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)

Little is known about the factors contributing to the reduced antibody response to hepatitis B vaccination in peritoneal dialysis patients. The influence of nutritional status [as assessed by serum albumin and nitrogen protein appearance (nPNA)], residual renal function, and dialysis adequacy (weekly Kt/V(urea)) on the development of hepatitis B antibodies was examined in 32 continuous ambulatory peritoneal dialysis/continuous cycling peritoneal dialysis patients. Vaccination with Engerix 40 micrograms given intramuscularly at 0, 1, 2, and 6 months resulted in a 63% response with 20 converters and 12 nonconverters. Patient age, sex, months on peritoneal dialysis, and race were not different among converters and nonconverters. Median serum albumin (3.75 vs 3.8 g/dL), nPNA (0.96 vs 0.94 g/kg/day initial and 0.78 vs 0.84 g/kg/day final), residual renal function (5.4 vs 4.0 mL/min), and final weekly Kt/V (2.12 vs 1.96) were not different among converters and nonconverters, respectively. Initial Kt/V was higher in converters (2.37 vs 2.01, p = 0.02). Nutritional status, residual renal function, and weekly Kt/V in nutritionally replete and well-dialyzed peritoneal dialysis patients do not predict response to hepatitis B vaccine. Patients with higher weekly Kt/V early in the course of peritoneal dialysis may be more likely to respond to hepatitis B vaccination.
Adv Perit Dial 1996
PMID:The influence of nutritional status, dialysis adequacy, and residual renal function on the response to hepatitis B vaccination in peritoneal dialysis patients. 886 27

This study evaluates the correlations between liver histology, cytolysis, cryoglobulinaemia, co-infection with hepatitis B virus, and immunosuppressive treatment in renal transplant patients with HCV infection. Forty-five of 378 kidney recipients (January 1973-September 1993) had anti-HCV antibodies (prevalence = 11.9%) detected by second generation ELISA (Abbott Pasteur). Viral RNA was detected in those patients by RT-PCR in serum and liver. HCV-positive patients underwent liver biopsy to assess their liver tissue lesions according to Knodell's score. Patients were also screened for Hbs, Hbc and Hbe antigens (ELISA, Abbott) and cryoglobulins (immunobinding, SEBIA). Of the 45 HCV+ patients, 38 (84.4%) had persistent viral replication in the serum and 29 of the 30 patients having undergone liver biopsy had PCR-positive liver tissue. The liver biopsies revealed no active hepatitis lesion in 14 patients (46.6%, Group CAH-), 16 (53.3%) had chronic active hepatitis (Group CAH+) and 3 (10%) had signs of cirrhosis. Comparing groups CH+ and CH- showed that viral replication was detected in all 16 patients with chronic active hepatitis, versus 10/14 patients in the CAH- group (P < 0.05). Patients were more frequently treated with azathioprine in the CH+ group (12/16 vs 8/14; P < 0.05). The duration of renal transplantation was significantly longer in patients with a Knodell score > 5 (58 +/- 56 months vs 35 +/- 29 months, P < 0.001). Incidence of co-infection with HBV was similar in both groups. The mean values of alanine aminotransferase correlated with the Knodell score (r = 0.4, P = 0.03). Mixed cryoglobulinaemia was more common in the replicant forms of HVC infection (12/38 vs 1/7, P < 0.0001). This study shows that liver histological lesions are correlated with HCV viral replication, are more frequent in patients treated with azathioprine and are more severe as the duration of transplant is longer.
Nephrol Dial Transplant 1996
PMID:Hepatitis C after renal transplantation: histopathological correlations. 891 55

