International Union for Circumpolar Health Ministry of Public Health and Social Development of RF Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Sciences Medical Polar Fund “Science” The Northern Forum

Abstracts

Northern Epidemiology

Morbidity of viral hepatitis type B and especially type C is transformed from the medical problem into the medico-social one. Its significance is considerably increased at combination hepatitises with opisthorchosis – a human disease, caused by trematode Opistorchis felineus, parasitizing in the intrahepatic bile ducts, gallbladder and pancreatic ducts. Western Siberia and the northern regions are the hyperendemic opisthorchosis centers. This helminthiasis impacts systemicaly on a human organism, weakens its physically, causes immunodepression. There processes become more severe at viral – parasitic combination. Affection of inhabitants of there regions comprises 51-82%, in some places more than 95%. It is necessary to pay attention that Op. felineus is considered to be a reservior of viral-bacterial infections organisms.

The purpose was to study the clinical, laboratory, morphological characteristics of viral hepatitis type B and C in patients with chronic opisthorchosis in the endemic area and to define the features of treatment.

Material and methods. A total of 375 patients aged 18-65 were examined. Among them males– 247 and females – 128. A combination HBV with opisthorchosis was registered in 292 patients, HCV – in 183 patients. Such examination methods as clinical, immunologi-cal, biochemical, serological, morphological, US, CT, PCR were used. Results of the studies and discusion. Circulation of virus in a human organism, re-sulting in immunopathogenetic changes at combination with opisthorchosis, characterizing such pathogenetic mechanisms as allergic, mechanical, viscero-visceral secondary – infectious, lead to the systemic evidences, severity of the disease. Along with the syndromes, typical for chronic viral liver diseases – astenic, jaundice, dyspepsic, cytolytic, mesenchymatous - inflammatory, pain – the allergic, cholangiocholecystitis, pancreapathies, gastrointestinal evi-dences are appeared, cholestasia, asteno-vegetative signs and etc. become more severe. There have been observered eosinophilia, increased JGE, alkaline phosphatase, gamma-glutamil-trasferase, de Ritis's coefficient, being equal or more than 1 in common blood analyse in the patients with Op. felineus invasion. The results of the morphological studies depended on the degree of activity of an inflammatory process. At combination with viral hepatitis there had been observed eosinophil infiltration in liver tissue samplings.

The treatment has some differences and consisted in a preparatory stage, including both pegintron, rebetol and drugs, bearing ursodedaxycholic acid, antihistominic means, specific chemotherapy with biltrizide according to the mild technique, developed by us (profes-sor A. Paltsev) and a two-staged rehabilitation therapy. Conclusions: Parasitic diseases of the bile-excreting tracts and viral liver diseases are the most spread in Siberia and the North. At combination chronic viral hepatitis type B and C with opisthorchosis invasion there is more severe clinical course of disease, systemic affections, laboratory and morphological changes, testifying to more evident pathological changes, needing a differential therapy.

Note. Abstracts are published in author's edition

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Last update: 06-Jul-2012 (11:52:05)