Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To evaluate the long-term toxicity and activity profile of 2',3'-dideoxyinosine (ddI), a potent inhibitor of human immunodeficiency virus (HIV) replication, in vitro. 58 patients with AIDS or AIDS-related complex were studied with additional reference to the effect of previous treatment with zidovudine, and the effect of ddI on HIV-induced cognitive dysfunction. Doses above 9.6 mg/kg per day of ddI were frequently associated with toxicity (peripheral neuropathy, pancreatitis, or hepatitis). Doses of 9.6 mg/kg per day or below were well tolerated for up to 21 months. A subset of patients receiving 3.2-9.6 mg/kg per day of ddI had long-term immunological improvement and reduction of serum HIV p24 antigen. Immunological changes were especially seen in patients who had little previous zidovudine therapy. 5 patients with HIV-induced cognitive impairment improved with ddI. Thus, ddI may have anti-HIV activity at doses which are tolerated for long-term therapy, although pancreatitis could be a life-threatening complication.
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PMID:Long-term toxicity/activity profile of 2',3'-dideoxyinosine in AIDS or AIDS-related complex. 197 29

Patients with the acquired immune deficiency syndrome (AIDS) frequently develop hepatic dysfunction. Although hepatic injury may indirectly result from malnutrition, hypotension, administered medications, sepsis, or other conditions, the hepatic injury is frequently due to opportunistic hepatic infection, directly related to AIDS. Infection with Mycobacterium avium intracellulare typically occurs in patients with advanced immunocompromise and with systemic symptoms due to widely disseminated infection. In contrast, hepatic tuberculosis often occurs with less advanced immunocompromise. Cytomegaloviral infection may produce a hepatitis. Cytomegaloviral and cryptosporidial infections have been implicated as causes of acalculous cholecystitis and of a secondary sclerosing cholangitis. About 10-20% of patients with AIDS have chronic hepatitis B infection. These patients tend to develop minimal hepatic inflammation and necrosis. The clinical findings in patients with hepatic cryptococcal infection are usually due to concomitant extrahepatic infection. Hepatic histoplasmosis usually develops as part of a widely disseminated infection with systemic symptoms. Hepatic involvement by Kaposi's sarcoma is rarely documented ante mortem because an unguided liver biopsy is an insensitive diagnostic procedure. Patients with non-Hodgkin's lymphoma of the liver typically have lymphadenopathy, hepatomegaly, and systemic symptoms. As a pragmatic approach, patients with liver dysfunction and HIV-related disease should have a sonographic or computerized tomographic examination of the liver. Patients with dilated bile ducts should undergo endoscopic retrograde cholangiopancreatography because opportunistic infection may produce biliary obstruction. Patients with a focal hepatic lesion should be considered for a guided liver biopsy. Patients with a significantly elevated serum alkaline phosphatase level should be considered for a percutaneous liver biopsy. When performed for these indications, liver biopsy will demonstrate a significant disease involving the liver in about 50% of patients with AIDS and in about 25% of patients who are HIV seropositive but who are not known to have AIDS. The clinical impact of a diagnostic biopsy is blunted by a lack of efficacious therapy for many opportunistic infections.
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PMID:Hepatobiliary manifestations of the acquired immune deficiency syndrome. 198 33

Two hundred eleven HIV-seropositive patients with AIDS, AIDS-related complex, or a CD4+ cell count less than 200 x 10(6) were examined for the presence of hepatitis B virus markers during the course of their HIV infection (median follow-up of 18 months; range of 1 to 107 months). Anti-HBs was detected initially in 138 patients (65%). Sixteen patients (8%) were HBsAg positive at entry. Fourteen had chronic HBV infection of whom 12 initially were positive for HBeAg and HBV DNA; 11 remained positive during follow-up, whereas one seroconverted to anti-HBe and lost HBV DNA. Two patients with chronic HBV infection were initially negative for HBeAg and HBV DNA: one later had reactivated HBV replication and one cleared HBeAg following onset of hepatitis D infection. The last two HBsAg-positive patients had resolving acute HBV infection. Six of the 57 patients who initially were negative for HBV markers acquired HBV infection during follow-up. Four of these six patients developed chronic infection whereas two patients had acute subclinical resolving hepatitis. In addition, four patients became HBsAg positive with their last serum samples, possibly indicating reactivation of HBV infection following progressive immunological and clinical deterioration. None of the patients developed clinical symptoms that could be ascribed to HBV infection, and transaminase elevations were only sporadically recorded. It is concluded that acquisition of HBV infections is not infrequent in HIV-seropositive patients with immune deficiency. Furthermore, the course of both previously established chronic HBV infection and newly acquired HBV infection is modified in such patients, whereas reactivation of past HBV infection seems to be a rare event.
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PMID:High incidence of hepatitis B infection and evolution of chronic hepatitis B infection in patients with advanced HIV infection. 200 76

