IMMUNODEFICIENCY SYNDROMES IN ACUTE HEPATITIS B CONVALESCENTS
Abstract
Background. Chronic hepatitis B (CHB) remains one of the most urgent problems in modern medicine. There are about 296 million people with CHB worldwide, 820 thousand dying annually of liver cirrhosis and hepatocellular carcinoma. Objective. To study the immunodeficiency syndrome peculiarities in acute hepatitis B (AHB) convalescents. Material and methods. We have studied immunodeficiency syndrome (IDS) in 104 AHB convalescents, the control group comprised 78 apparently healthy donors. All examined were between the ages 18-45. IDSs were studied according to the IDS Map developed by Acad. R.V. Petrov (1987). Results. In 17.3% of AHB convalescent patients IDSs were absent, while in 82.7% - at least one of the three IDSs (infectious, atopic and autoimmune) was detected. In 44.2% of cases, clinical variants of one IDS were noted, in 34.9% - those of two syndromes, in 20.9% - those of three syndromes simultaneously in various combinations. Convalescence from AHB with IDS either had a non-smooth course or the disease transformed into a chronic process in 24.4%, while in the control group - in 12.3% of cases. Conclusions. AHB with IDS should be included in the progredient form, i.e. as a high-risk pathology of liver cirrhosis and hepatocarcinoma development, thus determining its appropriate therapeutic strategy.
References
World Health Organization. World Hepatitis Day 2019 [Internet]. Available from: https://www.who.int/ru/campaigns/world-hepatitis-day/2019.
Vysotskaya VS, Volchenko AN, Kolomiets ND, Romanova ON, Glinskaya I. Vlijanie vakcinacii na jepidemicheskij process virusnogo gepatita В v Respublike Belarus [Vaccination effect on epidemic process of viral hepatitis B in republic of Belarus]. Jepidemiologija i vakcinoprofilaktika [Epidemiology and vaccinal prevention]. 2019;18(1):26-33. https://doi.org/10.31631/2073-3046-2019-18-1-26-33. https://www.elibrary.ru/schgmi. (Russian).
Churbakova OV, Akimkin VG, Pechkurov DV. Osobennosti jepidemicheskogo processa hronicheskogo gepatita B v Rossijskoj Federacii i Samarskoj oblasti [Features of the epidemic process of chronic hepatitis B in the Russian Federation and the Samara region]. Jepidemiologija i infekcionnye bolezni. Aktualnye voprosy [Epidemiology and infectious diseases. Current items]. 2020;10(2):11-14. https://doi.org/10.18565/epidem.2020.10.2.11-4. https://www.elibrary.ru/xddnsb (Russian).
Shapieva NT, Ponezheva ZhB, Makashova VV, Omarova HG. Sovremennye aspekty hronicheskogo gepatita B [Modern aspects of chronic hepatitis B]. Lechashhij vrach. 2019;(5):82-87. edn: JSAQUQ. (Russian).
Okada M, Enomoto M, Kawada N, Nguyen MH. Effects of antiviral therapy in patients with chronic hepatitis B and cirrhosis. Expert Rev Gastroenterol Hepatol. 2017;11(12):1095-1104. https://doi.org/10.1080/17474124.2017.1361822.
European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol. 2017;67(2):370-398. https://doi.org/10.1016/j.jhep.2017.03.021.
Terrault NA, Lok ASF, McMahon BJ, Chang KM, Hwang JP, Jonas MM, Brown RS Jr, Bzowej NH, Wong JB. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018;67(4):1560-1599. https://doi.org/10.1002/hep.29800.
Abdurakhmanov DT, Otrashevskaya AV. Jentekavir v lechenii hronicheskogo gepatita B: mnogocentrovye randomizirovannye issledovanija i realnaja klinicheskaja praktika [Entecavir in the treatment of chronic hepatitis B: multicenter randomized trials and real clinical practice]. Terapevticheskij arhiv. [Therapeutic archive]. 2014;86(11):100-104. edn: TGSDJT. (Russian).
Kalinina ZP, Dar’ina MG, Movchan KN, Mamicheva OYu, Gagarkina IB, Averina TYa, Balabash OA, Yefimova LI, Potemkina IV. O postvakcinalnom immunitete protiv virusnogo gepatita B u medicinskih rabotnikov Sankt Peterburga [Duration of postvaccinal immunity against hepatitis B in health care workers in St. Petersburg]. Infekcija i immunitet [Russian journal of infection and immunity]. 2015;5(1):89-92. edn: TVWXIV. (Russian).
Chou R, Dana T, Bougatsos C, Blazina I, Khangura J, Zakher B. Screening for hepatitis B virus infection in adolescents and adults: a systematic review to update the U.S. Preventive Services Task Force recommendation. Ann Intern Med. 2014;161(1):31-45. https://doi.org/10.7326/M13-2837.
Yeo YH, Ho HJ, Yang HI, Tseng TC, Hosaka T, Trinh HN, Kwak MS, Park YM, Fung JYY, Buti M, Rodríguez M, Treeprasertsuk S, Preda CM, Ungtrakul T, Charatcharoenwitthaya P, Li X, Li J, Zhang J, Le MH, Wei B, Zou B, Le A, Jeong D, Chien N, Kam L, et al. Factors Associated With Rates of HBsAg Seroclearance in Adults With Chronic HBV Infection: A Systematic Review and Meta-analysis. Gastroenterology. 2019;156(3):635-646.e9. https://doi.org/10.1053/j.gastro.2018.10.027.
Belozerov ES, Mitkovskaja OA, Zhdanov KV, Bulankov JuI. Klinicheskaja immunologija i allergologija [Clinical immunology and allergology]. Jelista: Dzhangar; 2011. 160 p. (Russian).
Ivashkin VT. Immunnaja sistema i povrezhdenija pecheni pri hronicheskih gepatitah В i С. Rossijskij zhurnal gastrojenterologii, gepatologii, koloproktologii [Russian Journal of Gastroenterology, Hepatology, Coloproctology]. 2009;19(6):4-10. edn: LETYLP. (Russian).
Lobzin YuV, Nikitin VYu, Sukhina LA, Tsigan VN, Mitin YuA. Immunopatogenez virusnogo gepatita С. Immunologicheskie markery progressirovanija zabolevanija [Immunopathogenesis of viral hepatitis immunological markers of the disease progression]. Zhurnal mikrobiologii, jepidemiologii i immunobiologii [Journal of microbiology epidemiology immunobiology]. 2007;(6):75-84. edn: IISQFJ. (Russian).
Mikhailov MI, Kyuregyan KK, Malinnikova EYu, Isaeva OV., Karlsen AA, Potemkin IA, Kichatova VS, Al-Sharabi SAS, Dogadov DI, Korzaya LI, Ignatieva ME, Polyakov AD. Virusnye gepatity: prognozy i problemy [Viral hepatitis: prognosis and problems]. Jepidemiologija i infekcionnye bolezni. Aktualnye voprosy [Epidemiology and infectious diseases. Current items]. 2019;9(1):71-80. https://doi.org/10.18565/epidem.2019.9.1.71-80. https://www.elibrary.ru/vwzppg. (Russian).
Petrov RV. Immunologija [Immunology]. Moskva: Medicina; 1987. 416 p. (Russian).
