Abstract:
Introduction: Mechanisms of viral persistence and
chronicity of the disease in chronic hepatitis B (CHB) are
studied insufficiently and the role of hormones of the slow
phase stress in chronic viral hepatitis is still unclear.
Purpose: Evaluation the ACTH and cortisol levels during
CHB in dependence on the activity and phase of the viral
infection.
Materials and Methods: We examined 83 patients. The
control group consisted of 30 healthy individuals. The lot
was divided into 3 groups: I group consisted of patients
with anti- HBe + and minimal activity (ALT <2N), II with
anti HBe + and moderate / maximum activity (ALT 2N), II
with HBeAg + and moderate / maximum activity (ALT 2N).
In this paper the author used original method of glucose
and euphyllin load test (TGE) ( Iu. Lupasco), with
determination of serum hormones both fasting and at 60
and 120 minute of the test.
Results. Increased levels of cortisol were found In CHB,
regardless of the disease form and activity, the most
significant in CHB HBeAg + ( IIIgr ) in all intervals of the
test (TGE) (354.0 ± 14.41 nmol / l, p <0.01; 369.60 ± 37.97
nmol / l, p < 0.01; 321.60 ± 36.20 nmol / l, p <0.01) in
comparison with control data. In this group hormone values
of ACTH were higher (29,0 ± 2,36 pg / ml) its levels in the
case of anti HBe + (IIgr ) as fasting – 16.30 ± 2.46 pg / ml,
as at 60, 120 minutes of the test ( 31.33 ± 4.39 pg / ml, p
<0.01; 14.50 ± 2.33 pg / ml, p <0.01). In CHB were found
not only changes in the ACTH and cortisol levels on empty
stomach, but also the shape of their curves changes during
loading test , that were different from control. This fact increases the importance of the TGE for evaluation of
hormonal changes in CHB.
Conclusions: Revealed changes of ACTH and cortisol levels
may be probably caused by excessive reaction to a longacting
form of stress in viral persistence on one hand, and
with hormone metabolism violation in the liver itself on the
other hand, presumably on the receptor and post receptor
levels of their action.