[Reaferon treatment in acute HBsAG-positive viral hepatitis]. / Lechenie reaferonom ostrogo HBsAg-polozhitel'nogo virusnogo gepatita.

Clinical, biochemical and serological examinations of 412 patients with acute HBsAg-positive virus hepatitis were conducted to assess therapeutic efficacy of Soviet recombinant alpha 2-interferon (reaferon). There were 309 cases of acute virus hepatitis B, 103 of delta infection (71--coinfection, 32--superinfection). The study and control groups were assigned randomly. Reaferon i.m. administration started on jaundice day 1-5 and lasted for 10-11 days. The treatment proved effective in acute hepatitis B running a moderately severe and severe course up to the development of acute hepatic encephalopathy. In delta infection reaferon produced response in coinfection only. In fulminant hepatitis the treatment was uneffective.

[Activation of the interferon system enzymes by recombinant alpha2-interferon in patients with chronic hepatitis B]. / Aktivatsiia rekombinantnym alpha2-interferonom fermentov sistemy interferona u bol'nykh khronicheskim gepatitom B.

Treatment of patients suffering from chronic hepatitis B with recombinant leukocytic interferon (reaferon) increased the levels of circulating interferon and activated interferon-dependent enzymes such as 2-5A-synthetase and histone kinase. Activation of the enzymes was observed for 1 to 2 weeks. After that period it was maintained at the required levels with intramuscular administration of 1-3 million units of reaferon 2 or 3 times a week. In parallel with increasing of the levels of the interferon system enzymes there was observed a decrease in the level of aminotransferase. The reaction of the viral antigens to the treatment with reaferon was not the same: HBe antigen and antibodies to HBe antigen disappeared, the content of HBs antigen and antibodies to delta-interferon did not change.

[Lymphocyte subpopulations in patients with viral hepatitis B and delta-infections]. / Subpopuliatsii limfotsitov u bol'nykh virusnym gepatitom B i del'ta-infektsiei.

Changes in subpopulations of T3, T4, T8, HNK-1, Ia-positive, B-IgM and B-IgG producing lymphocytes were studied in patients with acute and chronic active virus hepatitis B and delta infection. A decrease of T4-helpers/inducers was demonstrated in all the groups under study and of T3-lymphocytes only in patients with delta-hepatitis turning into liver cirrhosis. The number of suppressors/cytotoxic T8 cells increased and T4/T8 ratio decreased in most patients. The number of HNK-1, Ia-positive, B-IgM and B-IgG lymphocytes increased in many subjects examined. Most marked quantitative changes in lymphocyte subpopulations were observed in patients with severe forms of delta-hepatitis and with liver cirrhosis. Changes in lymphocyte subpopulations in patients with viral hepatitis B and delta-infection are explained by reconstruction of the immune system in response to infection, affection of lymphocytes with viruses and emergence of antilymphocyte antibodies.

[Interferon in the treatment of acute viral hepatitis B]. / Interferon pri lechenii ostrogo virusnogo gepatita B.

The Soviet leukocytic alpha 2-interferon obtained by gene engineering was assessed (according to the clinical and biochemical findings) for the therapeutic efficacy in acute viral hepatitis B. The drug was injected intramuscularly to patients with grave and medium-grave hepatitis during 10 days. The treatment was instituted within the first 1-5 days of jaundice. The patients with medium-grave acute viral hepatitis B manifested a beneficial therapeutic effect of alpha 2-interferon obtained by gene engineering as did the patients with the grave disease pattern before they developed the signs of liver encephalopathy.

[Ultrastructural changes in the hepatocytes in chronic delta infection]. / Ul'trastrukturnye izmeneniia v gepatotsitakh pri khronicheskoi del'ta-infektsii.

Electron microscopy and morphometry were used to study liver biopsies from 22 patients with chronic active hepatitis. On the basis of clinico-morphological data 9 patients were diagnosed as having chronic active delta hepatitis and 13 patients chronic active hepatitis B. The studies indicate more marked involvement of hepatocytes in chronic delta hepatitis as compared with chronic hepatitis of HB virus etiology. Morphometric methods allow quantitation of the degree of manifestations of hepatocyte ultrastructural changes in the two groups of patients.

[Chronic hepatitis B and delta-infection]. / Khronicheskii gepatit B i del'ta-infektsiia.

Delta infection was investigated in patients with chronic viral hepatitis by means of detecting antibodies to the delta agent in the patients' blood with the use of radioimmunoassay. It was demonstrated that chronic viral hepatitis B is often (in 44.5% of cases) associated with delta infection and takes a course similar to that of chronic hepatitis A. In this case demonstrable liver injury is observed, which is supported by the clinical, biochemical and morphological findings.

[Delta infection in patients with chronic viral hepatitis B]. / Del'ta-infektsiia u bol'nykh khronicheskim virusnym gepatitom B.

