[Chronic hepatitis delta--the course and approaches to therapy]. / Techenie khronicheskogo gepatita del'ta i podkhody k lecheniiu.

Variants of chronic hepatitis delta (CHD) course were studied in 94 patients. Slow progress (for decades) occurred most frequently, while rapid progress to hepatic cirrhosis (for 1-2 years) or benign course presenting as greater than 3-year remission were rare findings. In addition to routine therapeutic modalities, except corticosteroids, 43 CHD patients received recombinant alpha 2-interferon (reaferon). Follow-up results evaluated separately for hepatic cirrhosis and free of it CHD patients support clinical promise of Soviet recombinant alpha 2-interferon against CHD.

[Role of delta infection in fulminant course of viral hepatitis]. / Rol' del'ta-infektsii pri ful'minantnom techenii virusnogo gepatita.

Sera from 35 fulminant hepatitis patients admitted to the hospital at the USSR AMS Research Institute of Virology in 1985-1989 were studied for specific markers of NB and delta infection. Delta-infection as etiological factor of the disease proved in 26 patients (74.3%). Acute hepatitis of mixed etiology (HBV and HDV) occurred in 17, acute hepatitis delta in 9 patients carrying chronically HBsAg. Acute hepatitis B was verified in the rest 9 patients. Clinical, biochemical and serological aspects typical for the variety of etiological variants of hepatitis running a fulminant course are considered.

[The localization of delta antigen in the hepatocytes in chronic delta hepatitis]. / Lokalizatsiia del'ta-antigena v gepatotsitakh pri khronicheskom gepatite del'ta.

The results of immunohistochemical and electron microscopic examinations of liver biopsies from 47 patients with chronic delta hepatitis are presented. Delta antigen (HDAg) was detected by immunoperoxidase method in the liver of 35 (74.4%) patients. HDAg was demonstrated in hepatocyte nucleus alone in 22 (62.9%) patients, simultaneously in the nucleus and the cytoplasm in 9 (25.7%), in the cytoplasm alone in 4 (11.4%). In nuclear localization, delta antigen may fill the entire nucleoplasm or only the peripheral zone of the nucleus. When delta antigen fills the entire nucleus, hepatocytes undergo more marked pathological changes than those in which HDAg is localized in the nuclear periphery or those where no delta antigen was found.

[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.

[A study of the effect of thymotropin on immunologic indicators and excretion of virus in women with chronic cytomegalovirus infection]. / Izuchenie vliianiia timotropina na immunologicheskie pokazateli i ékskretsiiu virusa u zhenshchin s khronicheskoi tsitomegalovirusnoi infektsiei.

Thymotropic hormone was given subcutaneously in a dose of 100 mg twice a week for 3 months to 10 women with verified chronic cytomegalovirus infection. After termination of the treatment, in 8 women the virus excretion was decreased and this was accompanied with some improvement in immunological parameters: increased activity of natural killers, enhanced interferon-producing activity of lymphocytes, higher theophylline-resistant lymphocytes, and lower theophylline-sensitive T-cells. The above results confirm the association between the activity of cytomegalovirus infection and the state of immunity and allow thymotropic hormone to be recommended for treatment of other groups of patients with cytomegalovirus infection.

[Characteristics of viral hepatitis non-A, non-B with a fecal-oral mechanism of transmission of the infection in southern Uzbekistan]. / Kharakteristika virusnogo gepatita ni A ni B s fekal'no-oral'nym mekhanizmom peredachi infektsii v iuzhnom Uzbekistane.

An increase in the incidence of viral hepatitis was observed in the autumn of 1986 in one of the districts of southern Uzbekistan. The clinico-epidemiological data and highly sensitive tests for hepatitis A (HA) and B (HB) markers showed the absence of HB infection in most of the patients and prevalence of HA among children. In 68.7% of the patients, non-A-non-B hepatitis with fecal-oral mechanism of transmission of the infection was diagnosed. The bulk of HnAnB patients consisted of adults of 20-29 years. Pregnant women experience severe forms of the disease. Solid-phase enzyme-immunoassays and immune electron microscopy revealed in one fecal specimen from patients the antigen of non-A-non-B hepatitis serologically identical to that causing a rise in the incidence in northern Turkmenia in 1984-1985.

