Research objective: identification of the nature of liver damage in residents of endemic territory with a chronic phase of opisthorchiasis. In 273 patients with chronic phase of opisthorchiasis, by the absence of markers of viral, autoimmune hepatitis and aggravating factors (drug and alcoholic nature) and duration of invasion for at least five years, there were revealed pronounced pathomorphological changes of cytolytic syndrome (40,3%) to liver fibrosis (2,6 %) and carcinogenesis (1,1%). The nature of the pathology (according to ultrasound, computed tomography, liver biopsy) indicated the development of steatosis and steatohepatitis (in 42,9% and 8,8% of cases observed, respectively) with hepatomegaly (57,5%) and disorders of pigment metabolism in 19,4% of patients. In 15,7%, hyperbilirubinemia with predominance of the indirect fraction was a manifestation of Gilbert’s syndrome. The presented data should be taken into account when conducting differential diagnosis, etiological interpretation of liver pathology in the group of unspecified hepatitis and cirrhosis for timely diagnosis of opisthorchiasis, complete dehelminthization and prevention of development of adverse outcomes in such patients.

Introduction. HCV is the cause not only of cirrhosis, hepatocellular carcinoma, but also extrahepatic manifestations. Currently, HCV is considered as an independent risk factor for thyroid pathology. In recent years, the level of pathology of the thyroid gland in the Altai Territory has increased by 16.4 times, which determined the purpose of this study: to study the features of the thyroid status in patients with chronic hepatitis C (CHC) in the Altai Territory. Materials and methods. There was executed a prospective, dynamic clinical, laboratory and instrumental examination of 240 CHC patients (47,5% of men and 52,5% of women aged of from 18 to 50 years), 120 of whom had HCV (49,1% of men and 50,9% of women, aged of from 18 to 50 years, mean age: 41,1±9,91 years) who did not receive antiviral therapy (HTV), the pathology of the thyroid gland in them was established for the first time. The study included the assessment of the level of TSH, total and free T3, T4, antibodies to thyreperoxidase (APPO), ultrasound examination of the thyroid gland. The diagnosis of CHC is based on HCV RNA, anti-HCV (core, NS3-5), blood biochemistry, fibrosis level score according to Metavir (elastometry, PBP). Results of the study. In HCV patients there were revealed autoimmune thyroiditis (AIT) (5%), AIT with hypothyroidism (10%), AIT with latent hypothyroidism (8,3%), latent hypothyroidism (10%), hypothyroidism (16,6%), euthyroidism (49,1%) and thyrotoxicosis in only 1 patient. Variants of thyroid dysfunction were presented in the form of euthyroidism (60%), hypothyroidism (20%), hyperthyroidism (10%) and autoimmune thyroiditis (10%). The relationship between the development of the thyroid dysfunction (TD) and the history of the history of HCV infection has been established. Discussion and conclusions. CHC patients were more likely to have a history of euthyroidism and hypothyroidism. The relationship between TD and the duration of HCV infection can be regarded as its extrahepatic manifestation, and not as comorbid conditions. Thorough examination of the thyroid status it makes possible to identify TD people, which can be reflected in the choice of antiviral therapy and will determine the prognosis of the development of side effects.