Objective: the study of clinical and biochemical manifestations in pregnant women with chronic viral hepatitis B and C in the third trimester and their relationships with the activity of infectious process. Material and Methods. The study included 50 pregnant women with chronic viral hepatitis (group I), 83 women with chronic viral hepatitis C (group II), and 36 healthy women (group III). Complaints, clinical manifestations, biochemical parameters, and viral load (VL) were evaluated in pregnant women with chronic viral hepatitis. Results. In pregnant women with chronic viral hepatitis in the third trimester compared with healthy pregnant women, higher numbers of complaints and clinical symptoms were recorded. In healthy pregnant women, only heartburn, bloating, and swelling in the legs (8.34%) were observed. Heartburn (p≤0.05), pain in the right hypochondrium (p≤0.05), palmarerythema, and spider veins (p≤0.05) were detected more often in pregnant women with chronic viral hepatitis B compared with those who had chronic viral hepatitis C. Women with chronic viral hepatitis C more often had anxiety (p≤0.05), weakness (p≤0.05), tongue coating (p≤0.05), and swelling in the legs (p≤0.05). Loss of appetite, joint pain, and headache were found only in pregnant women with chronic viral hepatitis C. 92% of women with chronic viral hepatitis В had НВеАgnegative chronic viral hepatitis; women with chronic viral hepatitis C had genotypes 1 and 3 of the virus with the same frequency. In all pregnant women with chronic viral hepatitis, low VL<106 copies/mL occurred predominantly: in 68% of those with chronic viral hepatitis B and 71% of those with chronic viral hepatitis C. Conclusions. Pregnant women with chronic viral hepatitis in the third trimester had more often greater numbers of complaints and clinical manifestations compared with healthy controls. Low VL, НВеАg-negative forms in chronic viral hepatitis В, genotypes 1 and 3 in chronic viral hepatitis C, and reduced total protein and a moderate increase in alanine aminotransferase in pregnant women with chronic viral hepatitis C were predominant. The number of clinical manifestations increased along with an increase in VL.

The problem of parenteral viral hepatitis, in particular, viral hepatitis B (VHB), is urgent till now owing to some social, economic, and epidemiologic factors. The paper analyzes clinic-epidemiologic VHB indices in children for 1994—2009 in the Tomsk Region. The analysis includes 311 patients with acute and chronic VHB aged from 1 month to 18 years. The patients were treated in infectious hospitals of the city of Tomsk and Tomsk Region for the period of 1994 to 2009. Both clinic (short preicteric period, incomplete recovery after the normal hospitalization period) and epidemiologic (alternation of infection ways with time and their dependence on age, predomination of schoolchildren in the VHB age structure) VHB features are revealed.

There were 46 children with chronic otitis media with effusion (OME) under the supervision. After carried out virologic research by immune-enzyme analysis, polymerase chain reaction, metod-immunofluorescence-antitel, prevalence Epstein-Barr virus infection — 41 person (89,1 %), a smaller part children with respiratory syncytial virus — 18 children (39,1 %) and adenovirus infections — 15 children (32,6 %) — are noted. All patients were undergone surgical treatment — middle ear bypass surgery, after the surgery the thirst group patients received antiviral drug while the second group patients received standard treatment. Inclusion antiviral drug into the OME treatment algorithm decreases terms of patient¢s treatment.

The problem of parenteral viral hepatitis, in particular, viral hepatitis B (VHB), is urgent till now owing to some social, economic, and epidemiologic factors. The paper analyzes clinic-epidemiologic VHB indices in children for 1994-2009 in the Tomsk Region. The analysis includes 311 patients with acute and chronic VHB aged from 1 month to 18 years. The patients were treated in infectious hospitals of the city of Tomsk and Tomsk Region for the period of 1994 to 2009. Both clinic (short preicteric period, incomplete recovery after the normal hospitalization period) and epidemiologic (alternation of infection ways with time and their dependence on age, predomination of schoolchildren in the VHB age structure) VHB features are revealed.

Inactivated vaccine ОspaVir which was created in the NPO VIRION based upon high immunogenic vaccine virus strain of L-IVP is proved to be safe and having high immunologic activity. The vaccine does not decrease total immunity.

The paper presents the results of clinical tests of the comparative estimation of tolerance, effectiveness and clinic-laboratory indices of chronic HBV and HCV patients Laifferon and Reaferon-ES treatment within a year (12 month). Less collateral effect caused by laifferon is stated. The results of effectiveness of Laifferon and Reaferon-ES treatment of the chronic HBV and HCV patients did not differ in compared groups.

The research is devoted to study clinico-laboratory implications and indicators of coagulating system of blood at patiens with liver cirrhosis associated with virus hepatitises B, C and D. The group of 100 patients were analyzed. At patients combined the lesion of a liver viruses HCV and HBV met identical frequency with a HBV-infection (34%). The hepatocellular carcinoma is taped in 8% of cases. At 50 patients with a cirrhosis in subcompansation stage researches of coagulating system of blood have been carried out. According to the developed coagulogram consumption coagulopathy development became perceptible.

