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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infections with hepatitis A and B viruses are common in all parts of the world and constitute a major public health problem. The identification of specific antigenic markers of these viruses has led to the development of sensitive laboratory tests. These, in turn, have resulted in a better understanding of the epidemiology, pathogenesis, immunology, and the nature of these common infections. In the case of hepatitis type B, laboratory tests revealed a persistent carrier state of the surface antigen in some 120-175 million people and established the significance of hepatitis B virus in the pathogenesis of serious chronic liver disease, including a strong association with primary hepatocellular carcinoma in tropical and some subtropical regions. In addition, the specific diagnosis of hepatitis types A and B has revealed a previously unrecognized form of hepatitis which is clearly unrelated to either type. This new form of infection of the liver is now the most common type of hepatitis after the transfusion of blood and blood products in some areas of the world and it also appears to be an important cause of sporadic hepatitis, particularly among adults.
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PMID:The three type of human viral hepatitis. 7 70

Occurrence of fever in a patient with liver cirrhosis should suggest the following: 1. Endotoxemia. Endotoxins are normally present in portal blood; in hepatic cirrhosis they are insufficiently cleared by the liver and their presence can be demonstrated in the systemic circulation by the "limulus test". Fever is one of the many consequences ascribed to the presence of endotoxins in the blood. 2. Infections. Cirrhosis and alcoholism (which often accompanies it) impair host defenses against bacteria and other organisms. Thus, infections are actually more frequent in hepatic cirrhosis as is shown by the example of bacterial endocarditis. Spontaneous bacterial peritonitis must be searched for carefully when ascites is present. 3. Alcoholic hepatitis. This diagnosis is established histologically. The usual symptoms, occurring with variable incidence, include anorexia, nausea and vomiting, abdominal pain, fever and jaundice in the presence of hepatomegaly, leukocytosis and an elevated SGOT. Differential diagnosis from obstructive jaundice and a severe prognosis without alcohol abstinence make early diagnosis mandatory. Its evolution in cirrhosis can be astonishingly rapid. In the absence of hepatic encephalopathy, corticosteroids do not appear to be recommended. 4. Hepatoma.
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PMID:[Fever and liver cirrhosis]. 22 38

Infections in immunocompromised hosts have been an important clinical problem. Patients with liver cirrhosis and/or hepatocellular carcinoma are at a high risk of infection due to multiple factors. Five hundred and two patients admitted with liver cirrhosis and/or hepatocellular carcinoma were evaluated for infection. The infection rate was not influenced by the etiology of hepatic diseases or the presence of hepatocellular carcinoma, however, it increased with the advance of clinical stages of liver cirrhosis and hepatoma. The respiratory tract and urinary tract were the most common sites of infection, being involved in 50% and 28% of cases, respectively. The major pathogens of respiratory tract infection were S. aureus, H. influenzae, and P. aeruginosa. Gram-negative bacteria was the common isolate from sputum and urine, and S. aureus was also common in gram-positive bacteria. The infection rate was high in patients who died although infections could rarely be implicated as the direct cause of death. These findings should be a guide for the clinicians in treating patients with liver cirrhosis and/or hepatocellular carcinoma who exhibit signs of infection.
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PMID:Infections in patients with liver cirrhosis and hepatocellular carcinoma. 754 30

Infections by the hepatitis B or C virus are extremely common causes of acute and chronic liver disease, and coexistence of the two viruses in the same patient is not rare. Evidence has been found that such interaction may play an important role in fulminant hepatitis and in the development of hepatocellular carcinoma in cirrhotic patients. Liver disease activity and prognosis have been reported to be generally more serious in the presence of double infection, although an inverse relationship in the replicative levels of the two agents has been noted, suggesting viral interference, particularly in cases of chronic hepatitis. Thus, the two viruses seem to inhibit each other at the molecular level, while cytopathic effects appear to be enhanced. Further studies are needed to explain the mechanisms of these apparently contrasting effects.
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PMID:The interaction between hepatitis B virus and hepatitis C virus in acute and chronic liver disease. 760 74