Eighty-three patients with chronic end-stage renal failure, including 65 on haemodialysis and 18 on intermittent peritoneal dialysis, were evaluated for hepatitis B virus profile and antibodies to hepatitis C virus (HCV). All those positive for HBsAg were excluded from the study. Nineteen patients were found to be positive for antibodies to HCV by the ELISA II test. Eight cases were already positive for HCV antibody when they started dialysis in our unit, the other 11 became positive during dialysis in our unit. Only one of the patients on peritoneal dialysis was positive for HCV. A liver biopsy was obtained from 17 patients, who consented to the procedure. All the cases were evaluated for the number of blood transfusions received, HIV infection and the approximate time of contracting the HCV infection. Liver enzymes were determined every month. Only three patients had abnormally raised serum aminotransferase at the time of biopsy. The various histopathological lesions detected were chronic active hepatitis (n = 3, including one with changes consistent with cirrhosis), chronic persistent hepatitis (n = 4), non-specific hepatitis (n = 3) and haemosiderosis (n = 3); four biopsy samples were normal. There was no correlation between the biochemical and histopathological changes. Moreover, patients with normal serum aminotransferase levels had abnormal histopathological changes. All were negative for HIV and none of the patients had received a renal graft. Twelve patients had received blood transfusions varying from 2 to 12 units, four had not received any blood, and in one the history of blood transfusion could not be confirmed. The four patients with anti-HCV antibodies who had not received blood transfusion had relatively mild disease--non-specific hepatitis (n = 2) or normal biopsy (n = 2). One patient with cirrhosis died 30 months after liver biopsy from hepatic insufficiency and three received renal transplants. Others are continuing on dialysis and their biochemical tests are within normal limits 12-45 (30 +/- 14) months after biopsy. In conclusion, biochemical tests are poor indicators of liver disease, and liver biopsy is a definitive way of evaluating the patients of dialysis with positive HCV antibodies for prognosis.
Nephrol Dial Transplant 1996 Nov
PMID:Liver disease in dialysis patients with antibodies to hepatitis C virus. 894 88

In patients with chronic renal failure (CRF), parenteral transmission of the hepatitis B virus (HBV) is common. The response to the recombinant vaccine is 50%-80% of seroprotection. Therefore, to improve seroprotection, different strategies such as dose augmentation, vaccination at the predialysis stage, subcutaneous application, and using interleukin were tried, with unsatisfactory results. In children, there are no studies demonstrating the efficacy of the vaccine. The aim of this study was to evaluate the efficacy of the recombinant vaccine in children with CRF, in late as well as early phases, through the quantification of antibodies against the surface antigen in response to different doses of the vaccine against HBV. There were 103 patients who were assigned to three groups: (1) 25 patients with CRF in the early phase (undergoing pharmacological treatment only); (2) 67 patients with CRF in the late phase (treatment with peritoneal dialysis or hemodialysis); (3) 11 patients with CRF in the early phase (undergoing low-dose pharmacological treatment only). The antibodies against the serum antigen (HBsAg) were measured by the aEIA method. Urea, creatinine, and creatinine clearance were measured at 0, 2, and 12 months. In our seroprotection results we observed that group 1 and 3 developed earlier seroconversion (50% first month). In patients undergoing dialysis the seroconversion happened in 91% at month 13, but with lower concentration than group 1 and/or group 3 (p < 0.05). In conclusion, there is a better response in predialysis patients. The levels of antibodies are similar in groups 1 and 3 (with small doses), which are similar to the complete doses for an efficient immunity in children with chronic renal failure.
Adv Perit Dial 1997
PMID:Comparison of the response to the recombinant vaccine against hepatitis B virus in dialyzed and nondialyzed children with CRF using different doses and routes of administration. 936 Jul 2

