Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019163 (hepatitis B)
 38,309 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

More controversial aspects of the administration of vaccines are discussed with particular emphasis on the uncertainties surrounding measurement and significance of immunological markers in predicting efficacy. New areas of vaccine development are highlighted, particularly the importance of greater understanding of the gut immune mechanisms which promise oral delivery routes for a variety of immunogens. Emphasis is laid on the requirement for expert administration of intradermal injection if protection is to be reliable. Several new vaccines have been introduced recently and relevant issues relating to typhoid, cholera and hepatitis A vaccines are discussed. New possibilities for immunisation against travellers diarrhoea are appraised. The required frequency of booster doses is discussed for several vaccines where it is found that long term protection has often not been well researched. This is nowhere better demonstrated than with hepatitis B. Finally less commonly used vaccines are discussed and the importance of assessing true risk before deciding on use is emphasized.
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PMID:Travel vaccines--a review of current thinking. 833 95

A 31-year-old man was hospitalized for evaluation of chronic diarrhea accompanied by profound dehydration, abdominal pain, nausea, vomiting, and low-grade fever. He had been identified as hepatitis B surface antigen-positive in 1983 and HIV antibody-positive two years later. In 1987, after a diagnosis of Pneumocystis carinii pneumonia, he had been placed on zidovudine and prophylactic pentamidine. Subsequently, thrush developed, which was treated with nystatin. The patient's gastrointestinal symptoms were of about six months' duration and originally had responded fairly well to diphenoxylate. More recently, however, he had been losing weight steadily and had required emergency room rehydration on two occasions. A search for stool ova and parasites and routine enteric pathogens, conducted by the outpatient department, had revealed Cryptosporidium cysts.
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PMID:Evaluation of AIDS-related diarrhea. 838 Apr 25

A cross-sectional study of a cohort of 49 male human immunodeficiency virus (HIV)-infected intravenous drug users attending the Infectious Diseases Unit of the National University of Malaysia during 1991-94 yielded a clinical profile of these patients. The mean age of respondents was 33.2 years and the mean duration of intravenous drug use was 12.7 years. On average, these men had known of their HIV-positivity for 53.2 weeks. Intravenous drug use was the only reported HIV risk factor in 34 men (69%). Clinical symptoms at intake included fatigue (49%), weight loss (47%), night sweats (31%), fever (14%), and diarrhea (6%), while clinical findings included hepatomegaly (57%), lymphadenopathy (35%), and oral thrush (29%). Anemia (82%), leucocytosis (53%), hypoalbuminemia (43%), hyperglobulinemia (88%), elevated liver enzymes and hyponatremia (57%) were frequent laboratory findings. The prevalences of hepatitis B virus, cytomegalovirus, and toxoplasma infection were 12.1%, 72.7%, and 59%, respectively. A total of 91 diagnoses were made in these 49 patients: most common were pneumonia, tuberculosis, bacteremia, infective endocardiditis, mycotic aneurysm, and psychiatric disorders. The mean duration of known progression to acquired immunodeficiency syndrome (AIDS) in the 7 patients at this stage was 391 days. Pneumocystis carinii pneumonia was the most common AIDS-defining illness. Three months into the study, 19 men (57%) had defaulted, reflecting the difficulties of involving drug addicts in research and intervention projects. Moreover, 16 patients (33%) were first confirmed HIV-positive at presentation to the hospital, suggesting that many drug users' HIV status remains unknown until they develop symptoms requiring hospital care.
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PMID:A study of Malaysian drug addicts with human immunodeficiency virus infection. 906 11

A 32-year-old woman was admitted to our hospital because of diarrhea, fever, and liver dysfunction. IgM antibody to hepatitis C antibody and hepatitis B makers were negative. Antibodies to human deficiency virus was negative. Bacterial cultures of the stool were negative. Sigmoidoscopy on the 9th hospital day showed diffuse edematous and inflated mucosa in the rectum and left-sided colon. Multiple erosions and small ulcers were also present. Polymerase chain reaction examination revealed cytomegalovirus (CMV) DNA in the biopsy specimen of the rectum and the blood on the 10th hospital day. IgG antibody titer to CMV was low, but IgM titer was high. Her physical state had improved and fever resolved without anti-CMV therapy. Second sigmoidoscopy on the 24th hospital day showed normal mucosa. One month later the patient was free from any symptoms. Immunocompromised patients such as recipients of solid organ and bone marrow transplants, patients with AIDS, and patients with malignancies frequently complicate CMV colitis, which can be a major cause of death. Thus, CMV colitis is rarely overlooked in immunocompromised patients. Only a few cases of CMV colitis are reported in adult patients with no risk for CMV infection or associated disease. CMV colitis should be concluded in the differential diagnosis of acute or subacute colitis even in immunocompetent patients.
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PMID:[Cytomegalovirus colitis in a normal woman]. 910 68

