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

Hepatitis B and Non-A-non-B infections often become chronic and proceed to cirrhosis associated with a shortened life expectancy. Both infections are transmitted by parenteral or sexual routes. New insights in the structure of the hepatitis B virus (HBV) as well as in the immune response mechanism of the organism permit by serological testing a clear definition of the replicative state of the virus. Together with the parameters of inflammation (e.g. transaminases, liver histology) it is possible to determine the activity of the hepatitis. The most effective treatment of chronic HBV-infection today is the therapy with alpha- or beta-interferon. The aim of this treatment is the inhibition of HBV replication and accellerated elimination of the virus, indicated by seroconversion of HBEAg to anti-HBEAg. The most significant advance in the knowledge of percutaneous Non-A-non-B hepatitis is the identification of the responsible virus and the development of a diagnostic test for its serological detection. Since this type of hepatitis becomes chronic in 50-60% of the cases, therapy is urgently required. Clinical studies showed that also for Non-A-non-B virus infection alpha-interferon is most effective. Currently the optimal dosage, duration and point in time for interferon treatment is being evaluated.
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PMID:[Epidemiology and clinical aspects of chronic hepatitis B and non-A, non-B virus infections]. 250 33

Sanded nuclei are nuclei with eosinophilic inclusions identified by light microscopy in cases of chronic hepatitis B virus infection. In hematoxylin and eosin-stained sections, these inclusions have an almost homogeneous, finely granular texture giving a sandy appearance. They have been related to excess hepatitis B core antigen formation. We have studied liver biopsies from two HBsAg positive immunosuppressed patients with numerous sanded nuclei, morphologically identical to those previously described in hepatitis B. Immunohistochemically, sanded nuclei showed a strong nuclear positivity for delta antigen, but were negative for hepatitis B core antigen. Hepatitis B core particles were not demonstrable by electron microscopy. To our knowledge, this is the first time that sanded nuclei have been related to hepatitis delta virus (HDV) infection.
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PMID:Sanded nuclei in delta patients. 255 68

Chronic infection with the hepatitis B virus can result in the development of serious liver disease such as chronic active hepatitis, cirrhosis, and hepatocellular carcinoma. Vertical transmission from infected mothers to infants is thought to be partially responsible for the high prevalence of infection in certain high-risk groups. Immunoprophylaxis using hepatitis B vaccine and hepatitis immune globulin has been highly effective in decreasing the probability of chronic hepatitis B virus infection in infants with exposure. Previously, the Centers for Disease Control recommended screening pregnant women considered at high risk of hepatitis B infection to detect newborns who would benefit from postnatal immunizations directed at preventing the HBV carrier state. Because of the poor sensitivity of high-risk criteria in distinguishing pregnant women who harbor the hepatitis B virus, these recommendations have recently been revised to call for the routine screening of all pregnant women in the United States.
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PMID:Hepatitis B in pregnancy. 266 19

Twenty-one pretreatment variables were assessed for their significance in response prediction using data from 114 patients given alpha-interferon for chronic hepatitis B virus infection. In those patients who had received a minimum of 90 million units per m2 total dose over 12 weeks, a negative anti-human immunodeficiency virus antibody status (p less than 0.001), chronic active hepatitis on liver biopsy (p less than 0.005), high AST level (p less than 0.001), low hepatitis B virus DNA level (p less than 0.001) and a history of acute hepatitis (p less than 0.005) were all associated with an increased likelihood of response on univariate analysis. On stepwise logistic regression analysis, hepatitis B virus DNA, AST and a history of acute hepatitis predicted response independently (p less than 0.05). The most reliable combination of predictive factors was a negative anti-human immunodeficiency virus antibody status, with either a positive history of acute icteric hepatitis and AST greater than 45 IU per liter or no history of acute icteric hepatitis and AST greater than 85 IU per liter, which predicted response in 77% with a specificity of 79% (p less than 0.001). The loss of HBsAg in addition to HBeAg and hepatitis B virus DNA was more likely to occur in patients with chronic infection of less than 2 years duration (p less than 0.001).
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PMID:Which patients with chronic hepatitis B virus infection will respond to alpha-interferon therapy? A statistical analysis of predictive factors. 237 80

Two generic enzyme immunoassays (EIAs) were developed for detection of anti-hepatitis delta virus antibodies (anti-HD) and compared with a commercially available radioimmunoassay. Both generic assays were configured as blocking assays and used hepatitis delta antigen (HDAg) derived from infected chimpanzee liver (EIA-1) or from Escherichia coli transformed with a plasmid containing an insert from within an open reading frame encoding HDAg (EIA-2). Absolute sensitivity was ascertained by endpoint titration, which demonstrated essentially identical endpoints for EIA-1 and EIA-2. The absolute sensitivities of the EIAs were approximately four times greater than that of the radioimmunoassay. Specificity and sensitivity were ascertained by testing a panel of 176 serum specimens by each assay. The specimens were selected to represent a panel composed of sera from individuals with or without markers of viral hepatitis as follows: (i) serologically confirmed by exclusion as posttransfusion non-A, non-B hepatitis; (ii) acute or chronic hepatitis B virus infection, positive for hepatitis B surface antigen; (iii) resolved hepatitis B virus infection, positive for anti-hepatitis B surface antigen; (iv) acute hepatitis A virus infection, positive for anti-hepatitis A virus immunoglobulin M; and (v) normal human sera. All three assays for anti-HD gave similar specificity and sensitivity values. In conclusion, the recombinant expressed HDAg can replace antigen derived from infected liver tissue as a diagnostic reagent used to configure an EIA for detection of anti-HD. Furthermore, the results suggest that the expressed antigen contains the important immunodominant epitope(s).
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PMID:Development of an enzyme immunoassay using recombinant expressed antigen to detect hepatitis delta virus antibodies. 268 22

