[Detection of the markers of hepatites B and C and herpesvirus infection during pregnancy].

AIM: Identification of clinico-epidemiologic features of pareneteral hepatites (HB and HC) and herpesvirus infections (cytomegalovirus, CMVand herpes simplexvirus, HSV) duringpregnancy. MATERIALS AND METHODS: Two hundred pregnant women as well as 150 women--blood donors who comprised a control group were tested in Cheboksary (Chuvash Republic). There were no persons vaccinated against HB in both groups. Diagnostics of the HB and HC as well as CMV and HSV infections was performed by ELISA--HBsAg, anti-HBs, anti-HBc IgM and IgG, anti-HCV as well as IgM and IgG to CMV and HSV were determined; PCR was used to detect HBV DNA and HCV RNA. RESULTS: Moderate prevalence of HB and HC markers in pregnant (31% and 3% respectively) and donor women (34% and 2% respectively) as well as widespread prevalence of herpesvirus infections' markers (from 71% to 94.5%) was established. The studied women had no clinical manifestations of HB or HC as well as CMV or HSV infections at the time of the study. The study revealed the following: association between complications of pregnancy and detected markers of HB, HC, and herpesvirus infections according to trimester; detection rate of HBV and HCV markers in combination with CMV and HSV markers in pregnant women; association of pregnancy complications with presence of HB and HC markers with combination of herpesvirus infection markers. CONCLUSION: It was shown that pregnant women with presence of markers of studied infections present a risk group for development of miscarriage threat, inflammatory processes in placenta and amniotic membranes, and untrauterine fetal growth retardation.

[Immunoenzyme test-systems for diagnostics of cytomegalovirus infection].

Cytomegalovirus infection (CMVI) is becoming the serious medical-social problem both in clinical-epidemiological aspects and in connection with demographic consequences. One of the necessary conditions for solving this problem is the organization of regular and comprehensive epidemiological surveillance for CMVI. Thereby, improvement of methods of diagnostics is becoming the most actual issue. Immunoenzyme assay-based test-systems "ECOlab-CMV-IgM" and "ECOlab-CMV-IgG" which are able to detect IgM and IgG for CMVI diagnostics and assessment of IgG titers dynamics were presented. Their high specificity and sensitivity were shown.

[Seroepidemiological characterization of virus hepatitis in the Republic of Armenia].

The survey of the population immunological structure with respect to parenteral hepatitis showed awide circulation of hepatitis B (HB) and hepatitis C (HC) viruses among the adult population of Armenia. During the 5 year period of observation the number of persons having antibodies to HC virus increased 2.7-fold. High occurrence of antibodies to HBsAg of HB virus among the healthy population in 2002 (12.0%) in comparison with 1997 (5.4%) reflected a decreased infection rate with HB virus as well. Antibodies to hepatitis A (HA) virus were isolated, on the average, in 64 % of persons. Simultaneously with a decrease in the proportion of HA cases an increased number of HC patients was registered. No circulation of hepatitis E virus was detected. A high percentage of hepatitis cases of mixed etiology was established, as well as an increased number of combined parenteral hepatitis cases was registered (57.1%).

[Tendency and analysis of the epidemic situation in parenteral virus hepatitis B and C in the Russian Federation and a number of its regions].

As revealed in the present survey, during the last 3 years, against a background of decreased number of registered cases of acute hepatitis B (HB) and acute hepatitis C (HC), an increase in the proportion of patients with the chronic forms of these diseases was observed. The incidence rate of carriership of hepatitis B (HBV) and hepatitis C viruses (HCV) is many times greater than morbidity rates in acute and chronic forms of the disease. Such differences could be due to imperfect laboratory and clinical diagnosis. The registered statistics on HBV and HCV carriership included newly detected HBsAg and anti-HCV in the absence of clinical manifestations, which did not reflect the true spread of HBV and HCV in a given territory. The group of HBV and HCV carriers was found to include a considerable proportion of patients with asymptomatic form of HB and HC. It was testing for HBsAg, anti-HCV only without determination of virus replication markers (anti-HBc IgM, HBV DNA, anti-HCV IgM, HCV RNA) that seemingly determined the category of carriers greatly exceeding the true incidence. To obtain reliable epidemiological information, the complex detection of HB and HC infection markers is necessary.

[Viral hepatitis markers in saliva specimens from patients with acute hepatitis A, B and C]. / Markery virusnykh gepatitov v obraztsakh sliuny bol'nykh ostrymi gepatitami A, B i C.

