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Enzyme
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Target Concepts:
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Query: UMLS:C0019163 (
hepatitis B
)
38,309
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Hepatitis-B-surface antigen (HBsAg) was not detected by sensitive radioimmunoassays in the tear fluids of 6 HBsAg carriers with low and medium titers of HBsAg (less than 1:10,000) in the serum. However, HBsAg could be demonstrated in low concentrations in tear fluids of 5 of 6 HBsAg carriers with high serum titers (greater than 1:10,000). The concentration of HBsAg in the tear fluid was at least 100 times lower than in the sera of these 5 persons. Correspondingly HBsAg could be found in only 1 of the rinsing and in none of the storage solutions of the contact lenses of 7 persons with high titers of HBsAg in the serum (greater than 1:32,000). HBsAg was not adsorbed to smooth
HEMA
-lenses. Because of the low concentration of HBsAg in tear fluids and the dilution effect (about 5 x 10(-10)) the transmission of
hepatitis B
by multiple use of contact lenses by several persons during adaption is lighly unlikely. In addition, a special cleaning solution (Liprofin) can destroy nearly completely the antigenicity of HBsAg at 60 degrees C.
...
PMID:[Detection of HBsAg and HBeAg in cleaning, rinsing and storage solutions of contact lenses and in tear fluid of carriers of HBsAg (author's transl)]. 54 19
The present study compares two new factor VIII preparations currently used in the treatment of haemophilia. A Factor VIII was partially purified from plasma obtained from unpaid voluntary Belgian donors in the blood transfusion centers of Lille and Amsterdam and virus-inactivated by exposure to solvent-detergent (
FVIII
-SD) or by pasteurization (
FVIII
-P) respectively. The factor VIII content and the purity of both preparations were assessed in vitro, whereas in vivo we studied the recovery and the plasma half-life of both concentrates. The higher purity of
FVIII
-SD was confirmed. Factor VIII-P preparations contained more factor VIII than mentioned on the label. Both preparations gave good in vivo recoveries and half-lives. Patients who did not have antibodies to
hepatitis B
, hepatitis C or HIV at the initial screening, remained negative after six months treatment with the new concentrates. No patients developed neutralizing factor VIII antibodies. Furthermore patients appreciated the ease of administration of both preparations. In conclusion both
FVIII
concentrates are suited for the treatment of haemophilia A patients.
...
PMID:In vitro and in vivo evaluation of two factor VIII concentrates virally inactivated by solvent-detergent or by pasteurization. 166 50
Haemophilic patients are at increased risk from
hepatitis B
virus infection because of their need for blood product therapy. They are potentially poor responders to
hepatitis B
vaccine due to immunological abnormalities resulting from two causes: infection with the human immunodeficiency virus and treatment with clotting factor concentrates. The protective antibody response to
hepatitis B
virus in vaccinated haemophiliacs was investigated using a competitive enzyme-linked immunosorbent assay which employs a monoclonal antibody, RF-HBs-1, that recognises a virus-neutralising epitope on HBsAg. Serum samples from 55 haemophilic patients were studied at 7, 12, and 24 months after the first injection with HB vaccine. Twenty-four vaccinated normal subjects were used as controls. The level of neutralising antibody was found to correlate with the polyclonal anti-HBs response in the majority of subjects in both the control and patient groups. There was a small but statistically significant reduction in both antibody responses in the patients compared with the normal controls. Treatment with
FVIII
or FIX concentrate did not influence the antibody response in the patients. Eleven of the haemophilic patients were anti-HIV seropositive. This group had a significantly lower antibody response than anti-HIV negative patients, and this correlated with the duration of anti-HIV seropositivity, rather than with their T4 counts. We conclude that, following vaccination, the majority of haemophiliacs are able to mount a protective antibody response to
hepatitis B
virus. HIV infection was found to be the sole cause of immunological suppression of this response.
...
