Predicting acute viral hepatitis serum markers (A and E) in patients with suspected acute viral hepatitis attending primary health care centers in Baghdad: a one year cross-sectional study.

BACKGROUND: Viral hepatitis is an important preventable infectious disease with various rates of occurrence in different areas of the world. The main objective of the present study was to evaluate the role of some risk factors in predicting a positive acute viral hepatitis marker among patients with suspected acute viral hepatitis in a primary health care setting in Baghdad. Besides, finding out the occurrence of jaundice, contribution of viruses A and E to the cases that have occurred in Baghdad province was also searched for. METHODS: Over a period of 1 year a descriptive cross sectional study was carried out at the primary health care centers in Baghdad. A questionnaire form was used to collect data about demographic factors and the results of the investigations. Total serum bilirubin and bilirubin in urine were done at the primary health care center laboratory. The rest of the sera samples were sent to Hepatitis referral Lab at Central Public Health Laboratory (CPHL) to be tested for anti HAV IgM and anti HEV IgM using ELISA technique. RESULTS: A total of 7,576,372 consultations to primary health care centers were recorded in Baghdad. Among those a total of 2,692 cases (35.5 per 100,000 consultations) were labeled as acute viral hepatitis cases. A positive hepatitis viral marker (A, B, C and E) was found in 1,332 cases (17.6 per 100,000 consultations). More than two fifths (44.8%) of cases were positive for anti-HAV antibodies and another 1.6% had positive anti-HEV antibodies. CONCLUSION: During 1 year period, the rate of occurrence of suspected acute viral hepatitis cases was 35.5 per 100000 of consultations to the primary health care centers in Baghdad. Of the total suspected cases, only 17.6 per 100000 of the consultations were positive for one of the viral hepatitis markers. Those who tested positive for one of the viral hepatitis markers represent 49.5% of the suspected cases. Proportion of anti HAV IgM positive tests among suspected cases was 44.8%. Factors that were able to predict positive Anti HAV IgM were (younger age group, negative history of cupping or tattooing, negative past history of jaundice). Male gender was the least important predictor of a positive case for anti HAV IgM. Proportion of Anti HEV IgM positive tests among suspected cases was 1.6%. Of the factors studied, only age was able to predict a positive Anti HEV IgM in those more than 15 years. Further studies are recommended.

[Immunological safety and sensitizing effect of an MB-7-based vaccine against hepatitis A]. / Immunologicheskaia bezopasnost' i sensibiliziruiushchee deistvie vaktsiny protiv gepatita A na osnove shtamma MB-7.

The influence of a vaccine based on the MB-7 strain of hepatitis A virus (VP-MB-7) designed at the "Vector" Center of Virology and Biotechnology was studied. VP-MB-7 was found to provoke no allergic response and to have an activating effect on the specific and non-specific responses of cell and humoral immunity similar to those evoked by hepatitis A vaccine "Hep-A-in Vac".

[Safety research of a vaccine preparation in hepatitis A derived from the MB-7 rapidly growing strain]. / Izuchenie bezvrednosti vaktsinnogo preparata protiv gepatita A iz bystrorastushchego shtamma MB-7.

A study was undertaken to prove that a vaccine drug based on the fast-growing MB-7 (MB-7 VD) of hepatitis A virus (HAV) is safe. It was established that MB-7 VD, when once injected to white outbred mice and when 4 times injected to Hartley guineas pigs, did not cause any hematological and biochemical changes in the peripheral blood or in the condition of the central nervous system of experimental animals, which shows that MB-7 VD is free of any toxic properties.

[Peloid application to the area of the adrenal glands projection in the rehabilitation therapy of patient with viral hepatitis A and B]. / Applikatsii peloida na oblast' proektsii nadpochechnikov v reabilitatsionnoi terapii bol'nykh, perenesshikh virusnyi gepatit A i B.

Submitted in the paper are data secured in investigations designed to study efficacies of peloid applications to the area of projection of the adrenal glands in patients with the history of viral hepatits A and B presenting with a high risk of chronization of the illness. The analysis of the therapy effect was performed on the basis of examination of 45 VH reconvalescents with making use of clinical, biochemical and immunological investigational techniques. The findings obtained suggest restoration during the above therapy of the functional state of the liver as well as immunomodulating effect of the method, moderation of autoimmunoaggression, and expediancy of its employment in the rehabilitative period of VH in those patients presenting with signs of disfunction of the immunity system, history of allergoses and presence of concomitant pathology.

