N. Khorolsuren 

School of Medicine, Health Sciences University of Mongolia

Viral hepatitis (HCV) is a common disease in the world as well as in Mongolia. Discovery of HCV in 1989 gives an opportunity to diagnose this disease. HCV infection takes place of 10.7-34.6% in whole population of Mongolia, 9.8% in children, 20.3% among cases of acute and 38.8-46.5% of chronic viral hepatitis and 59.1 -62.1 % in cases of hepatocellular carcinoma. To study the feature of clinical picture of HCV infection in Mongolian women of reproductive age and its natural history, to work out the methods of diagnosis and management. The study was carried out in 257 patients which divided into 173 patients with acute and 21 with chronic viral hepatitis C. The diagnosis was established by positive anti-HCV, anti-HCV-IgM and HCV-RNA by PCR, negative anti-HAV-IgM, HBsAg, anti-HBc-IgM, anti-HDV. The dominant age of patients with acute hepatitis C was 20-39 years (86.1%). Common ways of transmission were blood and blood products transfusion in 42.8%, birth delivery through Cesarean operation 17.3%, normal birth delivery 19% and other gynecological manipulations 15%. Incubation period lasted approximately for 46.7 days. In clinical picture mild form of hepatitis C occurred in 43.9%, moderate in 43.9%, and severe in 12.2%, as comparing to B viral hepatitis predominated mild form (p<0.01). In preicteric period dyspeptic syndrome proceeded in 85.5%, astenovegetative in 58.9%, lasting 4.9 days. During icteric period the predominant complaints were: loss of appetite 74.5%, discomfort in the epigastria part 59.5%, nausea 59.5%, epigastria pain 26.5%. 170 patients had typical form of disease and high level of bilirubin correlated with the severity of illness (p<0.01), in which thejaundice disappeared after 18.4 days. But the level of ALAT in acute viral hepatitis C did not correlate with the severity of the disease and in 52.6% fell to normal level. 50 patients with acute form of HCV infection were observed following up for 10 years, in which 24% did not have complaints, any clinical signs, negative HCV-RNA, 76% involved in chronic hepatitis. In our study were involved 36 women who were infected by acute viral hepatitis C during their pregnancy. 9 (33.3±9%) premature labours occurred in 27 labours. Premature labour and labour complications (rupture of amniotic fluid, powerless labour, uterine bleeding) in women with acute viral hepatitis C were 3-7 times more frequently than in healthy one. The pregnancy didn't influence on the disease progress. In comparison study 2b interferon therapy 21 women with chronic hepatitis C were treated for a long time, in which this therapy showed effectiveness in 42.8%, compared with men. Our study showed the beneficial effectiveness of right selection of the patients to the interferon therapy. Acute viral hepatitis C is commonly parenterial transmission. The incubation period of disease was short and the progress was severe (p<0.01) at the time of transfusion of blood and blood products, surgical manipulations, and these transmission associated. Clinical picture of acute viral hepatitis C has tendency to mild form, but the rate of chronicity is in a high level (76%). Interferon therapy in women with chronic hepatitis C is more effective than in men.