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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We employed a questionnaire to survey 334 registered nurses regarding their knowledge, perceptions and vaccine acceptance for Hepatitis B virus (HBV) infections. The study population was those persons working in areas considered at high-risk for contracting HBV. The nurses were asked to provide information regarding blood and body fluid exposures and the reporting of these exposures. The questionnaire was completed by 169 nurses (50.6%). Less than half of the respondents (42%) had been vaccinated. We found that 13 of 14 black nurses, compared to 85 of 154 nonblack nurses, had not been vaccinated (p less than .01). No other demographic differences between recipients and nonrecipients were noted. Partially or totally incorrect answers regarding transmittal knowledge were given by 108 of 160 (68%) respondents. Reasons for failure to be vaccinated were varied. Fear of side effects of the vaccine, contracting AIDS or hepatitis from the vaccine, or doubt of efficacy of the vaccine were cited by 50 of 88 (58%) respondents as reasons for not being vaccinated. Inability to schedule an appointment or unawareness of the vaccine's availability were expressed by 23% and 17% of the individuals, respectively. Our data allow us to conclude that to improve vaccination compliance, the vaccine must be made more readily available, possibly through workplace on-site administration. Additionally, a concerted effort to educate our staff regarding HBV with particular emphasis on minorities is needed.
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PMID:Hepatitis B: perceptions, knowledge and vaccine acceptance among registered nurses in high-risk occupations in a university hospital. 213 90

During the period from January to December 1987, 2,191 serum samples were collected from different groups of the population in the Ivory Coast (1,126 healthy people selected from the general population, 416 blood donors, 112 healthy anti-HIV carriers, 173 AIDS patients, and 364 patients suffering from icterigenic hepatitis) and tested for anti-HIV (HIV-1 and HIV-2) antibodies, HBsAg, HBeAg, delta antigen (HDAg), and anti-delta (anti-HD) antibody. Anti-HIV antibodies were found in 30 (2.6%) of the general population. 55 (13.2%) blood donors, and 93 (25.5%) patients suffering from icterigenic hepatitis. HBsAg was observed in 103 (9.1%) of the general population, 45 (10.8%) blood donors, 15 (13.4%) healthy anti-HIV carriers, 59 (34.1%) AIDS patients, and 45 (40%) icterigenous hepatitis patients. The simultaneous presence of anti-HIV and HBsAg was noted in 4 (0.4%) of the general population, 8 (2%) blood donors, 15 (13.4%) healthy anti-HIV carriers, 59 (34.1%) AIDS cases, and 36 (10%) patients suffering from icterigenic hepatitis. A high prevalence of HBeAg and serological markers of infection by the delta agent were noted in the different groups. HDAg was noted only among AIDS patients or those suffering from icterigenic hepatitis, with a higher frequency among anti-HIV carriers. Our conclusion from this study is that healthy anti-HIV carriers are no more likely to be HBsAg carriers than the HIV-seronegative subjects. However, immunodeficiency induced previously by HIV infection is likely to be responsible for the high prevalence of HBsAg among AIDS patients.
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PMID:Increase of the prevalence of hepatitis B virus surface antigen related to immunodeficiency inherent in acquired immune deficiency syndrome (AIDS). 215 78

Disseminated adenovirus infection with fatal hepatic necrosis has been reported in 16 patients, 15 of whom had immunocompromising conditions. Herein we report three patients with AIDS and fatally disseminated adenovirus infection with hepatic necrosis. The median age of these 16 patients was 4.7 years, and their illness was characterized by fever (13 of 16 patients), coagulopathy (10 of 16), lower respiratory tract disease (10 of 16), and gastrointestinal hemorrhage (five of 16) in addition to clinical evidence of hepatitis. The adenoviruses isolated were the commonly found serotypes 1, 2, 3, 5, and 7 for 13 of the 15 cases for which this determination was available. With the high frequency of adenovirus infection in humans and the increasing prevalence of human immunodeficiency virus infection in children, it seems likely that this syndrome will continue to be seen.
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PMID:Disseminated adenovirus infection with hepatic necrosis in patients with human immunodeficiency virus infection and other immunodeficiency states. 215 68

