Epidemiology of hepatitis D virus (delta) infection in Yugoslavia.

In 614 HBsAg-positive Yugoslavian patients, radioimmunoassay testing for anti-delta showed the presence of this antibody in serum in 11.2%. Of the patients, 213 belonged to a risk group (i.v. drug users, hemophiliacs, hemodialysed patients and patients with posttransfusion hepatitis); a significant number of these patients (63; 29.6%) were found to have anti-delta. A second group was composed of 401 HBsAg-positive patients from the general population (patients with acute hepatitis B, with fulminant hepatitis B and patients with chronic HBV infection); delta infection was found only in six (1.5%). Immunohistochemical methods failed to demonstrate the delta antigen in the livers of 73 patients with chronic HBV infection. Testing the liver of 36 patients with fulminant hepatitis B for delta antigen demonstrated this reactivity in only one (2.8%) liver sample. Delta antigen was also found in the liver of a female patient who underwent biopsy in 1972. The results of this study suggest the HDV is not endemic in Yugoslavia; however, it is frequently found in patients at risk of blood exposure, primarily i.v. drug users.

[Diagnostic and prognostic criteria in acute non-A, non-B viral hepatitis with a prolonged course]. / Dijagnosticki i prognosticki kriterijumi u akutnom virusnom hepatitisu "ni-A-ni-Be" produzenog toka.

In a prospective three-year-long study of Non-A, Non-B infections carried out in the Institute of Infectious and Tropical Diseases in Belgrade, by a method of exclusion and in about 30% of patients' liver biopsies, 75 cases of acute viral hepatitis Non-A, Non-B were discovered. It makes only 2.29% of all cases of acute viral hepatitis diagnosed and treated in the same period in this institution. In prolonged forms of the disease (24 cases) the chronicity was shown by epidemiological data (posttransfusion hepatitis), fluctuation of transaminase and rise of gamma globulins in acute phase of the disease. Liver biopsies performed in the first four months of the disease were of no prognostic value.

Management of chronic active B hepatitis with alpha interferon.

Patients with chronic active B hepatitis entered into an open study of IFN maintenance therapy. They received 3 x 10(6) I.U. INTRON-A by subcutaneous injection three times a week for a 4-month period. Four patients out of ten became HBeAg negative and anti-HBe, which was accompanied by the return of serum liver function tests to normal. In a control group with eleven patients, given only vitamins, no changes were registered in serological and biochemical data. Fever, "flu-like illness", fatigue were the main side-effects observed during the course of IFN therapy, which had not to be discontinued.

Recovery from herpes simplex virus type-1 hepatitis in a female adult.

A study of one case of herpes simplex hepatitis in an adult woman is presented. The clinical feature and laboratory findings were typical for acute hepatitis in a febrile patient without herpetic mucocutaneous lesions. The evidence of high IgM antibody titer in serum against herpes simplex virus and confirmation of the herpes simplex virus hepatitis by immunofluorescent microscopy after liver biopsy helped us establish the diagnosis. After 3-months the patient recovered.

The levels of free cholesterol and cholesterol esters in serum before, during and after the induction of experimental allergic encephalomyelitis in the guinea-pig.

Cholesterol esters and free cholesterol were determined in the serum of guinea-pigs with experimental allergic encephalomyelitis (EAE). EAE was induced by immunization with myelin basic protein (MBP). The results showed a marked decrease in cholesterol esters (CHE) 4 days after immunization. Seven days after immunization the values of esters increased and reached a maximum during the period of manifest clinical signs of EAE. After the cessation of clinical signs, after 2 weeks, the values of esters returned to the initial or somewhat lower values. The level of cholesterol was inverse to the values of cholesterol esters. Histological analyses showed characteristic changes in the brain and spinal cord. A possible correlation between the changes in cholesterol esters and cholesterol of the brain and serum in EAE is suggested.

Cytomegalovirus hepatitis (diagnosis and differential diagnosis).

In a 12-year-old female patients with HBAg phi hepatitis a differential diagnosis of the diseases has been considered. The CMV etiology of the hepatitis was suspected on the basis of a persistent temperature, hepatomegaly, a mild icterus, enlarged glands in the neck, predominantly mononuclear cells in the peripheral blood, a negative Paul-Bunnell test, and insufficiently characteristic biochemical analyses for virus A hepatitis. The CMV etiology of the disease was virologically confirmed. On the basis of the clinical picture without virological results, the diagnosis could not have been made with certainty.

[The serum prealbumin significance in differential diagnosis of the liver diseases (author's transl)]. / Präalbumine im Serum in der Differentialdiagnose der Leberkrankheiten

We investigated the serum prealbumin by the immuno-diffusion method quantitatively according to the method of Manzini in 20 normal persons, 30 patients with hepatitis virosa acuta, 24 patients with hepatitis chronica and 11 patients with cirrhosis of the liver. The serum prealbumin was significantly decreased in patients with hepatitis acuta virosa, hepatitis chronica aggressiva and in cirrhosis of the liver, but in the patients with the hepatitis chronica persistens the serum prealbumin levels were normal or little increased. According to our results we concluded that the determination of serum prealbumin is important only for the differential diagnosis between the hepatitis chronica aggressiva and hepatitis chronica persistens. However these determinations are not of values in the differential diagnosis between hepatitis chronica aggressiva and cirrhosis of the liver.