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)

Genital Herpes simplex infection is noted increasingly in women of childbearing age and in neonates. Concern about transmission of herpes to the newborn has led to cesarean delivery of many pregnant women with a history of genital herpes. Severe herpes hepatitis has also been noted in pregnancy. Acyclovir is the drug of choice for this infectious organism. Because there are no data on the mechanism(s) of transport of this drug by the human placenta, this study addressed this issue. We used normal term human placentas. For study of overall placental transport of acyclovir, we used the single, isolated perfused cotyledon technique. For assessment of initial acyclovir uptake, we used microvesicles prepared from the maternal-facing syncytiotrophoblast. Overall transfer of acyclovir at therapeutic concentrations from maternal to fetal compartment was at a rate of about 30% that of a freely diffusible marker, antipyrine. The overall transport was not saturable, was not inhibited by 50-fold adenine concentration, and did not proceed against a concentration gradient. There was no placental metabolism of the drug. Fetal-to-maternal transfer of acyclovir was at a similar rate. In maternal-facing microvesicles net uptake of acyclovir was not saturable, but was temperature dependent and was inhibited by high concentrations of adenine and ganciclovir, but not by nucleosides (adenosine, cytidine, cytosine). These data are most consistent with a carrier-dependent, nucleobase-type uptake of the drug, but passive overall net transfer of acyclovir, dependent on its solubility characteristics.
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PMID:Acyclovir transport by the human placenta. 145 1

Although case reports of herpes simplex virus (HSV) causing acute hepatitis in otherwise healthy adults have appeared recently in the literature, a prospective study of the incidence of HSV-hepatitis in the general population hitherto has not been reported. In the present study, serum samples from 124 young adults attending a sexually transmitted disease clinic with either genital herpes infections (n = 86) or non-herpes sexually transmitted diseases (n = 38) (controls) were analyzed for liver enzyme abnormalities (including aspartate aminotransferase [AST] and alanine aminotransferase [ALT]). Twelve of eighty-six (14%) herpes-infected patients had mildly abnormal liver enzyme tests (less than or equal to twice the upper limit of normal) as opposed to only 1 of 38 controls (2.6%), (P less than .05). All individuals in the herpes-hepatitis group were anicteric, and only two complained of constitutional symptoms (malaise and fatigue). Liver enzyme tests were repeated in nine herpes-hepatitis patients 1 week after their genital lesions had resolved, and in six of nine patients the results had returned to within normal limits. Four patients subsequently returned at the onset of a recurrence of their genital herpes. In all four, serum ALT levels were elevated from the previous occasion, and in three of the four levels just exceeded the upper limit of normal. One patient was followed through three recurrences of his genital herpes. In that individual, the extent of liver enzyme abnormalities appeared to correlate with the presence or absence of his genital lesions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Genital herpes and hepatitis in healthy young adults. 301 68

Western society has undergone a vast sociological change during the 20th century in terms of the value of sexuality. Sexual choice has gained a new legitimacy never before experienced. There is less guilt surrounding issues of sexuality and it is now common place to hear and see explicit discussions about sex in the mass media. This acceptance has undoubtedly encouraged many people to be more daring and promiscuous in their sexual activities. Proof of this can be seen in the increase is the incidence of sexually transmitted diseases (STDs). Presently there are more than 20 epidemiologically significant diseases that are sexually transmitted. Beyond the 5 old standards of gonorrhea, syphilis, chancroid, lyphogranuloma venereum, and granuloma inguinala STDs now include: chlamydia trachomatis, genital herpes, human papillomavirus, human immunodeficiency virus, genital mycoplasms, cytomegalovirus, hepatitis, vaginitis, enteric infections, and ectoparasitic diseases. Keeping all this in mind, the question of the ethics of safe sex must be addressed. In many countries, the governments have undertaken large public education programs to encourage safe sex practices. All these programs a founded upon two ideas: that safe sex should be promoted free of any ethical discussions or considerations, and that technology alone, the condom, will protect the public from the problem of STDs. However these campaigns will fail to protect the public unless they try to intervene at some level other than the mechanical aspect of the sex act itself. Condoms have failure rates too high to be relied upon as the sole means of protecting the public. Sex education for children and an inclusion of the ethical aspects of sex, now that the consequences can mean death, must be included in these government programs if they are to be successful.
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PMID:The ethics of safe sex. 306 Jul 71

Documented disseminated infection with herpes simplex virus has been reported only five times in pregnancy. All cases have been severe and demonstrated common clinical features, including hepatitis and adenopathy. These reports are reviewed and two new cases added. Dissemination is undoubtedly more common, and commonly less dramatic in presentation then previously suspected. Hepatocellular dysfunction and generalized adenopathy should be clues to dissemination. Dissemination has occurred only in the second half of pregnancy, and even with infected amniotic fluid, has not always resulted in an infected infant. Transplacental maternal IGG has been documented, but is not protective, though newer antiviral drugs do show therapeutic potential. The clinician should be aware of the possibility of dissemination in any patient with oral or genital herpes and generalized signs or symptoms of disease.
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PMID:Disseminated herpes simplex in pregnancy: two cases and a review. 675 85

