[Bacterial complications in acute hepatic failure in patients with hepatitis B]. / O bakterial'nykh oslozhneniiakh pri ostroi pechenochnoi nedostatochnosti u bol'nykh virusnym gepatitom B.

With virus hepatitis B (VHB) associated with acute hepatic insufficiency, precoma and coma, one third of the patients develop bacterial purulent inflammatory complications involving mainly biliary system and intestine. Attendant bacterial complications promoted rapid progression of hepatic coma seen commonly on day 1-10 of the disease. The diagnosis in relevant patients recognizing bacterial complications clinically should be based on alterations in the liver size, the presence of fever, elevated body temperature, relatively low decrease of prothrombin index and fibrinogen against leukocytosis with stab neutrophil shift. These symptoms call for introduction of antibacterial drugs.

[Factors of nonspecific resistance in hepatitis B and acute hepatic insufficiency]. / Faktory nespetsificheskoi rezistentnosti pri virusnom gepatite B s ostroi pechenochnoi nedostatochnost'iu.

Studies of nonspecific resistance factors in grave forms of viral hepatitis B (VHB) have revealed their significance in the prediction of acute hepatic insufficiency (AHI) development and its unfavorable outcome. IgM and IgA levels were found the most informative as far as the prognosis is concerned; these levels were the highest in the patients with precoma eventuating in hepatic coma. C3 complement concentration was reduced in all the patients whatever the disease severity, but more so in those developing AHI, which fact may serve the criterion predicting AHI development in VHB; to add to this, C3 complement level reflects the degree of hepatocyte destruction whereas the degree of transferrin level reduction is explained by its impaired synthesis by the liver as well. Transferrin levels were reduced in all the patients with AHI.