We surveyed 420 paramedics employed by a large metropolitan fire department to determine the effects of educational seminars on their knowledge base, perceptions, and attitudes about AIDS and hepatitis B. All surveys were completed on an anonymous, voluntary, and confidential basis. Our educational efforts improved the paramedics' knowledge base concerning the medical manifestations of AIDS, identification of risk factors, modes of transmission, and means of infection control, but had no impact on paramedics' fear of contracting AIDS. While paramedics have a strong fear of contracting AIDS, we note that they underestimate their risk of acquiring hepatitis B. Only 17% of paramedics surveyed had received the hepatitis vaccine, despite attending an infectious disease seminar addressing the occupational risks of acquiring hepatitis B infections during the previous year. Further educational efforts to address the paramedics' attitudes about AIDS, as well as to encourage paramedics to recognize hepatitis B exposure as a significant personal health risk, are currently being pursued.
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PMID:Paramedics: knowledge base and attitudes towards AIDS and hepatitis. 204 47

Microsporidia are obligate intracellular protozoan parasites that are becoming increasingly recognized as opportunistic pathogens in patients with AIDS. They have been associated with enteritis, hepatitis, and peritonitis and recently keratoconjunctivitis. Gram stain demonstrates the presence of these organisms on light microscopic sections. The specific diagnostic features that distinguish microsporidia from other small nonspore-forming organisms are best demonstrated by electron microscopy, which is also used to characterize the members of Microsporea. In this study, salient histopathologic features of microsporidia in corneal epithelium obtained from an HIV-seropositive individual who developed AIDS are illustrated and discussed.
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PMID:Corneal microsporidiosis in a patient with AIDS. 206 49

In this pilot study, 12 patients with chronic delta hepatitis were studied. The diagnosis was based on the presence of antibodies to the hepatitis delta antigen in the serum and hepatitis delta virus RNA and hepatitis delta antigen in the serum and liver. All patients were also positive for hepatitis B surface antigen. The infection was presumed to have been transmitted by intravenous drug abuse in six of the patients, blood transfusion in one and by sexual contact in four (two had antibodies to human immunodeficiency virus in their serum, but did not show signs of acquired immunodeficiency syndrome). In one further patient, the source of infection was unknown. Interferon alfa-2b (INTRON A, Schering-Plough Corporation) was initiated at 5 million units per day subcutaneously for at least 4 months, being reduced by half if side effects occurred. Serum alanine aminotransferase levels, hepatitis delta virus RNA and hepatitis delta antigen were measured at monthly intervals for up to 12 months in some patients. Interferon therapy resulted in decreased serum levels of these three markers. On cessation of therapy, most patients experienced a relapse over 6 months, but alanine amino transferase levels could be normalized once more by restarting interferon therapy. In conclusion, interferon decreased hepatic inflammation by the inhibition of hepatitis delta virus replication, although relapse occurred when interferon was stopped and long-term therapy is required to achieve permanent control of the disease. Care will be required when treating patients with advanced or decompensated liver disease.
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PMID:Therapy of chronic delta hepatitis with interferon alfa-2b. 207 75