Pediatric patients on dialysis should receive all the vaccines currently recommended by the ACIP and the AAP for healthy children, except the oral polio vaccine (34, 35). Adult patients should receive the hepatitis B vaccine series, pneumococcal vaccine, yearly influenza vaccinations, tetanus-diphtheria toxoids, and varicella vaccine, if they are susceptible (33, 48, 69). Vaccines are well tolerated by these patients (33), but higher doses and/or additional boosters may be required periodically to adequately protect dialysis patients from vaccine-preventable diseases (33, 36, 37, 82, 83). Following vaccination, antibody concentrations for hepatitis B vaccine should be measured annually and booster doses administered when antibody concentrations fall below protective levels (33, 38). Although both children and adults on dialysis may show an impaired and/or delayed immunologic response to certain antigens, particularly hepatitis B virus and S. pneumoniae, appropriate immunizations can significantly reduce the risk of serious complications from vaccine-preventable diseases (11, 84). Because the protection these vaccines provide may be incomplete or transient, infection control strategies at hospitals and other health care facilities should be implemented simultaneously. Health care providers are encouraged to assess each patients need for vaccinations individually and formulate immunization strategies early in the course of progressive renal disease, ideally before the patient requires dialysis.
Semin Dial
PMID:Vaccine recommendations for patients on chronic dialysis. The Advisory Committee on Immunization Practices and the American Academy of Pediatrics. 1079 13

Twenty years after its introduction, peritoneal dialysis (PD) is a well-established alternative to hemodialysis (HD) as a modality of renal replacement therapy. Much debate and research is apparent in the literature, comparing hemodialysis and PD as "opposite" modalities and trying to ascertain which modality should be more optimal. In our opinion, HD and PD are two distinct modalities, each with its own advantages and disadvantages. In addition, it is clear that for both HD and PD, rates of technique failure are high, causing patients to transfer between modalities. The question is thus not which modality is best, but rather, which flow-chart of modalities makes best use of the advantages of each modality, while avoiding its disadvantages. In this respect, HD and PD appear to be complementary modalities. The better preservation of residual renal function, lower risk of infection with hepatitis B and C, better outcome after transplantation, preservation of vascular access, and lower costs are arguments to promote PD as a good initial treatment. When PD-related problems arise (adequacy, ultrafiltration, peritonitis, patient burnout), a timely transfer to HD has to be planned. This editorial tries to review arguments supporting the complementary nature of both modalities, and especially the role of PD as the first-line renal replacement therapy.
Perit Dial Int
PMID:The role of peritoneal dialysis as the first-line renal replacement modality. 1100 66

87-91% but still, 0.6% of those that did respond to vaccination became infected. The infection rate of the vaccinated populations in the Pacific Islands ranged between 0.7 and 3.8%, which is comparable to Taiwan. A vigorous polyclonal response This communication discusses the current status of research in the hepatitis B virus in relation to the South Pacific. The hepatitis B virus (HBV) is a small DNA virus--3200 nucleotides. It has a circular genome and replicates through an RNA intermediate giving this DNA virus many characteristics similar to RNA viruses. Viral genomes can be single-stranded (+ or - sense) or double-stranded. If not vaccinated, infants born to HBeAg positive mothers (i.e. with high viral titer) have a 90% chance of being infected and becoming HBV carriers themselves. Mutants that affect the major antigenic determinant in HBV surface antigens are probably responsible for HBV infection despite immunization and mutants in the polymerase protein may render HBV resistant to therapy with nucleoside analogs. Within HBV seven genotypes A-G have been reported that is, HBV genotype A (HBVA), HBV genotype B (HBVB) etc. HBV is endemic worldwide with an estimated that 5% of the worlds population being carriers. Before the introduction of vaccination programs carrier rates varied between 5-30% in communities of these ethnic groups, and in some cases 80-90% of a community tested positive for HBV markers (i.e. were infected or had been infected). In Taiwan, of vaccinated babies born to HBV positive mothers, the proportion of those that responded to vaccination varied between will usually result in an acute infection and viral clearance. An associated problem with HBV, in the South Pacific, is the hepatitis delta virus (HDV). HDV is a satellite viroid-like RNA virus that requires HBV for replication. It can either co-infect with, or super-infect upon HBV infection resulting in acute infection and/or chronic infection respectively.
Pac Health Dialog 2001 Mar
PMID:Hepatitis B virus genotypes: a South Pacific perspective. 1201 22