Although infrequent, untreated neonatal herpes results in death in half the cases and neurologic sequelae in three quarters of the survivors. Neonatal infection is usually acquired from maternal genital herpes, which is asymptomatic or unrecognized in 60% to 80% of women. The greatest risk of neonatal infection occurs when the mother has primary genital herpes involving the cervix at delivery, and the infant is premature and delivered with instrumentation (eg, scalp electrodes). More than 80% of neonates with herpes will have typical herpetic lesions of the skin, eye, or mouth, and most of the remainder will have either encephalitis or a sepsis syndrome with pneumonitis and hepatitis and negative bacterial cultures. Because herpes can mimic other neonatal infections, laboratory diagnosis is important, using cultures of the virus from lesions, peripheral blood white cells, or CSF. Treatment with intravenous acyclovir does reduce mortality and neurologic sequelae, but outcome is still guarded in babies with disseminated disease or encephalitis. Prevention focuses on caesarean section in women with active lesions at the time of impending delivery and avoidance of postnatal exposure. Further studies are needed to determine whether maternal screening (eg, HSV-2 type specific antibodies and vaginal cultures in selected women at delivery) will be cost effective in preventing neonatal herpes.
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PMID:Herpes simplex virus infection of the fetus and newborn. 801 61

This article provides population-based estimates of the prevalence of patient-reported sexually transmitted diseases (STDs) and characterizes patterns of treatment utilization according to specific STDs and client characteristics in the US. Using data from the 1992 National Health and Social Life Survey, which included 3432 persons aged 18-59, an estimated 2 million STDs were self-reported in the previous year, and 22 million 18-59 year olds self-reported lifetime STDs. Respondents reported bacterial STDs (gonorrhea, chlamydia, nongonococcal urethritis, pelvic inflammatory disease and syphilis) more than viral STDs (genital herpes, genital warts, hepatitis and HIV). About 49% of the respondents who had an STD mentioned having gone to a private practice for treatment, while only 5% had sought treatment at an STD clinic. Moreover, variations were seen in treatment-seeking for specific bacterial STDs, such as chlamydia and gonorrhea. Other factors that could influence where people go for treatment include gender, race, and income status. Characteristics of providers could also influence patient choice, such as geographic distribution, availability of support services, quality of care, convenience, and privacy.
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PMID:Where do people go for treatment of sexually transmitted diseases? 1002 27

Acute liver failure is a life threatening disease mostly triggered by drug-induced or toxic liver damage or viral hepatitis. Herpes Simplex virus (HSV) hepatitis is rare and accounts for only 1% of all acute liver failures. The importance of HSV-induced acute liver failure is based on its extremely severe clinical course with lethality rates of almost 75%. HSV hepatitis is just one of several clinical manifestations of HSV sepsis leading more frequently to encephalitis, pneumonia and esophagitis. Local herpes infection or recurrence of dermal lesions (herpes labialis, herpes genitalis), however, is common and account for the high prevalence of HSV-1 or HSV-2 infection in adults. Another rare entity is visual dissemination, which mostly affects immunocompromised patients. Compromised cellular immunity is a major risk factor for HSV sepsis because of either primary infection or reactivation of occult chronic HSV infection. Delayed diagnosis without antiviral therapy significantly contributes to the unfavorable outcome. Typically, anicteric hepatitis is seen in patients with HSV hepatitis. Because of its low incidence, however, and the lack of dermal manifestations, HSV hepatitis is rarely considered in the context of acute liver failure. In addition, diagnostic tests might not always be available. Therefore, it is a generally accepted consensus to begin antiviral therapy pre-emptively with acyclovir in cases of acute liver failure of unknown origin, in which high urgency (HU) liver transplantation remains the only therapeutical option. Even in the case of early specific therapy, sepsis may prevail and the indication for HU transplantation must be evaluated carefully. The outcome after liver transplantation for HSV-induced liver failure with reported survival rates of more than 40% is good. Because of the risk of recurrence, lifelong prophylaxis with acyclovir is recommended.
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PMID:Herpes simplex virus sepsis and acute liver failure. 1993 Mar 15

Herpes simplex virus type 1 (HSV-1) infections cause typical dermal and mucosal lesions in children and adults. Also complications to the peripheral and central nervous system, pneumonia or hepatitis are well known. However, dissemination to viscera in adults is rare and predominantly observed in immunocompromised patients. Here we describe the case of a 70-year-old male admitted with macrohematuria and signs of acute infection and finally deceasing in a septic shock with multi organ failure 17 days after admission to intensive care unit. No bacterial or fungal infection could be detected during his stay, but only two days before death the patient showed signs of rectal, orolabial and genital herpes infection. The presence of HSV-1 was detected in swabs taken from the lesions, oropharyngeal fluid as well as in plasma. Post-mortem polymerase chain reaction analyses confirmed a disseminated infection with HSV-1 involving various organs and tissues but excluding the central nervous system. Autopsy revealed a predominantly retroperitoneal diffuse large B-cell lymphoma as the suspected origin of immunosuppression underlying herpes simplex dissemination.
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PMID:Fatal multiorgan failure associated with disseminated herpes simplex virus-1 infection: a case report. 2482 37