aidsВИЧ-инфекция и иммуносупрессииHIV Infection and Immunosuppressive Disorders2077-9828Baltic Medical Education Center10.22328/2077-9828-2021-13-4-53-63aids-679Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESЧастота встречаемости и факторы риска развития внепеченочных проявлений у пациентов с хронической ВГС- и ВГС/ВИЧ-инфекциейIncidence and risk factors of extrahepatic manifestations in patients with chronic HCV and HCV/HIV infectionhttps://orcid.org/0000-0002-9504-0827ДунаеваН. В.DunaevaN. V.

Дунаева Наталья Викторовна — кандидат медицинских наук, доцент, заведующая поликлиническим соматическим отделением, врач-инфекционист

SPIN-код 9697–0190

190103, Санкт-Петербург, наб. Обводного канала, д. 179

St. Petersburg

nvch@mail.ruhttps://orcid.org/0000-0002-3386-672XПерваковаМ. Ю.PervakovaM. Yu.

Первакова Маргарита Юрьевна — кандидат медицинских наук, врач лаборатории диагностики аутоиммунных заболеваний, Научно-методический центр по молекулярной медицине Минздрава России

SPIN-код 8820–5850

197022, Санкт-Петербург, ул. Льва Толстого, д. 6–8

St. Petersburg

https://orcid.org/0000-0002-3055-6507МазингА. В.MazingA. S.

Мазинг Александра Васильевна — кандидат медицинских наук, ведущий научный сотрудник лаборатории молекулярной диагностики, Научно-методический центр по молекулярной медицине Минздрава России

SPIN-код 4458–4633

197022, Санкт-Петербург, ул. Льва Толстого, д. 6–8

St. Petersburg

alex_mazing@mail.ruhttps://orcid.org/0000-0002-4998-3699ЛапинС. В.LapinS. V.

Лапин Сергей Владимирович — кандидат медицинских наук, заведующий лабораторией диагностики аутоиммунных заболеваний, Научно-методический центр по молекулярной медицине Минздрава России

SPIN-код 9852–7501

197022, Санкт-Петербург, ул. Льва Толстого, д. 6–8

St. Petersburg

svlapin@mail.ruЦентр по борьбе со СПИД и инфекционными заболеваниямиРоссияCenters for AIDS and Other Infectious DiseasesRussian FederationПервый Санкт-Петербургский государственный медицинский университет имени академика И. П. ПавловаРоссияPavlov First Saint Petersburg State Medical UniversityRussian Federation2021280120221345363Copyright © Дунаева Н.В., Первакова М.Ю., Мазинг А.В., Лапин С.В., 20222022Дунаева Н.В., Первакова М.Ю., Мазинг А.В., Лапин С.В.Dunaeva N.V., Pervakova M.Y., Mazing A.S., Lapin S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://hiv.bmoc-spb.ru/jour/article/view/679

Цель: изучить встречаемость и факторы риска развития внепеченочных проявлений — артралгий, кожных проявлений васкулита, полиневропатии, ксерофтальмии, синдрома Рейно, хронической болезни почек (ХБП) у больных хронической ВГС-инфекцией и ВГС/ВИЧ-ко-инфекцией.Материалы и методы. В выборочное исследование был включен 331 пациент: 254 человека с ВГС, 77 — с ВГС/ВИЧ.Результаты. Какое-либо из изученных внепеченочных проявлений выявлено у 50% больных ВГС и 70% больных ВГС/ВИЧ, р=0,002. Наиболее часто у пациентов с ВГС и ВГС/ВИЧ встречались поражения суставов (42% против 46%, р=0,563), кожные высыпания (20% против 25%, р=0,345), полиневропатия (13% против 17%, р=0,441), ХБП (11% против 35%, р<0,001), реже синдром Рейно (3% против 8%, р=0,076) и ксерофтальмия (5% против 4%, р=0,661). Построение логистической регрессионной модели выявило значимую связь развития одного и более изученных внепеченочных проявлений у больных хронической ВГС-инфекцией с криоглобулинемией (р<0,001), наличием ВИЧ-инфекции (р<0,001) и возрастом (р=0,007). Однако построение аналогичных моделей для каждого из изученных проявлений выявило значимое влияние ВИЧ-инфекции только на развитие ХБП (р<0,001), в то время как наличие криоглобулинемии являлось значимым фактором риска для каждого из изученных проявлений, за исключением ксерофтальмии.Заключение. Полученные данные свидетельствуют о высокой частоте встречаемости внепеченочных проявлений у больных хронической ВГС и ВГС/ВИЧ-инфекцией, значимой роли ко-инфицирования ВИЧ для развития ХБП и роли криоглобулинемии в развитии всех изученных внепеченочных проявлений, кроме ксерофтальмии. 

Purpose. To study the incidence and risk factors for the development of extrahepatic manifestations like arthralgias, cutaneous manifestations of vasculitis, polyneuropathy, xerophthalmia, Raynaud’s syndrome, chronic kidney disease (CKD) in patients with chronic HCV infection, and HCV/HIV co-infection.Materials and methods. The cohort study included 331 patients: 254 people with HCV, 77 — with HCV/HIV.Results. Extrahepatic manifestations were detected in 50% of HCV patients and 70% of HCV/HIV patients (p=0,002). Among patients with HCV and HCV/HIV the most common were joint lesions (42% vs 46%, p=0,563), skin rashes (20% vs 25%, p=0,345), polyneuropathy (13% vs 17%, p=0,441), CKD (11% vs 35%, p<0,001), less often Raynaud’s syndrome (3% vs 8%, p=0,076) and xerophthalmia (5% vs 4%, p=0,661). The logistic regression model revealed a significant relationship between the development of one or more extrahepatic manifestations in patients with chronic HCV infection with cryoglobulinemia (p<0,001), the presence of HIV infection (p<0,001), and age (p=0,007). However, logistic regression models tested for each of the studied manifestations revealed a significant effect of HIV infection only on the development of CKD (p<0,001), while cryoglobulinemia possessed significant risk factors for each of the manifestations, except xerophthalmia. Conclusion. The data obtained indicate a high incidence of extrahepatic manifestations in patients with chronic HCV and HCV/HIV infection, also a significant role of HIV co-infection for the development of CKD, and the role of cryoglobulinemia in the development of extrahepatic manifestations, except xerophthalmia.

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The authors declare that there are no conflicts of interest present.