Hepatitis B virus (HBV) infections occur worldwide, with the endemicity of infection varying among geographical areas. Infections acquired by perinatal via commonly become persistent and can progress to chronic liver diseases, including cirrhosis and hepatocellular carcinoma. The possibility of vertical transmission of the VHB infection depend of the serological condition of the mother, women with AgsHB positive can infect 10 to 20% of her fetus while women with AgsHB more AgeHB positive can infect 80-90% of her products. Newborns of women with acute or chronic HBV infection must be immunized with vaccine and hepatitis B immune globulin at birth with the objective to reduce the risk of infection.
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PMID:[Hepatitis B in pregnancy: clinical and prophylactic implications]. 769 81

Serum amyloid A (SAA) protein is a major acute phase reactant in human and many other species. Infections and traumatic inflammation are characterized by a rapid increase of SAA; its concentration in the plasma may augment many-fold. Cytokines such as IL-1 and IL-6 are considered mediators of acute phase protein synthesis. The most accredited mechanism of action of IL-1 in inflammatory diseases is the stimulation of PGE2 release, which is highly dependent on the concentration of IL-1. In this study we found that human Hep 3B hepatoma cells treated with the combination of hrIL-6 (10ng/ml) plus hrIL-1 (1ng/ml) produced an augmentation in steady-state levels of SAA mRNA (87%) compared to hrIL-6 (10ng/ml) plus PGE2 (5 microM), which induced an increase of only 33%, compared to IL-6 alone, while cells treated with hrIL-6 plus PGE2 (0.5 microM) had a similar effect as hrIL-6 did alone. Moreover, the addition of exogenous PGE2 (5 microM) to the cell cultures produced no significant increase in concentration of SAA mRNA compared to the control. In addition, according to the data obtained by the blot analysis we also found, by ELISA method, that hrIL-6 acts in synergism with hrIL-1 on SAA protein secretion in human Hep 3B hepatoma cell cultures after 48 h incubation. In fact, the cell cultures treated with hrIL-6 plus hrIL-1 caused a higher release approximately 1.5-4-fold of SAA protein than the cells treated with IL-6 plus PGE2 5 microM or IL-1 + PGE2 5 microM, respectively. The synergistic effect of hrIL-6 plus hrIL-1 beta was inhibited by hrIL-1 receptor antagonist (hrIL-1ra) 50 micrograms/ml, a protein which specifically binds to the IL-1 receptor and is structurally similar to IL-1 beta but with no IL-1-like activity; while indomethacin (5 microM) was ineffective. These results strongly suggest that the synergism between hrIL-6 plus hrIL-1 on the transcription and the protein release of SAA release is not due to a PGE2-dependent process in human Hep 3B hepatoma cells. This finding highlights a specific biological effect of IL-1 not in relation to PGE2, suggesting a specific mechanism of action for IL-1 in regulating acute phase protein synthesis.
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PMID:Synergistic activation of serum amyloid A (SAA) by IL-6 and IL-1 in combination on human Hep 3B hepatoma cell line. Role of PGE2 and IL-1 receptor antagonist. 779 46

