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8CMV.In the clinical picture it was most often observed in this group of patients were followed for a long low-grade fever, lymphadenopathy, splenhepatomegaly.
In the study of cellular and humoral immunity in 12 (54.5%) children with CMV infection there was revealed an imbalance of immune cells and a weak production ofinterferons.
Analysis of clinical and laboratory parameters in children with CMV infection revealed the need for combination therapy using anticytomegaloviruses immunoglobulin, interferon or interferon inducers and immunomodulating drugs. Results and Discussion
All the children admitted with diagnosis of ARVI, received basic therapy: human leukocyte interferon, viferon, arbidol, expectorants, mucolytics (lazolvan, ACC, ambroksal, sinekod) in dosages of age. The treatment showed improvement, all children discharged from recovery. In this group of patients there were five children with long-term, recurrent infections. A characteristic feature of this group of sick children was the fact that the markers were identified as herpes viruses, Epstein-Barr virus (EBV). Two children with active CMV-treated specific immunoglobulin (neotsitotekt) at a dose of 2 ml / kg / day at intervals of 48 hours had normalization of temperature in 3-4 days, decrease of lymph nodes and improvementofhemogram with the disappearance of disease markers.
Other three children received the standard immunoglobulin preparation in the form ofimmunovenina. They also observed a positive effect, but markers werekeptfor 6 months up to 1 year. The good therapeutic effect was shownby the combination of antibodies, interferon, in particular genferon light and correction of intestinal biocenosis. Conclusion
The study showed that in children who were often illwithARVI having trouble in childbirth, it will be necessary testing for herpes, and in particular onCMV infection.
Initiated studies of children with CMV infection have shown efficacy when used in combination with immunoglobulin therapy of interferon and the best effect when using a particular drug - neotsitotekta.It should be noted that the combination therapy was used in both stationary and in outpatient conditions that contributes to effective treatment and prevention of relapse. Literature
1. KitsakV.Ya. Virus infections of pregnant women: pathology of a foetus and newborn children. - Koltsovo, 2004. - 84 p.
2. Korovina N.A., Zaplatnikov A.A., Cheburkin A.V. Cytomegalovirus (salivary gland virus) infection of tender age children: doctors' manual. - M.: Medpraktika-M, 2001. - 64 p.
3. Samokhin P.A. Cytomegalovirus (salivary gland virus) infection of children. - M.: Medicine, 1987. - 160 p.
4. Skripchenko N.V., Skoromets A.P., Sorokina M.N. Nervous system disturbance with congenital infections: methodical recommendations. - St. Petersburg, 2003. - 48 p.
Antivirial therapy (AVT) of chronic hepatitis C (CHC) in the Amur Regional
Infectious Hospital
Mateishen R.S., Sayapina Ye.A., ServirogI.L.,Marunich N.A., Polovitsa N.V., Churina S.A.,
Nitsiyevskaya L.S., Pahnyuschaya Y.N.
Amur State Medical Academy, Amur Regional Infectious Hospital, Blagoveschensk, Russia
Aim of investigation: treatment of CHC in spite of good progress is still a problem for doctors working in this field of medicine. Wide spreading of viral hepatitis C, high ability of chronic process formation and subsequent liver cirrhosis in the outcome of chronic viral hepatitis C,
virus variability and difficulties of vaccine development define great interest to this infection. According to international experts the standard of treatment of this disease is combination of interferon with ribavirin. As a rescilt of numerous in vestigatins criteria of laboratory diagnostics of chronic viral hepatitis C, indications and contraindications to the applicati on of recombinant interferons as well as doses and criteria of efficacy of interferon therapy were worked out.
The aim of the investigation was the study of efficacy of application of antiviral therapy in combination of interferon with ribavirin in patients of the Amur Regional Infectious Hospital who were under the care and treatment in the centre of viral hepatitis.
Key words: chronic viral hepatitis C (CHC), antiviral therapy, Peginterferon and ribavirin, statistical analysis, early viral response (EVR), stable or sustained viral response (SVR).
Material and methods: To provide the population of the Amur region with specialized medical aid the regional centre of viral hepatitis (RSVH) opertes on the basis of the department of viral hepatitis "Amur Regional Infectious Hospital" since 2005. Its main tasks are specified verification of diagnosis of chronic viral hepatitis in the directed for treatment patients from the medical and prophylactic establishments of the region, finding the optimal tactics of antiviral therapy with the subsequent medical observations for the treatment at the places and dispensarizations. Besides that the centre of viral hepatitis provides organizational, methodical and advisory assistance to medical establishment of the Amur region, by the problems of viral hepatitis, the centre conducts the register of patients who need antiviral therapy. Since 2011 the centre is included into the regional programme to provide highly technological help to patients suffering from chronic viral hepatitis.
