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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2019-21-248-253</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-5501</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ИНФЕКЦИИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>INFECTIONS</subject></subj-group></article-categories><title-group><article-title>Клиническая эпидемиология внепеченочных проявлений хронической инфекции, вызванной вирусом гепатита С</article-title><trans-title-group xml:lang="en"><trans-title>Clinical epidemiology of extrahepatic manifestations of chronic hepatitis C virus infection</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5195-9316</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Цветков</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Tsvetkov</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Цветков Валерий Владимирович, к.м.н., старший научный сотрудник; врач-инфекционист</p><p>197376, Россия, Санкт-Петербург, ул. профессора Попова, д. 15/17</p><p>197101, Россия, Санкт-Петербург, ул. Мира, д. 16</p></bio><bio xml:lang="en"><p>Valeriy V. Tsvetkov, Cand. of Sci, (Med), Senior Researcher; Infectionist</p><p>15/17, Professor Popova St., Saint-Petersburg, 197376, Russia</p><p>16 Mira St., St. Petersburg, 197101, Russia</p></bio><email xlink:type="simple">suppcolor@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9824-3945</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Токин</surname><given-names>И. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Tokin</surname><given-names>I. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p> Токин Иван Иванович, к.м.н., заведующий отделением экспериментальной терапии вирусных гепатитов; доцент кафедры инфекционных болезней</p><p>197376, Россия, Санкт-Петербург, ул. профессора Попова, д. 15/17</p><p> 191015, Россия Санкт-Петербург, ул. Кирочная, д. 41</p></bio><bio xml:lang="en"><p>Ivan I. Tokin, Cand. of Sci, (Med), Head of the Department of Experimental Therapy of Viral Hepatitis; Associate Professor of the Department of Infectious Diseases</p><p>15/17, Professor Popova St., Saint-Petersburg, 197376, Russia</p><p>41, Kirochnaya St., St. Petersburg, 191015, Russia</p></bio><email xlink:type="simple">ivan.i.tokin@rambler.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4812-1384</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Позднякова</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Pozdnjakova</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Позднякова Светлана Анатольевна, врач-эпидемиолог</p><p>197101, Россия, Санкт-Петербург, ул. Мира, д. 16</p></bio><bio xml:lang="en"><p>Svetlana A. Pozdnjakova, Epidemiologist</p><p>16 Mira St., St. Petersburg, 197101, Russia</p></bio><email xlink:type="simple">msgremlins@gmail.com</email><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Научно-исследовательский институт гриппа имени А.А. Смородинцева; Центр по профилактике и борьбе со СПИД и инфекционными заболеваниями Комитета по здравоохранению Ленинградской области<country>Россия</country></aff><aff xml:lang="en">Smorodintsev Research Institute of Influenza;Leningrad Region Center for Prevention and Control of AIDS and Communicable Diseases<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">Научно-исследовательский институт гриппа имени А.А. Смородинцева; Северо-Западный государственный медицинский университет им. И.И. Мечникова<country>Россия</country></aff><aff xml:lang="en">Smorodintsev Research Institute of Influenza; North-Western State Medical University named after I.I. Mechnikov<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru">Центр по профилактике и борьбе со СПИД и инфекционными заболеваниями Комитета по здравоохранению Ленинградской области<country>Россия</country></aff><aff xml:lang="en">Leningrad Region Center for Prevention and Control of AIDS and Communicable Diseases<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>28</day><month>01</month><year>2020</year></pub-date><volume>0</volume><issue>21</issue><fpage>248</fpage><lpage>253</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Цветков В.В., Токин И.И., Позднякова С.А., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Цветков В.В., Токин И.И., Позднякова С.А.