[FEATURES OF THE RELATIONSHIP BETWEEN IMMUNOLOGICAL PARAMETERS, LEVEL OF VIRAL LOAD AND SEVERITY OF MORPHOLOGICAL CHANGES IN THE LIVER ACCORDING TO NON-INVASIVE TESTS IN HBEAG--NEGATIVE PATIENTS WITH CHRONIC HEPATITIS B].

Aim - to investigate the relationship between immunological parameters, level of viral load and severity of morphological changes in the liver according to non-invasive tests in HBeAg-negative patients with chronic hepatitis B. The study included 55 HBeAg-negative patients with chronic hepatitis B. Age of patients was from 20 to 78 years. There were 20 women and 35 men. Quantitative content of HBV-DNA, HBeAg and anti-HBe, TNF-α and IFN-γ was determined in all patients> blood. Statistical processing was performed in Statistica 13 for Windows (StatSoft Inc., No. JPZ804I382130ARCN10-J). The study found an association between HBeAg/anti-HBe seroconversion and severity of liver fibrosis. It is shown that in the presence of liver fibrosis F 2-4 degree the frequency of seroconversion is lower compared with HBeAg-negative patients with F 0-1 (85,7 % vs. 100 %, p <0,05). The association of viral load above HBV-DNA >20000 IU/ml with a high degree of necro-inflammatory activity has also been shown. In HBeAg-negative patients in the presence of activity A 2-3 viral load >20,000 IU/ml is detected in 57,1 % against 20,8 % of patients with A 0-1 (p <0,05). However, it was shown that in HBeAg-negative patients with chronic HBV, TNF-α level in serum, regardless of the severity of morphological changes in the liver is higher, and IFN-γ level is not statistically different from that of healthy people. In HBeAg-negative patients with CHB the detection rate of HBeAg / anti-HBe seroconversion is significantly higher in fibrosis F 0-1. The viral load above the HBV-DNA level>20,000 IU / ml has a relationship with necroinflammatory activity, significantly higher with A 2-3. The TNF-α content is higher than in healthy people (p <0.05), and has no significant relationship with the severity of morphological changes in the liver according to non-invasive tests. The content of IFN-γ in the blood serum of HBeAg-negative patients with CHB does not statistically differ from those of healthy people.

DYNAMICS OF THE VEGETATIVE NERVOUS SYSTEM FUNCTIONAL STATE IN INTERACTION WITH THE CHANGES IN ADRENOCORTICOTROPIC AND SOMATOTROPIC HORMONES IN PATIENTS WITH SEROUS MENINGITIS.

The study included 64 patients with serous meningitis, in which the heart rate variability (HRV) spectrum, the content of ACTH and STH in serum was studied in the course of the commonly accepted treatment. The purpose of the study was to analyze the dynamics of indicators of functional state of the autonomic nervous system in correlation with changes of adrenocorticotropic and somatotropic hormones in patients with serous meningitis. According to the results, serous meningitis were predominantly moderate in severity, with generalization in the clinical picture dominated through general toxicosis, general cerebral and meningeal syndromes, but changes in the spectral parameters of HRV showed a marked imbalance with a shift in the functional activity of the autonomic nervous system towards vagotonia in combination with an ACTH level increase and STH decrease in serum (p<0.01). The purpose of the study was to analyze the dynamics of indicators of functional state of the autonomic nervous system in correlation with changes of adrenocorticotropic and somatotropic hormones in patients with serous meningitis. According to the results, serous meningitis were predominantly moderate in severity, with generalization in the clinical picture dominated by general toxicosis, general cerebral and meningeal syndromes, but changes in the spectral parameters of HRV showed a marked imbalance with a shift in the functional activity of the autonomic nervous system towards vagotonia in combination with an ACTH level increase and STH decrease in serum (p<0.01).

CLINICAL-PATHOGENETICAL ROLE OF DYNAMICS OF CONCENTRATION OF INTERLEUKIN-6 DEPENDING ON POLYMORPHISM OF ITS GENE IN CONDUCTING ANTIVIRAL THERAPY IN PATIENTS WITH CHRONIC HEPATITIS C.

The study included 83 patients with CHC who received antiviral therapy according to the EASL 2016 recommendations on a 12-week peg-IFN+SOF+RBV schedule. The aim of the study was to determine the role of IL-6 concentration dynamics in relation to the polymorphism of the gene that encodes it, in achieving a SVR during therapy. Based on the results of the study, it was established that the polymorphism of the IL-6 gene (rs1800795) in patients with CHC influenced the dynamics of IL-6 concentration and the effectiveness of AVT. In patients with CHC, the genotype CC of the polymorphism of the IL-6 gene was associated with fluctuations in the concentration of IL-6 in the blood within the reference range, which was prognostically favorable for the formation of SVR 24 for AVT according to the peg-IFNα + SOF + RBV. With the presence of CG/GG genotypes in patients with CHC, the efficacy of this treatment was lower than in patients with CC genotypes (85,5% vs. 100%). The ineffectiveness of AVT according to the scheme peg-IFNα+SOF+RBV was associated with the presence of CG/GG genotypes and the highest concentration of IL-6 in the blood.

CLINICAL-PATHOGENETICAL ROLE OF TOLL-LIKE RECEPTOR 2 (RS 5743708) AND INTERLEUKIN-10 (RS 1800896) GENES POLYMORPHISM IN THE COURSE OF HERPES ZOSTER IN ADULTS.

The study included 50 adult patients with shingles by which analyzed the clinical course of the disease depending on the gene polymorphism of interleukin-10 (rs 1800896) and toll-like receptor 2 (rs 5743708). According to the results of our study, it was established that genotype AA of gene Toll-like receptor 2 was associated with a high risk of Varicella-Zoster virus reactivation and manifestation of herpes zoster, moderate course. Analysis of the IL-10 gene polymorphism showed that genotype TT was associated with a risk of the development severe complicated course of shingles. The genotype CC of gene IL-10 caused to formation of recurrence course of the disease, and also significantly more frequently registered in patients with disseminated form of herpes zoster compared with patients with localized and generalized forms of the disease (χ2=11,94, р=0.0003). Subject to the formation of localized form in carriers of genotype CC more often was occurred damage paravertebral ganglia (p=0.01).