Chronic Viral Hepatitises in the Republic of Tajikistan
Clinical and Epidemiological Aspects of Decoded and Coded Chronic Viral Hepatitises in the Republic of Tajikistan
Tech Area / Field
- MED-DIS/Disease Surveillance/Medicine
8 Project completed
Senior Project Manager
Weaver L M
Institute of Gastroenterology, Academy of Sciences, Republic of Tajikistan, Tajikistan, Dushanbe
- Republic Center for Prevention and Avoidance of AIDS Infection, Tajikistan, Dushanbe
- Universitats Klinikum, Germany, Freiburg
Project summaryToday there is no official data on sickness statistics B hepatitis and C hepatitis in the most regions of the Republic of Tajikistan. Practically, particularities of epidemic processes of these infections are not investigated. It is known that the nature of infectious process is determined mostly by organism’s resistance. This notion includes not only immune system, presented by immunocompetent cells with their functional and metabolic properties, but it includes also mediators, which participate in inflammation. Such complex approach to investigation of organism’s resistance of patients allows having a more delicate perception of processes, which have place during various infections.
Immunological problem of interactions between virus-antigen and antibodies attracts special attention. Considerable changes of their concentrations: decrease of the level of one component and increase of the level of another component are labelled as seroconversion and reconvertion. In HBV replicative phase of some patients may be determined HBEAg elimination from organism and most of time the appearance of antibodies to it -anti -HBe have place as clinically unsuspected. At that early recurrent of acute viral hepatitis (AVH) in the most of cases is connected with seroconversion. Some of similar patients have sub-massive necrosis and encephalopathy V.E.Syutkin, T.N.Lopatkina, 1998, A.I.Khazanov, et al 1998. Absence of HBeAg in replicative phase of virus infection is suspicious in terms of possibility of mutation of pre-cortical zone of HBV, which may cause more serious course of viral hepatitis B Brillanti S. et al., 1999; Dienstag J.L. et al., 1999. On the whole the number of patients which have replicative type of HBV without HbeAg became considerably higher than 10 years ago /Vinogradova E.N., 1999; Lau D.T. et al., 2000/.
Wide prevalence of chronic viral hepatitis (CVH), phenomenon of their continuous accumulation among population, their high epidemic relevance as infection sources, discovery of new etiological agents (viruses of hepatitis G and hepatitis TT), ability for evolution into liver cirrhosis (LC) dictate the necessity of control and prevention of CVH on the basis of investigation and study of clinical and epidemiological, clinical and pathogenetic peculiarities and improvement of methods of their treatment, especially in the regions with high sickness rate of viral hepatitis C (HCV) and viral hepatitis B (HBV).
The problem of etiotropic therapy of CVH is very actual in today hepatology, too. Many scientists are looking for new means of treatment and methods of improvement of etiopathogenetic treatment [Yu.V.Lobzin with co-authors, 1996; A.G.Rahmonova with co-authors, 1997; T.V.Antonova with co-authors, 1998; K.V.Zhdanov with co-authors, 1998; P.E.Krel, 1998; M.Kh.Turyanov with co-authors, 1998; A.Ambrozaytie with co-authors, 1999; N.P.Blokhina, 1999; L.A.Kozhemyakin with co-authors, 2000; Lindsay K.L., 1997; Poynard T. et al., 1998; Brillanti S. et al., 1999; Dienstag J.L. et al., 1999; Ferenci P. et al., 1999; Yakovlev A.A., Vinogradova E.N., 1999; Lau D.T. et al., 2000]. But this problem is still exists because of insufficient efficiency of many medications and their high costs, which limits their wider application [D.K.Lvov, 1998; M.S.Balayan, M.I.Mikhaylov, 1999].
We shall evaluate the role of various infection risk factors and genotypic variety of chronic virus hepatitis in different population groups. On the basis of etiological decoding of CVH (including detection of RNA HCV and DNA HBV) will be determined the principle characteristics of epidemic processes of chronic viral hepatitis in the Republic of Tajikistan. We shall determine the differences between structure of transmission ways of HV and HC viruses among patients with HBV, HCV, and HV B+C. We shall determine sexual, age-specific, social, urban and ethnic factors for appearance of epidemic process of chronic viruses in the republic. Participation of hepatitis G virus in the development of CH.
The results of work allows to receive for the first time in Tajikistan the understanding of spread scale and transmission ways of TTV and TTV importance as agent, which is able in some cases to cause liver disease. Received results also will indicate on advisability lack for TTV determination during screening of blood donors and to determine the necessity of determination of this agent during decoding of cases of chronic hepatitis development.