The research is devoted to study clinico-laboratory implications and indicators of coagulating system of blood at patiens with liver cirrhosis associated with virus hepatitises B, C and D. The group of 100 patients were analyzed. At patients combined the lesion of a liver viruses HCV and HBV met identical frequency with a HBV-infection (34%). The hepatocellular carcinoma is taped in 8% of cases. At 50 patients with a cirrhosis in subcompansation stage researches of coagulating system of blood have been carried out. According to the developed coagulogram consumption coagulopathy development became perceptible.

The paper presents the results of field clinical tests of the new Russian vaccine "HEP-A+B-in-VAC" against hepatitis A and B. The vaccine has been found to be safe and to have a weak reactogenicity. After completion of a course of vaccination, seroconversion occurred in 100% of the vaccinated, the high titers of anti-HAV and HBs being found in 90.9 and 72.7% of the volunteers, respectively. A comparative analysis demonstrated that the reactogenicity of the new vaccine was less and its immunogenicity was higher than those in monovaccines against hepatitis A and B when they were co-administered.

Aim To study clinical and laboratory parameters in patients with acute viral hepatitis (AVH) given basic therapy in combination with a novel pathogenetic drug litovit versus ursosan. Material and methods 155 patients with AVH were divided into three groups: 70 patients of group 1 received basic therapy plus litovit, 10 patients of group 2--basic therapy plus ursosan, 60 patients of group 3--basic treatment only. Results Litovit was well tolerated. Side effects were absent. Hospital stay and severity of clinical AVH symptoms were significantly less in patients of group 1. Less pronounced were also hyperbilirubinemia, cytolytic and mesenchymal-inflammatory syndromes. Conclusion Clinical and laboratory parameters in AVH patients treated with adjuvant litovit improve quicker than in those with adjuvant ursosan or basic therapy. Litovit has enterosorptive and hepatoprotective activity. Low cost of vitovit therapy makes the drug applicable in wide practice.

This paper aims to study the morphological quality and reversible aggregation of erythrocytes of peripheral blood among the patients with chronic hepatitis virus (CHV) and mix-pathology. The specimens of peripheral blood of the patients with CHV at the age of 19-20 were analyzed with the electron microscope PEM-200. According to pathology the patients were divided into 3 groups. The first group consisted of patients with chronic hepatitis B virus (CHBV) and chronic hepatitis C virus (CHCV). The second group was comprised of patients with CHV and concomitant opisthorchiasis. The opiumism and CHV patients formed the third group. The control group included patients without concomitant somatic pathology. Results show that in both the control group and in others, the main mass of erythrocyte pool is represented by biconcave erythrocytes - discocytes. The main part of the reversibly changed erythrocytes was formed by spherocytes. In CHV patients, a decrease in normocytes, an increase in reversibly and reversibly changed erythrocytes that exceeded indexes of control group and an increase in the hollow ball - like erythrocytes were observed. In CHV and opisthorchiasis patients as well as the patients from the first group were noted to have increase of reversibly and irreversibly changed erythrocytes especially degenerative forms. Reversibly changed erythrocytes are represented by deflated ball shaped discocytes. The number of biconcave erythrocytes in all the studied groups appeared to be lesser than the analogous normal index. A tendency to increase the number of degenerative erythrocyte like a hollow ball has been observed in the first two groups, and increase the number of cupolashaped and spherical erythrocytes in the third group. A tendency to increase the number of degeneratively changed erythrocytes among CHV patients with concomitant opisthorchiasis and especially opiumism has been observed. In conclusion, the pathological processes caused by virus persistence in the organism and the presence of concomitant chronic opisthorchiasis and especially opiumism affect the superficial architectonics organization of erythrocytes.

This paper makes an appraisal of the immunological efficiency of the Vector-BiAlgam vaccine by testing the protective antibodies in comparison with instant introduction of monovaccine against hepatitis A and B. Also the reactogenity qualities of the vaccine when thrice repeated was evaluated. Results show that the local reactions in majority of the subjects manifested within a short time. The number of reactions in the experimental group at different stages of vaccination varied from 20.3 to 36.3%. By means of comparative analysis it was found that the general and local reactions in the control group were registered more often, although the reactions qualitatively were not different. For the vaccinated group, the reactions with the divaccine were slightly expressed and of short duration. Post vaccinal complications in both groups were not found. The research results of the immune qualities of divaccine "HEP-A+B-in-VAC" were positive: the percentage of seroconversions after three vaccinations was 100%. The great majority of the volunteers of the experimental group had 72.2% protective antibodies to the HBs-antigen that formed with a high titer (more than 1000 UI/L). High titers of antibodies to the hepatitis virus A were determined among 90.9% volunteers. In the control group after three vaccinations, seroconversion occurred among 100% of the vaccinated subjects. In conclusion, the received results of a newly elaborated hepatitis A and B "HEP-A+B-in-VAC" vaccine is the evidence of a weak reactogenity and a high immune activity.