Two distinct processes contribute to the spectrum of human cytomegalovirus (HCMV)-induced pathology. In the first instance, cytopathic effects appear to occur as a direct result of virus replication. This type of disease is characterized by persistent HCMV infection of neural or gastrointestinal tissue, which results in HCMV retinitis, encephalitis, hepatitis, or gastroenteritis. Direct cytopathic effects of HCMV are associated with congenitally acquired or acquired immune deficiency syndrome-related manifestations of HCMV infection. A second type of HCMV-associated disease process is driven by immunopathologic mechanisms and results in variable mononucleosis-like syndromes and/or pneumonia in normal or partially immunosuppressed individuals. Human cytomegalovirus-associated interstitial pneumonia appears to derive from a combination of these two types of disease processes. Here, persistent viral infection, immunopathologic mechanisms, and virus-induced expression or repression of cellular genes each constitutes an important factor in pathogenesis. An understanding of the multiple underlying mechanisms of pathogenesis is crucial to devising optimum treatment approaches.
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PMID:Epidemiology and pathogenesis of cytomegalovirus disease. 216 Jan 29

Vacuolar degeneration was constantly induced in the CNS of 4-week-old ICR mice by intracerebral or intranasal inoculation of JHM-CC virus, a small plaque mutant of mouse hepatitis virus (JHM). Most animals showed no symptoms or only mild hindlimb paresis. Irrespective of clinical manifestations, the virus was isolated from the CNS up to days 14 to 16. Viral antigen expression in the CNS tissue was most extensive around days 5 to 7 and became undetectable on day 14. Viral antigens were localized almost exclusively to neurons, and the temporal sequence of viral antigen distribution after intranasal inoculation clearly indicated the virus spread through the olfactory and limbic systems into the brainstem and spinal cord, and possible cell-to cell transmission of the virus within the CNS. Vacuolar changes, most conspicuous in the brainstem and spinal cord, were steadily progressive up to 4 weeks after infection, but became indistinct by 4 months. Although the distribution of vacuolar lesions largely agreed with that of viral antigen-positive cells, the severity of vacuolation did not correlate with that of inflammation. Intramyelinic splitting, periaxonal edema, and swollen neurites were major ultrastructural substrates for vacuolar changes. This model could provide a better understanding of new types of neurologic disorders associated with viral infections, including vacuolar myelopathy in AIDS.
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PMID:Vacuolar degeneration in mice infected with a coronavirus JHM-CC strain. 216 Oct 91

Fatty infiltration of the liver has been described in association with a large number of systemic conditions. The authors describe a case of multifocal fatty infiltration simulating metastatic disease. The patient had acquired immunodeficiency syndrome and pathologically proved cytomegalovirus hepatitis. To the authors' knowledge, neither entity has been described in association with this radiologic finding.
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PMID:Multifocal cytomegalovirus-associated hepatic lesions simulating metastases in AIDS. 216 68

In a retrospective study of 421 patients infected with human immunodeficiency virus, 15 (3.5%) had varicella. Twelve patients had a typical varicella. Complications were as follows: profuse eruption, 6; hemorrhagic eruption, 1; hepatitis, 5; and pulmonary involvement, 1; 1 patient developed an intravascular disseminated coagulation and died of varicella. Three patients with acquired immunodeficiency syndrome, having a history of varicella, presented with an atypical form of varicella with a small number of disseminated cutaneous poxlike lesions; 1 of these patients experienced three relapses of atypical varicella. Assay of serum antibodies to varicella zoster virus showed that, while typical varicella was the primary varicella zoster virus infection, atypical varicella was a reactivation of varicella zoster virus infection. Acyclovir was given to 11 patients and vidarabine to 1 patient. The one patient who died and the one who suffered a relapse had received acyclovir. Thus, varicella in patients infected with human immunodeficiency virus may be complicated and even lethal. Atypical forms of varicella could be, as is the case with herpes zoster, a reactivation of endogenous varicella zoster virus.
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PMID:Varicella in patients infected with the human immunodeficiency virus. 220 Mar 49

