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A study was made of the immune system of patients with chronic HB-viral infection who showed the signs of secondary immundeficiency. The high frequency of the impairment of immunocompetent cells seen in chronic hepatitis B was established as was the appearance of different-temperature autolymphocytotoxins in response to the infection of mono-nuclears in all the disease stages. The treatment with thymalin proved effective in patients with the lack of cold autolymphocytotoxins or in those with low activity of the latter ones. The combined treatment (decaris plus prednisolone) turned out effective in children with a pronounced autoimmune component of the process (the presence of cold autolymphocytotoxins). It has been shown that the discovered interrelations between the different components of the immune system are conductive to the determination of the pathological process type and the choice of adequate therapy.

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The work deals with the results of the study of T-lymphocytes and their subpopulations (active, thermostable, theophylline-sensitive and theophylline-resistant) in 102 children with chronic viral hepatitis B, depending on the effectiveness of thymalin therapy. The sensitization of lymphocytes to specific antigens was studied. Among patients with chronic viral hepatitis B and cirrhosis of the liver the homozygous phenotype of haptoglobin is registered essentially more frequently (63.6% and 82.4% respectively) than among healthy persons (44.0%). The patients of this group showed a decrease in the number of T-lymphocytes, disturbances in the suppressor/helper ratio: hypersuppression in persisting hepatitis and hyposuppression in active hepatitis. In 71.6% of cases thymalin therapy produced an effect manifested by clinico-biochemical remission, an increase in the number of T-lymphocytes, thermostable cells and the normalization of the T-suppressor/T-helper ratio. In these patients sensitization to HBsAg essentially decreased (from 30.5% to 13.9%), while sensitization to human liver lipoprotein retained its high level even after treatment with thymalin.

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The effects of different kinds of anesthesia on the function of live (evaluated on the basis of activity of enzymes -- aspartate aminotransferase, fructose-I-monophosphate aldelase and glutamate dehydrogenase) were studied in 63 infantile patients with Hodgkin's disease who underwent diagnostic laparotomy with splenectomy. It was found that during the first 6 days after surgery, the rate of activity of these enzymes shows a rise and reaches the upper limits in 77.8% of cases. Halothane anesthesia induced excessive enzymatic activity in 100%, while neuroleptanalgesia -- in 53.8% of cases. Repeated application of halothane produced a higher hepatotoxic effect as manifested by enhanced activity of glutamate dehydrogenase on days 1--2 after operation.

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Having determined in the time course of the disease the percentage and absolute numbers of T- (according to Bach) and B-(according to Mendes) lymphocytes the authors concluded that there was a secondary immunosuppression in the active stage of the process in three infections: acute viral hepatitis, acute respiratory viral infections and epidemic mumps. In patients with these diseases the percentage of T-lymphocytes decreased. The absolute number of T-cells decreased considerably in patients with moderately severe forms of viral hepatitis, with acute respiratory viral infections as well as with epidemic mumps in the presence of neurotoxicity or the involvement of the central nervous system. The amount of B-lymphocytes increased in patients with respiratory viral infections and epidemic mumps but did not differ from physiological norm in viral hepatitis. The immune response of the patients was restored with the decline of the activity of the pathological process.

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In chronic virus hepatitis B the causative virus replicates for a long time as manifested by HBsAg persistence. Examinations of 92 sick children revealed changes in cellular and humoral immunity indices. The content of T-lymphocytes (determined according to Bach et al.) was reduced to 31.5 +/- 1.4% in the exacerbation stage (the normal content 50.8 +/- 1.3%), the percentage of O-cells increased, while the number of B-cells according to Mendes et al. did not change significantly. The inhibition of adhesion of A-cells (Halliday et al.--A. F. Blyuger) and "immune" plaque formation (according to A. F. Blyuger) in the presence of HBsAg were also increased maximally in the exacerbation stage. HBs-antigenemia was found to occur most frequently in the exacerbation stage. The content of immunoglobulin G was reduced. An increase in the number of tissue lymphocytes and their blast forms (in the "skin window" sample by Rebuck) was demonstrated. The authors assume that the long-term persistence of HBs-Ag and, consequently, the maintenance of the pathologic process activity are due to a defficiency of cellular immunity factors. The prospects of enhancing cellular immunity in virus hepatitis B in children are discussed.

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In order to choose the most informative indicators of echohepatograms characterizing affections of the liver the results of an ultrasonic investigation of the liver were analized by using bSM-6 type computer. It was found that such indicators as the number of peaks, their summary amplitude may be made use of in making differential diagnosis of diverse hepatic lesions in children.

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