[Biochemical indices of connective tissue metabolism in patients with chronic hepatitis B and C].

37 patients with chronic hepatitis B and C were examined. Patients were divided into 3 groups depending on the degree of connective tissue dysplasia. We investigated: free and protein-bounded hydroxyproline, collagenase activity, total alkaline phosphatase and its bone fraction, creatinine, calcium and phosphorus content in the blood serum and urine. It has been found the dependence of collagen synthesis from the state of connective tissue. The higher is the degree of dysplasia, the more intensive is the process of collagen synthesis (P < 0.05). The index of corellation between protein-bounded and free fraction can be used as a biochemical marker for determination the stage of pathological process in the liver and for monitoring the effectiveness of therapy.

[Retherapy with lamivudine in hbeag-negative chronic hepatitis B patients unresponsive to interferon/peginterferon treatment].

The paper gives data on retherapy with lamivudine in seven HBeAg-negative chronic hepatitis B patients previously unresponsive to interferon-alpha and peginterferon-alpha2b therapy (6 unresponsive patients and 1 with recurrence). Prior to lamivudine therapy, hepatic biopsy and HBV genotyping were carried out and the baseline level of viremia and the presence of YMDD mutations were determined in all the patients. Its therapeutic efficiency was based on viremia level and AIAT activity at 6, 12, 18, and 24 weeks of treatment. Six of the 7 patients, including 2 receiving peginterferon-a2a, achieved a virological response. Trends in viremia within the first 12 weeks of treatment were a major factor to assess the virological response. Positive predictors during retreatment with lamivudine are discussed.

[Spontaneous HCV clearance: an association with gender, age, viral genotypes, infection transmission routes, and markers of HBV and HIV].

AIM: To determine the rate of spontaneous recovery depending on gender, age, prior icteric hepatitis, infection transmission routes, HCV genotype, markers of HBVand HIV. SUBJECTS AND METHODS: A humoral immunity response to core antigen and nonstructural viral proteins was assessed in patients with HCV clearance and in a group of patients with chronic hepatitis C (CHC). Two hundred and thirty-eight anti-HCV positive patients were examined. Spontaneous viral clearance (SVC) was diagnosed in 27 (12.1%) patients; a false-positive anti-HCV reaction was seen in 15. The spontaneous recovery group comprised young patients with a female predominance: 66 versus 41.9% in the CHC group. RESULTS: 25.2% of the examinees with SVC had a history of the icteric form of acute viral hepatitis. There were no significant differences between HCV genotype and disease outcome. The markers of retrospectively sustained HBV infection were more detectable in the spontaneous recovery group: anti-HBc 48.1% and anti-HBs 14.8%; these were 32.6 and 8.7%, respectively. HIV co-infection reduced the likelihood of recovery. The determination of antibodies to nonstructural viral proteins could state their rare identification in patients with spontaneous HCV clearance (anti-NS3 HCV, 100%; SVC, 42.3%; NS4 HBC, 95.5%; SVC, 30.8%; p < 0.0001). AntiNS5 was only in 15.4% of the recovered patients and in 89.8% of the patients with chronic infections (p < 0.0001). CONCLUSION: Rare detection of anti-NS5 may serve as an additional serological marker indicating to spontaneous HCV clearance in anti-HCV positive patients.

[Antiphospholipid syndrome at the onset of clinical manifestations of chronic autoimmune hepatitis of type I].

The paper describes a case of chronic autoimmune hepatitis of type I (CAH-I) that showed an onset accompanied by the antiphospholipid syndrome (APS). At the same type, CAH-I ran without both clinical manifestations and the major laboratory syndrome - cytolytic one, which substantially made the diagnosis of a hepatic disease difficult. It is concluded that the clinical manifestations fitting into the APS necessitates meticulous clinical, laboratory, and instrumental studies to find out the underlying disease.

[Latent HBV infection in single blood donors].

A total of 14,366 one-time blood donors were examined; 984 (6.8%) donors of them were found to have anti-HBc. All anti-HBc-positive samples were tested for HBsAg, IgM anti-HBc, HBeAg, anti-HBe, and specific DNA-HBV by polymerase chain reaction (sensitivity 400 coplml or higher). Anti-HBc in combinations with HBsAg, anti-HBe, IgM anti-HBc was detected in 29 (2.9%), 3 (0.3%), 5 (0.5%) donors, respectively. Specific HBV DNA was identified in 29 donors with HBs-antigenemia and in 9 anti-HBc positive donors in the absence of serum HBsAg. The activity of AIAt was correlated with neither HBsAg nor HBV DNA. Thus, latent HBV infection is 0.9% of anti-HBc-positive one-time blood donors and tests for anti-HBc may be useful in identifying persons who need a more meticulous study for HBV DNA.