[Antiviral therapy of chronic hepatitis C: 30 years success story].

Exactly 30 years ago, hepatitis C virus was identified. Over the years, tremendous success has been achieved in the treatment of hepatitis C, which is currently considered to be an almost completely curable disease. The review presents the main stages in the development of hepatitis C antiviral therapy, the efficacy of various treatment regimens. The greatest progress in treatment was noted over the past 5 years when drugs with direct antiviral action appeared and began to be widely used, including in Russia, which ensure the elimination of the virus in 90-95% of cases.

[Malignant tropical malaria in native Africans living in a large city]. / Zlokachestvennaia tropicheskaia maliariia u korennykh afrikantsev, zhitelei krupnogo goroda.

The clinical and laboratory features of severe Plasmodium falciparum-induced malaria were analyzed in 91 adult patients living a large African city. Within a week, 52 patients developed the disease from the manifestations of overall intoxication to the complete picture of severe malaria accompanied by coma. Fifty eight patients were found to be residents of Conakry and 54 of them left the city 2 months before the malaria attack. Eighty one patients had experienced malaria, including 38 patients had 1-2 attacks in the past year. The patients were parenterally treated with quinine in a dose of 750-850 mg of the active ingredient for 24 hours during 4.1 +/- 1.7 days at hospital. In 17 of 34 patients, parasitemia disappeared from single to 5-10 parasites and more in the field of thick drop field, in the other 17 patients it decreased from 5-10 to single parasites at recovery. Twenty four comatose patients died at days 3-8 of hospital stay, most of them had symptoms of oligoanuria. The high cost of hospitalization and specific drugs were the reasons for late referral to hospital and for the use of low daily and course doses of quinine. The necessity of reviewing the principal trends of a national malaria control programme.

[The importance of fluid perfusion for the outcome of the disease in malarial coma due to Plasmodium falciparum in adult Africans]. / Znachenie perfuzii zhidkosti dlia iskhoda bolezni pri maliariinoi kome, vyzvannoi Plasmodium falciparum, u vzroslykh afrikantsev.

Malaria coma induced by P.falciparum was diagnosed in 51 of 390 adult African patients who had been admitted to the therapeutical unit of the Donk Central Hospital and were receiving parenteral quinine at day 1 of the onset of coma. Examining some clinical and laboratory manifestations of malaria coma indicated that fatal outcome was significantly recorded among the patients with severe concomitant anemia and among the patients who had not or had received inadequate liquid parenterally on the first day of coma. The occurrence of acute renal failure in 4 patients with malaria coma resulted in 3 deaths. No great impact on the prognosis of malaria "hyperparasitemia", the severity of fever, the values of blood pressure was found. Whether it is advisable to use the parameters characterizing the opportuneness and scope of health care delivered to patients with severe malaria is discussed.

[Morphological changes in the liver in primary sclerosing cholangitis (a histological and electron microscopic study)]. / Morfologicheskie izmeneniia pechni pri pervichnom skleroziruiushchem kholangite (gistologicheskoe i élektronno-mikroskopicheskoe issledovanie).

9 cases (males) of primary sclerosing cholangitis (PSC) were studied clinico-morphologically. In puncture liver biopsies, sclerosis of walls of big ducts and portal tracts was found in 2 cases only; cell infiltration was minimal. Lobular hepatitis with intralobular fibrosis and moderate sclerosis of portal stroma was found in 3 patients, monolobular inactive liver cirrhosis in 4 patients. In all cases mild intralobular cholestasis was found which was followed with a considerable increase of copper and manganese in the liver and serum. The accumulation of a large amount of collagen of different types was observed around bile ducts which ultrastructurally was seen as fibrillar structures and homogeneous substance similar to the basal membrane. The elements of the epithelium destruction were found in foci of the duct basal membrane alteration, in the absence of cell infiltration. Progressing fibrosis of both portal tracts without inflammation and individual segments of the bile ducts and the intralobular stroma is at the basis of PSC.

[Cellular immunity responses in studies of the specificity of leukocyte hepatitis virus]. / Reaktsii kletochnogo immuniteta v izuchenii spetsifichnosti leíkotsitarnogo virusa gepatita

Hypersensitivity of a delayed type to leukocyte hepatitis virus (LHV) was established in patients with virus hepatitis. The results of the skin tests with the LHV antigen were positive in 15 out of 20 patients with active chronic hepatitis, in 17 out of 20 convalescents and in 3 out of 20 patients in the acute stage of virus hepatitis, and negative in 4 normal subjects and in 12 out of 14 patients with chronic hepatitis in the stage of stabilization. The results of the skin tests with the antigen of donor leukocytes were negative in 130 patients with hepatitis and normal subjects. In the leukocyte migration inhibition test, 1/4 of the patients with chronic hepatitis were found to be sensitized to the LHV antigen, in the absence of sensitization by this test to the HB antigen and the antigen in the plasma of hepatitis patient.