Lipid peroxidation and its connection with the change in composition and antioxidant properties of lipids in comatogenic forms of acute viral hepatitis B

: 81 patients of acute viral hepatitis B (AVHB) without symptoms of acute hepatic encephalopathy, 39 AVHB patients with such symptoms and 115 age and sex match healthy controls were biochemically and clinically investigated. Besides usual biochemical analyses, some special parameters such as interrelationship between the patterns of lipid peroxidation (LPO) (conjugated dienes and ketodienes and the lipid antioxidant activity) and alterations in lipid composition (content of total lipids, phospholipids and cholesterol) were studied in blood serum. Concentration of LPO products in patients with mild, moderate and severe AVHB without symptoms of encephalopathy was found to be significantly lower than in controls. Relative content of phospholipids in the total lipid fraction as well as antioxidant activity of lipids were elevated, while relative content of cholesterol and level of lipid oxidation were lowered. Increasing of antioxidant activity and decreasing of LPO products coincides with the severity of disease. Intensification of LPO occurs only in patients with symptoms of acute hepatic encephalopathy (in coma and precoma). High levels of LPO products and low levels of total phospholipids in blood serum were found in these patients. The persistence of a high level of peroxides in AVHB suggests the existence of severe, irreversible lesions. Among the patients a risk for the development of severe outcome was found. We suppose that the parameters of oxidative stress may be useful as early prognostic factor and that antioxidants may be a useful for the optimal therapy of comatogenous state of AVHB.