[Long-term results of HBV and HCV infection in patients with blood system diseases].

AIM: To specify trends in clinical and laboratory manifestations of virus hepatitis B and C (HBV and HCV) in patients with blood diseases from the moment of the first positive specific tests for HBV and HCV markers; to assess effects of HBV and HCV infection on efficacy of treatment of blood disease treatment, i.e. lifespan of patients with hematological diseases. MATERIAL AND METHODS: The study enrolled 257 patients: 205 with acute leukemia - AL, 40 with lymphoproliferative diseases, 4 - with CML and 8 - others; 8 healthy bone marrow donors. The patients were admitted to Russian Hematological Research Center in 2004-2006 Follow-up median was 253 days. A total of 7800 biological samples were studied, among them about 4000 tests for HBV DNA and HCV RNA. RESULTS: Positive tests for specific markers of HBV and HCV were absent only in 78 (29.4%) patients. Positive markers of coinfection were detected in 57 (32.8%) of 174 patients with HBV infection and in 81.4% of 70 patients with HCV infection. Probability of detection of HCV markers after positive tests for HBV markers and vice versa is about 3 times higher than probability of their isolated detection. Among patients infected with HBVsymptoms of hepatitis B are likely to appear in 56% patients to day 500 of follow-up from the date of the first positive specific test. Median of the interval between the first positive test for HBV markers and probable clinical signs of hepatitis was 30 days. Among patients with HCV infection, 85% develop hepatitis to follow-up day 300 since the date of the first specific positive test. Almost 100% patients infected with two viruses develop hepatitis to follow-up day 600. Median of the interval between the first positive test for HBV and HCV markers and probable hepatitis picture was 47 days. Overall 3-year survival of AL patients was 40%, of patients with lymphoproliferative diseases - 58%. Overall 7-month survival was 75% in AA patients. HBV infection in patients with blood disease is associated with high risk of death, especially in AA and AL. Association between HCV infection and survival is not proved. CONCLUSION: A high rate of clinical realization of viral hepatitis B and C, especially in coinfection, calls for virological and clinical monitoring of patients with any positive test for HBV and HCV markers.

[Detection of hepatitis C markers--nucleocapsid protein, RNA and virus-specific antibodies in blood donor plasma]. / Vyiavlenie markerov virusa gepatitia C--belka nukleokapsida, RNK i virusspetsificheskikh antitel v plazmakh krovi donorov.

Comparative study of hepatitis C virus (HCV) markers (core protein, RNA, and virus-specific antibodies) was carried out in plasma samples from 80 donors. A method based on sandwich ELISA with monoclonal antibodies to recombinant protein was developed for measuring core protein. Nucleocapsid protein was detected after various treatments of precipitates obtained after concentration of virus-containing material from plasma samples. These treatments allowed differentiation of core protein in virions, free nucleocapsids, and immune complexes circulating in peripheral blood. The minimal detectable concentration was 5 pg/ml, maximal 850 pg/ml. The detection of core protein virtually coincided with the detection of HCV RNA: 94.4% RNA-positive samples contained the virus protein. Other parameters (activities of antibodies to HCV in ELISA and level of SGPT) did not allow differentiation of plasma samples by the presence of actively replicating virus. Assay of nucleocapsid protein in the plasma of subjects infected with HCV in various populations of virus particles is important from practical (for blood service) and theoretical viewpoints (for studies of virus pathogenesis mechanisms).

[The serodiagnosis of viral hepatitis C]. / Serodiagnostika virusnogo gepatita C.

Sensitivities and specificities of four commercial enzyme immunoassay test systems manufactured by Ortho (USA), Abbott (USA), Organon (Netherlands), Innotest (Belgium) and of three pilot Russian diagnostic agents created at the Mazai Research and Production Amalgamation (Moscow) and the D. I. Ivanovskii Institute of Virology (Moscow) and Pasteur Institute (St. Petersburg) for detection of antibody to hepatitis C have been compared. A high incidence of hepatitis C virus infection was revealed in various Moscow populations: blood and plasma donors, inpatients, and medical staff.

[The diagnosis and prevention of parenterally transmitted viral infections]. / Diagnostika i profilaktika virusnykh infektsii s parenteral'noi peredachei.

The rate of the detection of the antibodies to HIV-1/2, HTLV-1, the markers of hepatitis B and C viruses and cytomegaloviruses in blood and plasma donors and persons with high risk of the infections was studied. A high percentage of the detection of the antibodies to hepatitis C virus (anti-HCV) was observed in the donors with increased levels of the serum enzymes, hematological patients, hemodialysis patients and drug addicts. A high rate of the indication of the HB virus markers was also observed in hematological patients and medical personnel of hematological and surgical clinics. At least 1 marker of HB virus was shown to be detected per 45 per cent of the reserve donors. The rate of the detection of anti-HCV in the donors of various regions ranged within 1-3 per cent in the Baltic countries, 2-5 per cent in Russia, 5-7 per cent in the Middle Asia and 8-12 per cent in Moldova. The data on the sensitivity and specificity of two commercial test systems for the detection of the antibodies to hepatitis C virus (Ortho, USA and Organon, Holland) were comparable.

[A retrospective examination of a hepatitis focus in plasma donors]. / Retrospektivnoe obsledovanie ochaga gepatita u donorov plazmy.

Data are presented on the retrospective epidemiological serological investigation of episodes of hepatitis-like diseases among plasma donors in Krasnoyarsk. A mixed structure of the focus was established with prevalence of B- and non-A-, non-B hepatitides. Markers of recent infection with HB virus were recorded in 43.6% of sick donors, at the same time no donors had IgM antibodies to hepatitis A evidencing the acute stage or early convalescence. The use of the insufficiently sensitive passive hemagglutination test for HBsAg identification has resulted in incomplete detection of donors-carriers of HB virus.

[The serodiagnosis of viral hepatitis C and B in different population groups]. / Serodiagnostika virusnykh gepatitov C i B sredi razlichnykh grupp nasea.

Data on the frequency of detection of serological markers of hepatitis C and B viruses using enzyme immunoassay for examinations of blood donors in different regions of the country, of patients with hepatitis of obscure etiology and patients with hemophilia regularly receiving hemostatic therapy are presented. The rate of detection of antibody to hepatitis C (anti-HCV) in reserve donors varied from 2% (Baltic states) to 9.2% (Moldavia), that of the carrier state of HBsAg from 0.3% to 10.3%, respectively. Among patients with hepatitis of obscure etiology, anti-HCV was found in 9-18%. A higher rate of anti-HCV was found in donors with high levels of aminotransferases (18.75%) and in patients with hemophilia (77.6%). Epidemiological serological surveys of group incidence of hepatitis revealed a high portion of incidence of virus hepatitis C (from 50 to 90%).

[Serological markers of viral infections and various indicators of immunity in patients with hemophilia]. / Serologicheskie markery virusnykh infektsii i nekotorye pokazateli immuniteta u bol'nykh gemofiliei.

The authors have studied the incidence rate for markers of viruses of AIDS (HIV), hepatitis B (HBV) and cytomegalia (CMV), as well as certain parameters of antiinfectious defense in hemophilia patients. A high incidence rate of HBV and CMV markers was established in the investigated patients, and among them no seropositive subjects, by antibodies to HIV, were detected. In the presence of a low incidence rate of chronic HBsAg-carriership in this category of patients, a significant number of immune subjects was observed, that correlated with a relative stability of such immunity parameters as concentration of serum immunoglobulin G and the level of circulating immune complexes.