International Medical Journal, Vol. 20., Iss. 1, 2014, P. 75−80.
CLINICAL CHARACTERISTICS OF THE COURSE OF VIRAL HEPATITIS A DEPENDING ON THE GENOTYPE OF HAV AND TYPE OF IMMUNE RESPONSE
1 Kharkiv Medical Academy of Postgraduate Education; 2 V.N. Karazin Kharkiv National University
One hundred and fifty−six patients of specialized in−patients hospitals (Kharkiv, Sumy, Donetsk, Poltava, Zakarpatia regions) were examined to investigate the frequency of HAV genotypes in various regions of Ukraine, clinical peculiarities of hepatitis A depending on the determined genotypes of the virus and production of immune response mediators. The diagnosis of hepatitis A was made using clinical, epidemiology, immunogenetic and biochemical data determining anti−HAV IgM in the blood serum with IEA and HAV RNA with polymerase chain reaction. Virus genotyping was done using restriction analysis by M. Mizokami et al (1999) modified by Central Research Institute of Epidemiology (Moscow). Two genotypes were revealed on the territory of Ukraine 1A and 3A, with 1A prevalence (75%). The patients with 3A genotype demonstrated more severe course of the disease with longer reconvalescence period when compared with the patients with 1A HAV genotype. Similar immune reactions resulting from the character of the response of main cytokine regulators was noted at different stages of the infection process. The necessity of complex examination of the patients with hepatitis A with determining the markers of active viral replication (RNA) as well as TNF−alpha, IL−4, IL−2 was proven.
Key words: hepatitis A, genotype, regulatory cytokines, immune response types.