Терапевтический архив (Nov 2003)
Autoimmune manifestations in acute viralhepatitides
Abstract
Aim. To study autoimmune reactions in patients with acute viral hepatitis A, B, and С in the dynamics of an infectious process. Materials and methods. 134 patients with acute viral hepatitides of various etiology were examined. Among them there were 36 patients with acute viral hepatitis A, 40 with B, and 58 with viral hepatitis С Antinuclear antibodies (ANA), antismooth muscle antibodies (SMA), and antimitochondrial antibodies (AMA) were determined by immunofluoresence assay using the test systems ATS COMVI-1, IMMCO diagnostics (USA). Serum rheumatoid factor was detected by the semiquantitative latex-agglutination test on a slide manufactured by the Human"firm (Germany). Cryoglobulins were identified by the qualitative visual method. Results. SMA, ANA were detected in the diagnostically significant titers (1:40-1:160) in patients with acute viral hepatitis A, B, and С A distinction of autoimmune manifestations was ascertained in viral hepatitis C. It has been demonstrated that in 71% of the patients cryoglobulins appear in the acute period of the disease and, in their presence, rheumatoid factor was found in 17.2% and 6.9% exhibited anti-LKM-1 and AMA. Conclusion. The presented data on the nature and time course of changes in autoimmune reactions in patients with acute viral hepatitis A, B, and С during an infectious process suggest that autoimmune disorders are characteristic of viral hepatic lesions just at the early stages of the disease irrespective of N 4. its etiology and play a prominent role in the pathogenesis of these nosological entities.
