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Clinico-immunological features in patients with chronic viral hepatitis C associated with infection from Herpesviridae family


Author: Adela Ţurcanu
Degree:doctor of medicine
Speciality: 14.00.05 - Internal Diseases (with specification: Pulmonology, Gastroenterology, Hepatology, Nephrology, Functional Diagnostics and Endoscopy)
Year:2006
Scientific adviser: Vlada-Tatiana Dumbrava
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Lucia Andrieş
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 22 February, 2006
Approved by NCAA on the 27 April, 2006

Abstract

Adobe PDF document0.36 Mb / in romanian

Thesis

CZU 616.36-002.2 + 002.523

Adobe PDF document 1.27 Mb / in romanian
123 pages


Keywords

chronic hepatitis, virus hepatitis C, herpes infection, genital herpes, herpes simplex, mixt hepatitis, monoinfection, viral coinfection, cytolisis, cholestasis, immunity response

Summary

A total of 144 patients with chronic viral hepatitis C were enrolled in that complex and profound study. All patients with chronic viral hepatitis C have been investigated on the presence of herpes infection type I,II, which was confirmed by the detection of antibodies anti HSV I,II IgG and IgM, DNA HSV I,II. The major frequency of HCV C associated with HSV I,II (28.4%) have been registered. The patients were divided into 2 groups depending on the presence of herpes infection: I) 103 patients with chronic viral hepatitis C (monoinfection) and II) 41 patients with chronic viral hepatitis C associated with herpes infection I,II. In addition, 20 patients with HSV I,II have been investigated. There have been studied clinico-paraclinical features of hepatic function in patients with hepatits C (monoinfection), hepatitis C associated with HSV I,II and herpes infection I,II (monoinfection). Thus, in patients with chronic hepatitis C associated with HSV I,II have been determined a major frequency of astheno-neurotic, dyspeptic, pain syndromes and hepatosplenomegaly than in patients with chronic hepaitis C (monoinfection), in whom prevailed manifestations of astheno-neurotic, dyspeptic syndromes and hepatomegaly. In patients with viral hepatitis C associated with HSV I,II clinical date were completed by specific manifestations of herpes infection. In patients with herpes infection I,II prevailed herpes manifestations (genital burn, veyicular eruption). The biochemical disturbances were more sever in mixed chronic hepatitis (hepatitis C associated with HSV I,II) versus chronic viral hepatitis c (monoinfection). In chronic hepatitis C associated with herpes infection I,II prevailed cytolytic, cholestatic and hepatodepressive syndromes than in patients with chronic hepatitis C (monoinfection) in whom the cytolitytic syndrome was more expressive. There were no biochimical disturbances in patients, with herpes infection I,II (monoinfection), excepting elevated level of AST. Cellular and humoral immune status in patients with chronic HCV associated with HSV I,II presens severe disturbances, such as elevated concentration of IgA, IgG, limphocytes B, as well as decreased absolute value of T total lymphocytes and subpopulations (CD3, CD4, CD8, CD16), immunoreglatory index. While in patients with chronic hepatitis C (monoinfection) prevailed high concentration of IgM (in active phase) and IgG (in latent phase) incresed values of T-totale, B-lymphocites, immunoreglatory index and decresed value of CD8, CD16. In patients with herpes infection the immune disturbances weren′t significants, reflecting uniimportant elevation of IgA and IgG, diminution imunoreglatory index. In patients with mixed infection heve been established that the complex treatment with Aciclovir and Ursodeoxycholic acid had a good efficiency in evolution of clinical syndromes, markers of cytolysis (decreasing of ALT, AST activity) and cholestasis (diminution of gama-GTP, total bilirubine, alkaline phosphatase) versus patients with Acyclovir alone.