Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic hepatitis C virus (HCV) infection, including its sequelae, is an important healthcare problem in Taiwan. The seroprevalence of HCV infection in first-time blood donors in Taiwan is 1.2% and an estimated 2-5% in the general population, with a great geographic variation. Genotype 1b is the most prevalent HCV genotype in Taiwan, with a prevalence rate of 50-70%. An increasing incidence of hepatocellular carcinoma (HCC) is mainly attributed to HCV infection, while the declining role of HBV is observed in Taiwan. The seroprevalence of hepatitis B surface antigen among patients with HCC was 90% three decades ago, while recently, chronic HCV infection accounts for more than 30% of HCC patients in the National Taiwan University Hospital. With the advent of a combined conventional interferon (IFN)-alpha and ribavirin therapy, to which Taiwan has contributed in the early study phase, the sustained virological response rate has been greatly improved compared with IFN monotherapy. The sustained virological response rate in Taiwanese patients treated with the combination therapy for 6 months has reached up to 50-60%, which is higher than that reported in patients from the Western countries receiving a 12-month regimen. It is necessary to search for the underlying mechanisms for the better treatment outcome with IFN plus ribavirin combination therapy in Taiwanese patients. Whether long-term effects of IFN plus ribavirin therapy can reduce the incidence of HCC needs to be established.
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PMID:Combined interferon and ribavirin therapy for chronic hepatitis C in Taiwan. 1616 95

Chronic hepatitis C virus (HCV) infection may lead to cirrhosis and hepatocellular carcinoma. Interferon (IFN)-alpha is effective in the treatment of chronic hepatitis C. The rate of response to IFN is enhanced by increasing the IFN dose. Extending the treatment duration can reduce the relapse rate. Addition of ribavirin to IFN increases the sustained virological response (SVR). Thus, combination therapy with IFN and ribavirin was adopted for the treatment of chronic hepatitis C in Kaohsiung Medical University Hospital in 1998. Approximately 60% of patients receiving IFN/ribavirin therapy gained SVR. IFN 6 million units three times per week combined with daily ribavirin for 6 months achieved SVR more frequently than combination therapy with 3 million units. Factors for SVR in these combination regimens were HCV genotype, viral load and early virological response. Long-term follow-up of patients treated with IFN has shown that SVR might reduce the risk of progression to cirrhosis and hepatocellular carcinoma. Pegylated (peg)-IFN has a longer half-life and better efficacy. Combination therapy with peg-IFN and ribavirin accomplished higher SVR than conventional IFN and ribavirin. A multicenter clinical trial was conducted in Taiwan to compare the efficacy of combination therapy between peg-IFN/ribavirin and conventional IFN/ribavirin for 6 months. SVR was higher in patients receiving peg-IFN and ribavirin, especially in those infected with HCV genotype 1b. Based on the results obtained, the national health insurance started to sponsor the combination therapy in October 2003, with a suggested duration for 6 months. Some small-scale studies in Taiwan have postulated higher SVR for treatment duration of 12 than of 6 months in patients with genotype 1b. Further investigation should be conducted in the near future.
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PMID:Treatment of chronic hepatitis C in southern Taiwan. 1616 97

Chronic hepatitis C virus (HCV) infection is a worldwide health problem causing serious complications, such as liver cirrhosis and hepatoma. Alpha interferon (IFN-alpha) or its polyethylene glycol-modified form combined with ribavirin is the only recommended therapy. However, an alternative therapy is needed due to the unsatisfactory cure rate of the IFN-based therapy. Using a modified reporter assay based on the HCV subgenomic-replicon system, we found that sodium stibogluconate (SSG), a compound used for leishmania treatment, suppressed HCV replication. We have previously reported that SSG is effective at inhibiting HCV replication in a cell line permissive for HCV infection/replication and in an ex vivo assay using fresh human liver slices obtained from patients infected with HCV (26). In this study, we show that the SSG 50% inhibitory dose for HCV replication is 0.2 to 0.3 mg/ml (equivalent to 345 to 517 microM of Sb) in the HCV subgenomic-replicon system. We also found that SSG and IFN-alpha exert a strong synergistic anti-HCV effect in both the traditional isobologram analysis and the median effect principle (CalcuSyn analysis). The combination of SSG and IFN-alpha could sustain the antiviral response better than SSG or IFN-alpha alone. The results suggest that SSG may be a good drug candidate for use in combination with other therapeutics, such as IFN-alpha and ribavirin, to treat HCV infection.
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PMID:Inhibition of hepatitis C virus replication by antimonial compounds. 1618 98

Chronic hepatitis C remains the significant epidemiological and clinical problem. Its serious sequelae include cirrhosis, liver failure and hepatocellular carcinoma. The only approved treatment of chronic hepatitis C are interferon (IFN) alfa-based regimens. Pegylated IFN alfa in combination with ribavirin has been proved to be the most effective therapy with sustained virological response rate of 72%, regardless of HCV genotype. Qualifying for antiviral therapy needs careful initial assessment, regarding of contraindications and certain conditions, and then close monitoring during treatment. Despite the significant progress in hepatitis C management currently available therapies are often ineffective and unsuitable for certain patient populations. The results of molecular researches on HCV biology give rise to the new therapeutic approaches to HCV therapy.
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PMID:[Molecular virology and treatment of patients with chronic hepatitis C]. 1619 May 60

