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 VOLUME Vol.05 Issue04 2025 

PAGE NO. 43-46 

DOI 10.37547/ajbspi/Volume05Issue04-10 

 
 
 
 

Diagnostic Significance of Clinical and Objective Signs 

in Chronic Viral Hepatitis C 
 

Khayrullaeva D.Kh. 

Tashkent Medical Academy, Tashkent city, Uzbekistan 

 

Mamatyusupov M.Kh. 

Tashkent Medical Academy, Tashkent city, Uzbekistan 

 

 

Received: 26 February 2025; Accepted: 22 March 2025; Published: 25 April 2025 

 

Abstract: This article describes the prevalence and clinical features of 105 patients with chronic hepatitis. As a 
result of the study, it was found that the disease is more common in women and the different picture of subjective 
or objective symptoms is higher in patients. 

 

Keywords: Chronic hepatitis, liver, virus, subjective sign, objective sign. 

 

Introduction: Relevance and importance of the topic. 
According to the World Health Organization (WHO), 3% 
of the world's population, or approximately 170 million 
people, are infected with the hepatitis C virus (HCV). 
According to the researched scientific analysis, the 
wide distribution of liver tissue damage caused by the 
virus, the high percentage of it becoming chronic and 
liver cirrhosis and liver tumor indicate that the disease 
is not only a medical, but also a social problem 
[1,2,5,8,9]. The disease in 80% of cases becomes 
chronic and undergoes constant mutations, the 
difficulties in creating a vaccine and the high cost of 
treatment make the disease a pressing problem in 
modern therapy and infectious diseases. Acute and 
chronic forms of viral hepatitis are often asymptomatic, 
and laboratory tests are also observed in borderline 
values [2,3,4,5,10,11]. Currently, much attention is 
being paid to the systematic study of the clinical and 
laboratory features of chronic viral hepatitis. However, 
the number of studies that can confirm this idea is 
extremely small, and the data they contain are 
unreliable. Based on these considerations, the aim of 
our work is to assess liver function in patients with 
chronic viral hepatitis by determining clinical and 
laboratory markers and biochemical parameters. 

Viral hepatitis C continues to be the most important 
medical and social problem worldwide. This is due to 

high morbidity, especially among young people, the 
severity of complications and the degree of chronicity. 
Viral hepatitis C is the most common cause of 
hepatocellular carcinoma. Chronic viral hepatitis C is 
one of the socially significant infectious diseases. The 
importance of this disease is determined by the high 
proportion of chronicity of acute hepatitis (up to 80% 
of cases), the ability of the hepatitis C virus to 
constantly mutate and the associated difficulties in 
creating a vaccine, the high cost of treatment [5, 7, 11]. 
In 2019, according to the World Health Organization 
(WHO), 71 million people worldwide were infected 
with the hepatitis C virus, and 350,000 to 500,000 
people die each year. Chronic viral hepatitis C is 
considered one of the leading causes of liver cirrhosis 
and the development of hepatocellular carcinoma. It is 
the clinical outcomes of hepatitis C that more often 
than other etiological factors lead to transplantation. 
According to various authors, 250-400 million people 
chronically infected with the hepatitis C virus are 
registered in the world. The relevance of the problem 
is also associated with the possible consequences of 
chronic viral hepatitis. It has now been proven that 
chronic HCV infection leads to progressive liver 
inflammation; in 20-30%, progression of liver cirrhosis 
with subsequent decompensation or formation of 
hepatocellular carcinoma is observed [3]. It has been 
established that in patients with hepatitis B, in 70-90% 

 

https://doi.org/10.37547/ajbspi/Volume05Issue04-10
https://doi.org/10.37547/ajbspi/Volume05Issue04-10
https://doi.org/10.37547/ajbspi/Volume05Issue04-10
https://doi.org/10.37547/ajbspi/Volume05Issue04-10


American Journal of Applied Science and Technology 44 https://theusajournals.com/index.php/ajast 

American Journal of Applied Science and Technology (ISSN: 2771-2745) 
 

 

of cases, hepatocellular carcinoma may develop at 
stages up to the development of liver cirrhosis [2]. The 
study of the mechanisms of pathogenesis of chronic 
viral liver diseases against the background of the 
growth of this pathology in the world is an urgent task 
of hepatology. The basis of liver damage in HCV 
infection is a combination of direct cytopathic and 
immune-mediated cellular damage induced by the 
virus [1]. It is believed that disruption of the liver 
structure with the development of necrotic and fibrotic 
changes in it is associated with the level of production 
of proinflammatory cytokines - interleukin-6 and tumor 
necrosis factor alpha (TNF-a) [4]. 

It is known that TNF'α is involved in tissue destruction 
and reparation processes against the background of 
inflammation, and its elevated level is observed in viral 
and bacterial infections, oncological diseases and many 
inflammatory reactions. During an exacerbation of 
gastrointestinal diseases, the concentration of TNF'α in 
the blood serum exceeds the norm by an average of 10 
times, and in some patients by 75–80 times [2,8]. 

