Prevalence of hepatitis C virus and distribution of its genotypes in Northern Eurasia.

We tested hepatitis C virus (HCV) antibody in 4216 sera collected from healthy people living in European part of Russia (including Northern, North-Western, Central, Central-Blacksoil, Volga-Vyatka, Volga, and North-Caucasian regions), non-European part of Russia (the Urals, East-Siberia, and the Far-East regions) and Mongolia. Prevalence of HCV antibody varied significantly by regions, ranging from 0.7% in Central region of European part of Russia to 10.7% in Mongolia. Genotyping of HCV (into 1a, 1b, 2a, 2b, and 3a) was performed on 469 sera from blood donors and patients (in Russia, Moldova, Turkmenistan, and Mongolia) who were positive for both HCV antibody and RNA. Genotype 1b was the most dominant genotype irrespective of regions (68.9%), with the highest rate in Moldova (96%). HCV unclassifiable into genotypes 1a-to-3a was found in 28 (6.0%) samples: particularly 4 of 10 samples from Lipetzk were untypable. Overall, HCV genotypes in European part of Russia were more similar to those in European countries, while those in Eastern part of Russia more similar to China or Japan. Genotype distribution was not associated with the clinical expression of HCV disease: acute hepatitis, chronic hepatitis or liver cirrhosis.

[The transformation of acute viral hepatitis B into chronic]. / Transformatsiia ostrogo virusnogo gepatita B v khronicheskii.

500 patients with hepatitis B have been followed up from the acute onset to long-term outcome. As for chronic transformation of the disease, at higher risk are patients with mild form, progredient run and inadequate immune response. Of the highest value for identification and prognostication was a dynamic quantitative control over the system HBeAg-anti-HBe providing separate prognosis of establishment of replicative or integrative variants of chronic hepatitis B. In progredient infection an early administration of reaferon in combination with thymogen is thought valid which in many patients is sufficient to prevent the disease transformation into a chronic form.

[Control over the viral DNA level of patients with hepatitis B in the prognosis of its chronicity]. / Kontrol' za soderzhaniem virusnoi DNK u bol'nykh ostrym gepatitom B v prognozirovanii khronizatsii.

Viral DNA in the blood was measured by molecular hybridization in 210 patients with acute hepatitis B (HB) running mildly. It was established that the disease chronicity may be predicted by dynamic control of HBV DNA content. Relevant algorithm has been derived. Early detection of the chronicity threat was of great importance for early start of preventive etiotropic antiviral therapy.

[Clinico-immunological variants of extremely severe course of hepatitis B]. / Kliniko-immunologicheskie varianty osobo tiazhelogo techeniia gepatita B.

Analysis of the results of comprehensive clinical and immunologic examinations of 29 patients with hepatitis B running a particularly severe course has helped single out 2 variants of the immunogenesis of this form of the disease. Contribution of hyperimmune and autoimmune mechanisms and a high degree of the determination of the immunopathologic process are the major features of the first variant. In the second variant the infectious process per se plays the major role due to the direct viral cytolysis of the hepatocytes and/or a higher infective dose. Dynamic monitoring of hepatitis B specific markers, of the T-lymphocyte reaction, of autoimmune process markers, together with immunologic screening help predict the possible development of various patterns of particularly severe course of the disease and thus give grounds for differentiated therapy.