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)

A study is currently underway to investigate the efficacy of interferon therapy in patients with prolonged (greater than or equal to 10 weeks but less than 6 months) hepatitis B infection. To date, a total of 15 patients have been enrolled in the study and randomly assigned to receive either placebo for 24 weeks (n = 8) or interferon 5 million units subcutaneously 3 times a week for 24 weeks (n = 7), with follow up for 1 year. Thirteen patients have completed the follow-up period: seven patients in the placebo group and six in the treated group. Five of the six treated patients completely eradicated the infection during interferon therapy, with clearance of hepatitis B e and surface antigens, and seroconversion to antibody positivity in each case. Two of the eight placebo patients seroconverted during the placebo period. Clearance of hepatitis B e antigen was associated with a sudden rise in serum transaminase levels and an exacerbation of hepatitis, a phenomenon that has also been reported in chronic hepatitis B patients who have responded well to interferon therapy. Therapy was well tolerated in all cases. Our results suggest that interferon treatment of patients with prolonged hepatitis B infection may prevent progression to chronicity. If confirmed by further study, they should trigger more vigilant screening for patients with raised serum transaminase levels and viral markers of hepatitis B infection.
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PMID:Possible prevention of chronic hepatitis B by early interferon therapy. 170 41

The effects of interferon (INT) therapy in the chronic aggressive hepatitis of viral origin (CAVH) are critically reviewed. The main factor which favours the progress of acute viral hepatitis to chronic forms is the persistence of viral replication in conditions of immune deficit of the host. INT has antiviral, immunomodulating and antitumoral action. The INT alpha class proved to be the most adequate for the CAVH treatment. Many recent clinical trials have demonstrated the INT alpha effectiveness in CAVH. The results of such studies are separately analysed for each hepatitis virus. The importance of various factors, i.e., dose, treatment duration, race, sex, age, histologic lesions, ALAT level, viral DNA titer, associations with adenine-arabinoside, acyclovir, corticosteroids, a.o., is discussed in relation with the rate of therapeutic response and the risk of viral infection recurrences.
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PMID:Interferon therapy in the chronic aggressive viral hepatitis. 170 92

The author analyzes current data on the potentialities of antiviral therapy of patients suffering from chronic viral hepatitides. Provides the data on the short- and long-term therapeutic effects of interferon drugs and other antiviral agents, describes side effects produced by such type drugs. Compares the clinico-enzymatic, pathohistologic characteristics of the liver status with the degree of elimination of serum antigenic markers of virus B hepatitis in patients afflicted with chronic viral hepatitides. Relates the effects of antiviral drugs in patients suffering from chronic virus non-A non-B hepatitis.
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PMID:[Antiviral preparations in the therapy of chronic viral hepatitis]. 171 74

We investigated the effects of interferon therapy on hepatocyte human leukocyte antigen class I and class II antigen expression and intrahepatic lymphocyte subsets in patients with chronic viral hepatitis B (n = 11) and C (n = 10). Interferon-alpha was administered intramuscularly in doses ranging from 3 to 18 million international units daily for 4 wk. Liver biopsy specimens were obtained just before and immediately after treatment, and the specimens were stained by the indirect immunoperoxidase method for evaluation of human leukocyte antigen expression and lymphocyte subsets. Before therapy, no significant difference was noted between hepatitis B and C in human leukocyte antigen class I antigen expression on hepatocytes or in the lymphocyte subsets in the intralobular and portal areas. After interferon-alpha treatment, hepatocyte expression of human leukocyte antigen class I antigens and serum beta 2-microglobulin levels were virtually unchanged in chronic viral hepatitis C patients, but both were increased in chronic viral hepatitis B patients. Human leukocyte antigen class II antigens were not expressed during treatment. The mean number of intralobular CD3+ and CD8+ cells and the mean serum ALT level decreased significantly in chronic viral hepatitis C patients (p less than 0.05) but not in chronic viral hepatitis B patients. The mean number of intralobular CD4+ cells was unaffected by interferon therapy in both groups. In all 21 patients, the changes in CD8+ cell numbers paralleled the changes in serum ALT levels. Our findings suggest that T-cell cytotoxicity may play an important role in hepatocyte damage in both chronic viral hepatitis C and chronic viral hepatitis B and that the response to interferon-alpha differs in these two types of hepatitis.
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PMID:Effects of interferon on intrahepatic human leukocyte antigens and lymphocyte subsets in patients with chronic hepatitis B and C. 171 Oct

