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)

In a pediatric hemodialysis unit, 10 children (aged 1 to 14 years) with chronic renal failure were immunized against hepatitis B infection (HB) by means of a vaccine. The vaccine was prepared by purification of Hepatitis B surface antigen (HGs Ag) from human sera and was formalin inactivated. Seven children were undergoing periodic hemodialysis and three were still managed with conservative treatment. There HBs Ag chronic carriers children were also dialysed in the unit and therefore represented a permanent high risk of HB for the whole unit. All the vaccinated children sero-converted for antibody to HBs Ag (anti-HBs) after vaccination. A follow-up from 16 to 33 months did not evidence clinical, biological and serological sign of hepatitis B in the vaccinated children. Presence of anti-HGs and absence of appearance of hepatitis B following immunization suggest that hepatitis B vaccine has represented for these children an effective means of prevention against hepatitis B infection.
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PMID:Vaccine against hepatitis B in children: prevention of hepatitis in a pediatric hemodialysis unit. 710 16

Hepatitis C virus (HCV) RNA and genotypes, as well as markers of hepatitis B virus infection, were surveyed in 171 patients with chronic liver disease, 276 patients with chronic renal failure, and 961 blood donors in Thailand. HCV RNA was detected in 30 (23%) of 128 patients with non-alcoholic chronic liver disease and hepatitis B surface antigen (HBsAg) in 60 (47%), and both HCV RNA and HBsAg in 3; the cause of liver disease was not established in 41 (32%) patients. HCV RNA was detected in 44 (20%) of 221 patients on maintenance hemodialysis or with kidney transplantation, but in none of 55 patients on peritoneal dialysis. Antibodies to synthetic HCV core peptides were detected in 39 (4.1%) of sera from 961 blood donors, and HCV RNA was detected in 8 (0.8%). Of the 90 HCV RNA samples from patients and donors, genotype V prevailed (46%) followed by II (22%), I (14%), III (3%), and VI (2%); genotypes were not classifiable into any of I-VI in the remaining 10%. There were six sera which contained HCV RNA, but were without antibody to HCV detectable by the second-generation enzyme immunoassay. HCV RNA titers were high in four patients with kidney transplantation, but low in one patient with chronic liver disease and one patient on maintenance hemodialysis. HCV RNA at high titer (> or = 10(4)/ml) was not classifiable in one patient. These results indicate HCV of novel genotypes in Thailand, seronegative HCV infection in patients with kidney transplantation, and a low risk of HCV infection in patients treated by peritoneal dialysis.
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PMID:Hepatitis C virus infection in patients with chronic liver disease or chronic renal failure and blood donors in Thailand. 753 58

A defect in the immune response of patients with chronic renal failure leads to low response rates and insufficient antibody concentrations following a number of highly recommended vaccinations. This has been shown before for immunization against hepatitis B and influenza. Few data are available concerning the efficacy of vaccination with tetanus toxoid in these patients. In a prospective, controlled study we vaccinated seronegative patients with chronic renal failure not on dialysis, patients on chronic intermittent hemodialysis, and patients after kidney transplantation with tetanus toxoid. The results were compared with those of a control group consisting of 13 age-matched patients with mild essential hypertension and normal kidney function. Only 11 of 20 (55%) patients in the chronic renal failure group and 16 of 23 (69%) in the dialysis group had a protective antibody response after triple vaccination. In contrast, all the patients in the control group and six of seven transplant patients seroconverted. The response to tetanus toxoid was highly associated with the response to a previously administered vaccination against hepatitis B. Responders to this vaccination also had a better response rate to tetanus toxoid. The antibody concentrations after vaccination were lower in all patient groups compared with the controls; the lowest titers were found in the transplant patients. Therefore, renal patients will need revaccination much earlier, and tetanus toxoid antibody levels should be checked if a patient is injured and potentially requires vaccination.
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PMID:Tetanus immunization and its association to hepatitis B vaccination in patients with chronic renal failure. 764 53