Clinical tests have been performed by the specialists of Infectious Diseases Department of the post diploma training chair Siberian State Medical University and scientific industrial association "Virion" on the base Infection Department of Municipal Clinic Hospital N3 (Tomsk). The aim of the study was to determine the efficiency of a half dose of hepatitis B (HB) virus vaccine produced by "Virion" among persons aged 17-19. Vaccination was performed according to the special scheme: 0-1-2, 12 months - booster dose. The experimental group was vaccinated with half dose (10 mcgr HBs Ag) of DNA-recombinant vaccine against hepatitis B virus produced by "Virion". Control groups were vaccinated with a full dose (20 mcgr HBs Ag) of yeast liquid vaccine produced by "Heber Biobac" (Cuba) and one control group was vaccinated with anti hepatitis B virus vaccine "Virion" (Tomsk). During the research of immunologic efficacy of the compared vaccines it was found that in a month after the third vaccination titer of HBs Ag antibodies in the control groups was rather high and approximately identical, and in the experimental group 1,5 times lower. In a year from the beginning of vaccination before introduction of booster dose the HBs Ag antibody titers became considerably higher and approached the control groups' level. In 13 months from the beginning of the tests in the final analyses of antibodies level antibody titers in volunteers who had been vaccinated with three different vaccines were practically both identical in the experimental groups and in the control ones. Thus the preliminary studies of a half dose vaccine against hepatitis B virus produced by "Virion" among young people of 17-19 allow to make a conclusion about the application expediency.

Aim. To design and substantiate an effective combined therapy scheme for patients with chronic viral hepatitis (CVH) and chronic opisthorchiasis (CO). Material and methods. 10 patients with CHB and 12 patients with CHB+C in the presence of CO. All the patients have undergone clinical and device. examinations before the treatment and in the course of therapy with biltricide and reaferon. Results. Patients with CVH at the stage of moderate activity and in the phase of virus replication received antihelminthic therapy with biltricide which caused neither complications nor deterioration, antihelminthic effect was observed in 20 of 22-patients. In a month, the patients started on,,reaferon given for therapy of hepatitis. As a result, all the patients. improved clinically with normalization of biochemical blood parameters. Markers of viral hepatitides disappeared:in 17 of 22 patients. Conclusion. Combined therapy of CVH in active process in the presence of CO may, include antihelminthic and antiviral, treatment and should be staged.

AIM:To design and substantiate an effective combined therapy scheme for patients with chronic viral hepatitis (CVH) and chronic opisthorchiasis (CO).MATERIAL AND METHODS:10 patients with CHB and 12 patients with CHB + C in the presence of CO. All the patients have undergone clinical and device examinations before the treatment and in the course of therapy with biltricide and reaferon.RESULTS:Patients with CVH at the stage of moderate activity and in the phase of virus replication received antihelminthic therapy with biltricide which caused neither complications nor deterioration, antihelminthic effect was observed in 20 of 22 patients. In a month, the patients started on reaferon given for therapy of hepatitis. As a result, all the patients improved clinically with normalization of biochemical blood parameters. Markers of viral hepatitides disappeared in 17 of 22 patients.CONCLUSION:Combined therapy of CVH in active process in the presence of CO may include antihelminthic and antiviral treatment and should be staged.

AIM:To study clinical and laboratory manifestations of acute viral hepatitis C in parenteral drug addicts.MATERIALS AND METHODS:Acute viral hepatitis C (AVHC) was diagnosed in 114 patients included in the trial by serological evidence and virus RNA determination at polymerase chain reaction. Among the examinees there were 63 addicts and 51 non-addicts.RESULTS:In addicts, AVHC manifests with pain in the liver, anorexia, moderate intoxication, hepatomegalia, abstinence syndrome. At admission most the addicts had a moderate rise in bilirubin concentration with prolonged normalization. 25% of the addicts had ALT < 1400 micromol/l/h, its lowering was slow. In convalescence, the addicts' liver long remained enlarged, concentrations of ALT, alkaline phosphatase, GGT remained high.CONCLUSION:VHC runs a moderate course in parenteral drug addicts, shows polymorphic symptomatology, hepatomegalia, high blood levels of ALT. Convalescence is long, hepatic functions recover slowly.

Clinical and laboratory parameters investigated in pseudotuberculosis patients with and without CO proved patients with mixed infection to be more seriously affected. They had more pronounced polymorphism of clinical symptoms, more severe intoxication, fever, hepato- and splenomegaly, longer convalescence, more frequent relapses, worse laboratory findings. Complicated course of pseudotuberculosis patients with CO may be due to hypersensitization of the body and hepatobiliary disorders resultant from parasitic invasion.