The levels of 2'-5' oligoadenylate synthetase activity (2-5AS) were measured in the lymphocytes and sera of 32 patients with acute viral hepatitis and 20 patients with HBeAg positive chronic type B hepatitis, and the relationship between the effectiveness of interferon (IFN) therapy and 2-5AS reactivity was then studied. The lymphocyte 2-5AS (L.2-5AS) and the serum 2-5AS (S.2-5AS) levels in patients with any type of acute viral hepatitis at the acute stage were significantly higher than in the healthy subjects. The 2-5AS level in cases of acute type A viral hepatitis was significantly higher than in type B and type non A non B hepatitis. However, no significant difference in the 2-5AS levels between type B hepatitis and type non A non B hepatitis was observed. After recovery, the L.2-5AS and S.2-5AS levels decreased in patients with any type of acute viral hepatitis. No significant difference between the L.2-5AS level in healthy subjects and patients with chronic type B hepatitis was observed. The S.2-5AS level was significantly higher in patients with chronic type B hepatitis than in healthy subjects. During IFN administration, the L.2-5AS and S.2-5AS levels increased, with the maximum level and maximum rate of increase obtained on the 3rd day with respect to the L.2-5AS, and after one week with respect to the S.2-5AS. Of the 20 patients with chronic type B hepatitis with positive HBe antigen, 11 showed normalization of DNA-P, 4 disappearance of HBe antigen and 2 seroconversion of HBe antigen. In cases with a higher maximum rate of increase of the L.2-5AS, the effect of IFN therapy was observed to be greater.
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PMID:[2'-5' oligoadenylate synthetase activity in patients with acute viral hepatitis and chronic type B hepatitis, and its clinical significance]. 171 48

Sera from 30 patients with community-acquired, biopsy-proven chronic non-a,non-B hepatitis (NANBH) were tested for antibodies to the C100 protein of hepatitis C virus (HCV). The 20 patients who showed reactivity in this assay were followed prospectively for 6 months, during which time seven were treated with recombinant alpha-interferon. HCV RNA was detected by "nested" polymerase chain reaction (PCR) in 19 of the 20 anti-C100-positive sera taken at the onset of the study and also in five of the ten anti-C100-negative sera. Pretreatment viraemia levels ranged from 2 x 10(3) to 2 x 10(8) HCV genomes/ml. After 6 months of interferon, elevated serum alanine aminotransferase (ALT) levels had fallen to normal in four of the seven treated patients. In each case the response to interferon was accompanied by either a disappearance of or a decline (1 log to 8 log reduction) in viraemia. HCV genome titres in the three nonresponders and in the 13 untreated anti-C100-positive patients did not change significantly over this 6 month period. These findings confirm the aetiological role of HCV in community-acquired NANBH and suggest that quantitative PCR will become a valuable technique for monitoring the antiviral effect of interferon and other experimental treatments.
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PMID:Effect of alpha-interferon therapy on hepatitis C viraemia in community-acquired chronic non-A, non-B hepatitis: a quantitative polymerase chain reaction study. 171 96

Currently, alpha interferon is the only recognized therapy for chronic viral hepatitis. As a result of its success in several multicenter trials, the agent was approved recently by the FDA for use in the clinical management of patients with chronic hepatitis C. FDA approval for its use in chronic hepatitis B is anticipated. Based upon this experience in nonimmunosuppressed individuals, the efficacy of alpha interferon therapy in patients who are recipients of liver allografts and are receiving chronic immunosuppression was assessed in a preliminary trial of the agent in 30 patients (13 with HBV, 11 with HCV, and 6 with hepatitis non A, non B, non C). Therapy was initiated at a dose of 3 X 10(6) units three times per week and continued for 6 months. Dose reduction in the amount of the alpha interferon administered was determined by a preestablished protocol. Nine percent of those with HCV and 18% of those with hepatitis non A, non B, non C experienced a full response to alpha interferon therapy. No full responses to alpha interferon therapy. No full responses were seen in those with HBV disease. Partial responses were common in all three groups but were most frequent in those with hepatitis non A, non B, non C and least frequent in those with HCV-related disease. This preliminary experience demonstrates the following: 1. Viral hepatitis following OLTx can be treated with alpha-2b-interferon. 2. The complications of alpha-2b-interferon therapy utilized prior to OLTx can be avoided by giving the therapy following successful OLTx. 3. The high rate of partial responses noted suggests that future studies should utilize either higher doses or longer durations of therapy or both. 4. The response rate was greatest for those having non A, non B, non C hepatitis and least for those with HCV hepatitis. 5. In this small preliminary series, no episodes of liver graft rejection could be ascribed to the use of alpha-2b-interferon in the patients so treated.
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PMID:Preliminary experience with alpha-2b-interferon therapy of viral hepatitis in liver allograft recipients. 173 58