</copyright-holder><copyright-holder xml:lang="en">Tsvetkov V.V., Tokin I.I., Pozdnjakova S.A.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/5501">https://www.med-sovet.pro/jour/article/view/5501</self-uri><abstract><p>Внепеченочные проявления наблюдаются более чем у половины пациентов с хронической инфекцией, вызванной вирусом гепатита С, и могут представлять не меньшую опасность для здоровья и жизни больного, чем изолированная патология печени. Хроническая инфекция, вызванная вирусом гепатита С, часто сопровождается формированием нейрокогнитивных расстройств, клинически проявляющихся общей слабостью, быстрой утомляемостью и неспособностью длительно сохранять концентрацию внимания. У каждого пятого больного хроническим гепатитом C развивается депрессия. Развитие сахарного диабета 2 типа среди пациентов с хронической инфекцией, вызванной вирусом гепатита С, наблюдается в 1,7 раз чаще, чем среди неинфицированных лиц. Смешанная криоглобулинемия наблюдается не менее чем у 30% больных, однако клинические проявления этой патологии развиваются лишь в 4,9% случаев, из которых поражение кожи составляет 69–89%, дистальная сенсорная и сенсомоторная полинейропатия – 19–44%, мембранопролиферативный гломерулонефрит – 30%, поражение суставов – 28% случаев. Среди пациентов с хроническим вирусным гепатитом С отмечаются более высокие, чем среди неинфицированных лиц, показатели распространенности таких нозологий, как лимфома из клеток маргинальной зоны – в 2,47 раза, диффузная крупноклеточная B-клеточная лимфома — в 2,24 раза, гипотиреоидизм – в 3,1 раза. Существенно более редко встречающимися внепеченочными проявлениями хронической инфекции, вызванной вирусом гепатита С, являются поражения кожи, не связанные с развитием криоглобулинемического васкулита: приобретенная поздняя кожная порфирия, некролитическая акральная эритема и красный плоский лишай. Вопрос патогенетической связи хронической инфекции, вызванной вирусом гепатита С, с сердечно-сосудистой патологией остается открытым.</p></abstract><trans-abstract xml:lang="en"><p>Extrahepatic manifestations occur in more than half of patients with chronic hepatitis C virus infection and may be no less dangerous to the health and life of the patient than the isolated pathology of the liver. Chronic hepatitis C virus infection is often accompanied by the formation of neurocognitive disorders, clinically manifested by general weakness, fatigue and the inability to maindoi tain concentration for a long time. Every fifth patient with chronic hepatitis C develops depression. The development of type 2 diabetes among patients with chronic hepatitis C virus infection is observed 1.7 times more often than among non-infected individuals. Mixed cryoglobulinemia is observed in at least 30% of patients, however, the clinical manifestations of this pathology develop only in 4.9% of cases, of which 69–89% of skin lesions, 19–44% of distal sensory and sensorimotor polyneuropathy, 30% of membranoproliferative glomerulonephritis, 28% of joint damage. Among patients with chronic hepatitis C virus infection, higher prevalence than among non-infected individuals is observed, the prevalence rates of such nosologies as lymphoma from cells of the marginal zone are 2.47 times, diffuse large cell B cell lymphoma – 2.24 times, hypothyroidism – 3.1 time. Significantly more rarely encountered extrahepatic manifestations of chronic hepatitis C virus infection are skin lesions that are not associated with the development of cryoglobulinemic vasculitis: acquired late skin porphyria, necrolytic acral erythema and lichen planus. The question of the pathogenetic relationship of chronic hepatitis C virus infection with cardiovascular pathology remains open.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>хронический гепатит С</kwd><kwd>внепеченочное проявление</kwd><kwd>внепеченочная патология</kwd><kwd>депрессия</kwd><kwd>сахарный диабет</kwd><kwd>смешанная криоглобулинемия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>chronic hepatitis C</kwd><kwd>chronic hepatitis C virus infection</kwd><kwd>extrahepatic manifestation</kwd><kwd>extrahepatic pathology</kwd><kwd>depression</kwd><kwd>diabetes mellitus</kwd><kwd>mixed cryoglobulinemia</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. 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