Anti-HVA IgM, HBsAg, anti-HBc IgM, anti-HVC were determined in the blood sera and saliva specimens obtained from patients with acute hepatitis A, B, C (HA, HB, HC) and from healthy persons of the control group. 37 HA patients, 27 HB patients and 24 HC patients, observed in the dynamics of the disease (for a period of 1 month and longer from the appearance of manifestations of the disease), as well as 30 practically healthy persons (the control group) were examined. Anti-HVA IgM could be found in saliva specimens taken from the HA patients 100% of cases, but could not be found in saliva specimens from the persons of the control group and HB patients. The presence of HBsAg was established in 92.8% and anti-HBc IgM, in 100% of cases in saliva specimens from patients with acute HB. In no case HB markers were found in saliva samples obtained from HA patients and from the persons of the control group. In HBsAg-positive saliva specimens HB virus DNA was detected by the method of polymerase chain, reaction, which opened new aspects for the modern interpretation of the role of saliva as a factor in the natural transmission of HB. Anti-HVC could be found in all patients both in the blood serum and saliva specimens, but proved to be absent in the persons of the control group, as well as in HA and HB patients. The dynamic study of HA, HB and HC patients for the detection of anti-HVA and anti-HBc IgM, HBsAg and anti-VHC demonstrated the possibility of detecting these markers for 1 month and longer in the blood sera and in saliva specimens. The results of these investigations suggest that saliva specimens may be regarded as an alternative to blood sera in the diagnosis of HA, HB and HC in patients with acute viral hepatitis; these results also open prospects for the use of saliva specimens as an object of study in diagnostic laboratories, the deciphering of viral hepatitis outbreaks, the diagnosis of HA in persons with anicteric forms of HA.

[An unusual course of viral hepatitis A in children]. / Neobychnoe techenie virusnogo gepatita A u detei.

To determine the present-day specific clinical features of viral hepatitis A (HA) in children, observation on 447 children aged 1 year and 10 months to 14 years with verified HA monoinfection was carried out. At the season of 1993 essential differences were observed in the clinical picture of HA: the disease took a more severe course with the prevalence of medium-severe (59.3%) and severe (3.6%) forms of this infection, a tendency to a prolonged convalescence period and fermentative aggravations, an increase in the occurrence of cholestatic forms. One of the causes of this phenomenon may be attributed to changes in the properties of the infective agent.

[The morbidity and immunological structure of the population in viral hepatitis A at different phases in the development of multiyear epidemic cycles]. / Zabolevaemost' i immunologicheskaia struktura naseleniia pri virusnom gepatite A v raznye fazy razvitiia mnogoletnikh épidemicheskikh tsiklov.

For the first time population immunity to virus hepatitis A has been studied during three different phases of prolonged morbidity cycles of this infection, and the results of this study have been compared with the data on morbidity in different age groups. Pronounced variability of the immunological structure of the population in different age groups, found to be related to the dynamics of hepatitis A morbidity, has been established. Fluctuations in immunity level are most pronounced among children aged 1-6 and 7-14 years, having the least proportion of seropositive persons. A new epidemic cycle is started among these groups of the population, and at the first stage this cycle is manifested by an increase in the intensity of the latently developing epidemic process. This is followed by the activation of registered morbidity among the whole of the population. Seroepidemiological study may be used both for prognostication purposes and in the system of surveillance on this infection.

[A prognostic model of hepatitis A morbidity]. / Prognosticheskaia model' zabolevaemosti gepatitom A.

The growing interest to the study of the processes of the spread of hepatitis A (HA) in big cities of our country has stimulated the development of a new prognostic model at the Gamaleia Research Institute of Epidemiology and Microbiology. The model specifically takes into account a number of factors linked with the dynamics of the development of the disease in 6 stages and some regularities in the seasonal rises of HA morbidity. Quantitative relations in the mathematical model are determined by a system of nonlinear integral-differential equations with the first order partial derivatives and under the integral type boundary conditions, which increases the strictness of modeling of HA. The use of this new model has made it possible to carry out the prognostic-analytical study of HA morbidity among children in Perm and to evaluate a decrease in HA morbidity due to the hypothetical vaccination of children in spring months.

[HB viral infection in kidney diseases in children]. / HB-virusnaia infektsiia pri zabolevaniiakh pochek u detei.