6 commercially available ELISA kits and 4 new Brazilian made methods for detecting HIV were compared on 2 panels of sera, 292 from AIDS patients, HIV-positives and negatives, and 180 sera from asymptomatic blood donors, including 90 HIV-positives. The kits tested were 5 ELISAs: Roche Diagnostica (Basel), Hoechst Enzygnostic (Sao Paulo), Virgo Electronuclionics (Columbia MD), Organon Teknika (Boxtel, Netherlands), Salck Industria e Comercio de Produtos Biologicos (Sao Paulo), and a passive hemagglutination test, (Salck Ind), and indirect immunofluorescence IIF (Virgo electronucleonics, Columbia), a dot blot (Embrabio, Empressa Brasiliera de Biotecnologia Ltda, Sao Paolo) and Karpas AIDS cell test, Fujichemical Industries Ltd (Chokeiji, Takaoka, Japan). The sensitivities ranged from 84.2% to 100% with no significant differences in sera from panel A. In panel B, the sensitivity of the PHA test was significantly lower than that of the ELISA and the AIDS cell tests. The specificities of the PHA and the AIDS cell tests were also lower than that of the ELISA. The costs of all the tests were similar, but the equipment needs varied. The simplest tests to perform were the dot blot assay, PHA and Karpas AIDS cell test. The Hoechst ELISA is simpler because it does not require dilution of the serum. The dot takes too long for use in a blood bank, 16-18 hours. Immunofluorescence tests would be practical in countries already screening blood for malaria or Changes disease. Brazil is not doing so on a large scale due to lack of political will. In countries with high incidence of malaria, Chagas disease, leishmania, hepatitis and leprosy, HIV test need to be tested on local sera because of possible B cell activation.
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PMID:Evaluation of enzyme-linked immunosorbent and alternative assays for detection of HIV antibodies using panels of Brazilian sera. 209 32

On the basis of a literature survey, mainly of two American periodicals from 1987 the epidemiology, manifestations and treatment of AIDS patients are discussed with particular reference to the changes development on oral mucosa and to the treatment of these changes. The knowledge, attitudes and behaviour of stomatologists towards the risk-group patients and AIDS patients are discussed on the basis of the results of an inquiry with participation of 541 dentists from California. The degree of risk of infection of stomatologists and medical personnel with HIV during treatment of AIDS patients is discussed for protection of the dentists and auxiliary personnel the use is recommended of rubber gloves, masks and protective goggles during work. It is thought generally in the light of our knowledge up to now that the possibility of HIV infection during the work of dentists is low, lower than in the case of hepatitis virus B infection if the basic hygiene principles and caution are observed.
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PMID:[AIDS primer for stomatologists on the basis of a literature survey]. 210 95

The surgeon has to keep abreast of changing advantages and disadvantages as well as alternatives in the context of homologous blood transfusions. We ought to realise that normovolaemic anaemia is better tolerated than we used to assume in the past. It is no longer necessary to provide transfusions to patients with 10 g/% Hb. About 8 g/% should rather be considered the adequate threshold. Possible transmission of hepatitis and AIDS virus is a genuine risk associated with blood transfusion. No hard evidence has yet been produced to immunosuppression and effects on the prognosis of cancer patients. More attention will have to be given in the future to preoperative supply of blood for autohaemotherapy.
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PMID:[Perioperative blood transfusions. Changed indications and new alternatives]. 211 Jul 6

Microsporidia are unicellular organisms, which lack mitochondria. They have prokaryotic-like ribosomes and characteristic spores containing an extrusible polar tube which serves as a passage for inoculation of the infectious agent (sporoplasm) into host cells. Clinically apparent infections in man appear to be limited to immunoprivileged sites or immunocompromised patients. One species, Encephalitozoon cuniculi, has been reported several times in patients with neurological disorders and once causing a fatal hepatitis in an AIDS patient. The most recently discovered species, Enterocytozoon bieneusi, is known only from the small intestinal enterocytes of patients with the acquired immunodeficiency syndrome, and is easily differentiated from other microsporidia by the precocious development of spore organelles in the sporont and by the poor development of the endospore layer of the spore wall. Although only about 40 cases have been reported, circumstantial evidence suggests that E. bieneusi may be the cause of a severe watery diarrhoea, which responds only temporarily to treatment with metronidazole.
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PMID:Enterocytozoon bieneusi (Microspora): prevalence and pathogenicity in AIDS patients. 211 86


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