest vrlo heterogenog kliničkog tijeka pri čemu je osnovni čimbenik dugoročne prognoze brzina napredovanja jetrene fibroze koja konačno rezultira cirozom i njenim komplikacijama uključivo i nastankom hepatocelularnog karcinoma. Na prirodni tijek bolesti značajno utječu karakteristike domaćina. S lošijom prognozom povezuju se muški spol, starija dob kod stjecanja infekcije, bijela rasa, određeni aleli gena sustava HLA, interleukina i kemokina, koagulacijskih faktora, faktora rasta, tkivnih metaloproteinaza, opterećenje željezom te steatoza jetre u sklopu metaboličkog sindroma. Prepoznavanje i analiza ovih čimbenika iznimno je značajna za brzu identifikaciju bolesnika s potencijalnom brzom progresijom bolesti i optimizaciju njihovog liječenja.Hepatitis C virus infection is an important global public health problem with 200 million people suffering from chronic disease worldwide. The clinical course of chronic hepatitis C is heterogeneous. The most important predictor of long-term diseases outcome is the dynamics of liver fibrosis progression which leads to cirrhosis and hepatocellular carcinoma. Natural course of chronic infection is significantly determined by the characteristics of the host. Male sex, older age at the disease onset, Caucasian race, host\u27s genetic polymorphism for HLA, interleukins, chemokines, coagulation factors, growth factors, tissue metalloproteinases as well as iron overload and liver steatosis represent host factors associated with unfavorable disease outcome. Recognition and analysis of these factors is important for the early identification of rapid progressors and treatment optimization of these patients