A total of 142 children aged 2-15 years with different nephropathies, among them 94 children with glomerulonephritis (GN), 26 children with pyelonephritis and 22 children with oxalate nephropathy, were examined. The diagnosis was histologically confirmed in 36 children. Mesangial proliferative GN was detected in 22 patients and membrane proliferative GN, in 14 children. The presence of the markers of HBV infection (HBsAg, anti-HBs and anti-HBc total immunoglobulins, anti-HBc IgM) was detected in the sera of all patients by the enzyme immunoassay. As the result of this examination, essential changes in the distribution of different markers of HBV infection in children with nephropathies were detected. The combination of HBsAg with anti-HBc IgM proved to be the most characteristic feature of patients with the nephrotic syndrome; this was indicative of active HBV infection, and in patients with the mixed form of GN this combination occurred twice as frequently. The established correlation between the activity of HBV infection and the severity of the course of GN made it possible to suggest the participation of HBV in the pathogenesis of GN. This suggestion was indirectly confirmed by a higher detection rate of HBsAg and anti-HBc IgM in patients with the membrane proliferative form of GN.

[The dynamic production of interferons, interleukins and arachidonic acid metabolites by the blood cells of children with glomerulonephritis associated with HB virus infection while treated with reaferon]. / Dinamika produktsii interferonov, interleikinov i metabolitov arakhidonovoi kisloty kletkami krovi u detei s glomerulonefritom, assotsiirovannym s HB-virusnoi infektsiei, na fone lecheniia reaferonom.

The efficacy of therapy with reaferon (recombinant alpha 2-interferon) was studied in children with glomerulonephritis (GN) associated with hepatitis B virus infection as well as its effect on the interferon status (IFN), production of interleukins (IL) 1 and 2 and synthesis of active arachidonic acid (AA) metabolites by the blood cells in the course of treatment. The IFN status, IL-1, IL-2 production, and synthesis of AA active metabolites (LTB 4- and 5-HETE) by the blood cells, as well as markers of HBV-infection (HBsAg, anti-HBs, anti-HBc total and anti-HBc of the IgM class) were examined over time in 60 GN patients treated with reaferon alone and administered immunosuppression therapy (IST), with antioxidants, or IST alone. The employment of reaferon for treatment of GN patients was shown to increase the efficacy of GN treatment, especially in combination with immunosuppressive drugs, to prevent reactivation of hepatitis B virus when prednisolone and/or cytostatic drugs were used, and to reduce hepatitis activity. It way be assumed that the above effects were mainly due to the action of reaferon and antioxidants on the improvement of the condition of immunocompetent cells, primarily monocyte-macrophage system and leukocytes. During reaferon therapy, normalization of alpha-IFN and IL-1 production by the blood cells and inhibition of production of AA active metabolites were observed.

[The incidence of detecting HB viral infection in the families of patients with kidney diseases]. / Chastota vyiavleniia HB-virusnoi infektsii v sem'iakh bol'nykh s zabolevaniiami pochek.

A total of 33 families were surveyed with a view to determine the presence of viral hepatitis B markers in persons with diagnosed renal diseases. In all patients markers of hepatitis B virus infection (HBsAg, anti-HBs antibodies, anti-HBc total and IgM antibodies) were determined in the enzyme immunoassay. Those families in which examinees with renal pathology were found to have markers of hepatitis B virus infection exhibited a high level of contamination with hepatitis B virus. A high proportion of examinees with viral hepatitis B was established in the families where mothers were found to have markers of hepatitis B virus infection. These facts indicate that everyday contacts play an important role in the transmission of the virus. The study points out that in the family foci of hepatitis B virus infection non-manifest or slightly manifest forms of this infection are mainly registered.

[Effects of parathormone on 45Ca2+ accumulation in neurosecretory cells and contents of vasopressin in blood after administration of parathyroidin in parathyroid gland insufficiency]. / Vliianie paratgormona na nakoplenie 45Ca2+ v neirosekretornykh kletkakh i soderzhanie vazopressina v krovi pri vvedenii paratireoidina i nedostatochnosti okoloshchitovidnykh zhelez.

The functional state of hypothalamic-hypophyseal-neurosecretory complex was studied in parathyroidin injection and hypofunction of the parathyroid glands. In these conditions vasopressin levels in blood of the rats increased. The incubation of the hypothalamus with parathormone and 45Ca2+, as well as the injection of parathyroidin increased 45Ca2+ transfer to the neurosecretory cells and vasopressin release in the blood. Various mechanisms of similar influence of the parathormone and hypofunction of the parathyroid glands on a vasopressin level in blood are discussed.

[Morphofunctional state of the rat supraoptico-neurohypophyseal system in hypoparathyroisis]. / Morfofunktsional'noe sostoianie supraoptiko-neirogipofizarnoi sistemy krys pri gipoparatireoze.

