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[Problem of chronic hepatitis (classification, pathogenesis and treatment]
Insights
This study updates chronic hepatitis classification, introducing chronic lobular hepatitis and detailing immune responses to hepatitis B virus (HBV). Findings link autoimmune issues to HBV, highlighting cellular immunity
Area of Science:
- Hepatology
- Immunology
- Virology
Background:
- Chronic hepatitis classification requires updates.
- Immune responses in hepatitis B virus (HBV) infection are complex.
- Autoimmune abnormalities may be integral to HBV infection.
Purpose of the Study:
- To update the classification of chronic hepatitis.
- To describe chronic lobular hepatitis and immune responses to HBV.
- To explore the role of cellular immunity in viral hepatitis pathogenesis.
Main Methods:
- Classification of chronic hepatitis.
- Description of chronic lobular hepatitis.
- Analysis of immune responses to HBV.
- Subpopulation analysis of immunocompetent blood cells in chronic active hepatitis and hepatic cirrhosis correlated with HBsAg.
Main Results:
- A new form, chronic lobular hepatitis, is described.
- Autoimmune abnormalities are linked to HBV infection and considered essential components.
- Cellular immunity plays a leading role in the pathogenesis of viral hepatic lesions.
- HBV biological cycle influences the type and intensity of the host's immune response.
Conclusions:
- Updated classification and description of chronic lobular hepatitis.
- Recognition of autoimmune abnormalities as a key component of HBV infection.
- Emphasis on cellular immunity's role in viral hepatitis.
- Consideration of HBV's biological cycle for treatment strategies.
- Proposed criteria for using immunomodulators and immunosuppressants in chronic viral and autoimmune hepatitis.
Abstract:
Update information is added to classification of chronic hepatitis. A new form--chronic lobular hepatitis is described as well as characteristic features of immune response to hepatitis B virus (HBV). The findings enable the authors not only to relate autoimmune abnormalities to HBV infection, but to consider them an essential component of this infection. The leading role in pathogenesis of viral hepatic lesions is played by cellular immunity. A sound subpopulation analysis of immunocompetent blood cells was carried out for chronic active hepatitis and hepatic cirrhosis in correlation with HBsAg. It is emphasized that a biological cycle of HBV development determines the type and power of the macroorganism immune response and should be allowed for when designing policy of treatment of chronic hepatic viral diseases. Criteria are proposed for deciding on immunomodulators and immunodepressants for chronic viral and autoimmune hepatitis.