THE CLINICAL SIGNIFICANCE OF MOLECULAR GENETIC RESEARCH OF THE VIRUS GENOME IN ACUTE VIRAL HEPATITIS B
The aim of this paper is to characterize the molecular genetic structure of hepatitis B virus circulating in St. Petersburg and describe the clinical and laboratory features of acute viral hepatitis B depending on the genotype and infection with "wild" or mutant virus strain. The virus with acute viral hepatitis B was genotyped in 34 patients. A comparative analysis of the course of the disease in patients with D (n = 29) and A (n = 5) genotypes, as well as depending on the presence of pre-core/core mutations of the HRV site (n = 11) or their absence (n = 23) was conducted. In the analyzed patients the genotype D dominates in 85,3% of cases and the genotype A - in 14,7% of cases (p = 0,001) is significantly less determined. There were no significant differences in the analysis of biochemical parameters and viral load depending on the genotype of the virus. In 32.4% of cases, pre-core mutations of hepatitis B virus are detected. Acute hepatitis B virus course in patients with a mutant strain of the virus, compared to those infected with the "wild strain", was characterized by more significant hyperbilirubinemia, a large decrease in PTI and severe insufficiency of protein-synthetic liver function, which increases the risk of adverse outcomes and complications. The results of this research can help the physicians to allocate patients at risk of severe acute viral hepatitis B and prevent chronic outcomes and complications by further individualization and optimization of therapy.