The results of examination for anti-delta antibodies in the blood of 86 patients (33 children and 53 adults) with chronic persisting hepatitis (CPH) and chronic active hepatitis (CAH) verified by morphological examinations of liver biopsy specimens are presented. Delta infection was found in 43 (31.5%) of patients with CAH, only anti-HBe being demonstrable in the blood. In this group of patients, marked enzymatic disorders and more intensive changes in the morphological picture of the liver were demonstrated.

[Incidence of antibodies to the delta antigen in chronic hepatitis patients]. / Chastota rasprostraneniia antitel k del'ta-antigemu u bol'nykh khronicheskim gepatitom.

Elisa was used to study the rate of detection of antibodies to delta antigen in 74 patients with chronic HBsAg-positive hepatitis. These antibodies were found in 33.8% of the subjects examined including 60.9% of the patients with chronic active hepatitis and 20.0% of patients with chronic persisting hepatitis.

[Immunological patterns in acute viral hepatitis B]. / Immunologicheskie zakonomernosti pri ostrom virusnom gepatite B.

The results of studies on hepatitis B markers (HBsAg, anti-HBs, anti-HBc) by highly sensitive methods in 560 patients aged from 15 to 77 years are presented. Three immunologic groups of HB patients were detected. The first group is most numerous (77%), HBsAg is found in the blood of patients in high concentrations by the gel precipitation test. The second group (19%) has a low concentration of HBsAg detectable only by the RIA. The third, smallest (4%), group showed antibodies to HBsAg of IgM class in the blood from the first days of jaundice in the absence of HBsAg. All the 3 groups differed in the regularities of detection of humoral and cellular immunity and in clinical manifestations of the disease in the acute and convalescent periods. The most severe forms of the disease are associated with the early appearance of free anti-HBs in the blood and a significant decrease in the levels of T-lymphocytes which may be used as immunologic markers for prognosis of the disease.

[HBcAg antibodies in acute viral hepatitis B in adults and infants in the 1st year of life]. / Antitela k HBcAg pri ostrom virusnom gepatite B u vzroslykh i detei 1-go goda zhizhi.

The study was carried out with blood sera from 122 patients with viral hepatitis B (94 adults and 28 infants). The specific markers of hepatitis B virus (HBsAg, anti-HBs, anti-HBc) were tested in the time course of the disease at 10-day intervals in the acute period and for a year after the discharge. Radioimmunoassay (RIA) revealed anti-HBc in the blood of adults and infants suffering from hepatitis B both in the presence and absence of HBsAg. Anti-HBc titres were mostly high (over 1:1500) in the acute period of the disease and persisted at high levels (1:1900) for a year after the acute disease. Anti-HBc titres were found to correlate with the severity of the disease: low titres (1:500) were detected only in severe cases. Anti-HBc demonstrated in the blood from the first days of the disease belonged to immunoglobulins M. A group of patients with hepatitis B was examined in the acute period for anti-HBc only in the absence of HBsAg and anti-HBs by RIA. In convalescence all these patients developed anti-HBsAg. No fatal outcomes were observed.

[Improvements in the laboratory diagnosis of hemorrhagic fever with a renal syndrome]. / Usovershenstvovanie laboratornoi diagnostiki gemorragicheskoi likhoradki s pochechnym sindromom.

The results of the employment of direct solid-phase enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA) for the detection of antigen and antibody to the virus of hemorrhagic fever with renal syndrome (HFRS) are first presented. Unlike the previously used fluorescent antibody technique (FAT), the immunosorbent methods allow the quantitation of te HFRS antigen, the sensitivity of ELISA and RIA methods for antigen detection being 8-16-fold higher than that of FAT. In antibody determinations, a significant advantage of ELISA and RIA consists in reproducibility of the results due to the standardization of the antigen dose. The observed dynamics of antibody response to HFRS virus is peculiar and somewhat similar to seroconversion in epidemic nephropathia in the Scandinavian countries.

[Non-A, non-B hepatitis: a new form of serum hepatitis]. / Gepatit "ni A, ni B"--novaia forma syvorotochnogo gepatita.

Forty-seven patients with acute icteric form of "non-A-non-B" hepatitis which was diagnosed on the basis of clinico-epidemiological data, confirmed by the lack of HBsAg in the blood serum of the patients tested by sensitive methods (RIA, ELISA), and by the lack of rise in antibody titers to HBsAg and hepatitis A virus were observed. All the patients had undergone parenteral manipulations including blood transfusions in 34% of the cases. The incubation period was 66.9 +/- 7.07 days. "Non-A, non-B" hepatitis ran a comparatively mild course, with rapid regression of biochemical and clinical signs. Chronic persisting hepatitis developed in 5% of the cases. The above results suggest that "non-A-non-B" hepatitis is a distinct form of serum hepatitis.