Search

Hepatitis B, despite of being a controlled infection today, is one of the most common form of hepatitis in the world. According to the experts' evaluation there are about 3 million patients with chronic hepatitis B in our country. The global strategy of the World Health Organization includes the elimination of viral hepatitis by 2030.The program used in the North-West Federal District to eliminate acute hepatitis B has reduced the incidence rate due to the widespread vaccination coverage of children and the annual increase in adult immunization coverage.However, the relevance of HBV-infection in children still remains high which is associated with a high infection by hepatitis B virus in women of childbearing age and the possibility of the transmission of the infection from mother to her child. In case of perinatal infection the formation of chronic hepatitis B in children reaches up to 90%. The natural course of chronic hepatitis B is characterized by a change in pathogenetically determined phases, and HBsAg-negative infection, which is a latent (occult) form of hepatitis, was added to them in 2009. Occult hepatitis B is an epidemiological danger, for the child as well, if the mother suffers from this form of chronic hepatitis B. Monitoring of pregnant women is often limited to identifying only HBsAg, which is not enough to detect occult hepatitis B. Lately diagnosed occult HBV-infection can become a source of the infection for the baby, especially in cases when due to some reasons there are disorders in hepatitis B vaccination schedule after birth. The article presents an interesting clinical case of family hepatitis B.

Objective : to study the status of markers of the transport system of iron metabolism and the marker profile of HBV infection, depending on the degree of iron overload syndrome in children with chronic hepatitis B. The object of the study were 1 85 children with HBV with iron overload syndrome, aged 4—18 years. Specific research methods included determination by ELISA: sTfR (soluble transferrin receptors), FR (ferritin), FPN (ferroportin), HEPH (hefestin), TfR-2 (transferrin-2 receptors) and serum active Hepcidin-25 (HPS) blood. Viro-logical verification was performed by ELISA and PCR: HBsAg, HBsAb, HBeAg, HBeAb, total HBcorAb, HCVAb, HDVAb, HBV-DNA. A directly proportional dependence of the FPN level and an inversely proportional dependence of the level of HEPH/TfR-2 on the degree of iron overload syndrome were revealed — the higher the presentability of hemosiderosis, the higher the expression of FPN and the suppression of HEPH/TfR-2 with the consequence of decreased transcription of hepcidin-25 in hepatocytes. Confirmation of this fact served as the severity of HBV activity, which correlated with the degree of iron overload syndrome, the lower the transferrin saturation ratio, the higher the viral aggression, which we interpreted as an unfavorable factor in terms of the prognosis of the disease.

In analytical review describes the pathogenic mechanisms of hepatocarcinogenesis and some risk factors of grow more serious progress of HCC. There modern classifications of HCC, aetiology, some of diagnostic methods in suspicion on HCC and different variants of treatment by means of medical drugs and nonmedical tactics are presented. The main risk factors for the development HCC — liver cirrhosis, man, the age of 50 year, HBV DNA > 104 copies/ml, positive HBeAg in blood serum, genotype С HBV, mutations in the area core promoter, increased activity ALT. The clinical example of patient with HCC and the outcome of liver cirrhosis are illustrated.

The objective of the work – is to study the course of HBV-infection in pregnant women, infected and uninfected with HIV, based on the analysis of clinical-laboratory parameters. Materials and methods. HBV-infection was diagnosed in 5.6% of women with negative HIV-status and in 9.4% positive with HIV. To verify the diagnosis of HBV-infection, the data of anamnesis, clinical examination, laboratory tests: general clinical, biochemical, EIA, PCR, and VL in each trimester of pregnancy were used. Research. In HIV-negative pregnant women, 71.6% of the patients were diagnosed with HBsAg carrier status and 28.4% – the replication stages. Replication stages were only in HIV-positive patients. The frequency of clinical manifestations of CHB is higher in HIV-positive women – it is 33.33% vs 10.00% in HIV-negative (p

The article presents the result of observation of children born to mothers with HBV infection and peculiarities of primary chronic hepatitis B in the dynamics.

The analysis of serological efficiency and duration of maintaining specific immunity at the children imparted by various vaccines against hepatitis B within the national calendar of inoculations in the territory of St. Petersburg is submitted. It is revealed that high credits of antibodies (more 100 mME/ml) were more often observed at children in the first 3 years after vaccination (68.2%). Eventually levels of antibodies decreased, and in 5 years protective credits have remained at 84.5% examined, the number of patients with a caption of antibodies less than 10 Mmeml has grown from 8.5 to 15.5%.

This review article deals with the possibility of using the quantitative determination of HBsAg (qHBsAg) to monitor the natural history of the disease. The necessity of unification of qHBsAg use to monitor the natural history of the disease and antiviral therapy, with insuring recommendations in the continental guidelines for HBV-infection, is indicated., В обзорной статье представлены возможности использования количественного определения HBsAg (qHBsAg) для мониторинга естественного течения заболевания. Указана необходимость унификации использования qHBsAg для мониторинга естественного течения заболевания и противовирусной терапии с закреплением рекомендаций в континентальных руководствах по HBV-инфекции., В оглядовій статті наведено можливості використання кількісного визначення HBsAg (qHBsAg) для моніторингу природного перебігу захворювання. Зазначена необхідність уніфікації використання qHBsAg для моніторингу природного перебігу захворювання і противірусної терапії із закріпленням рекомендацій в континентальних посібниках з HBV-інфекції.