Patients with advanced chronic renal failure develop uremia, which is uniformly fatal if not treated by either RT or RD. At this time in the United States, there are about 200,000 individuals receiving dialysis at a cost of $7 billion a year. The precise biochemical reasons why uremia develops and why dialysis is partially successful are not fully understood. Many tests are performed on uremic patients to monitor their clinical course and the success of dialysis. The tests to judge the adequacy of dialysis and the amount and type of dialysis for individual patients (the DP) may not be optimal and are the subject of further study and modification. Some of these tests are classified in HCFA's Medicare Coverage Issues Manual as "other than routinely performed." Among these are NCTs, ECGs, chest x-rays, and tests for the presence of hepatitis B antigens and antibodies. At this time, HCFA allows reimbursement for the routine performance of these tests at specified frequencies. There is no reliable evidence to support the usefulness of such tests performed routinely in patients with ESRD. Only in the case of NCT is there a substantial literature that addresses the usefulness of this type of test in a manner specific for ESRD.
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PMID:Laboratory tests in end-stage renal disease patients undergoing dialysis. 770 85

In patients with chronic renal failure alterations in monokine production are a common feature. Their clinical relevance has not yet been proven. We show here a correlation between an overproduction of interleukin-(IL)-6 and tumor necrosis factor alpha (TNF alpha) upon stimulation with LPS by mononuclear cells in vitro and the clinical grade of immunodeficiency found in these patients. Higher levels of IL-6 and TNF alpha were correlated with an immunocompromized state, that is, non-responsiveness to hepatitis B vaccination, whereas patients with a better immune competence showed the same levels of these cytokines as healthy controls. Only the patients with a good immune function showed a high secretion of IL-10. The feedback mechanism of IL-10 for reducing monokine synthesis seems to be intact in these patients. Thus the secretion of IL-10 might be regarded as a compensatory mechanism which controls monokine induction by chronic renal failure and hemodialysis treatment. Immunocompromized patients who are unresponsive to hepatitis B vaccination seem to be unable to enhance IL-10 synthesis for control of monokine overproduction. This results in higher levels of IL-6 and TNF alpha that might be involved in the pathogenesis of reduced immune defense.
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PMID:Production of interleukin-6, tumor necrosis factor alpha and interleukin-10 in vitro correlates with the clinical immune defect in chronic hemodialysis patients. 772 41

The relationship between diminished response to hepatitis B vaccine in renal failure patients and serum creatinine level, age and other factors is unknown. The immune response of patients with renal failure of varying severity to hepatitis B vaccine was determined in this study. Sixty-eight patients with renal failure of varying severity who were negative for hepatitis B markers received four doses of hepatitis B vaccine, and anti-HBs titers were determined at 0, 1, 2, 3, 6, 8 and 12 months. Maximum anti-HBs titers were seen at 8 months. At this time 86% of patients with creatinine < or = 4 mg/dl but only 37% with creatinine > 4.0 mg/dl had a protective titer of > or = 10 mIU/ml (p < 0.002). Age was inversely related to anti-HBs titer (p = 0.045) and was independent of serum creatinine in predicting antibody response. We conclude that all patients with chronic renal failure should be immunized against hepatitis B as early as possible in the development of their disease, to ensure maximum response, and to minimize the effects of elevated serum creatinine and increasing age.
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PMID:Increasing serum creatinine and age reduce the response to hepatitis B vaccine in renal failure patients. 783 17