International travel has increased enormously in recent years. With the greater movement of people have come increased encounters with a wide variety of diseases: malaria, dengue, cholera, typhoid fever, Ebola virus, and many more. The need for greater scope, consistency, and knowledgeability in pretravel health care to meet these challenges has been met by the emergence of the discipline of travel medicine. Travelers are well advised to become informed of the risks they face and to take steps to minimize those risks. After reviewing a traveler's medical history and a detailed itinerary, a travel medicine practitioner can offer expert advice on behavioral modifications, immunizations, and chemoprophylaxis regimens which will increase the traveler's margin of safety. The issues most frequently addressed in a travel clinic include treatment of traveler's diarrhea, malaria chemoprophylaxis, and immunizations, for hepatitis A, typhoid fever, tetanus/diphtheria, influenza, pneumococcus, hepatitis B, polio, meningococcus, measles, mumps, rubella, varicella, and rabies. Pretravel consultation must consider the age and underlying health problems of the traveler, the nature of the trip (wilderness, jungle, rural, urban, resort, or cruise), the duration of travel, and the latest available information on the site in terms of disease outbreaks, terrorism, and natural calamities.
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PMID:A week in the life of a travel clinic. 933 67

A 21-year-old male presented with a 1-month history of fever, diarrhea, fatigue, sore throat, mouth lesions, lymphadenopathy, and a 9-kg weight loss. His medical history was remarkable for peptic ulcer disease, urinary tract infections, recent 5-month history of asthma, and pericarditis 4 months earlier. He had two suicide attempts, one of which was prompted by turmoils about his homosexuality, a history of polysubstance abuse, including intravenous drugs, and unsafe sex practices. Initial HIV-1 antibody by ELISA, HIV-1 antigen test, and HIV-1 culture were all negative, as were the urinalysis and serologies for hepatitis B and C. Four months later HIV-1 antigen test was still negative, but ELISA and Western blot test were positive, and his CD4 count was dropping. This case was consistent with severe primary HIV disease, with negative HIV antibody test due to the recent exposure to the virus; seroconversion took approximately 5 months.
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PMID:Fever, Adenopathy, Thrush, and a Negative HIV Antibody Test. 1035 89

Twenty-four patients with chronic hepatitis B virus (HBV), antibody to hepatitis B e antigen (anti-HBe), HBV DNA positivity, and alanine transaminase (ALT) elevation who failed previous interferon alfa (IFN-alpha) therapy were included in a pilot study of combination therapy with ribavirin and IFN-alpha. The patients received daily oral ribavirin (1,000-1,200 mg according to body weight) plus 5 million units (MU) IFN-alpha2b three times a week for 12 months and were followed-up for 12 months. The median viremia level decreased significantly at the end of treatment (1.2 x 10(3) copies/mL) and follow-up (4.0 x 10(2) copies/mL) compared with the baseline (3.0 x 10(6) copies/mL; P <.05). After 12 months, 8 of 24 (33%) patients had cleared HBV DNA and 12 (50%) had normal ALT levels. At the end of the study virological and biochemical response was 50% and 21%, respectively. Thus, virological and biochemical response sustained in 5 of 24 (21%) patients retreated with ribavirin and IFN-alpha; none of them lost hepatitis B surface antigen (HBsAg). Liver histology improved in 2 of 4 sustained responders but in none of the 12 nonresponders with paired biopsies (P =.05). The response was independent of dose and duration of previous treatment, viral load, or the distribution of HBV precore wild-type/mutant variants. However, sustained responders had significantly higher necroinflammation (P =.036) and fibrosis (P =.007) scores. IFN-alpha-related side effects were mild and reversible on discontinuation. In 4 (17%) patients who suffered nausea and diarrhea the ribavirin dosage was reduced by 50% after 1 month of therapy and finally discontinued in all of them. No patient had liver disease decompensation. In summary, combination therapy with ribavirin and IFN-alpha may be efficacious to treat viremic anti-HBe-positive patients with chronic hepatitis B who have failed previous IFN therapy.
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PMID:Pilot study of combination therapy with ribavirin and interferon alfa for the retreatment of chronic hepatitis B e antibody-positive patients. 1065 77

