Characteristics of cellular immunity in children with acute viral hepatitis A

AIM: To study the populational composition of lymphocytes and the specific features of production of cytokines in children with acute viral hepatitis A (AVHA). MATERIALS AND METHODS: 128 patients aged 11 to 14 years who had AVHA, moderate AVHA being in 83.5% were examined. In 87.2% of the children, the disease was cyclic. The etiology of the disease was verified by simultaneously detecting anti-HAV IgM (enzyme immunoassay) and by the presence of HAV RNA (polymerase chain reaction) in the blood. Peripheral lymphocytes (CD) were phenotypes in the indirect immunofluorescence test using monoclonal antibodies; cytokines were determined by the enzyme immunoassay; serum beta 2-microglobulin was done by radioimmunoassay. RESULTS: The children with AVHA were found to have elevated levels of tumor necrosis beta-factor, interleukin-1 beta (IL-1 beta), and IL-4 in the icteric period, as well as a decrease in their levels at convalescence. IL-6 was detected in individual patients only in the first 3 days of the icteric period. The peak of AVHA was characterized by relative lymphocytosis, by decreases in the counts of T helper/inductor cells and natural killer cells, by increases in the count of CD25 cells, convalescence, by preserved lymphocytosis, by the increased levels of T lymphocytes that carry the markers CD3, CD4, CD8, CD16, CD25, and CD95, and by higher toxicity of beta 2-microglobulin.