Serum-soluble Tac peptide was measured by an enzyme-linked immunosorbent assay in 12 patients with acute type B hepatitis, 33 patients with chronic type B hepatitis, and 15 age- and sex-matched controls. All 12 patients with acute type B hepatitis had elevated levels of soluble Tac peptide with a mean (+/- SD) of 1527 +/- 432 U/ml, significantly higher than that of normal controls (264 +/- 74 U/ml) or patients with chronic type B hepatitis (646 +/- 399 U/ml). Serial follow-up showed that serum levels of soluble Tac peptide tended to return to normal 2-4 months after onset of acute hepatitis along with the normalization of alanine aminotransferase and seroconversion of hepatitis B surface antigen (HBsAg) to anti-HBs. Patients with chronic type B hepatitis also had significantly higher levels of soluble Tac peptide than normal controls, although only 63.6% (21/33) of them had a level greater than the upper limit of normal. Serum levels of soluble Tac peptide in patients with chronic type B hepatitis varied considerably with the inflammatity in liver. The hepatitis B e antigen (HBeAg)-positive patients with chronic active liver disease had significantly higher levels of soluble Tac peptide (928 +/- 424 U/ml) than HBeAg-positive (412 +/- 146 U/ml) or anti-HBe-positive (424 +/- 175 U/ml) patients with chronic persistent hepatitis or minimal histological change. In addition, there was a significant positive correlation between serum levels of soluble Tac peptide and alanine aminotransferase. These findings suggested that activation of T cells might play an important role in the pathogenesis of acute and chronic type B hepatitis. Assay of serum-soluble Tac peptide might provide a simple and useful means to better understand the immune mechanisms of acute and chronic hepatitis B virus infection.
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PMID:Serum levels of soluble Tac peptide in acute and chronic hepatitis B virus infection. 278 45

A unique kindred with an unusual high incidence of serological markers of past or present hepatitis B infection was studied. None of eight relatives had clinical or chemical evidence of hepatitis and all were negative for IgM anti-hepatitis A, but four sisters, each with at least one hepatitis B marker, had features of rheumatic disorders. The index patient had polyarteritis nodosa, two sisters had Raynaud's disease, and the fourth and unclassifiable non-inflammatory polyarthralgia. A daughter of one sister with Raynaud's developed the aortic arch syndrome. There was no segregation of HLA-A, -B and -C alleles with hepatitis B infection. The intrafamilial occurrence of B virus infection and multiple vasculopathies suggests a wider role of this virus in inflammatory vessel diseases.
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PMID:Multiple vasculopathies and hepatitis B in a family. 285 41

Waterborne non-A, non-B hepatitis (NANB) is responsible for outbreaks of hepatitis with a predilection for young adults. The disease is usually mild, except in pregnant women, who have a high case-fatality rate from fulminant hepatic failure. Diagnosis is largely based on the epidemiological findings of faecal contamination of drinking water and serological exclusion of hepatitis A and B virus infection. Histological features of liver biopsy specimens are characteristic and virus-like particles in the stool are aggregated by antibody present in acute and convalescent phase sera of the test subject. NANB is widespread in India and several countries of South-East Asia; it is increasingly recognised in Africa and may occur in Latin America. Control measures include provision of clean water supplies, safe disposal of human excreta, and sound personal and food hygiene practices. Passive immunisation with immunoglobulin derived from healthy donors resident in the countries affected by the disease may protect vulnerable groups.
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PMID:Waterborne non-A, non-B hepatitis. 289 1

Two hundred forty southern African black patients with hepatocellular carcinoma and control subjects matched for race, sex, age, and urban or rural background were questioned about their smoking habits. Patients with hepatocellular carcinoma were not more likely to smoke or to smoke heavily than the control subjects. This was also true of the subgroups: men and women, and urban and rural background. There was a slightly increased relative risk associated with smoking in all patients who showed no serum markers of current or past hepatitis-B virus infection and in patients older than 50 years who did not have markers of current or past hepatitis-B virus infection. However, this was not statistically significant, and was not supported by a linear trend, the risk in heavy smokers being less than 1. Rural black patients, who have a higher incidence of hepatocellular carcinoma than urban black patients, smoked less than their urban counterparts. We conclude that smoking is not an unqualified risk factor for hepatocellular carcinoma in southern African black patients. There may, however, be a trend toward smoking playing an etiologic role in patients without hepatitis-B virus infection, especially in older patients.
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PMID:Smoking as a risk factor in hepatocellular carcinoma. A case-control study in southern African blacks. 299 52

Fifty cases of symptomatic acute viral hepatitis presenting at the Washington, D.C., Veterans Administration Medical Center between 1976 and 1978 were tested for serological markers of hepatitis virus infection. The etiology of the acute hepatitis appeared to be hepatitis A virus in 20%, hepatitis B virus in 52%, non-A, non-B agents in 22%, delta hepatitis in 4%, and infectious mononucleosis in 2%. The diagnosis of type B hepatitis was difficult to verify because 10% of cases were seronegative for HBsAg and another 10% were seronegative by conventional testing for IgM antibody to hepatitis B core antigen (a putative marker of acute hepatitis B virus infection). Accurate serodiagnosis of acute viral hepatitis depends upon the correct application of testing for IgM antibody to hepatitis A virus, IgM antibody to hepatitis B core antigen, HBsAg, and tests for syphilis and mononucleosis.
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PMID:Serological diagnosis of acute viral hepatitis. 299 63


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