In December 2000, all U.S. dialysis centers were surveyed regarding selected patient care practices and dialysis-associated diseases. The results were compared with similar surveys conducted in previous years. During 1997-2000, the percentage of patients vaccinated against hepatitis B virus infection increased from 47% to 58% and the percentage of staff vaccinated increased from 87% to 88%. In 2000, an estimated 64% of patients were vaccinated for influenza and 27% for pneumococcal pneumonia. In 2000, routine testing for antibody to hepatitis C virus (anti-HCV) was performed on staff at 40% of centers and on patients at 58% of centers; anti-HCV was found in 1.7% of staff and 8.4% of patients. During 1995-2000, the percentage of patients who received dialysis through central catheters increased from 13% to 24%; this trend is worrisome because infections and antimicrobial use are higher in patients receiving dialysis through catheters. However, during the same period the percentage of patients receiving dialysis through fistulas increased from 22% to 28%. In 2000, 25% of catheters were used for new patients awaiting an implanted access, 28% for established patients with a failed access awaiting a new implanted access, 41% as an access of last resort, and 6% for other reasons, including patient preference. The percentage of centers reporting one or more patients infected or colonized with vancomycin-resistant enterococcus (VRE) increased from 11.5% in 1995 to 32.7% in 2000.
Semin Dial
PMID:National surveillance of dialysis-associated diseases in the United States, 2000. 1210 Apr 54

The total number of end-stage renal failure patients treated by renal replacement therapy increased, from 1435 at 31 December 2000 to 1542 at 31 December 2001 (7.5% increase). At the end of 2001, 771 p.m.p. end-stage renal failure patients were treated by renal replacement therapy in Slovenia, 73% of them with haemodialysis, 7.4% with peritoneal dialysis and 19.7% had a functioning graft. Incident (new) patients in 2001 were 144 p.m.p. The number of haemodialysis patients increased by 7% compared with the year before, the number of patients on peritoneal dialysis decreased by 3.4% and the number of patients with a functioning graft increased by 13.9%. The gross mortality rate of dialysis patients was stable between the years and was 10.4% in 2001. Erythropoietin therapy was prescribed to 87.3% of dialysis patients (88.9% of haemodialysis patients and 71.7% of patients on peritoneal dialysis). The number of dialysis patients positive for hepatitis B or hepatitis C virus is relatively low, 3.2% of all dialysis patients; an increased number of MRSA-positive dialysis patients is observed in 2001 (2.9% of all dialysis patients). The epidemiology of renal replacement therapy in Slovenia is in general comparable with that of the countries of the European Union.
Nephrol Dial Transplant 2003 Jul
PMID:Renal replacement therapy in Slovenia: annual report 2001. 1281 72

There has been much attention directed toward the high mortality of patients with end-stage renal disease (ESRD), with much of the focus on cardiovascular disease. However, infectious disease is the second most common cause of death in late-stage chronic kidney disease (CKD) patients. Although CKD patients are immunocompromised, some vaccines such as influenza, retain their efficacy and reduce infection rates with a standard immunization schedule. Other vaccines, such as hepatitis B and pneumococcal vaccines, require more frequent and/or higher doses to produce and maintain protective antibody levels. Attention has recently been given to the efficacy of influenza vaccination in ESRD patients in reducing morbidity and mortality. Centers with vaccination protocols have demonstrated reduced infection rates and resultant decreased morbidity and mortality. It could be extrapolated from this that widespread vaccination would reduce the total cost of ESRD patient care, and potentially improve patient well-being. However, vaccination appears to be underutilized in CKD patients, and it is a readily available intervention to improve outcomes.
Semin Dial
PMID:The value of vaccination in chronic kidney disease. 1525 Sep 26


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