Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Pivot Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Target Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Query: EC:2.6.1.2 (
alanine aminotransferase
)
26,722
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Fifty-two patients on regular haemodialysis at our institution were evaluated for the presence of HCV infection. Evaluation included detailed history, clinical examination, and monthly screening for anti-HCV antibody, liver enzymes (
ALT
, AST), serum iron and ferritin. Also, three-monthly screening for other viral markers, HBV (HBsAg, HBsAb, HBcAb), CMV (IgG and IgM), EBV, and HIV. Anti-HCV antibody was found in 21 patients (40.4%). There was a significant (P less than 0.05) relationship between presence of anti-HCV antibody and proportion of patients who received blood transfusion. During a 12-month follow-up, four (11.4%) patients seroconverted to be Anti-HCV positive while one case (4.8%) seroconverted to be anti-HCV negative. The frequency of elevation of liver enzymes was significantly higher in Anti-HCV positive cases (14/18) than in negative cases (11/28, P = 0.01). Evaluation of liver biopsies of 13 patients showed chronic persistent hepatitis in six and chronic active hepatitis in seven cases. We concluded that hepatitis C is a common problem among chronic haemodialysis patients at our institution; HCV infection is documented in 70% of all clinically diagnosed NANB hepatitis. Presence of anti-HCV antibodies cannot differentiate between active and past infection and cases with early HCV infection can be missed when relying on the mere detection of anti-HCV antibodies.
Nephrol
Dial
Transplant 1992
PMID:Hepatitis C virus infection in chronic haemodialysis patients, a clinicopathologic study. 128 48
Prospective studies have shown that the annual incidence of non-A, non-B (NANB) hepatitis may be high in haemodialysis patients. To assess whether hepatitis C virus (HCV), the major causative agent of post-transfusion and community-acquired NANB hepatitis, has a role in the pathogenesis of liver disease in dialysed patients, we have studied the prevalence and significance of antibodies to HCV in a cohort of patients with end-stage renal disease on chronic haemodialysis treatment. Seventy-four (30%) had circulating antibodies to HCV. Statistically significant associations with the anti-HCV carrier status were duration of haemodialysis treatment, blood transfusions, and the finding of abnormally elevated
ALT
on retrospective analysis. In contrast, only one of 103 dialysis staff members showed transient positivity for anti-HCV, suggesting a low risk of professional exposure to HCV. These findings suggests that HCV infection is relatively frequent in haemodialysis patients and may be responsible for a significant proportion of liver disease in this clinical setting.
Nephrol
Dial
Transplant 1991
PMID:Abnormal alanine aminotransferase activity reflects exposure to hepatitis C virus in haemodialysis patients. 171 92
Three hundred and thirty-nine dialysis patients from two centres (278 patients on continuous ambulatory peritoneal dialysis (CAPD) and 61 on maintenance haemodialysis (HD) were tested for antibody against hepatitis C virus (anti-HCV) using first-generation enzyme immunoassay kits (Ortho Diagnostics). Anti-HCV was detected in five (1.8%) CAPD patients and ten (16.4%) HD patients (P less than 0.00001). Anti-HCV was confirmed to be positive in three (1.1%) CAPD patients and eight (13.2%) HD patients using neutralisation enzyme immunoassay kits (Abbott Laboratories). The marked difference in prevalence of anti-HCV among CAPD and HD patients was related to a significantly greater transfusion requirement of the HD patients. All the anti-HCV positive patients had been transfused. The risk of HCV infection was significantly increased in those who had received more than five units of blood. Four (26.7%) anti-HCV positive patients had one or more episodes of elevated serum
alanine aminotransferase
(
ALT
) values.
Nephrol
Dial
Transplant 1991
PMID:Hepatitis C infection among dialysis patients: a comparison between patients on maintenance haemodialysis and continuous ambulatory peritoneal dialysis. 172 91
One hundred and thirty six patients receiving haemodialysis in a HB antigen-free unit were prospectively studied over a period of 29 months for evidence of hepatitis. Twelve/one hundred and eleven patients who were dialysed in this unit for at least one month developed elevation of
ALT
which proved to be related to neither toxic hepatitis nor hepatitis due to any of the following viruses: hepatitis B virus (HBV), hepatitis A virus (HAV), cytomegalovirus (CMV) or Epstein-Barr virus (EBV). Therefore these cases were considered to be non-A non-B (NANB) hepatitis. In 5 patients the liver disease was of short duration, whereas in 7 others hepatitis had a chronic course with
ALT
remaining elevated for more than 6 months. During the same period, one/sixty staff members who were working for at least one month in this unit also developed presumed non-A non-B hepatitis. Serological markers of NANB infection tested by double immunodiffusion were present in 10/12 patients and in the one staff member.
