Personal site of Ph.D Roman G. Myazin

Chronic Viral Hepatitis B (second example)

Patient K-ov., 31, visited gastroenterologist - hepatologist on June,22, 2009. From anamnesis: in April, 2008 during the preventive examination it was detected for the first time that the patient had superficial «australian» HBs Ag for hepatitis B virus. Subjectively nothing caused any problems to the patient during the last year.

Objectively: dermal integuments and sclera are of usual staining, the liver is along the costal margin, palpation is painless. The spleen isn’t palpable. Normal results of the abdominal cavity ultrasound investigation. Common blood analysis is norma. Liver function tests (22.06.2009) showed a little increase of ALT level up to 43,4 u/l, all the rest rates are in the range of norma. AST -30,5 u/l, total bilirubin -10,3 mkmol/l, direct bilirubin – 2,8 mkmol/l, GGT -39,4 u/l, thymol test -1,9 u.

The detailed virologic investigation (22.06.2009) showed positive DNA HBV, positive HBs Ag, HBcor Ig G and HBe Ig G. Anti-HBcor Ig M, HBe Ag, anti-HBs, anti HDV Ig M, anti-HDV Ig G and anti-HCV  were not detected.

The initial diagnosis was formed: «Chronic viral hepatitis B, cytolysis syndrome».

For the purpose of antiviral treatment of hepatitis B and for the liver detoxication in July, 2009 the patient underwent the first course of intravenous dripple infusions of Natrii Hypochloriti as a monotherapy according to the patented scheme. The patient underwent the procedures successfully.

The investigation of the range of virologic tests taken 3 months after the ending of the first course of treatment in October, 2009 showed the positive dynamics. It was detected the minimal level of viral load: «HBV DNA is low positive». All the range of liver function tests were in norma.

The diagnosis in the process of treatment was: «Chronic viral hepatitis B, the stage of the minimal activity».

For the purpose of following treatment of hepatitis B in November, 2009 the patient underwent the second course of Natrii Hypochloriti treatment as the monotherapy, analogous to the first one. The subjective state of the patient remained good.

The investigation of the range of virologic tests made 1 month after the finishing of the second course of treatment In December, 2009 showed the further positive dynamics. The viral load was not detected: «HBV DNA is negative». Other virologic tests hadn’t any negative dynamics. Liver function test results remained being normal.

Taking into consideration a good response of the patient to the treatment, the concluding diagnosis is: «Convalescence (recovery) after the viral hepatitis B infection».

Recommendations at discharging of the patient: to follow the rational diet № 5. In 6, 12 and 18 months to repeat the investigation of virologic tests range. To be observed by the gastroenterologist and infectiologist. 

On condition that HBV DNA is negative during the period of 1,5 years, the patient  can be struck off the dispensary observation register of such diseases.

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