Etiological and pathogenetic aspects of diagnosis and treatment of viral hepatitides

Abstract

The commencement address highlights the results of the long-term scientific research of the department of infectious diseases of the Kazan State Medical University on the problems of viral hepatitides diagnosis, treatment and prevention. The era of research of the acute viral hepatitides was based primarily on the clinical and biochemical differential diagnosis, considering epidemiologic data and specific prevention (vaccination) of hepatitis A and B. The development of modern technologies opened up new opportunities for etiologic decoding and morphologic evaluation of the infectious process activity in chronic viral hepatitis B, D and C. The results of hepatitis B and C genotyping, opening new opportunities for epidemiologic evaluation of their prevalence and antiviral treatment efficacy prediction, especially in family settings, are presented. A serious contribution is made to the study of latent HBV-infection, which is forming the long-term outcomes to cirrhosis and primary hepatocellular carcinoma. Pathogenetic connection of the systemic endotoxinemia, gastrointestinal bacterial overgrowth syndrome and immune dysfunction defined the morphologic and clinical and pathogenetic activity of the chronic viral hepatitis considering its molecular biologic verification. Contemporary diagnostics of chronic viral hepatitis (including HIV-coinfection) allowed to obtain the encouraging results in the development of the modern methods of antiviral (interferone, cytokines, nucle-os(t)ide analogs) and pathogenetic (metabolic correction - dimethyloxobuthylphosphonyldimethylate (dimephosphon), medical ozone, hepatoprotectors) treatment, in perspective - clinical use of direct antiviral agents (inhibitors of protease, polymerase etc.).