Health care of Kyrgyzstan
Zdravoohraneniye Kyrgyzstana

ISSN 1694-8068 (Print)

ISSN 1694-805X (Online)

Clinical and laboratory characteristics of viral hepatitis of unspecified etiology

Clinical and laboratory characteristics of viral hepatitis of unspecified etiology
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Abstract

Introduction. An analysis of 12 cases of acute viral hepatitis of unspecified etiology is presented. In patients, negative markers of viral hepatitis were obtained twice, the autoimmune nature was excluded by the absence of autoimmune antibodies. Antibodies (IgG) to HSV (11 patients), EBV (9 patients) and CMV (7 patients) were detected. In patients with recent infection with HSV (low avidity index), the clinic of acute hepatitis developed in young people against a background of high immunocompetence, which led to recovery in a short time. Whereas, in the group of patients with high avidity, the disease developed among the older age group with a longer course. The aim of study. To study the clinical and laboratory characteristics of viral hepatitis of unspecified etiology. Material and methods. Clinical and laboratory characteristics of hepatitis of unspecified etiology were studied in 12 patients. All patients underwent a standard general clinical examination, which included an assessment of complaints and physical examination data, biochemical blood tests, general clinical blood and urine tests, determination of viral hepatitis markers by ELISA, and ultrasound of the abdominal organs. Antibodies to HSV, CMV, EBV were determined by ELISA, as well as the avidity of IgG to HSV. Results and its discussion. According to the RCIB for the period 2014 - 2020 the proportion of hepatitis of unspecified etiology ranged from 2.3% to 7.1%, averaging 4.39 ± 0.58. The observed patients had persistent symptoms of yellowness of the skin and sclera, weakness, abdominal pain and loss of appetite. The study of biochemical parameters showed a significant increase in "liver tests" in all examined patients. According to the ultrasound data from the liver, all patients showed signs corresponding to changes in acute hepatitis. The diagnosis of viral hepatitis was excluded after repeated negative tests for markers, which served as the basis for further search for an etiological factor and the patients were examined for viruses of the herpes group (HSV, CMV, EBV), taking into account their hepatotropicity, as well as for the presence of AMA and ANA to exclude an autoimmune nature. The results of examination for herpes viruses showed the presence of IgG antibodies to HSV in 11 patients, EBV - in 9 and CMV - in 7 patients. Antibodies to all three HSV, EBV and CMV viruses were found in 6 patients, to two HSV and EBV viruses - in 3 patients, one patient had antibodies only in CMV. The hepatotropicity of herpes viruses (CMV, EBV, HSV) was confirmed by the detection of their antigens in the hepatocytes of the examined patients. Conclusions: In the etiological structure of viral hepatitis, a certain place can be occupied by viral hepatitis caused by the herpes simplex virus, cytomegalovirus, Epstein-Barr virus, etc., the clinical picture of viral hepatitis is similar in form, severity, course and outcomes;in case of laboratory exclusion of viral hepatitis A, B, C, D, E, it is necessary to continue laboratory studies to confirm the etiology of other viral hepatitis.

About the authors

Иманбаева Лира Асанбековна, ассистент кафедры инфекционных болезней и дерматовенерологии МВШМ,Бишкек, Кыргызская Республика.

Imanbaeva Lira Asanbekovna, Assistant of the Department of Infectious Diseases and Dermatovenerology of IHSM, Bishkek, Kyrgyz Republic. 

Иманбаева Лира Асанбековна, ЭАЖММнын жугуштуу оорулар жана тери оорулардын кафедрасынын ассистенти,  Бишкек, Кыргыз Республикасы. 

