FEATURES OF EPIDEMIOLOGICAL SEASON 2017-2018 – DEVELOPMENT OF LIVER LESION ASSOCIATED WITH MEASLES VIRUS

Abstract

The aim – to study the connection of hepatotoxicity syndrome, found in patients with measles in the epidemic season 2017–2018, with the viral etiology of the underlying disease.

Materials and methods. We retrospectively collected 100 clinical cases with approved measles diagnosis. Patients were hospitalized in Zaporizhzhia Regional Infectious Disease Hospital during September 2017 – March 2018. Data were distinguished in two study groups based on activity of alanineaminotransferase (ALT). Group 1(G1) with laboratory approved reactive hepatitis were privilege 54 % and 46 % control group 2(G2).

Results and discussion. General amount of complications was higher in study G1 (88.8 %) as well as level revealed hepatomegaly (59.3 %). According to general blood count results were observed undirected signs of inadequate immune response associated with measles virus lesion. In contradistinction based on level lympocytopenia/lymphocytosis ratio was revealed retarded immune reaction in G1 compered to G2. Cytolisis syndrome was assessed between first blood testing (ALT-1 was taken on 1–2 day) and repeat one (ALT-2 which was taken on 5–7 day). We established that mild ALT increase (ALT>in 1–2 times) was easily reversible in dynamic: ALT-1 72.2 % compared to ALT-2 46.9 %. On the other hand, middle (ALT>in 2.5–5 times) and sever (ALT>in 5–10 times) lesions persisted without significant changes for more than 7 days.

Conclusions. Modern measles singularity – liver lesion which is registered in 54 % cases. Reactive hepatitis development associated with direct cytopathic activity of the virus. Mild ALT increase and its following normalization point at favorable outcome and fast recovery of liver function. In addition, in patients with reactive hepatitis was detected rerated immune response rate. These processes could be connected with greater amount of bacterial complications in study G1. According to aforementioned statements patients with measles virus lesion and reactive hepatitis development have to be consider as risk group in bacterial complications development.