Anti HCV was checked using Enzyme Immuno assay (EIA) (C100-3-Abbott) in 68 patients with chronic renal failure (CRF) who were on maintenance haemodialysis and 48 patients on conservative management. Mean age of the patients was 50 years. The duration of illness ranged from 3 months to 18 years (mean 3 years). All patients were Hepatitis B surface antigen (HBsAg) negative. In haemodialyzed group 31 (46%) and in conservative group only 3 (6%) were Anti HCV positive. High Frequency of Anti HCV positivity in haemodialyzed group was related to period on dialysis (1 year) and number of blood transfusions (>4 units). Patients in whom dialyzer was re-used showed 60% positivity as compared to only 17% in those with single use. Anti HCV positivity predominated in females as compared to males, 42.6% vs 20.3%. Nine out of 10 patients with a history of jaundice and six out of 8 patients with raised transaminase levels were Anti HCV positive. Fifteen of 37 Anti HBc (IgG) positive cases were Anti HCV +ve.
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PMID:Hepatitis-C virus antibodies (anti HCV) in haemodialyzed vs non-dialyzed patients. 804 Sep 87

Patients undergoing chronic haemodialysis are at increased risk for infection with hepatitis B virus (HBV), but response to currently available vaccines is suboptimal. We undertook a 4-year prospective study of the efficacy of hepatitis B vaccine in patients with renal insufficiency, who were not yet dialysis-dependent. A booster dose of Recombivax HB was given at 3 or 4 years to those whose antibody levels fell below a predetermined point. Progression to dialysis was associated with poorer initial response to vaccination compared with those remaining dialysis-independent, but response to booster immunization was favourable in both groups. It is concluded that immunization of predialysis patients and subsequent booster vaccine results in a more favourable antibody response than has been seen historically in haemodialysis patients. Local endemicity and cost of vaccine should be considered when determining the best strategy for HBV immunization of patients with chronic renal failure.
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PMID:Hepatitis B vaccination and booster in predialysis patients: a 4-year analysis. 825 4

We studied the presence of Hepatitis C Virus (HCV) antibodies in a defined Malaysian population and examined the association, if any, between HCV and the Hepatitis B Virus (HBV), using sensitive recombinant DNA second generation Enzyme Immunoassay (EIA) test kits. This sero-prevalence study comprised 1,434 sera from eleven distinct groups comprising intravenous drug users (IVDU), haemophiliacs, male homosexuals, female prostitutes, healthy blood donors, staff of dialysis unit and laboratory personnel, chronic renal failure patients undergoing dialysis (CRFD), patients with liver cirrhosis, chronic active hepatitis, chronic persistent hepatitis and primary liver cancer. Except in laboratory personnel and dialysis staff, HCV antibodies were detected in each group of patients ranging from 3% in blood donors to 85% in IVDU. The main modes of HCV transmission identified were parenteral drug use, transfusion and/or dialysis related. The HBV was found to be the major viral etiological agent in 75% of chronic liver disease (CLD); while in 10% of cases both HCV and HBV were detected. HCV was implicated as the sole viral agent in only a small proportion (1.5%) of patients with chronic liver disease.
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PMID:Hepatitis C--the Malaysian story. 826 52

Recent knowledge into the pathophysiological mechanisms mediating the immune abnormalities characteristic of end-stage renal disease (ESRD) has focused on the dual activation versus deficiency state of immunocompetent cells. Despite major advances in renal replacement therapy, notably hemodialysis, no significant improvement in the immune status of uremic patients has been achieved. After a brief review of the role of T cells and B cells in the normal immune response, the functional and phenotypic T and B cell abnormalities observed in uremic patients are presented. Special emphasis is placed on our recent findings indicating that these abnormalities are observed at an early stage in the course of chronic renal failure, worsen with the progression of uremia, and are exacerbated by the dialysis procedure. The previous hypotheses that could reconcile the so-called Janus-faced behavior of T cells in uremia are updated in light of the recent findings obtained in the search of therapeutic strategies that could counteract the impaired responsiveness of patients with ESRD to vaccination against hepatitis B virus. Perspectives of research aimed at elucidating the respective role of T helper cell subpopulations (Th1 and Th2) could contribute to understanding of the mechanisms of the multifaceted process of uremia-related immune dysregulation and of the rationale for possible immunointervention strategies.
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PMID:T cells and B cells in chronic renal failure. 873 61


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