[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.

[Effectiveness of using recombinant interferon alfa2 (reaferon) combined with antioxidants in children with acute hepatitis B]. / Effektivnost' primeneniia rekombinantnogo alfa2 interferona (reaferona) v komplekse s antioksidantami pri ostrom virusnom gepatite B u detei.

The authors describe the results of the first experience gained with the use of recombinant alpha 2-interferon in children with acute viral hepatitis B. The drug was administered rectally in combination with antioxidants (tocopherol). The study was carried out by the double blind method with randomization and two control groups (given tocopherol alone or placebo alone). 73 children with acute viral hepatitis B were examined. The therapeutic combination reaferon plus tocopherol was established to favour more rapid elimination of dyspeptic and abdominal phenomena, to shorten the time of the liver and spleen size increase, duration of hyperfermentemia, to provide for an accelerated reduction of HBsAg titers, elimination of HBeAg and seroconversion, to stimulate alpha-interferon production by leukocytes, and to activate the system of mononuclear phagocytes.

[Functional-metabolic activity of the mononuclear phagocyte system of the blood, liver, spleen and skin in children with hepatitis B]. / Funktsional'no-metabolicheskaia aktivnost' sistemy mononuklearnykh fagotsitov krovi, pecheni i selezenki, dermy pri virusnom gepatite B u dete'i.

A total of 102 children aged 5 to 14 years with virus hepatitis B were examined for the status of the mononuclear phagocytic system in accordance with the absolute monocyte count in the circulating blood, esterase and acid phosphatase activity in the monocytes, for function of organ macrophages of the liver and spleen using dynamic scintigraphy with TC-colloid and for macrophages of the skin by the "skin window" method. The rise of the absolute count and lowering of the functional and metabolic activity of blood monocytes were directly proportional to the gravity of virus hepatitis B. The changes persisted for a long time, namely up to 1.5 to 3 months since the disease onset. There was a progressive drop of the functional activity of Kupffer cells in the liver with a maximum decrease seen within 4 to 6 weeks since the disease onset, followed by returning to normal in cyclic disease and preservation of the changes in lingering and chronic virus hepatitis B. Spleen macrophages play an active compensatory role, maintaining normal "purifying" function of the mononuclear phagocytic system. That compensatory response tension appeared high in lingering and especially in chronic virus hepatitis and may serve as a criterion for process chronicity. The changes in the mononuclear phagocytic system observed in cyclic course of mild and medium-gravity virus hepatitis B may be regarded as normal adaptive reaction and do not require any drug correction. The latter one may only be indicated in patients with grave, lingering or chronic disease patterns associated with break down or depletion of the adaptive mechanisms of the system in question.

[Evaluation of the activity of liver and spleen macrophages in children with hepatitis A and B]. / Otsenka aktivnosti organnykh makrofagov pecheni i selezenki pri virusnykh gepatitakh A i B.

To form a judgement about function of liver and spleen macrophages (MP) in vivo, use was made of dynamic scintigraphy with Tc-colloid. Sixty-seven children aged 5 to 14 years were examined. Of these, 45 children were afflicted with virus hepatitis B (VHB), 16 with virus hepatitis A (VHA), and 6 children had VHA associated with asymptomatic HBsAg carriership. There was an appreciable decrease of the activity of liver MP attended by consistent compensatory activation of spleen MP in all the etiological types of virus hepatitis. The changes seen in patients with VHA and VHB turned out similar, differing in the rate of the recovery of normal correlations, which was more rapid in VHA. The characteristic feature of liver and spleen MP function in patients with VHA associated with HBsAg carriership consisted in the lack of the compensatory reaction on the part of spleen MP, which was likely to be connected with overstrain of long standing and depletion of the MP system due to permanent antigenic stimulation of HBsAg. The relationship was disclosed between the activity of organ MP and the phase of the infectious process, its gravity and course as well as the character of the patient's premorbid status and intercurrent infection.