[Current clinico-pathogenetic aspects of chronic hepatitis B]

The author analyzes the results of clinical morphologic and immunologic studies carried out in 55 patients (78.2 percent of these with chronic active hepatitis, 12.7 percent with chronic latent hepatitis, and 9.1 percent with chronic passive hepatitis) with the virus replication phase serum markers and in 57 patients (82.5 percent with chronic passive and 17.2 percent with chronic active condition) with the hepatitis B virus integration phase markers. Histologic examination of the liver has revealed hepatocyte necroses, lobular necroses predominating in the patients with the replication phase markers (90.9 percent) and periportal necroses in those with the integration phase markers (17.5 percent). Clinical symptoms and laboratory findings, irrespective of the stage of hepatitis B virus, were not representative. Chronic hepatitis associated with the viral replication stage, was characterized by a reduction of T lymphocyte functional activity, elevation of T suppressor count, and reduced immunologic regulation index. In-Chronic hepatitis associated with viral integration phase the immunologic parameters did not much differ from those in the controls. The results evidence that the dialogic cycle of hepatitis B virus development plays the major role in the pathogenesis of chronic hepatitis; active stage of the disease is associated with the replicative phase of viral development and regressive stage and arrest of the condition with the integration phase.