Proc Eur
Dial
Transplant Assoc 1980
PMID:A non-A non-B hepatitis epidemic in a HB antigen-free haemodialysis unit. Demonstration of serological markers of non-A non-B virus. 678 82
Elevated serum
alanine aminotransferase
(
ALT
) for more than one year was found in 36 (28.8%) of 125 patients on maintenance haemodialysis. In 10 the
ALT
returned to normal spontaneously but in 26 it remained high. Liver tissue from 21 patients with high
ALT
and seven with normal
ALT
was examined. Statistically significant correlations were found between the mean
ALT
during the year prior to the biopsy and assessments of the lymphocytic infiltration (p less than 0.001), fibrosis (p less than 0.001) and amount of silicone particles in the liver (p less than 0.001). Epithelioid cell granulomata, lobular and portal macrophages and perivenular fibrosis were related to silicone particles. Lymphocytes were not spacially related to the particles; nevertheless, there was a significant correlation between amounts of silicone and lymphocytic infiltration (p less than 0.01). No associations were found between high
ALT
, hepatitis B serology, serum ferritin, parenchymal siderosis, propensity to fluid overload, alcohol abuse and HLA-B8.
Proc Eur
Dial
Transplant Assoc 1983
PMID:Chronic liver disease in haemodialysis patients. 687 29
We assessed the prevalence of anti-hepatitis C virus (anti-HCV) antibodies and markers of hepatitis B virus (HBV) infection in patients of three haemodialysis centres before initiating anti-HBV vaccinations. Of the 94 patients, 39 (41.5%) were anti-HCV positive (+) and 81 (86.2%) were anti-hepatitis B core antigen (HBc) positive. There was a high rate of anti-HBc positivity among anti-HCV (+) patients (92.3%), although the presence of anti-HCV and anti-HBc antibodies were not significantly related to each other. Multiple blood transfusions (> 5 units) was a risk factor for development of HCV infection (P < 0.02), while none of our patients admitted intravenous drug abuse. Although 53.8% of anti-HCV (+) patients have had moderate serum
alanine aminotransferase
(
ALT
) elevations during the study period, none has had considerable liver disease, nor did the increased
ALT
correlate with the presence of anti-HCV. Only two of 17 staff members participating in the survey were anti-HCV (+), though almost every one gave a history of accidental needlestick exposure. All the study subjects were human immunodeficiency virus (HIV) negative. Our results, obtained with the second-generation, highly specific enzyme immunoassay and verified by the immunoblot assay for anti-HCV antibodies, support a recent suggestion that earlier reports might have underestimated the true prevalence of anti-HCV antibodies in haemodialysis patients.
Nephrol
Dial
Transplant 1993
PMID:High prevalence of antibodies to hepatitis C virus in three haemodialysis centres in south-western Poland. 769 55
We used first- and second-generation assays such as Ortho 1, Ortho 2 and 4-RIBA to define prevalence and risk factors for anti-HCV antibodies in haemodialysed patients. Forty-nine (24%) subjects were found to be anti-HCV positive. Anti-HCV positivity was related to duration of dialysis and past or current elevations of GOT and
GPT
; the frequency of transfused patients was greater in HCV-positive than in HCV-negative subjects; there were 31 patients (prevalence of 20%) with anti-HCV antibodies among non-transfused patients. These findings show that, tested by second-generation assays, HCV infection is detected more than twice as commonly in haemodialysis patients and may be responsible for a significant proportion of liver disease in this clinical setting. Acquisition of hepatitis C virus by dialysis patients is not only through blood transfusions but also secondary to hepatitis C virus presence within the unit itself.