The primary aim of this study was to assess the tolerability and immunogenicity of a new Haemophilus influenzae type b (Hib)/AlPO4 (CHIRON, SpA) vaccine, in two-month-old healthy infants. Twenty-three subjects were enrolled and administered the new Hib vaccine containing AlPO4 adjuvant at two, three and four months of age concomitantly with diphtheria-pertussis-tetanus (DPT) and hepatitis B vaccines according to the local program. Children were observed for 30 minutes after each immunization for any immediate local and systemic reactions. An active surveillance for side effects was performed on the 2nd and 7th days following each immunization by telephone. Families also filled out diaries for the first seven days. From the 2nd day to the next immunization only data about adverse events necessitating a physician's visit or about serious adverse events were collected. Blood samples were obtained before the first immunization and one month after the third dose for evaluation of anti-polyribosylribitol phosphate (PRP) antibody response. Local reactions at the Hib site were mild and less frequent compared to those observed at the DPT site. Systemic reactions noted after the three immunizations were fever in 70 percent, irritability in 48 percent, persistent crying in 26 percent, change in eating habits in 22 percent, diarrhea in 17 percent, sleepiness in 17 percent, vomiting in 9 percent, and unusual crying in 4 percent of the cases. There was no serious adverse event. One hundred percent and 95 percent of children achieved an anti-PRP antibody response over 0.15 microg/ml and 1.0 microg/ml, respectively. The geometric mean titer was 15 microg/ml and the geometric mean ratio 84. It was concluded that the new (Hib)/AlPO4 vaccine is safe and well tolerated, and induced a good PRP antibody response in healthy two-month-old infants.
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PMID:Safety, tolerability and immunogenicity of a Haemophilus influenzae type b vaccine containing aluminum phosphate adjuvant administered at 2, 3 and 4 months of age. 1077 Jan 9

A 26-year-old male patient with mitral valve prolapse and HLA-B27 antigen received endodontic treatment for dental caries. Two weeks later fever, dysuria, diarrhea, sterile inflammatory arthritis of lower limbs, enthesitis, dactylitis, conjunctivitis, and uveitis consecutively developed. Blood culture performed at the time of active arthritis yielded Streptococcus viridans. He did not have any history of psoriasis, acute infectious diarrhea, chronic inflammatory bowel diseases, or sexually transmitted diseases. Laboratory studies also excluded the possibility of infections by human immunodeficiency virus, hepatitis B or C virus, chlamydia, and streptococci from the upper airway. This report indicates that Streptococcus viridans can be the triggering microorganisms of Reiter's syndrome in some circumstances.
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PMID:Reiter's syndrome caused by Streptococcus viridans in a patient with HLA-B27 antigen. 1089 81

The 20th century has witnessed many important events in the control of infectious diseases that mostly affect children. In addition to the eradication of smallpox, the interruption of poliomyelitis transmission in many countries with a distinct possibility of its eradication by the turn of this century are some of the major achievements. Also, the rates of other vaccine preventable diseases such as measles, pertussis and diphtheria have gone down significantly. The discovery and use of vaccines have made it possible to save approximately 8 million deaths, annually. This is in addition to the reduction in millions of children's suffering and disability. It is now important to build on these gains through adequate utilisation of other vaccines e.g., hepatitis B, typhoid and Haemophilus influenzae type b that are currently available, but in limited use. But, a high level of coverage for any vaccination programme is a pre-requisite to witness the effective reduction of the specific disease against which child population is vaccinated. This paper reviews the coverage levels by surveys in the last 3 years. It has been observed that vaccination coverage levels are falling. Keeping the promises of immunising every child to fulfill his/her right is the need of the hour. To achieve this the major action points are: (a) The need for organising fixed immunisation sessions at the community, where low proportion of sessions are held; and (b) The need to improve demand generation activities where the coverage is poor despite better service availability at the community level. Therefore, the challenge for the next century is to make sure that the enormous impact of vaccines on the health and well-being of the population is maintained as well as expanded. Vaccines that effectively prevent rotavirus diarrhoea, pneumococcal pneumonia, menigococcal meningitis, if made available, could prevent deaths up to two million a year. Research efforts are currently under progress to develop new vaccines against malaria, tuberculosis, shigella-induced dysentery, and Esch coli-induced diarrhoea.
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PMID:Trends and determinants of immunisation coverage in India. 1101 38


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