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.