Objective. To study the molecular and genetic properties of hepatitis B virus (HBV) and their relationship with clinical and laboratory parameters in patients with chronic HBV infection.Materials and methods. The study group included 228 patients with chronic HBV-infection. Routine hematological and biochemical tests, serum HBV DNA level, liver fibrosis (F) stage were measured. The determination of HBV genotype, subtype and drug resistance mutations was carried out by sequencing followed by phylogenetic analysis in 131 patients.Results. HBV DNA level above 2000 IU/ml was found in 68,4% of patients. The majority of the patients were HBeAg-negative (87,3%), they had viral load lower as compared with those HBeAg-positive (p<0,001). The viral load had a positive correlation with aminotransferases activity and severity of liver fibrosis, and negative correlation with the platelets count, albumin and prothrombin levels. HBV DNA level in patients with advanced liver fibrosis (F2-F4) was significantly higher vs. those with liver fibrosis stage F0-F1 (p=0,001). In patients with viral load above 2000 IU/ml hepatic necrosis, hypoalbuminemia and dysproteinemia were more pronounced. Phylogenetic analysis revealed the circulation of HBV genotypes D (74,8%) and A (23,7%), as well as genotype C and recombinant form D/A/D were detected. Patients with genotype D had higher aminotransferases and gammaglutamiltransferase (p<0,05) levels, and higher proportion of advanced liver fibrosis (F2-F4, p=0,04) vs. those with genotype A; no differences in viral load were found. Antiviral treatment is indicated in 59,2% of patients with genotype D, and only in 38,7% with genotype A (p=0,046).

Objective: to study features of PCR analysis of TTV ( Torque teno virus ) viruses and their prevalence in patients with chronic liver diseases and in relatively healthy individuals. Material and methods. To conduct the research, polymerase chain reaction (PCR), electrophoretic detection, and statistical method were applied. 212 patients with chronic liver diseases and 125 relatively healthy individuals were examined. Results. TTV, TTMV and TTMDV DNAs in the main and control groups were detected. The data of absolute values, relative frequencies (confidence interval - 95% CI) of DNA detection of TTV, TTMDV, TTMV viruses and their various combinations in the control and main groups of patients are given. Conclusion. The work shows the predominance of mixed infections: TTV, TTMDV and TTMV DNAs were detected in 67 % and 72 % patients of the main and control groups, respectively. The combination of TTV + TTMV viruses was detected in 15.6 % patients of the main and in 12 % patients of the control group. Other combinations, as well as mono-infection of TTMDV and TTMV, were considerably less common and were only single instances. The absence of TTV, TTMV, TTMDV or their combinations in human organism is rare, the frequency of DNA detection of at least one of these viruses in the main and control groups is 95.3% and 89.6%, respectively, with no statistically significant difference.

Гомельский государственный медицинский университет 2 Гомельская областная инфекционная клиническая больница Цель: оценить значение непрямых маркеров для определения выраженности фиброза печени у пациентов с хроническими гепатитами В (ХГВ) и С (ХГС).Материалы и методы. Обследовано 137 пациентов с ХГВ (n = 34) и ХГС (n = 103) с известной стадией выраженности фиброза, определенной на основании биопсии печени либо непрямых методов (фиброэластометрия, фибротест). Учитывались 9 показателей гемограммы и биохимического анализа крови, а также 8

Background. Hepatitis B virus (HBV) infection remains a global public health problem. Objective – to analyze the prevalence of viral coinfections with human immunodefciency virus (HIV), hepatitis C virus (HCV), hepatitis delta virus (HDV), TT-viruses and SENV in patients with chronic hepatitis B (CHB) and to assess their influence on liver disease severity. Material and methods. The observational cross-sectional study included 287 patients with chronic hepatitis B virus (HBV) – those with monoinfection and coinfected with HIV, HCV, HDV. Routine hematological and biochemical tests were performed, serum HBV DNA level as well as liver fbrosis stage were measured. Blood samples from 62 patients for Torque teno virus (TTV), Torque teno mini virus, Torque teno midi virus, SENV (D and H genotypes) DNAs were examined by polymerase chain reaction. Results. Among patients with CHB the prevalence of coinfection HBV + HIV is 6.6%, HBV + HCV – 6.3%, HBV + HDV – 3.8% and HBV + HDV + HCV – 1.7%. CHB patients coinfected with HIV, HCV, HDV had more pronounced biochemical differences and higher proportion of liver cirrhosis vs. HBV-monoinfected ones. The detection rate of TT viruses and their various combinations in patients with CHB is 91.9%, SENV – 66.1%. Conclusion. Coinfection with HIV, HCV, HDV in CHB patients is associated with more severe forms of chronic liver disease as compared to HBV-monoinfection. TT viruses and SENV are widespread and don’t affect the severity of liver disease in patients with CHB.

The present article describes a clinical case of ischemic cerebral infarction in а female patient with chronic HCV-infection. Although the prevalence of this pathology does not seem to be very high in comparison with that in general population, it remains life-threatening and must be well studied as one of the possible neurologic complications of chronic HCV infection concordant to mixed cryoglobulinemia, the most prevalent anhepatic HCV manifestation. However, the etiology and peculiarities of visceral cryoglobulinemia manifestations in chronic HCV infection need further research, which makes this problem extremely actual in the present-day HCV treatment.