Nephrol
Dial
Transplant 1993
PMID:Antibodies to hepatitis C virus (HCV) and transaminase concentration in chronic haemodialysis patients: a study with second-generation assays. 769 56
Chronic hepatitis C is a common cause of viral liver disease in kidney transplant recipients. To assess the efficacy and the safety of therapy with interferon alpha (IFN alpha) in such a population we conducted a prospective study where 16 kidney transplant recipients with chronic hepatitis C received recombinant IFN alpha 3 million units three times weekly scheduled for 24 consecutive weeks. All the patients had stable renal function for at least 1 year (mean serum creatinine 125.4 +/- 41 mumol/l). Fifteen patients had a positive HCV viraemia at the beginning of the study. In 15 patients serum
alanine aminotransferase
(
ALT
) levels decreased rapidly and normalized (48 +/- 44 vs 98.5 +/- 46 IU/l; P = 0.0044).
ALT
remained in the normal range as long as IFN alpha was continued. Serum levels of gamma glutamyl transpeptidase decreased from 129.75 +/- 111.2 to 88 +/- 85 IU/l; P = 0.012). After discontinuation of IFN alpha therapy seven responders relapsed within 1-9 weeks. HCV viraemia assessed 1 month after the end of IFN alpha therapy remained positive in all the patients who scored positive at the beginning, i.e. 15. Side effects of IFN alpha (fatigue, anorexia, weight loss) were frequent leading to four patients dropping out of the study. The haematological tolerance was moderate. The major concern was the increase in serum creatinine (162.5 +/- 57.6 vs 125.4 +/- 41 mumol/l; P < 0.05). In fact only six patients experienced renal failure occurring 45-168 days after the beginning of IFN alpha. Kidney transplant biopsies showed oedema, scarce scattered interstitial inflammatory cellular infiltration and moderate mesangial hypertrophy.(ABSTRACT TRUNCATED AT 250 WORDS)
Nephrol
Dial
Transplant 1995
PMID:Preliminary results of treatment of chronic hepatitis C with recombinant interferon alpha in renal transplant patients. 852 7
Nineteen haemodialysis (HD) patients with chronic hepatitis C were treated with interferon-alpha 2b (IFN-alpha) at a dose of 3 or 1 MU thrice weekly for 6 months and were followed-up for another 14 months without treatment. Six patients discontinued treatment because they either presented severe side-effects to IFN-alpha or had complications of their primary disease. Levels of AST and
ALT
were within normal limits on the 2nd month of treatment and remained so throughout the treatment and the follow-up period in all patients except one who showed an elevation of transaminase levels 2 months after the end of treatment. Serum HCVRNA became negative in 10/13 patients at the end of treatment and was negative in all patients on the 6th month and in 12/13 patients on the 14th month during the follow-up period. Levels of 2'5' oligosynthetase were increased significantly on the 2nd and 4th month of treatment and returned to pretreatment values the 2nd month after treatment. These findings demonstrate that haemodialysis patients with chronic hepatitis C respond well to interferon treatment and that a long-term response is achieved in a high proportion of patients.
Nephrol
Dial
Transplant 1995 Oct
PMID:Interferon-alpha 2b treatment of chronic hepatitis C in haemodialysis patients. 859 90
The prevalence of HCV infection is high in renal transplantation (RT) patients: 29% in our cohort of 399 RT recipients. The consequences of that infection on the liver have to be carefully assessed. Clinical chronic hepatitis was detected from
ALT
concentrations (> x 1.5 N) in only 26 patients (22%) with constant (15%) or fluctuating (85%)
ALT
elevation. Only three of 117 cases developed cirrhosis (3%). No liver cancer was noted. Liver biopsy was performed (mean interval = 60.2 months) in 62 patients with HCV infection alone. We found 26 cases (42%) of chronic active hepatitis (CAH) with a mean Knodell score as low as 6.1 (range: 3-12), a mean activity grade of 4.9, and a fibrosis stage of 1.3. Twelve patients (19%) presented with normal liver pathology and met the criteria of healthy HCV carriers (positive viraemia, normal
ALT
and normal liver). The rest presented with portal lesions, either inflammation or fibrosis. In addition, patient and graft survival rates did not differ in HCV+ recipients. To conclude, HCV infection did not appear too deleterious for the liver in this cohort of patients. There is therefore no contraindication for HCV-positive recipients to undergo renal transplantation.
Nephrol
Dial
Transplant 1996
PMID:HCV liver disease in renal transplantation: a clinical and histological study. 891 54
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