Vol 21, No 2 (2016)

Introduction Changes in the levels of DNA of hepatitis B virus (HBV) infection and the quantitative content of the surface antigen (HBsAg) in acute hepatitis B, as well as the concomitant co-injection of other hepatitis viruses have been insufficiently studied so far. Materials and Methods In 21 patients with acute HBV monoinfection and 27 patients with co-infection of HBV + HCV and/ or HDV three to four serum samples were withdrawn with interval of 6-10 days and the dynamics of HBV viral load and concentration of HBsAg was examined. Results Logarithm of the concentration of DNA HBV was established to decrease from 4.0 ± 0.65 to 3.0 ± 0.59, to 2.5 ± 0.47, to 1.9 ± 0.65 (IU /ml, M ± s), the half-life of DNA HBV was increased from 1.6 days at baseline to 4 days to the end of the study. The decline of the HBsA concentration proceeded much slower: from 38 to 23, 12, 3.8 pg/ml. Half-life period of HBsAg accounted of 8 days at the beginning and 5.7 days at the end of the study, however, in 11 patients there was observed rapid elimination of HBsAg and disappearance of HBV DNA. Conclusion The fact of co-infection with hepatitis C virus (HCV) had no significant effect on the dynamics of HBV DNA and HBsAg levels. In patients infected with Hepatitis D virus (HDV) HBV viral load was significantly lower, and the concentration of HBsAg, by contrast, is significantly higher than in acute monoinfection with HBV. Thus, in acute hepatitis B DNA elimination occurs much faster than the elimination of HBsAg. In addition, in co-infection HDV inhibits replication of HBV, but at the same time stimulates the expression of HBsAg. The obtained data should be considered in the interpretation of laboratory tests in patients with acute hepatitis B, both in the earlier period, and at follow-up.

The cytokine status was studied in 46patients hospitalized in Specialized Clinical Infectious Diseases Hospital in 2013-2014. Acute course of the infection of Ixodes tick borreliosis (ITB) was observed in the 41 (89%) case, subacute and chronic - in 5 (11%), in the dynamics of the disease there was studied the level of proinflammatory (IFN-y, IL-1β, IL-2) and anti-inflammatory ( IL-4, IL-10) cytokines. The average age of diseased patients in the acute course of the erythemalform of ITB amounted to 41,1 ± 1,83 years, men accouted for 37%, women - 63%. In 31.1% of the patients there were observed symptoms of the involvement of the peripheral nervous system PNC, in 51.1% - changes in the cardiovascular system. For the acute course of the erythemal form of ITB there is typical the significant increase ofIL-1β, IFN-y and IL-4 level, while in maintaining of normal levels of IL-2 and IL-10 low values in the majority of patients. In subacute and chronic course of Ixodes borreliosis there is persisted the elevated level of IL-1β, IFN-y, normal values of IL2 and low values of IL-10, while the level of IL-4 is also lowered. The increase of the IL-2 level in the acute course of the erythemal form of Ixodes borreliosis is associated with fever and involvement of the cardiovascular system. In the process of causal treatment with ceftriaxone (examination on the 5th and 12th day of the treatment) there was a significant decrease in the level of IL-2 (p <0,05), whereas treatment with doxycycline failed to affect the level of interleukins investigated. The revealed changes in the cytokine status in acute course of Ixodes borreliosis correspond to the development of the immune response on the type of antibody-dependent cell-mediated cytotoxicity. The decline of elevated level of IL-2 permits to evaluate the effectiveness of the causal treatment. The chronic course of the diseases is differed by low levels of IL-4.

There is reported an example of a clinical diagnosis and successful treatment of acute acquired toxoplasmosis, manifested in the first trimester of pregnancy. Implementation of specific antiparasitic therapy starting from the second trimester of pregnancy contributed both to the normalization of the status of women and prevention of congenital malformations of the fetus. Dynamic following up of the child showed stable positive neurological status, psychomotor development corresponded to age over 8 years. The increasing of cytochemical activity of monocytes and lymphocytes is a sensitive additional diagnostic test for acute toxoplasmosis in pregnant women.

The article presents the life and career of a prominent national epidemiologist, the talented organizer of Health care, well-known public figure, academician of the USSR Academy of Medical Sciences, Professor Hovhannes Vagarshakovich Baroyan.