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

Hepatitis represents a serious complication in the transfusion of blood and blood products. In examining patients from the haemophilia centre in Jena HBsAg was identified in no case, HBsAK, however, in 80% of them. The rate of hepatitis infection increased here with the increasing frequency of transfusion. It should be determined by regularly checking HBsAG, HBsAK and transferases within the scope of prophylactic examinations.
 ...
PMID:[Incidence of hepatitis B in hemophilia patients]. 244 93

The development of factor VIII concentrates has greatly facilitated hemophilia care and has made the home care of hemophilia possible. However, factor VIII concentrate that has been produced using traditional methods contains large amounts of foreign proteins and viruses. This has resulted in the development of immunologic abnormalities in many hemophiliacs and has exposed many of these patients to blood-borne viruses such as the human immunodeficiency virus (HIV) and hepatitis viruses. Factor VIII circulates in plasma in complex with the von Willebrand factor (vWF). Both factor VIII and vWF have been purified and monoclonal antibodies (mAb) have been generated to both of these proteins. When bound to a solid support, these mAb's can be used to isolate selectively the proteins of interest. Recently, two separate procedures have been used in the immunoaffinity purification of factor VIII on a commercial scale. One product (Monoclate) has been prepared using a mAb to the vWF bound to a chromatography column. The other product (Hemophil M) uses immobilized mAb to the factor VIII molecule. Factor VIII concentrate purified using either of these approaches is far more pure than traditional factor VIII concentrates. In addition, the use of both viral purification and viral inactivation procedures has greatly reduced the risk of viral contamination. Early clinical studies have demonstrated that these products are effective in treating bleeding episodes and that the risk of viral infection with HIV or hepatitis viruses is low. Factor VIII concentrate produced using mAb technology appears to be the product of choice in previously untransfused hemophiliacs. Its role in the treatment of patients who have already been infected with HIV is less clear.
 ...
PMID:Immunoaffinity purification of factor VIII. 250 62

The case histories of a carrier of haemophilia A with chronic post transfusion non-A non-B hepatitis and a severe haemophiliac with chronic delta hepatitis are described. Therapy with lymphoblastoid alpha interferon resulted in improvement of NANB and HDV related chronic hepatitis and resolution of HIV related thrombocytopenia. Interferon may modulate replication of more than one transfusion transmitted virus in the haemophiliac.
 ...
PMID:Interferon therapy for chronic non-A non-B and chronic delta liver disease in haemophilia. 250 26

The introduction of factor VIII and IX concentrates in the early 1960s brought a significant change in the hemophiliac's life. In consequence hemophilia treatment has been improving rapidly since, and today most life-threatening hemorrhages are controlled by replacement therapy. Hemophilic arthropathy through recurrent joint and muscle bleedings occurs later in life and is often limited to one joint only. Major surgery in hemophiliacs involves little more risk than in non-hemophilic patients, provided of course there is close teamwork between surgeon and hematologist. The most frequent causes of death are no longer hemorrhages but blood-product-associated AIDS and hepatic failure. Fortunately these side effects have been overcome by the use of virus-inactivated concentrates which in Switzerland have been generally administered since 1986. Factor VIII and IX concentrates must contain a precisely declared quantity of factor VIII and IX activity respectively, with a high specific activity. High-purity concentrates should be preferred because of the hazardous effect of foreign proteins administered intravenously in large quantities over a long period. Activation of fibrinolysis with consequent failure of hemostasis or even worsening of hemorrhage may be a clinically relevant side-effect of DDAVP therapy. When DDAVP is used for prophylactic treatment before surgery, an interval of one hour between the intravenous administration of DDAVP and surgery ensures the latter is performed at the time of highest factor VIII and von Willebrand factor level but with already decreased t-PA and fibrinolytic activity. If DDAVP is used in case of hemorrhage or postoperatively, however, the whole fibrinolytic potential must be taken into account. In these cases subcutaneous administration is advantageous due to more protracted t-PA release and the subsequent lower fibrinolytic activity, which can more easily be neutralized by tranexamic acid. To prevent hemophilic arthropathy, correct replacement therapy in hemarthroses is essential: it should be performed as early as possible, preferably in a home therapy program; adequate levels of factor VIII or IX should be achieved and maintained over a sufficient length of time. Hemophiliacs who did not receive replacement therapy during childhood often need major surgery because of severely destructed joints. Joint replacement by total knee and hip prostheses has proved very successful if certain special conditions are fulfilled. Surgical indications should, however, be carefully considered and the possibilities and limits of replacement therapy should be well known. Blood-product-associated hepatitis will be of prognostic relevance in many hemophiliacs treated formerly with non-virus-inactivated concentrates.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:[Current clinical aspects in hemophilia treatment]. 250 19

Seventeen previously untreated boys with haemophilia A were treated with high purity heat treated factor VIII concentrate (8Y) for up to 36 months. Liver function tests were assessed monthly. No boy's serum has been shown to contain HIV antibodies and no increases in alanine transaminase activity have been detected. In only one patient was a single rise in aspartate transaminase activity noted, and this was without a corresponding rise in alanine transaminase. A second patient's serum contained hepatitis B core antibody transiently. It was thought likely in both cases that the abnormalities reflected intercurrent infections rather than disease associated with transfusion. The physical treatments used in the production of 8Y seem to inactivate the agent(s) responsible for non-A, non-B hepatitis and HIV transmission by transfusion of factor VIII has been abolished. There are, however, problems associated with conducting safety trials in young haemophiliac patients.
 ...
PMID:Safety trial of heated factor VIII concentrate (8Y). 251 Jun 7

