Chronic viral hepatitis is a systemic disease characterized by a wide range of extrahepatic manifestations, such as cognitive impairment, chronic fatigue, sleep disorders, depression, anxiety and a decrease in quality of life. This article presents a summary of the main theories and hypotheses about the occurrence of cognitive impairment, features of treatment of patients with chronic viral hepatitis. Often, extrahepatic manifestations can outstrip the clinical manifestations of liver damage itself, which requires the use of additional diagnostic and treatment methods, and they can also significantly change the treatment tactics and prognosis of the disease. Changes in neuropsychological parameters and cognitive impairments are often recorded in patients with chronic viral hepatitis at stages characterized by the absence of significant liver fibrosis and liver cirrhosis. These changes usually occur regardless of the genotype of the infection and in the absence of structural damage to the brain. The purpose of this review is to study the main aspects of the formation of cognitive impairment in patients with chronic hepatitis, cirrhosis of viral etiology.

Background: The Turkestan region of Kazakhstan is the natural focus of the Congo-Crimean hemorrhagic fever (CCHF). Every year, some of the patients treated in hospitals are not included in official statistics and remain in the group of possible cases of CCHF. Objectives: This study aimed to verify the genotypes of the CCHF virus (CCHFV) in the Turkestan region and Shymkent City. Methods: Twelve blood samples from patients with CCHF were studied, the diagnosis of which was verified on the basis of positive specific immunoglobulins IgM to the virus. To isolate viral RNA, we used a special MAGNO-sorb kit. To detect RNA, CCHFV was used with a set of Amplisens CCHFV-FL by real-time polymerase chain reaction (PCR) using a Rotor-Gene Q device. For the reverse transcription reaction, we used a set of Reverta-L. Results: The study of the genome sequence of CСHFV from GenBank demonstrated that isolates from the Turkestan region belonged to genetic groups Asia-1 and Asia-2. Conclusions: For the first time in Kazakhstan’s history, a phylogenetic analysis of RNA sequences of viruses from patients with CCHF was performed in the Turkestan region, as a result of which genetic groups Asia-1, reassortant Asia-1, and Asia-2 were established

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Chronic viral hepatitis has a significant impact on morbidity, quality of life and mortality and is characterized by a growing economic and social burden in the context of disability of the population and an increase in life expectancy. Chronic viral hepatitis can significantly worsen health-related quality of life indicators (HRQoL), which are a reflection of the influence of the disease and therapy on the physical and emotional components of the patient's health, especially in patients with progressive liver disease and/or active viral activity. To assess the quality of life related to health, you can use general tools and tools for specific diseases. Common tools available in the scientific literature include the Short Form 36 questionnaire (SF-36) and the Euroqol five-point questionnaire (EQ-5D). However, since general instruments cannot always detect the subtle effects of a particular condition on the quality of life, the use of special instruments is of great value, due to their ability to clinically characterize the quality of life in patients with chronic viral hepatitis. The use of recently developed special tools for assessing the quality of life will greatly assist in the verification of preventive and therapeutic interventions in this area. One of the priorities of any measures for the prevention and treatment of chronic viral hepatitis is to improve the quality of life in this category of patients.