Hepatitis B virus (HBV) variants which cannot express e-antigen (HBeAg) are characteristic for many viremic anti-HBe positive chronic carriers who often have particularly severe and fluctuating hepatitis. Whether such variants are selected for and are less amenable to interferon treatment is under dispute. Therefore, by DNA amplification and direct sequencing we have investigated the emergence of HBV pre-C sequence variants in nine e-antigen positive chronic carriers, all of whom seroconverted to anti-HBe or lost HBeAg during interferon treatment, and in three of whom no viral DNA was detectable after interferon treatment. In most, but not all of the patients we found newly emerging pre-C sequences in a subpopulation of the viral genomes that included silent point mutations, amino acid changes, start and stop codon and frameshift mutations. The emergence of these mutations was paralleled by a drastic decrease of viremia during treatment. The observed mutations appeared most frequently during interferon treatment. Some of the mutations appeared or disappeared late after interferon treatment concomitant with anti-HBe antibody development. The appearance or lack of mutations in the pre-C region of a subpopulation of HBV of these patients was independent of successful virus elimination. These data indicate that interferon treatment is frequently associated with the simultaneous fall in titer of viral DNA by several orders of magnitude and the emergence of novel pre-C sequences, some of them preventing HBeAg expression. However, the presumably immune-mediated selection for pre-C mutant viruses and decrease in viremia under interferon treatment appears not to be prognostic for successful or unsuccessful virus elimination.
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PMID:Frequent and rapid emergence of mutated pre-C sequences in HBV from e-antigen positive carriers who seroconvert to anti-HBe during interferon treatment. 173 29

Five major types of viral hepatitis have been identified. Hepatitis A is an acute, usually self-limited illness. Prophylaxis with immune globulin (Gamastan, Gammar) is effective in household and sexual contacts of infected patients. Hepatitis B has both acute and chronic forms. Treatment trials for chronic hepatitis B with interferon alfa-2b have shown promise. Hepatitis C is the name now given to non-A non-B hepatitis. Interferon alfa-2b (Intron A) has been approved for treatment of chronic hepatitis C. Hepatitis D occurs only in patients with hepatitis B. The only treatment for hepatitis D is prevention of hepatitis B. Hepatitis E is seen after natural disasters in developing regions of the world. Further advances in serologic testing and treatment of viral hepatitis can be expected.
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PMID:Hepatitis A, B, C, D, and E. Update on testing and treatment. 174 56

The 2'-5' oligoadenylate synthetase (2-5 AS) activity of peripheral blood mononuclear cells and serum was measured in 23 patients with chronic non-A, non-B hepatitis during interferon therapy, 16 of whom were found to have antibody to hepatitis C virus (anti-HCV). Patients received a daily dose of either 1 million, 3 million or 6 million units of human interferon-alpha or -beta for 4 to 6 weeks. Before treatment, the 2-5 AS activity was not significantly different from that in normal control subjects or patients with chronic hepatitis B. However, during treatment the 2-5 AS activity increased 2- to 41-fold from the initial level. Alanine aminotransferase (ALT) levels normalized promptly after the start of treatment in 15 (65.2%) of the 23 patients, but remained elevated in the remaining 8 (34.8%). Six (40%) of the 15 patients showed consistently normal ALT levels for 6 to 30 months after the end of treatment. There was no significant difference between the responders and non-responders in the pattern of change of 2-5 AS activity, but pretreatment activity levels in peripheral blood mononuclear cells were significantly higher (P less than 0.001) in the patients whose ALT levels did not normalize during treatment. The frequency of patients with a positive anti-HCV was significantly higher (P less than 0.05) in the group in which ALT levels normalized. Therefore, these findings suggest that the pretreatment 2-5 AS activity and the detection of anti-HCV may be useful parameters for predicting the response to interferon therapy.
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PMID:2',5' Oligoadenylate synthetase activity in peripheral blood mononuclear cells and serum during interferon treatment of chronic non-A, non-B hepatitis. 175 91


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