Viral hepatitis is a major public health problem in all parts of the world. Infections with hepatitis B are of particular concern since such infection in some individuals can lead to chronic liver disease, cirrhosis of the liver, and hepatocellular carcinoma. Comparative studies of the morbidity rates of hepatitis B and hepatitis A virus infections in various European countries indicate that these diseases are highly endemic in Romania. A 300 case per 100,000 population incidence was reported in 1989 national surveillance data for all types of viral hepatitis. A seroprevalence survey of viral hepatitis was conducted in Bucharest, Romania, during April-July 1990 on 1355 people from both the general population and groups at higher risk of infection. The low-risk sample was comprised of 201 individuals aged 0-16 years who had been admitted to the hospital for the first time in their life and who had a noninfectious diagnosis; 200 healthy adults who were attending premarital or recruitment medical examinations; and 204 pregnant women attending antenatal clinics. 214 children younger than three years old selected at random from the five orphanages in Bucharest and 336 medical personnel working at any of four health facilities in the city comprised the high-risk sample. ELISA was used to identify markers of hepatitis A, B, and C in sera. The prevalences of hepatitis A and B markers were high in all low-risk groups, with a past history of acute hepatitis reported by 10.5% of healthy adults. The prevalence of anti-hepatitis A markers increased with age. Almost two-thirds of the subjects younger than 20 years old had been infected with hepatitis A, 50.7% of the 77 children under 5 years old were positive for at least one hepatitis B virus marker, and 34.8% of individuals aged 5-19 years demonstrated seropositivity for hepatitis B virus. 47% of adults from the general population had at least one marker for hepatitis B, 7.8% of pregnant women were seropositive for hepatitis B surface antigen, and 54.6% of the infants aged 0-3 years living in orphanages had at least one marker for hepatitis B. Hepatitis C is circulating in the country. These results are consistent with national surveillance data and confirm that viral hepatitis is a major public health problem in Romania. Prevention measures must include hepatitis B immunization of infants, with an appropriately targeted immunization strategy determined through further epidemiological studies.
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PMID:Viral hepatitis in Bucharest. 831 96

Experience in liver transplantation (OLT) in Italy over a ten-year period is reported. Data were obtained using a multiple-items form collected from Italian liver transplant centres (reference centres) and other Italian institutions actively involved both in the processes of evaluation of the candidates and the follow-up of liver transplant recipients (afference centres). During this period, a total of 1046 liver transplants were performed on 954 patients, with a cumulative proportional survival of 71%. The most common indication for liver transplantation was post-hepatitic cirrhosis due to either hepatitis B virus (+/-hepatitis Delta virus) or hepatitis C virus infection. Good survival rates were observed, particularly in controversial indications, such as alcoholic cirrhosis, post-hepatitic hepatitis B virus-related cirrhosis and hepatocellular carcinoma, most likely due to proper and careful selection of the patients. Cirrhosis, secondary to an autoimmunity-based liver disease, showed the highest rate of rejection episodes. Infections, in our study population, were the most common cause of death after transplantation.
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PMID:Liver transplantation in Italy: preliminary 10-year report. The Monotematica Aisf-Olt Study Group. 889 51

Several epidemiological studies suggest that chronic alcoholics are at risk of viral infections. Clinical and basic research has demonstrated that alcohol not only worsens the natural history of chronic viral hepatitis, but also seems to interact with the viral replication cycle leading to an unusual serum virological profile and/or modification in the serum concentration of viral particles. Infections with hepatitis B and C viruses are a major risk for the development of hepatocellular carcinoma in excessive drinkers who should be protected against these viruses.
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PMID:ESBRA 1997 Award lecture: relationship between excessive alcohol drinking and viral infections. 963 45

Infections with the hepatitis B, C or D virus can all lead to chronic hepatitis. Serological and molecular methods are essential for diagnosis and for differentiation between the different forms of chronic virus hepatitis. In adults between 5 and 10% of all infections with the hepatitis B virus become chronic while the rate is as high as 80% with the hepatitis C virus. All forms of chronic hepatitis are frequently asymptomatic for a long period of time. Complications are liver cirrhosis and hepatocellular carcinoma. During chronic hepatitis B infection in around 1% of the patients per year the virus is eliminated spontaneously while virus elimination occurs rarely in patients with chronic hepatitis C infection. In patients with chronic hepatitis C infection over a period of 30 years around 3% of the patients die due to chronic hepatitis C infection. As soon as chronic virus hepatitis is diagnosed treatment should be considered. Standard therapy for all forms of chronic viral hepatitis is interferon alpha. Additionally recent results indicate that nucleoside analogous are effective for chronic hepatitis B and C virus infection. For chronic hepatitis B infection studies with famciclovir and lamivudine show that viral replication can be effectively blocked. For chronic hepatitis C infection a combination therapy with interferon and ribavirin has been shown to reach higher elimination rates compared to interferon mono-therapy. The last treatment option for all forms of viral hepatitis is liver transplantation.
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PMID:[Chronic viral hepatitis--diagnosis, therapy and prognosis]. 1020 Jun 10


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