Materials for the present investigation were case histories, outpatient's cards, cards of dispensary observation, reports about the work of the centre of viral hepatitis for 2009-2012. While conducting analysis the specialists were guided by the worked out strategy in the treatment by antiviral therapy of patients with chronic viral hepatitis with regard for virus genotype, the level of viral load and the stage of fibrosis.The results of clinical method of examination of patients, biochemical indices with the control of alanine aminotransferase, IFA, MGM with the revealing of genotype and viral load, instrumental methods - us and elastometria were used. For patients with genotype 1 genetic polymorphism IL-28B was determined for the purpose of prognostication of treatment efficacy.
Investigation included 75 adult patients with CHC at the age of 18-53 years, from them there were 41 males and 34- females. There were 27 patients with genotype 1 and 48 patients with genotype 2 and 3. Antiviral therapy with Peginterferon alpha plus ribavirin in standard doses with regard for body weight was received by all patients. Patients with genotype 2-3 received AVT during 24 weeks, persons with genotype 1 - 48 wks. RVR has been achieved in 65 patients (86,6%), partial RVR - in 10 patients (9,3%), SVR - in 62 patients (82,6%). In 13 patients relapse of the disease after termination of the treatment was observed. Objectionable phenomena during PVT were observed in all patients in the form of asthenic syndrome (66,6%), depressive syndrome (12,8%), hematologic changes (52,1%), body weight reduction (52,2 %), changes connected with the work of the thyroid gland and cardiovascular system (32,4%). The reveated mentioned above phenomena were corrected during therapy and didn't lead to it's abolition. In most patients (57,3%) the middle level of virusological load (104 - 105 IU/ml) prevailed.
Results and discussion: Antiviral therapy conducted for patients with CHC allowed to achieve stable or sustained antiviral response on the average in 82,6% of patients. These indices were determined by the prevalence of patients with genotype 2-3 that is coordinated with data of the other authors. According to the data of the observation the level of virus in patients with CHC from low to high didn't reveal reliable statistical differences and didn't have an influence on the frequency of SVR. Patients with genotype 1 and high viral load (>106 IU/ml) were included into the category of "difficult patients" for the treatment of persons with CHC and carrying out of AVT during 48
wks was necessary. In this group of patients' prevalence of relapses in comparison with other patients having genotype 2-3 was marked.
Conclusions: Foundation and functioning of the Regional centre of viral hepatitis on the basis of the Amur Regional Infection Hospital allowed to co-ordinate and direct the work of medical establishments of the Region in providing specialized medical aid to the patients with CHC, including modern antiviral therapy. References:
1.Nikulkina Ye. V.,Krel P.Ye. and others. Combination therapy with Peginterferon alpha and
ribavirin in the primary patients with chronic hepatitis C//Clinical pharmacology and therapy.
2004 №13(2);
2.Nikishin I.G. Peginterferon-alpha: new means in the treatment of chronic gepatitis C//
Pharmacokinetics 2002.№9;
3. Fried M.W. Shiffman M., Reddy Retal. Peginterferon alpha-2a plus ribavirin for chronic hepatitis
C viral infection // Nengl J.Med., 2002, 347;
4. Hadziyannis S.J., Sette H.J.,et al Pegintron -2a and ribavirin combination therapy in chronic
hepatitis C. A randomized study of treatment duration and ribavirin dose. Ann. Jntern. Med. 2004;
140
The non-specific resistance of the organism, cytotoxicity of blood plasma in the development of pathological processes, and its evaluation by means of
independently living cells
A.P. Matytsin, V.A. Maksimenko, V.G. Yartsev, V.V. Kostina
Amur state medical academy, Blagoveshchensk, Russia
Abstracts: There were revealed disclosed and important medical and biological aspects of the phenomenon of cytotoxicity of the plasma and blood, were also given the comparative assessment of the evolution of the phenomenon in normal and pathological conditions. It is shown that the cytotoxicity of blood plasma is an important link in the non-specific resistance of the organism, has no species stability, its severity is related to the level of organization of the body, the state of immunological reactivity and is an important defense mechanism of action flogogenic factors. The cytotoxic effect of blood plasma has a direct link with the cellular responses and can be seen as an integrative measure of the state of plasma factors of nonspecific protection. For cytotoxicity studies of blood plasma and other biological fluids during the development of pathological processes there can be used alone living cells (paramecium or other), but interpretation of the results can not be evaluated uniquely (negatively or positively).
Key words: Reactivity, resistance, toxicity, immune system, allergy, basophils, eosinophils, fishes, amphibians, mammals, paramecium go test.
Numerous studies have shown that for any pathological and immunological processes rearrangements occur in the body, the blood picture changes significantly. Protein profile changes plasma cytotoxicity concentration of biologically active substances, immunoglobulins and other components is changed blood cell composition and the functional activity of the cells. However, the interpretation of these changes are often contradictory. It is debatable and efficiency paramecium go test to determine the cytotoxicity of plasma and blood in various forms of pathology [1,2,3,4,5,6]. It should be noted that the issue of "blood toxicity" and the mechanisms of this phenomenon is far from resolved and in biological terms - debatable.