Chronic hepatitis C is often asymptomatic and undiagnosed yet can progress to liver failure or hepatocellular carcinoma. This study determined the prevalence of hepatitis C in Texas and estimated the progression of disease in this cohort. National Health and Nutrition Evaluation Survey III data on the national prevalence of an antibody to the hepatitis C virus were extrapolated to Texas using census data weighted for local characteristics. A Markov model estimated the progression of liver disease. Results showed that 387,395 Texans (1.79%) are infected with the hepatitis C virus. County prevalence varied from 1.25% to 2.63%, with higher rates concentrated along the US-Mexico border. However, most cases of infection were located near major Texas cities. The number of infected persons will decline in the future. However, the proportion of cases progressing to cirrhosis will increase, resulting in more complications such as liver failure and hepatocellular carcinoma. Thus, chronic hepatitis C is common in Texas and will result in an increase in complications of cirrhosis in coming years. The disease will tax health care facilities and transplant units in the state.
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PMID:The prevalence of hepatitis C virus infection in Texas: implications for future health care. 1620 Jan 41

Chronic hepatitis C is highly heterogeneous in clinical presentation and outcomes. This heterogeneity is largely related to host factors that have been clearly proven to affect the severity and rapidity of disease progression. The most relevant factors that have been shown to accelerate progression to cirrhosis include age at infection, alcohol abuse and the metabolic syndrome with insulin resistance, obesity and hepatic steatosis. Co-infection with HIV and/or HBV also increases the risk of progression to cirrhosis and to hepatocellular carcinoma. Surprisingly enough, viral related factors appear as less important and neither the virus genotype and load have been found to exert a clear influence on disease severity and progression, although more data in this field, and particularly on the role of different viral proteins in causing cytopathic effects, are awaited and may change this view in the near future.
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PMID:Review article: chronic hepatitis C--natural history and cofactors. 1622 79

Chronic hepatitis C is a leading cause of hepatocellular carcinoma (HCC) worldwide. Prevention of chronic hepatitis C-related HCC is one of the most important issues in current hepatology. We conducted 2 cohort studies, one among patients with chronic hepatitis C mostly without cirrhosis and another among those with compensated cirrhosis, to confirm the prevention of HCC by interferon. We also conducted a randomized controlled study among patients with HCV-related HCC treated completely by ablation to examine the effect of interferon therapy on prognosis. With the chronic hepatitis C cohort, we showed that the risk of HCC development, which was strongly associated with the stage of liver fibrosis, age, and gender, was reduced by interferon therapy to one fifth among sustained virologic responders compared with untreated patients. Life expectancy was also significantly prolonged. The benefit of interferon therapy was greater among those with the higher risk of HCC. We confirmed efficacy in HCC-prevention in the second study among patients with compensated cirrhosis who received interferon therapy. The third study among HCC patients who had received complete tumor ablation showed that interferon therapy was associated with better survival, primarily as a result of the preservation of liver function and also probably prevention of recurrence. We have shown beneficial effects of interferon therapy on HCC prevention and liver function preservation. They were the strongest in sustained virologic responders. Further improvement in prognosis may be expected in the future because the current combination therapy of pegylated interferon and ribavirin shows higher efficiency than interferon alone.
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PMID:Prevention of hepatocellular carcinoma and its recurrence in chronic hepatitis C patients by interferon therapy. 1623 63

Chronic hepatitis C virus infection is responsible for a significant and growing burden on NHS services. It is one of the commonest causes of liver cirrhosis and hepatocellular carcinoma, and the leading indication for liver transplantation. Major advances have been made in treatment, which can eradicate the virus in more than 50% of patients and reduce complications, but progress is hampered by inadequate detection and access to treatment.
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PMID:Hepatitis C: tackling the silent epidemic. 1625 65

Infection with the hepatitis C virus (HCV) represents an important public health problem and is a leading cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma. Chronic hepatitis C is a heterogeneous disease. Many patients have mild disease at presentation but not all of them will develop advanced liver disease. However, the identification of these patients with mild hepatitis C who will show progressive disease is difficult and is based on histological criteria and the assessment of co-factors (age, alcohol intake, steatosis). In addition, serum transaminases that are persistently normal on several occasions during 18 months may point to a more benign course. Patients with mild hepatitis C should not be excluded "a priori" from the possibility of being treated, as treatment with pegylated interferon and ribavirin is safe and effective in this group. Overall, the decision to initiate therapy should be individualized and based on the severity of the disease by liver biopsy, the potential of serious side effects, the probability of response and the motivation of the patient.
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PMID:The management of patients with mild hepatitis C. 1626 17

Long-term graft survival and mortality after liver transplantation continue to improve. However, disease recurrence remains a major stumbling block, especially among patients with hepatitis C. Chronic hepatitis C recurs to varying degrees in nearly all patients who undergo transplantation. Transplantation for hepatitis C is associated with higher rates of graft failure and death compared with transplantation for other indications, and retransplantation for hepatitis C related liver failure remains controversial. Recurrence of hepatitis B has been markedly reduced with improved prophylactic regimens. Further, rates of hepatocellular carcinoma recurrence have also decreased, as improved patient selection criteria have prioritized transplantation for those with a low risk of recurrence. Primary biliary cirrhosis recurs in some patients, but it is often relatively mild. Autoimmune liver disease has also been shown to have a relatively benign post-transplantation course, but some studies have indicated that it slowly progresses in most recipients. It has been recently reported that alcoholic liver disease liver transplant recipients who return to drinking have worsened mortality. In such patients worse outcomes are not due to graft failure, but instead to other comorbidities. Recurrences of other diseases, including nonalcoholic steatohepatitis and primary sclerosing cholangitis, are now being recognized as having potentially detrimental effects on graft survival and mortality. Expert clinical management may help prevent and treat complications associated with disease recurrence.
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PMID:Recurrence of diseases following orthotopic liver transplantation. 1677 63


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