[Viral hepatitis A and the possible pathogenetic mechanisms of a protracted convalescence]

Metabolites of connective tissue (free serum oxyproline, protein-bound plasma oxyproline, total urine oxyproline, serum glycosaminoglycans), proteolytic enzyme elastase, proteolysis inhibitors (alpha 1-inhibitor, alpha 2-macroglobulin) were investigated in 103 patients with viral hepatitis A. It was established that connective tissue and its metabolites produce a negative effect on hepatocytic repair. Longterm convalescence is attributed to elastase hyperactivity in the presence of relative deficiency of proteolytic inhibitors.