PMID:Protective antibodies to hepatitis B virus in haemophiliacs. 182 37
Incubation of an
AHF
concentrate with 0.3% tri(n-butyl)phosphate (TNBP) and 0.2% sodium cholate was shown to inactivate at least 10,000 infectious doses of lipid-enveloped viruses, including
hepatitis B
and non-A, non-B viruses and HTLV-III [Prince et al., Lancet i, pp. 706-710, 1986]. The use of TNBP/detergent combinations for virus sterilization was evaluated further to determine its effect on the structure and function of a wide variety of blood proteins. Vesicular stomatitis and Sindbis viruses were used as markers of virus inactivation. TNBP/detergent treatment did not significantly alter the function of
AHF
, factor VII, factor IX, factor X, fibrinogen, factor XIII, fibronectin, anti-HBsAg and anti-HA in normal serum globulin, haptoglobin, tumor necrosis factor, alpha-interferon, and both native and chemically polymerized stroma-free hemoglobin. As compared with partially purified derivatives, the extent of virus sterilization of plasma and component cryoprecipitate with 0.3% TNBP and 0.2% sodium cholate at ambient temperature could be improved by raising the TNBP concentration and temperature. Virus sterilization by TNBP/detergent mixtures appears to be generally applicable to blood protein derivatives.
...
PMID:Tri(n-butyl) phosphate/detergent treatment of licensed therapeutic and experimental blood derivatives. 311 Oct 89
Plasma derivatives can be separated into those with either a low or a high risk of transmitting viral hepatitis. Low-risk products, with few exceptions, will remain low-risk irrespective of the plasma from which they are manufactured because they are heated at 60 degrees C for 10 hours (Albumin, Plasma Protein Fraction) or because they contain protective antibodies (Immune Globulin). This would appear to be the case not only for
hepatitis B
but also for non-A, non-B hepatitis. The risk of
hepatitis B
associated with plasma derivatives is reduced but not eliminated by HBsAg screening of donors. Further decreasing the risk of
hepatitis B
associated with
AHF
or Factor IX lots, as well as newer products like AT-III, alpha-1 antitrypsin, Fibronectin, C-1 Inactivator, and Factor XIII, may be accomplished either by the combination of stabilization and heating or by assuring that these products contain an excess of anti-HBS. For highly-purified products with little residual immunoglobulin it may be necessary to add anti-HBs. The addition of antibodies against non-A, non-B hepatitis agents when they are identified, could prevent transmission of both forms of viral hepatitis by plasma derivatives. Methods to stabilize and heat high-risk plasma derivatives to inactivate hepatitis viruses have the potential to remove both
hepatitis B
and non-A, non-B hepatitis infectivity.
...
PMID:Plasma derivatives and viral hepatitis. 681 45
The Council of Europe and the EEC Council of Ministers have strongly promoted self-sufficiency for plasma products on the basis of voluntary non-remunerated donors. Several European countries have a programme of self-sufficiency with plasma products, either with national fractionation plants (e.g. Belgium, Finland) or based on contract fractionation (e.g. Norway, Slovenia). Advantages of national self-sufficiency includes epidemiological factors, economical factors and also ethical and moral issues. Self-sufficiency is one of the basic conditions for reducing the hazard of transmission of infectious diseases. Norway has been self-sufficient with coagulation factors since 1981. Price mechanisms and market forces have been important factors in ensuring the necessary plasma volume, and fractionation methods rendering high yields of factor VIII are initially preferred. This policy has resulted in a low prevalence of antibodies against human immunodeficiency virus (6%),
hepatitis B
virus (28%) and hepatitis C virus (41%). No Norwegian haemophiliacs have been infected with hepatitis A through
FVIII
concentrates.
...
PMID:Self-sufficiency and blood transmitted diseases. 749 63
A retrospective study was conducted to evaluate the status of hemophilia care in Zimbabwe. Parirenyatwa Hospital in Harare has the only hemophilia clinic in Zimbabwe. This monthly clinic facilitates diagnosis, registration, and long-term management of hemophilia. In mid 1993, there were 190 registered hemophilia cases in Zimbabwe. During 1991-1993, only 70 patients were seen more than once in the clinic. The National Blood Transfusion Service (NTSB) supplies blood products for hemophiliacs. Solvent-detergent treated Factor VIII and IX (
FVIII
and FIX, respectively) concentrates are imported from South Africa. They are the most common blood products used in Harare. Laboratory staff screen fresh frozen plasma and cryoprecipitate for HIV antibody and
hepatitis B
surface antigen. Five NTSB branches also distribute blood products. Blood products are expensive. Most hemophiliacs are covered by a social welfare program. 45 hemophiliac cases had been receiving home care since 1987. 67% of 24 home care patients receiving
FVIII
did not store
FVIII
packs in a refrigerator. Most home care patients injected blood products 0-6 hours from onset of symptoms (e.g., nosebleed). About 33% did not know how to calculate the dose required. All home care patients were satisfied with treatment. In 1992, Parirenyatwa Hospital registered 3 deaths of hemophiliacs. When considering only the 70 regular clinic attenders, the mortality rate for 1992 was 5.7%. Of the 73 hemophiliac cases tested for HIV infection, 32% tested positive. All HIV-positive hemophiliac cases began treatment for hemophilia before 1986, the year before HIV testing of hemophiliacs started. So far, about 33% of hemophiliacs tested positive for hepatitis C. The only social support system for hemophiliacs is the Zimbabwe Hemophilia Association. None of the 38 hemophiliacs screened for coagulation factor inhibitors had any inhibitors. Hemophilia care in Zimbabwe has a good start and can be used as a model for other developing countries. Expansion and close supervision of the effective home treatment program is advised.