Photochemical inactivation of viruses and bacteria in platelet concentrates by use of a novel psoralen and long-wavelength ultraviolet light.

BACKGROUND: A photochemical treatment process has been developed for the inactivation of viruses and bacteria in platelet concentrates. This process is based on the photochemical reaction of a novel psoralen, S-59, with nucleic acids upon illumination with long-wavelength ultraviolet light (UVA, 320-400 nm). STUDY DESIGN AND METHODS: High levels of pathogens were added to single-donor platelet concentrates containing 3 to 5 x 10(11) platelets in 300 mL of 35-percent autologous plasma and 65-percent platelet additive solution. After treatment with S-59 (150 microM) and UVA (0-3 J/cm2), the infectivity of each pathogen was measured with established biologic assays. In vitro platelet function after photochemical treatment was evaluated during 7 days of storage by using a panel of 14 assays. The in vivo recovery and life span of photochemically treated platelets were evaluated after 24 hours of storage in a primate transfusion model. RESULTS: The following levels of pathogen inactivation were achieved: >10(6.7) plaque-forming units (PFU) per mL of cell-free human immunodeficiency virus (HIV), >10(6.6) PFU per mL of cell-associated HIV, >10(6.8) infectious dose (ID50) per mL of duck hepatitis B virus (a model for hepatitis B virus), >10(6.5) PFU per mL of bovine viral diarrhea virus (a model for hepatitis C virus), >10(6.6) colony-forming units of Staphylococcus epidermidis, and >10(5.6) colony-forming units of Klebsiella pneumoniae. Expression of integrated HIV was inhibited by 0.1 microM S-59 and 1 J per cm2 of UVA. In vitro and in vivo platelet function were adequately maintained after antiviral and antibacterial treatment. CONCLUSION: Photochemical treatment of platelet concentrates offers the potential for reducing transfusion-related viral and bacterial diseases.

[The efficacy of caleflone in treating patients with viral hepatitis]. / Efektyvnist' kaleflonu pry likuvanni khvorykh na virusnyi hepatyt.

Effects were studied of caleflone on the course of viral hepatitis A and B in 94 patients presenting with moderately severe form of the condition. The drug was found to have a positive effect on the course of the illness. In the patients examined, inhibitory action of caleflone on lipid peroxidation was revealed. Caleflone is recommended for use in a combined treatment of patients with viral hepatitis A and B.

[Virus-induced dyslipidemias as possible risk factors in the development of somatic diseases]. / Virusindutsirovannye dislipidemii kak vozmozhnye faktory riska v razvitii somaticheskikh zabolevanii.

Experimental and clinical studies showed a number of virus infections to be accompanied by lipidemic disorders. Experimentally, dyslipidemias were found in tick-borne encephalitis (TBE) in mice, rotavirus infection in rabbits, and amyotrophic leukospongiosis in guinea pigs. The possibility of correcting the virus-induced lipidemic disorders with an antiviral drug, lincomycin, was demonstrated in TBE in mice. Dynamic study of the lipidemic status of patients with virus hepatitis A revealed marked dyslipidemia of the atherogenic type which was stable and persisted up to the time of clinical recovery. The data obtained supplement the current concepts concerning the pathogenesis of virus infections.

Serum osteocalcin levels are decreased in patients with acute viral hepatitis.

In 16 patients with acute viral hepatitis and 32 sex- and age-matched control subjects the serum levels of osteocalcin, a biochemical parameter of bone formation, as well as the serum levels of parathyroid hormone, 25-hydroxyvitamin D, calcium and phosphorus were measured. The serum levels of osteocalcin (P less than 0.0001) and parathyroid hormone (P less than 0.0001) were significantly lower when measured at the time of maximal aminotransferase levels in the patients with hepatitis than in the control subjects. In contrast, the serum levels of calcium and 25-hydroxyvitamin D were similar in the patients and the controls. In nine patients with acute hepatitis measurements of the biochemical bone metabolism parameters were performed after normalization of the liver enzymes. In these patients a significant increase of serum osteocalcin levels towards normal values (P less than 0.0005) was found, parathyroid hormone levels tended to increase. Our data suggest an alteration of bone metabolism in patients with acute viral hepatitis. Bone formation as reflected by serum osteocalcin levels seems to be decreased in acute hepatitis and returns to normal after recovery from hepatitis.

