V.KH. FAZYLOV, ZH.G. EREMEEVA, E.R. MANAPOVA

Kazan State Medical University, Kazan

Contact details:

Fazylov V.Kh. — MD, Professor of the Department of Polyclinical Therapy and General Practice

Address: 49 Butlerov St., Russian Federation, Kazan, 420012, tel.: +7-917-254-89-97, e-mail: [email protected]

The purpose of the work is to determine the clinical and laboratory criteria for the activity of the infectious process in HBsAg-negative chronic HBV infection.

Material and methods. An in-depth clinical and laboratory examination of 59 patients with the HBsAg-negative form of chronic HBV infection was carried out. According to the preliminary results of an enzyme immunoassay of blood serum, the patients had the only marker of the disease — total antibodies to the core antigen of the hepatitis B virus (anti-HBcor) in the absence of HBsAg. Traditional methods of biological statistics were used with Student’s reliability not less that 95%.

Results. Comparative characteristics of the two groups based on the results of DNA detection in the polymerase chain reaction (DNA HBV+; n = 30 and DNA HBV–; n = 29) established comparability in terms of the minimum clinical picture, mainly due to concomitant pathology of the gastrointestinal tract in 40, 31% of cases, respectively; serological spectrum with the detection of total anti-HBcor in 100% of cases in the absence of HBsAg, a marker of inflammation and increased permeability of the hepatitis membrane — the activity of the enzyme alanine aminotransferase at a normal level in 65% of cases, and the absence of liver fibrosis in 89% of cases.

Сonclusion. Thus, the relevance of studying HBsAg-negative (hidden, latent, occult) hepatitis B is of particular importance for the science and practice of healthcare today, as a source of infection with a risk of reactivation and subsequent development of the process with an outcome in liver cirrhosis and hepatocellular carcinoma.

Key words: HBsAg-negative hepatitis B, pathogenesis, diagnosis.

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