Thanks to recent developments and evolution in prenatal diagnosis and early onset within the first year of life, hemophilia may now be considered a pathology of primarily pediatric interest. The treatment of hemophilia in children has furthermore undergone a number of changes that include 2 main events in therapy that have served to modify the quality of life of the hemophiliac. The first of these events regards blood products and the prevention of viral infections, hepatitis and HIV transmission. Prevention is based on various factors which include: donor selection, immunization, product testing and heat treatment of blood products. The second extremely important aspect of treatment in hemophilia is the concept of global assistance, which includes: the treatment of the bleeding episode itself, and an ongoing psycho-social support system. In this paper we suggest some practical treatment schedules for the therapy of bleeding episodes in addition to examining the severe side effects of HIV and Hepatitis viruses. The message which our paper attempts to transmit is that the hemophilic child must be ideally assisted in an exclusively pediatric environment.
 ...
PMID:[Treatment of hemophilia in children]. 251 39

Since 1982, when the World Federation of Hemophilia first published a document on the state of the art of hemophilia diagnosis and care, there have been lights and shadows in this field. Although the widespread infection of hemophiliacs with the human immunodeficiency virus (HIV) contaminating clotting factor concentrates is still a threatening and formidable shadow, the gloomy picture brought about by the AIDS epidemic is partially lightened by spectacular improvements in therapy and diagnosis. Carrier detection and first-trimester prenatal diagnosis can now be performed accurately in most kindreds by analysis of DNA of the factor VIII or IX genes. An important step forward towards the elimination of the risk of blood-borne infections transmitted by plasma products was recently made through the application of virucidal methods to clotting factor concentrates. Since HIV appears more vulnerable to such methods than the hepatitis viruses, currently available concentrates can be considered substantially free from the risk of transmitting HIV infection. Even though transmission of hepatitis is much reduced but not totally abolished, virucidal methods are continuously being improved, so that it can be foreseen that concentrates will become safer and safer. Finally, factor VIII produced by recombinant DNA technology is undergoing the first clinical trials in hemophiliacs. Hopefully, it will free from the risk of transmitting infections and will be available in sufficiently large amounts to meet the need of hemophiliacs worldwide. In 1982, the World Federation of Hemophilia published a message on the status of diagnosis and treatment of hemophilia. Since then, hemophilia care has been complicated by widespread infection of hemophiliacs with human immunodeficiency virus (HIV).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Hemophilia: state of the art of hematologic care 1988. 265 17

Antibody to hepatitis B surface antigen (anti-HBs) has been used clinically to indicate an immune response to hepatitis B virus (HBV) and a protection against reinfection with the virus. We describe a child with hemophilia who had high-titer IgG anti-HBs in his serum and who subsequently developed viral B hepatitis. The child had received a unit of fresh frozen plasma 17 days prior to the determination of anti-HBs. The fresh frozen plasma donor was later found to be anti-HBs positive. The patient's anti-HBs was most likely passively acquired and therefore did not signify immunity to HBV. Various tests, including hepatitis B surface antigen group-specific and subtype determinants, ratio units of anti-HBs, and antibody class, have been used to determine whether or not anti-HBs will confer immunity. Although these tests have been thought to accurately predict immune status against infection with HBV, our case shows this may not be true, especially in patients who have been recently transfused. Anti-HBs testing may be predictive of immunity to HBV in the absence of a source of passively acquired anti-HBs.
 ...
PMID:Passively acquired antibody to hepatitis B surface antigen. Pitfall in evaluating immunity to hepatitis B viral infections. 271 76

Mononuclear leucocytes (mainly lymphocytes), isolated by Ficoll-Paque gradient centrifugation of blood freshly drawn from a haemophilia A patient with chronic non-A, non-B hepatitis (NANB), caused NANB when infused in a susceptible chimpanzee. Plasma from the same patient also transmitted the disease, as witnessed by elevated levels of liver enzymes in serum, histopathological signs of viral hepatitis and submicroscopic cytoplasmic alterations in the hepatocytes, considered to be specific for NANB in chimpanzees. In contrast, neither lymphocytes nor plasma from a chimpanzee apparently fully recovered from two episodes of NANB had the same effect.
 ...
PMID:Preliminary results of transmission experiments of non-A, non-B hepatitis by mononuclear leucocytes from a chronic patient. 286 Jan 18

In an 8-year study of 79 unselected patients with haemophilia who had received clotting factor concentrates, there was evidence of chronic progressive liver disease in at least 17 (21%). 8 patients had chronic active hepatitis and 9 had cirrhosis (5 with oesophageal varices). Histological evidence suggested that non-A non-B hepatitis was mainly responsible, although the influence of other viruses could not be excluded. Serial liver biopsies showed progression from chronic persistent hepatitis to chronic active hepatitis and cirrhosis within 6 years, suggesting that chronic persistent hepatitis in haemophiliacs is not as benign as hitherto supposed. Symptoms and abnormal physical signs were uncommon in these patients. There was no relation between degree of abnormality of serum aminotransferase levels and severity of the underlying liver disease. It is anticipated that liver disease in haemophiliacs will become an increasing clinical problem in the future.
 ...
PMID:Progressive liver disease in haemophilia: an understated problem? 286 20


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>