Diagnostical, klinical and morphological percualirities of chronic type B hepatitis - wild and mutant forms

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Abstract

Aims of this study was to investigate spreading of mutant HBeAg+AbHBe- chronic type B hepatitis, clinical peculiarities and differences of mutant and wild chronic type B hepatitis.

Methods. It has been researched all markers of HBV-infection by enzyme-linked immune assay and DNA HBV level by semiquantitive polimerase chain reaction assay in liver tissue and blood in 112 chronic type B hepatitis patients. It has been carried out comparative biochemical, histological, virological analysis in 2 groups of patients: I - with classical serological markers of wild HBsAg+, HBeAg+ AbHBe- chronic type B hepatitis (14 patients, 24,1%) and II - with serological markers of mutant HBeAg-AbHBe+ chronic type B hepatitis (44 patients, 75,9%). Sequence analysis was carried out in 6 patients and it showed mutations in precore/core region.

Results. It has been revealed, that mutant chronic type B hepatitis patients were older, they have more longer period of HBV-infection, more often have chirrosis, have reliably more high levels of ALAT, gammaglobulins, immunoglobulins, index of histological activity and sclerosis compared with wild chronic type B hepatitis patients. But it has been revealed more rare DNA HBV in blood in mutant chronic type B hepatitis patients and there was more low DNA HBV level compared with wild chronic type B hepatitis patients. It has been observed high positive korrelative connection, more expressive in mutant chronic type B hepatitis, beatween indexes of necroinflammatory process: level of ALAT, parenchimal injury, periportal necrosis, portal inflammation, and viral load both in liver and blood.

Conclusion. Mutant HBeAg-AbHBe+ chronic type B hepatitis was in 75,9% of patients and characterized a more high rate of klinico-biochemical and histological activity compared with wild HBeAg+chronic type В hepatitis. There is positive high correlation beatween activity of hepatitis and viral load.

About the authors

O. P. Dudanova

University of Petrozavodsk; Influenze Institute of Sanct-Petersburg

Author for correspondence.
Email: shabanov@mail.rcom.ru
Russian Federation, Petrozavodsk; Saint Petersburg

O. I. Yachontova

University of Petrozavodsk; Influenze Institute of Sanct-Petersburg

Email: shabanov@mail.rcom.ru
Russian Federation, Petrozavodsk; Saint Petersburg

L. N. Valenkevich

University of Petrozavodsk; Influenze Institute of Sanct-Petersburg

Email: shabanov@mail.rcom.ru
Russian Federation, Petrozavodsk; Saint Petersburg

O. I. Kisilev

University of Petrozavodsk; Influenze Institute of Sanct-Petersburg

Email: shabanov@mail.rcom.ru

академик РАМН

Russian Federation, Petrozavodsk; Saint Petersburg

M. P. Grudinin

University of Petrozavodsk; Influenze Institute of Sanct-Petersburg

Email: shabanov@mail.rcom.ru
Russian Federation, Petrozavodsk; Saint Petersburg

M. M. Pisareva

University of Petrozavodsk; Influenze Institute of Sanct-Petersburg

Email: shabanov@mail.rcom.ru
Russian Federation, Petrozavodsk; Saint Petersburg

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