[Problem of chronic hepatitis (classification, pathogenesis and treatment]

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.