features of a current of a chronic hepatitis at children of the first year of a life.

It is established, that the leader by infection of children of 1st year of life NV - and Nanoseconds-viruses is - perinatalnyj. At patients of this age it is registered in 75,0 % of cases at GV and in 90,0 % - at GS [46, 48, 82, 445].

Studying genotipirovanija HCV in system "mother-child" has shown to an infection domination 1в a genotype at 62,5 % of women and 70 % of children of early age with coincidence of genotypes at 80 % that proves the importance of risk of a vertical transmission of infection [174, 198].

Without carrying out of specific preventive maintenance the risk of a becoming infected from mothers having in blood serum HBsAg and HBeAg, makes 80-90 %, and risk of development of a chronic HBV-infection at children infected at a birth — about 90 % [445]. For lack of HBeAg risk of a becoming infected much more low — 2-15 %, and the chronic HBV-infection at infected children develops seldom, development of an acute hepatitis in newborns however can be observed. From the women infected HBV and HDV, becoming infected HDV in perinatalnom the period probably together with HBV, however the role perinatalnogo ways of transfer for HDV is smallest. At HCV-infection HCV RNA in blood it is found out
Approximately at 70 % of the infected newborns in 1 month and at 90 % — in 3 months after a birth, that also testifies to a primary becoming infected in sorts. At a HCV-infection correlation of risk of a becoming infected of the child with presence and level viremii HCV at mother [74, 80] is shown.

At malosimptomnom disease long time the infection is shown by only proof allocation serologicheskih markers VG; clinical symptoms usually arise in the first days of a life of the child (but can appear and in later terms) in a kind slabovyrazhennogo a hepatolienal syndrome and insignificant is hepatic-cellular giperfermentemii. At morphological research of a tissue of the liver received by a method of an intravital puncture biopsy, the picture slabovyrazhennogo a chronic hepatitis is found out, is more rare — moderate chronic geyopatita. At a demonstrative congenital hepatitis In at 50 % of patients the cytolytic form is taped; the cytolytic form with a cholestasia - at 28,8 %; the chronic form - at 21,2 % of children. [14, 204]

The virus hepatitis With at HCV-positive newborns is shown by a hepatomegalia (92 %), an icterus (85,4 %) a cholestasia syndrome (42,8 %), a cytolytic syndrome with augmentation of activity ALT and ACT [198].

Disease at children infected GV and GS on 1st year of a life, in most cases (in 57,5 % and 76,7 %) accepts the chronic current characterised by poor semiology and high concentration of a virus in blood, especially at a HCV-infection.

Feature HGV is more expressed clinico-biochemical implications in the first 3 years of disease, and HGS - more expressed virus activity of process (high frequency of revealing PHK-HCV and high level viremii).

HGV and With at children infected on 1st year of a life, it is characterised by an optimum current with slow advance of a fibrosis [46, 47, 48, 83, 139].

1.4.6.