Volumes of nuclei and nucleoli of neurosecretory cells of the hypothalamic supraoptic nucleus were investigated morphometrically, and the amount of neurosecretion in the posterior hypophyseal lobe was determined photometrically in rats at varying time of parathyroprivic hypocalcemia. The data obtained were indicative of increased function of the hypothalamic supraoptic nucleus on the 5th day of parathyroprivic hypocalcemia and a decrease in the amount of neurosecretion in the posterior hypophyseal lobe that can be interpreted as a sign of an increased discharge of neurosecretion into the blood flow. A decrease in function of neurosecretory cells of the supraoptic nucleus in parallel with an increase in the amount of neurosecretion in the posterior hypophyseal lobe on days 15 and 30 of development of parathyroprivic hypocalcemia indicated retention of a discharge of neurosecretion. Return of neurosecretion to normal tended to occur on day 60.

[Effect of parathyroid hormone on 45Ca2+ absorption in various rabbit tissues]. / Vliianie paratireoidnogo gormona na pogloshchenie 45Ca2+ v razlichnykh tkaniiakh krolika.

The 45Ca2+ absorption by the different tissues under PTH influence was studied by the radioisotope method as dependent on the incubation time. In all cases it was found that the tissue faculty of 45Ca2+ accumulation increases especially in the early period of the incubation. This effect results from a more intense activity of the membrane channels.

[Presence of markers of hepatitis B in patients with nephrotic syndrome]. / Chastota markerov HB-virusnoi infektsii u bol'nykh s nefroticheskim sindromom.

The purpose of the present work was to study the rate of HB viral infection from the standpoint of its pathogenetic importance in children with the nephrotic syndrome (NS). As many as 71 children aged 2 to 15 years with the NS were examined. 23 children with hematuric glomerulonephritic (GN) served as control. HB viral infection markers (HBsAg, anti-HBs, total anti-HBc and IgM anti-HBc) were detected in the blood serum by means of IEA in all the patients. The examinations made it possible to reveal material differences in the distribution of various combinations of VHB markers in children with the NS and hematuric GN. The combination of HBsAg and IgM anti-HBc turned out most characteristic for the NS, pointing to active NB viral infection. In patients with mixed GN, that combination was detectable twice as often. The data obtained attest te a high rate of the association of HB viral infection with GN, particularly with that running its course with the NS. In this case, the rate mentioned was significantly higher than in the population. A definite relationship between the activity of HB viral infection and the gravity of the NS suggests that VHB is implicated in the pathogenesis of GN. This suggestion may be indirectly supported by a far higher rate of HBsAg and IgM anti-HBc demonstration in patients suffering from membranoproliferative GN.

[Morphofunctional characteristics of neurosecretory cells of the supraoptic nucleus of rats with parathyroprival hypocalcemia]. / Morfofunktsional'naia kharakteristika neirosekretornykh kletok supraopticheskogo iadra u krys s paratireoprivnoi gipokal'tsemiei.

Humori-positive neurosecretory cells of the supraoptic nucleus of the hypothalamus have been investigated during various time of parathyroprival hypocalcemia after extirpation of the parathyroid glands. Contents of total and ionized calcium, phosphorus in blood serum have been estimated. Volume of nuclei and nucleoli has been measured. In 5 days functional activity of the supraoptic nucleus increases (lightly stained cells predominate, volume of the nuclei and nucleoli increases). In subsequent 15-30 days its activity decreases (increase in amount of dark-stained cells, nucleolar volume decreases). In 60 days there is a tendency to restoration of neurosecretion.

[Changes in the interferon status of patients with viral hepatitis B when genetically engineered alpha 2-interferon is used]. / Izmenenie interferonovogo statusa u bol'nykh virusnym gepatitom B pri ispol'zovanii genno-inzhenernogo al'fa 2-interferona.

The status of the interferon (IF) system in patients with acute viral hepatitis B (AVHB) was studied, and its importance as a criterion in the evaluation of the effectiveness of interferon therapy was demonstrated. The clinical study of alpha 2-IF was done in 152 patients with AVHB of moderate severity. The preparation was inoculated intramuscularly or intravenously in a dose of 1 X 10(6) IU twice daily for 5-10 days, a course dose being 10,000,000-20,000,000 IU. Considerable disorders in the functioning of the IF system and significant differences in the interferon status of patients in the study and control groups were demonstrated. The influence of alpha 2-IF on the time course of the interferon status depended on the clinical variants of the disease and the time of the preparation administration. The parameters of the IF system correlated with clinical manifestations of the disease and duration of hepatitis B virus persistence in the blood. This made it possible to use them as a criterion in the evaluation of the therapeutic effectiveness of alpha 2-IF.