References

1. Malyi V.P., Lyadova T.I., Gololobova O.V., Boyko V.V. Clinical and diagnostic characteristics of genotyping of obligate hepatotropic viruses. The influence of viral genotypes on clinical manifestations and outcomes of the disease. // Actual Infectology. - 2013. - № 1 (1). - P. 37-43.
2. Mukomolov S.L., Semenenko T.A., Gerasimova I.E. The burden of hepatitis A in the Russian Federation: a scientific
overview. // Epidemiology and Vaccine Prophylaxis. - 2014.- № 6 (79). - P. 24-34.
3. Yushchuk N.D., Tsyganova E.V., Znoiko O.O. et al. Acute hepatitis of unspecified etiology: etiological structure and clinical and laboratory features. // Experimental and Clinical Gastroenterology. –2009. – № 8. – P.12-18.
4. Totolyan G.G., Storozhakov G.I., Fedorov I.G. and other Viruses of the herpes group and liver damage. // Medicine. - 2009. –№2. – P. 4-11.
5. Anthony Khoo. Acute cholestatic hepatitis induced by EpsteinBarr virus infection in an adult: case report. // Journal of medical case reports. - 2016. – № 10 (75) –P. 1-3.
6. Moreno-Treviño María G. et al. Acute cytomegalovirus hepatitis in a non-immunosuppressed patient: a case report. // Rev.Latinoam.Patol.Clin.Med.Lab. –2017. - № 64 (2). - P. 60-62
7. Chaudhary D. et al. Acute liver failure from herpes simplex virus in an immunocompetent patient due to direct inoculation of the peritoneum. // ACG case reports journal. - 2017.- № 4 P. 23
8. Zaitsev I.A., Kirienko V.T. Hepatitis caused by herpes simplex viruses. // Family medicine. - 2016.- № 3 (65). - P.127-130.
9. Uchaikin V.F., Smirnov A.V., Chuelov S.B. and other Herpesvirus hepatitis in children. //Pediatrics. - 2012. - № 3(91).– P. 136-142.

1. Malyi V.P., Lyadova T.I., Gololobova O.V., Boyko V.V. Clinical and diagnostic characteristics of genotyping of obligate hepatotropic viruses. The influence of viral genotypes on clinical manifestations and outcomes of the disease. // Actual Infectology. - 2013. - № 1 (1). - P. 37-43.
2. Mukomolov S.L., Semenenko T.A., Gerasimova I.E. The burden of hepatitis A in the Russian Federation: a scientific
overview. // Epidemiology and Vaccine Prophylaxis. - 2014.- № 6 (79). - P. 24-34.
3. Yushchuk N.D., Tsyganova E.V., Znoiko O.O. et al. Acute hepatitis of unspecified etiology: etiological structure and clinical and laboratory features. // Experimental and Clinical Gastroenterology. –2009. – № 8. – P.12-18.
4. Totolyan G.G., Storozhakov G.I., Fedorov I.G. and other Viruses of the herpes group and liver damage. // Medicine. - 2009. –№2. – P. 4-11.
5. Anthony Khoo. Acute cholestatic hepatitis induced by EpsteinBarr virus infection in an adult: case report. // Journal of medical case reports. - 2016. – № 10 (75) –P. 1-3.
6. Moreno-Treviño María G. et al. Acute cytomegalovirus hepatitis in a non-immunosuppressed patient: a case report. // Rev.Latinoam.Patol.Clin.Med.Lab. –2017. - № 64 (2). - P. 60-62
7. Chaudhary D. et al. Acute liver failure from herpes simplex virus in an immunocompetent patient due to direct inoculation of the peritoneum. // ACG case reports journal. - 2017.- № 4 P. 23
8. Zaitsev I.A., Kirienko V.T. Hepatitis caused by herpes simplex viruses. // Family medicine. - 2016.- № 3 (65). - P.127-130.
9. Uchaikin V.F., Smirnov A.V., Chuelov S.B. and other Herpesvirus hepatitis in children. //Pediatrics. - 2012. - № 3(91).– P. 136-142.

1. Malyi V.P., Lyadova T.I., Gololobova O.V., Boyko V.V. Clinical and diagnostic characteristics of genotyping of obligate hepatotropic viruses. The influence of viral genotypes on clinical manifestations and outcomes of the disease. // Actual Infectology. - 2013. - № 1 (1). - P. 37-43.
2. Mukomolov S.L., Semenenko T.A., Gerasimova I.E. The burden of hepatitis A in the Russian Federation: a scientific
overview. // Epidemiology and Vaccine Prophylaxis. - 2014.- № 6 (79). - P. 24-34.
3. Yushchuk N.D., Tsyganova E.V., Znoiko O.O. et al. Acute hepatitis of unspecified etiology: etiological structure and clinical and laboratory features. // Experimental and Clinical Gastroenterology. –2009. – № 8. – P.12-18.
4. Totolyan G.G., Storozhakov G.I., Fedorov I.G. and other Viruses of the herpes group and liver damage. // Medicine. - 2009. –№2. – P. 4-11.
5. Anthony Khoo. Acute cholestatic hepatitis induced by EpsteinBarr virus infection in an adult: case report. // Journal of medical case reports. - 2016. – № 10 (75) –P. 1-3.
6. Moreno-Treviño María G. et al. Acute cytomegalovirus hepatitis in a non-immunosuppressed patient: a case report. // Rev.Latinoam.Patol.Clin.Med.Lab. –2017. - № 64 (2). - P. 60-62
7. Chaudhary D. et al. Acute liver failure from herpes simplex virus in an immunocompetent patient due to direct inoculation of the peritoneum. // ACG case reports journal. - 2017.- № 4 P. 23
8. Zaitsev I.A., Kirienko V.T. Hepatitis caused by herpes simplex viruses. // Family medicine. - 2016.- № 3 (65). - P.127-130.
9. Uchaikin V.F., Smirnov A.V., Chuelov S.B. and other Herpesvirus hepatitis in children. //Pediatrics. - 2012. - № 3(91).– P. 136-142.