[Relation of changes in plasma cAMP, cGMP and the clinical conditions, pathology and the type of traditional Chinese medicine in 50 cases of chronic severe icteric hepatitis].

Plasma of cAMP and cGMP in 30 cases of chronic active hepatitis (group of cholestatic patients) as well as in 20 cases of chronic hepatitis with submassive or massive necrosis (group of chronic severe hepatitis patients) were studied with 125I-marked radioimmunoassay. 50 cases with their serum bilirubin levels higher than 171 mumol/L were selected as subjects for this study. Among them, 42 were diagnosed as hepatitis B, 6 as coinfection of hepatitis A and B. According to differentiation of symptoms and signs of TCM, 24 were diagnosed as simple hepatitis due to blood stasis and blood heat, 17 as hepatitis due to blood stasis and blood heat accompanying symptoms of Yang deficiency of the Spleen and Kidney. 20 healthy persons were selected as controls. The results were as follows: cAMP was 56.82 +/- 25.54 ng/L and 80.32 +/- 20.73 ng/L, and cGMP was 9.07 +/- 6.56 ng/L and 19.49 +/- 9.34 ng/L in the group of cholestatic patients and in the group of chronic severe hepatitis patients respectively. Both were higher than those in the control group whose cAMP was 14.12 +/- 3.25 ng/L and cGMP was 5.87 +/- 1.44 ng/L (P less than 0.01). Increase in cGMP and decrease in the ratio of cAMP and cGMP in the cases accompanying symptoms of Yang deficiency of the Spleen and Kidney were much higher than those in the other two types of hepatitis patients (P less than 0.01 and 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

[Effect of hyperbaric oxygenation on the disease course and blood coagulation function in patients with acute viral hepatitis]. / Vliianie giperbaricheskoi oksigenatsii na techenie zabolevaniia i sostoianie gemokoaguliatsii u bol'nykh ostrym virusnym gepatitom.

The paper is concerned with an analysis of clinico-biochemical indices and 14 parameters of the plasmatic and platelet links of hemostasis in 29 patients with acute virus hepatitis of a varying degree of severity treated by hyperbaric oxygenation and in 40 controls. HBO made a modulating effect on most indices of hemocoagulation and fibrinolysis bringing them nearer to a certain standard which was optimum for a certain stage and degree of AVH. Probable mechanisms of the HBO effect on various indices of homeostasis in AVH and clinico-pathogenetic importance of the state of hemocoagulation against a background of HBO-therapy were discussed.

[Effect of interlok, remantadine and biotop on normal monocyte functional activity and in acute viral hepatitis]. / Vliianie interloka, remantadina i biotopa na funktsional'nuiu aktivnost' monotsitov v norme i proi ostrom virusnom gepatite.

The influence of interlok, biotop and remantadine on the functional activity of monocytes was determined with the use of the NBT test permitting the quantitative evaluation of this characteristic. In this study interlok was found to give promising results in the treatment of acute viral hepatitis, due both to its antiviral action and to the stimulation of the functional activity of monocytes. biotop proved to render a sharply pronounced stimulating effect on the functional activity of monocytes, thus enhancing antiviral resistance. Remantadine suppressed the functional activity of monocytes and increased their lesion by the virus, thus creating favorable conditions for virus persistence in monocytes.

[Results of a double blind study on the effect of silymarin in the treatment of acute viral hepatitis, carried out at two medical centres (author's transl)]. / Zur Wirkung von Silymarin bei der Behandlung der akuten Virushepatitis. Ergebnis einer an zwei medizinischen Zentren durchgeführten Doppelblindstudie.

In a double blind study carried out under standard conditions at two treatment centers silymarin, 2 sugar-coated tablets 70 mg three times daily, showed a definite therapeutic influence on the characteristic increased serum levels of bilirubin, GOT and GPT associated with acute viral hepatitis. The above mentioned values in 28 patients treated with silymarin were compared with those in 29 patients treated with placebo. The laboratory parameters in the silymarin group regressed more than in the placebo group after the 5th day of treatment. The number of patients having attained normal values after 3 weeks' treatment was higher in the silymarin group than in the placebo group. A statistical comparison revealed a difference between bilirubin and GOT values in the placebo and silymarin groups and a definite trend in the regression of GPT values in favour of silymarin. The course of the immune reaction in HBS Ag patients was not influenced by silymarin. As already proved by other investigators, the use of silymarin in acute viral hepatitis can lead to an accelerated regression in pathological values, thus indicating its use in the treatment of this liver disease.