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CNAA / Theses / 2006 / May /

Clinical, biochemical and immunological characteristic of negative HBsAg acute B viral hepatitis


Author: Angela Roşca
Degree:doctor of medicine
Speciality: 14.00.10 - Infections Diseases
Year:2006
Scientific adviser: Constantin Andriuţă
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Gheorghe Cuşnir
doctor, associate professor (docent)
Institution:
Scientific council:

Status

The thesis was presented on the 17 May, 2006
Approved by NCAA on the 29 June, 2006

Abstract

Adobe PDF document0.28 Mb / in romanian

Thesis

CZU 616.36 - 002.1

Adobe PDF document 1.88 Mb / in romanian
115 pages


Keywords

negative HBsAg acute HBV, biochemical, immunological, serological tests, epidemiological methods clinical forms, syndrom and diagnosis methods

Summary

This paper represents a complex research of clinical, biochemical and imunological aspects of HBsAg -negative acute B viral hepatitis comparative with positive –HBsAg acute HVB which was performed in 136 pacients: 86 with negative HBsAg acute HVB (main group) and 50 from them with positive HBsAg acute HVB (control group). Ouresults determined that negative AgHBs acute BVH affects the young persons (21-30 years old.) Acute HVB diagnosis according to the clinical, epidemiological, serological (compulsory presence of IgM anti-HB body and absence of BHsAg by ELISA) and clinical polymerization reaction for AND-VHB finiding by PCR have been determined. Clinical manifestations of both pacients group of acute BVH were the same, having mixt astenovegetative and dispeptic syndrome. In the control group, cholestatic ones with mixt combination has been observed. In the main group the easier form of acute BVH frequently has been determined, but the severe one – more rarely in combination with these forms from the control group. The scleral and tegumentar jaundice duration was shorter in patients with negative AgHBs acute BVH. There were observed icteric form also. In the main group pacients clinical symptomatology rarely appeares and rapidly disappeared comparative with control group. Positive AgHBs persons finding in the family focus of negative acute HBsAg HVB pacients and decelaration of BVH-DNA by PCR in some patients from the main group confirm their inffectivity for healthypersons, being one of the infection sourse. Biochemical tests determined total bilirubin increase, ALAT, thymol in the ascent and apogee jaundice stage in pacients from both groups being decrease in the main group. The decrease in dynamic of biochemical indexes (aproximatly till the normal values) was more rapidly and freguently has been observed in the main group comparative with control one. After discharging out from the hospital the biochemical indexes remain on the low level in the main group comparative with those from the control one (thymol exception ones). In patients after negative HBsAg acute BVH, 1-18 months investigation from dicharging out anti-HBs appearance confirms immunity, but chronic signs of the disease in this case has not determined.

Immune status of negative HBsAg acute BVH in the ascent and apogee stage of jaundice was characterized by relative tendency of relative lymphocytosis, increase of E-RFC cells count with increase affinity, IgM concentration increase and less in IgG serical comparative with immunity indexes in pacients with positive HBsAg acute ВVH. In all cases these indexes were reduced.