...
PMID:Haemophilia care in Zimbabwe. 877 37
Most haemophiliacs treated with non-virally-inactivated clotting factor concentrates have been infected with hepatitis C virus (HCV). We have studied the natural history of chronic HCV infection by following all 138 HCV-positive patients from our centre for periods of up to 28 years. As well as the clinical and biochemical characteristics, we studied 116 liver samples from 63 patients obtained at elective biopsy (n = 103) or autopsy (n = 13). 36 (26%) of the patients were HIV positive, and three were chronic carriers of
hepatitis B
. Evidence of previous exposure to hepatitis A and B was found in 37.2% and 48.1% respectively. Raised transaminase levels were found in 82.6% of patients. 11 of 15 patients with normal transaminases tested by PCR for HCV RNA were positive, indicating that most patients, even in this group, have chronic hepatitis C infection. Cirrhosis was diagnosed by liver histology in 19 patients, and nine patients developed liver failure. The incidence of cirrhosis rose rapidly 15 years after HCV infection to 15.6 per 1000 person-years. Multivariate analysis showed that HIV status, length of time since HCV infection and age at HCV infection were independently associated with both the development of cirrhosis and liver failure. Two patients developed hepatocellular carcinoma: one of these was exposed only to a single batch of
FVIII
concentrate 11 years earlier. Chronic hepatitis C is increasingly recognized as a major cause for morbidity and mortality in haemophiliacs, especially those who are HIV positive and who were infected at an older age.
...
PMID:The natural history of chronic hepatitis C in haemophiliacs. 907 37
A patient with severe haemophilia A underwent orthotopic liver transplantation because of changes correlated to end-stage liver cirrhosis due to
hepatitis B
, C and D infection. Replacement therapy was carried out for 4 days and the clinical course was uneventful. At the time of reporting the patient has a normal working life.
FVIII
plasma concentration is normal. The indirect hyperbilirubinaemia may be related to the Gilbert's anomaly of the donor.
...
PMID:Orthotopic liver transplantation in a patient with severe haemophilia A and with advanced liver cirrhosis. 1046 84
The present study summarizes the results of 12 cardiac surgical procedures performed in a carrier of Haemophilia B and in six patients with Haemophilia A at a single centre from 1979 to 1998. The median age of the patients at the time of intervention was 56 years ranging from 18 years to 73 years. The six patients with Haemophilia A ranged in severity from moderately to mildly affected. Three patients were hepatitis C antibody positive. No patients were HIV antibody or
hepatitis B
surface antigen positive. The cardiac procedures included cardiac catheterization (n=4), coronary artery bypass surgery (n=2), percutaneous transluminal coronary angioplasty (n=1), cardiac valve replacement (AVR n=1 and AVR/MVR n=2), and closure of an atrial septal defect and subsequent drainage of a pericardial effusion (n=1). No patients had demonstrable inhibitors at the time of surgery. Haemostasis was achieved with
AHF
in 10/11 procedures and high purity factor IX (Immunine) in one procedure. The initial procedures involved intermittent bolus factor therapy while more recently,
AHF
was administered by continuous intravenous infusion. All patients demonstrated excellent intra- and post-operative haemostasis. These results, although from a small and varied group of patients, demonstrate that cardiac surgical procedures can be performed safely in patients with Haemophilia.
...
PMID:Cardiac surgery and catheterization in patients with haemophilia. 1078 Nov 93
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