Для цитирования

Иманбаева Л.А.Клинико-лабораторная характеристика вирусных гепатитов неуточненной этиологии. Здравоохранение Кыргызстана 2021, № 2, с. 48-54;

https://doi.org/10.51350/zdravkg202162648

For citation

Imanbaeva L.A.Clinical and laboratory characteristics of viral hepatitis of unspecified etiology.Health care of  Kyrgyzstan 2021, no 2, pp. 48-54;


https://doi.org/10.51350/zdravkg202162648

Цитата үчүн

Иманбаева Л.А.Такталбаган этиологиядагы вирустук гепатиттин клиникалык жана лабораториялык мүнөздөмөлөрү.Кыргызстандын Cаламаттык Cактоо 2021, № 2, б. 48-54;


https://doi.org/10.51350/zdravkg202162648

Authors manbaeva L.A.
Link doi.org https://doi.org/10.51350/zdravkg202162648
Pages 48-54
Russian
Об авторах

Иманбаева Лира Асанбековна, ассистент кафедры инфекционных болезней и дерматовенерологии МВШМ,Бишкек, Кыргызская Республика.

Полный текст

PDF (RUS)

Список литературы

1. Malyi V.P., Lyadova T.I., Gololobova O.V., Boyko V.V. Clinical and diagnostic characteristics of genotyping of obligate hepatotropic viruses. The influence of viral genotypes on clinical manifestations and outcomes of the disease. // Actual Infectology. - 2013. - № 1 (1). - P. 37-43.
2. Mukomolov S.L., Semenenko T.A., Gerasimova I.E. The burden of hepatitis A in the Russian Federation: a scientific
overview. // Epidemiology and Vaccine Prophylaxis. - 2014.- № 6 (79). - P. 24-34.
3. Yushchuk N.D., Tsyganova E.V., Znoiko O.O. et al. Acute hepatitis of unspecified etiology: etiological structure and clinical and laboratory features. // Experimental and Clinical Gastroenterology. –2009. – № 8. – P.12-18.
4. Totolyan G.G., Storozhakov G.I., Fedorov I.G. and other Viruses of the herpes group and liver damage. // Medicine. - 2009. –№2. – P. 4-11.
5. Anthony Khoo. Acute cholestatic hepatitis induced by EpsteinBarr virus infection in an adult: case report. // Journal of medical case reports. - 2016. – № 10 (75) –P. 1-3.
6. Moreno-Treviño María G. et al. Acute cytomegalovirus hepatitis in a non-immunosuppressed patient: a case report. // Rev.Latinoam.Patol.Clin.Med.Lab. –2017. - № 64 (2). - P. 60-62
7. Chaudhary D. et al. Acute liver failure from herpes simplex virus in an immunocompetent patient due to direct inoculation of the peritoneum. // ACG case reports journal. - 2017.- № 4 P. 23
8. Zaitsev I.A., Kirienko V.T. Hepatitis caused by herpes simplex viruses. // Family medicine. - 2016.- № 3 (65). - P.127-130.
9. Uchaikin V.F., Smirnov A.V., Chuelov S.B. and other Herpesvirus hepatitis in children. //Pediatrics. - 2012. - № 3(91).– P. 136-142.

Для цитирования

Иманбаева Л.А.Клинико-лабораторная характеристика вирусных гепатитов неуточненной этиологии. Здравоохранение Кыргызстана 2021, № 2, с. 48-54;

https://doi.org/10.51350/zdravkg202162648

English
About authors

Imanbaeva Lira Asanbekovna, Assistant of the Department of Infectious Diseases and Dermatovenerology of IHSM, Bishkek, Kyrgyz Republic. 