The clinical manifestations of cytomegalovirus (CMV) infection in persons with AIDS are described, and recent advances in the management of these syndromes with antiviral agents are reviewed. CMV infection is the most common serious opportunistic viral infection in AIDS patients. Clinical manifestations include chorioretinitis, gastroenteritis, hepatitis, pneumonia, CNS infection, adrenalitis, and a wasting syndrome. The diagnosis of CMV infection requires laboratory demonstration of a serologic response to the virus, detection of viral components or products, or isolation of the virus. Ganciclovir is an acyclic nucleoside analogue marketed for the treatment of CMV-related retinitis in immunocompromised hosts. After i.v. ganciclovir induction therapy, more than 80% of patients show improvement or stabilization of retinitis. Relapse is common in AIDS patients, however, and low-dose i.v. maintenance therapy is recommended. The most serious dose-limiting effect is neutropenia. Intravitreal injection of ganciclovir has been well tolerated and efficacious. Ganciclovir has shown some efficacy in the treatment of other life-threatening CMV infections, especially gastroenteritis, but data are limited. Ganciclovir-resistant strains have been reported. Foscarnet, a pyrophosphate analogue with activity against both human CMV and human immunodeficiency virus, is undergoing clinical trials. Foscarnet has shown promise in the therapy of CMV-related retinitis, but results for other CMV infections are disappointing. Nephrotoxicity is the major dose-limiting effect. AIDS patients with sight-threatening and rapidly progressive CMV-related retinitis should be treated with ganciclovir. Foscarnet may offer an alternative when it becomes available. More must be learned about the efficacy of these drugs in the treatment of CMV infection in patients with AIDS.
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PMID:Management of cytomegalovirus infection in patients with acquired immunodeficiency syndrome. 216 89

In 1986, health workers collected 358 serum samples from 134 people living in rural Kitgum district in north Uganda and, in 1987, 90 serum samples from 30 healthy people in the Butezi and Ruyigi regions of central Burundi to compare the seroepidemiology of HIV, hepatitis B virus (HBV), delta agent hepatitis, and Treponema pallidum infections. Laboratory staff used ELISA to test for HIV and confirmed all positive samples with the Western blot test. The radioimmunoassay (RIA) test was used for HBV infection and for delta agent hepatitis infection. T. pallidum hemagglutination (TPHA) test was used to check for past syphilis infection. 10% of the people in Kitgum district tested positive for HBV surface antigens (HBS-Ag) and 66.2% for HBV antibodies (HBS-Ab) compared to 15.6% and 68.9% for those in Butezi. Further 3.1% of all people tested in northern Uganda tested positive for anti delta agent hepatitis. Moreover 30.6% of the people in northern Uganda who tested positive for HBS-Ag also tested positive for anti delta agent hepatitis. Yet no one in Butezi district who tested positive for anti delta agent hepatitis. In healthy patients, 14.2% of those in Kitgum district and 9.5% of those in Butezi district tested positive for HIV. In clinically suspected AIDS patients, these corresponding figures were 84.2% and 74.1%. 32.7% of the people in northern Uganda and 7.85 of those in Burundi tested positive for T. pallidum. Further 64% of all HIV positive cases also tested positive for TPHA compared to 25.8% of HIV negative cases (p.01). In Butezi, these figures were 21.4% and 1.6% (p.04). As for those with clinical features of AIDS and tested positive for HIV, 62.5% also tested positive for TPHA in Uganda and 25% in Burundi. In conclusion, HIV infection was strongly associated with previously preexisting patterns of sexually transmitted diseases, i.e., TPHA, but not with the HBV mode of transmission.
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PMID:HIV, HBV, delta-agent and Treponema pallidum infections in two rural African areas. 218 36

The history of 29-year-old male from Surinam with antibodies to HIV-1 and long-lasting fever, lymphadenopathy, pain in the right upper abdomen and a granulomatous hepatitis is described. The patient suffered from disseminated histoplasmosis, a fungal disease rare in The Netherlands, which is the indicator disease for the diagnosis of AIDS (CDC-IVCI). It is stressed that in seropositive patients coming from endemic areas, including Surinam, the possibility of this disease should be considered.
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PMID:[Histoplasma capsulatum infection, a manifestation of AIDS unusual for The Netherlands]. 221 72


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