[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.

[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.

[Characteristics of the course and outcome of viral hepatitis A in patients treated at home]. / Kharakteristika techeniia i iskhodov virusnogo gepatita A pri lechenii bol'nykh na domu.

As many as 40 adult patients aged 15 to 40 years with virus hepatitis A treated at home were followed up since October 1987 to March 1988 in 6 districts of Moscow. There were 23 women and 17 men. The control group comprised 101 adult patients (46 women and 51 men) admitted to the Clinical Infectious Hospital No. 1. The diagnosis of virus hepatitis A was made on the basis of the clinico-epidemiologic and biochemical data, supported by detection of specific IgM antibodies to virus hepatitis A. Staying in bed, sparing diet and abundant drinking were indicated to all the patients. The patients who reported for work were followed up for 6 months. The mean duration of disability constituted 34.1 +/- 1.69 days, if the patients were treated at home and 38.6 +/- 1.26 days, provided they received hospital treatment. The number of lingering cases was 4 (10%) during the treatment at home and 11 (10.9%) at hospital treatment. The data obtained attest to the possibility of treating adult patients with virus hepatitis A at home.

[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.

[Immunoenzyme method for demonstrating the antigen and antibodies to the human immunodeficiency virus and its use for the serological examination of different population groups]. / Immunofermentnyi metod indikatsii antigena i antitel k virusu immunodefitsita cheloveka i ego ispol'zovanie dlia serologicheskogo obsledovaniia razlichnykh grupp naseleniia.

An enzyme immune diagnosticum for the detection of the antigen and antibody to human immunodeficiency virus (HIV) has been developed at D. I. Ivanovskii Institute of Virology of the USSR AMS. The method is based on the principle of competitive analysis using an antiviral conjugate which allows the sera to be tested without preliminary dilution and ensures a high sensitivity of the diagnosticum. The survey for HIV antibody covered 5743 subjects, among them 4898 Soviet citizens predominantly belonging to high risk groups of contracting AIDS infection, and 845 foreigners. No antibody to HIV has been detected in any of the Soviet citizens. Among the foreigners, antibody to HIV were detected in 6 subjects, all of them arriving from different African countries.

[The immune status in variants of the course and outcome of acute delta virus infection]. / Immunnyi status pri razlichnykh variantakh techeniia i iskhodov ostroi del'ta-virusnoi infektsii.

The immune status was investigated in 32 patients with acute hepatitis of mixed etiology and in 39 HBsAg carriers, superinfected with delta virus. The relationship of changes in the immune status with a course and outcomes of acute delta virus infection was revealed. These changes returned to normal on patients with a cyclic course of disease, persisted in patients with a lingering process, and progressed in the development of subacute liver dystrophy. The most noticeable shifts (a decrease in all indices of the immune system) were revealed in patients with a fulminant course of disease.

[Diagnostic significance of detecting respiratory virus antigens in cerebrospinal fluid and brain cells]. / Diagnosticheskoe znachenie obnaruzheniia antigenov respiratornykh virusov v likvore i kletkakh mozga.

Cerebrospinal fluid (CSF) from 202 patients (114 children and 88 adults) was studied by immunofluorescent techniques. Antigens of respiratory viruses in the CSF were most frequently encountered (22%) in patients with the involvement of the central nervous system (usually meningoencephalitis) in the presence of acute respiratory disease. In lethal outcomes in the same group viral antigens in brain cells were also identified. Clinical and morphological findings suggest that these lesions are infectious-allergic in nature. In rare cases (4%) viral antigens in the CSF and brain cells may also be found in patients with acute respiratory diseases without central nervous system involvement which happens when patients' blood-brain barrier is especially permeable.