[Chronic changes in the liver in our patients].

VHB infection together with alcohol ist the most important ethiologic factor in the genesis of chronic liver parenchyma damage in our sample. Selection of patients with chronic diseases of the liver should be done on the basis of hepatitis markers determination, that is on the presence of HBsAg and HBeAg and the activity of aminotransferases in blood. Doing this it can be seen that more that half of the patients with chronic liver damage do not need therapy, and they have work capacity preserved. In these cases occasional controls of hepatitis markers and the level of AT in blood are needed. Presence of the virus replication can be determined on the basis of presence of the HBeAg in blood and HBcAg in the hepatocyte nucleus (histologic assay), since HBV-DNA and HBV-DNA polymerases in blood are not determined in the day's routine. Biopsy and rebiopsy of the liver tissue (pathohistologic assay) is the only confident my to determine the degree of liver damage. Introducing of the unique criteria in the management of the patients who have the signs of chronic liver damage would lower the diagnosis and treatment costs, as well as the unnecessary patient's absence from work. Proceeding of the preventive measures, vaccination of the persons who are exposed to VHB infection, as well as the struggle against alcoholism, stay on as the main source in prevention of chronic liver damage genesis.