METHODS  

The study included data on the results of clinical, 
laboratory and instrumental examinations of 105 
patients diagnosed with chronic viral hepatitis. 67 
(64.1%) of the patients were female, 38 (35.8%) were 
male, and their age ranged from 20 to 75 (mean 
44.2±3.2) years. The results of the examination were 
assessed using a clinical-reference card 
(questionnaire). The study was approved by the 
members of the ethics committee established under 
the auspices of the Bukhara Medical Institute. Inclusion 
criteria for the study: patients with chronic hepatitis 
aged 20-75 years; persons who provided written 
consent for clinical, laboratory and instrumental 
examinations. Exclusion criteria: alcohol or drug 
addiction, toxic hepatitis, alcoholic hepatitis, serious 
illnesses (uncontrolled arterial hypertension, type 2 
diabetes mellitus in the decompensation stage, chronic 
heart failure III-IV functional class, patients with 
myocardial infarction and stroke), pregnant and 

lactating women. To rule out alcoholic liver disease, a 
history (absence of regular alcohol consumption) was 
collected and screened using a special CAGE 
questionnaire [4]. During the study, a comparative 
assessment was performed with 60 healthy subjects 
(aged 20-65). In the process of diagnosing patients, 
anamnesis data were collected, laboratory and 
ultrasound examinations were used. Abdominal 
ultrasound examination (assessing the size of the liver 
and spleen, the condition of the parenchyma, the 
extrahepatic bile ducts, the vascular pattern of the 
liver, identifying signs of portal hypertension: the 
presence of ascites, the diameter of the splenic vein > 
10 mm, portal vein > 13 mm, splenomegaly, re-
drainage of the umbilical vein was determined by 
parameters and the following symptoms were noted: 
liver enlargement, increased echogenicity, relatively 
decreased liver density compared to the spleen (liver-
spleen index less than 1), decreased sound 
conductivity, poor visualization of the portal and 
hepatic veins. 

Ultrasound elastography was performed in 105 
patients to rule out fibrosis in liver parenchyma.  

Biochemical tests of blood: alanine aminotransferase 
(ALT) and aspartate aminotransferase (AST), γ-
glutamyltranspeptidase (GGTP), alkaline phosphatase 
(IF), total bilirubin, total protein and its fractions, blood 
clotting system activity were studied. 

The obtained data were statistically processed using 
the Student's t-test, and the difference in results with 
P<0.05 was considered reliable 

RESULTS  

The ratio of women to men in our study was 1.3:1. The 
prevalence of chronic hepatitis by age is shown in Table 
1. 

                                                                

                                                                            

 

Table 1. 

Description of the examined group of patients 

Indicators 

 

Main group n =105 

 

Control group n=60 

 

Men N 38 25 

% 35,8 41,6 

Woman N 67 35 

% 64,1 58,3 

Average age of patients 

 

44,2±3,2 44,2±3,2 



American Journal of Applied Science and Technology 45 https://theusajournals.com/index.php/ajast 

American Journal of Applied Science and Technology (ISSN: 2771-2745) 
 

 

As can be seen from Table 1, when analyzed by gender, 
the results of the analysis showed that SG is more 
common in women, and is observed mainly in the 
working-age population. 

To assess the characteristics of clinical manifestations, 

the first task was to determine the range of leading 
symptoms that make up the essence of the disease. 
After that, each clinical and objective sign was 
analyzed.  The frequency and incidence of clinical signs 
in SG were analyzed in detail. 

Table 2. 

The rate of meeting subjective and objective symptoms in chronic hepatitis 
Indicators  

 

Asymptomatic 

Occurrence 

 

Subjective or 

objective signs  

 

Occurrence of 

subjective and 

objective signs 

 

Asthenovegetative syndrome - 

weakness, reduced work capacity, 

sleep disorders, agitation, low mood, 

headache, weight loss 

 

26 (25%) 55 (45,8%) 35 (29%) 

Dyspeptic syndrome – biliary 

dyspepsia with a bitter taste in the 

mouth, nausea, belching,  

Intestinal dyspepsia – flatulence, 

persistent diarrhea 

 

27 (25,8%) 61 (50,8%) 28 (23,3%) 

Pain syndrome - pain under the right 

rib, a feeling of heaviness 

 

24 (23,3%) 59 (49,1%) 33 (27,5%) 

Cholestatic syndrome - yellowing of 

the skin, sclera, mucous membranes 

 

28 (26,6%) 58 (48,3%) 2828 (23,3%) 

The main set of clinical symptoms characteristic of 
chronic hepatitis is as follows: weakness, reduced work 
capacity, sleep disorders, irritability, low mood, 
headache, weight loss, heaviness and discomfort under 
the right rib, flatulence, constipation, flatulence, 
yellowing of the skin and sclera.  

As can be seen from the data presented in the table, 
the frequency of symptoms in CKD varies and depends 
on the stage of the disease. 

It was observed that 25% of patients had no symptoms 
of asthenovegetative symptoms, 45.8% of patients had 
only one of the subjective or objective symptoms, and 
29% of patients had only one of the subjective or 
objective symptoms. 

Among the dyspeptic symptoms, 50.8% of patients had 
a full sensation of bitterness in the mouth, nausea, 
while dyspeptic syndrome was observed in 23.3% of 

patients, and 25.8% of patients had no symptoms. Pain 
under the right rib, a feeling of heaviness, subjective 
and objective signs were found in 49.1% of patients, 
and objective signs were found separately in 27.5% of 
patients 

Cholestatic syndrome - yellowing of the skin, sclera, 
mucous membranes was not observed in 28.3% of 
patients, subjective and objective symptoms were 
observed in 48.3% of patients, and only one symptom 
was observed in 23.3% of patients. 

In conclusion, it was found that chronic hepatitis is 
more common in women than in men. The clinical 
picture often shows a combination of subjective and 
objective signs. 

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