Full text

PDF (RUS)

References

1. Malyi V.P., Lyadova T.I., Gololobova O.V., Boyko V.V. Clinical and diagnostic characteristics of genotyping of obligate hepatotropic viruses. The influence of viral genotypes on clinical manifestations and outcomes of the disease. // Actual Infectology. - 2013. - № 1 (1). - P. 37-43.
2. Mukomolov S.L., Semenenko T.A., Gerasimova I.E. The burden of hepatitis A in the Russian Federation: a scientific
overview. // Epidemiology and Vaccine Prophylaxis. - 2014.- № 6 (79). - P. 24-34.
3. Yushchuk N.D., Tsyganova E.V., Znoiko O.O. et al. Acute hepatitis of unspecified etiology: etiological structure and clinical and laboratory features. // Experimental and Clinical Gastroenterology. –2009. – № 8. – P.12-18.
4. Totolyan G.G., Storozhakov G.I., Fedorov I.G. and other Viruses of the herpes group and liver damage. // Medicine. - 2009. –№2. – P. 4-11.
5. Anthony Khoo. Acute cholestatic hepatitis induced by EpsteinBarr virus infection in an adult: case report. // Journal of medical case reports. - 2016. – № 10 (75) –P. 1-3.
6. Moreno-Treviño María G. et al. Acute cytomegalovirus hepatitis in a non-immunosuppressed patient: a case report. // Rev.Latinoam.Patol.Clin.Med.Lab. –2017. - № 64 (2). - P. 60-62
7. Chaudhary D. et al. Acute liver failure from herpes simplex virus in an immunocompetent patient due to direct inoculation of the peritoneum. // ACG case reports journal. - 2017.- № 4 P. 23
8. Zaitsev I.A., Kirienko V.T. Hepatitis caused by herpes simplex viruses. // Family medicine. - 2016.- № 3 (65). - P.127-130.
9. Uchaikin V.F., Smirnov A.V., Chuelov S.B. and other Herpesvirus hepatitis in children. //Pediatrics. - 2012. - № 3(91).– P. 136-142.

For citation

Imanbaeva L.A.Clinical and laboratory characteristics of viral hepatitis of unspecified etiology.Health care of  Kyrgyzstan 2021, no 2, pp. 48-54;


https://doi.org/10.51350/zdravkg202162648

Kyrgyz
Авторлор жөнүндө

Иманбаева Лира Асанбековна, ЭАЖММнын жугуштуу оорулар жана тери оорулардын кафедрасынын ассистенти,  Бишкек, Кыргыз Республикасы. 

Толук текст

PDF (RUS)

Шилтемелер

1. Malyi V.P., Lyadova T.I., Gololobova O.V., Boyko V.V. Clinical and diagnostic characteristics of genotyping of obligate hepatotropic viruses. The influence of viral genotypes on clinical manifestations and outcomes of the disease. // Actual Infectology. - 2013. - № 1 (1). - P. 37-43.
2. Mukomolov S.L., Semenenko T.A., Gerasimova I.E. The burden of hepatitis A in the Russian Federation: a scientific
overview. // Epidemiology and Vaccine Prophylaxis. - 2014.- № 6 (79). - P. 24-34.
3. Yushchuk N.D., Tsyganova E.V., Znoiko O.O. et al. Acute hepatitis of unspecified etiology: etiological structure and clinical and laboratory features. // Experimental and Clinical Gastroenterology. –2009. – № 8. – P.12-18.
4. Totolyan G.G., Storozhakov G.I., Fedorov I.G. and other Viruses of the herpes group and liver damage. // Medicine. - 2009. –№2. – P. 4-11.
5. Anthony Khoo. Acute cholestatic hepatitis induced by EpsteinBarr virus infection in an adult: case report. // Journal of medical case reports. - 2016. – № 10 (75) –P. 1-3.
6. Moreno-Treviño María G. et al. Acute cytomegalovirus hepatitis in a non-immunosuppressed patient: a case report. // Rev.Latinoam.Patol.Clin.Med.Lab. –2017. - № 64 (2). - P. 60-62
7. Chaudhary D. et al. Acute liver failure from herpes simplex virus in an immunocompetent patient due to direct inoculation of the peritoneum. // ACG case reports journal. - 2017.- № 4 P. 23
8. Zaitsev I.A., Kirienko V.T. Hepatitis caused by herpes simplex viruses. // Family medicine. - 2016.- № 3 (65). - P.127-130.
9. Uchaikin V.F., Smirnov A.V., Chuelov S.B. and other Herpesvirus hepatitis in children. //Pediatrics. - 2012. - № 3(91).– P. 136-142.

Цитата үчүн

Иманбаева Л.А.Такталбаган этиологиядагы вирустук гепатиттин клиникалык жана лабораториялык мүнөздөмөлөрү.Кыргызстандын Cаламаттык Cактоо 2021, № 2, б. 48-54;


https://doi.org/10.51350/zdravkg202162648

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