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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors describe the results of prospective examination of the incidence and importance of hepatitis B virus and hepatitis D virus in the aetiology of chronic liver disease at Slavonski Brod Hospital. HBV incidence is significant in the aetiology of chronic liver disease, since it has been found in 100/144 (69.4%) of the examinees. Most of the patients were male (75.0%), their mean age was 32.8, and their age ranged between 15 and 60. A high percentage (37.0%) was found in the category of HBV infection high-risk patients. Most of them were intravenous drug addicts, their mean age was 24.9, and they were mostly male (96.9%). In most patients HBV infection caused a milder histological and clinical form of chronic liver disease, i.e., chronic persistent hepatitis. The disease was recorded in 62.9% of the patients outside of the high-risk category, and it was found in 52.6% of the high-risk patients. The incidence of the hepatitis D virus in the aetiology of chronic liver disease was found in 19/100 (19.0%) of the HBV positive patients. 18/19 of the HDV infection patients belonged to the high-risk category, 16 of them being drug addicts. Hepatitis D virus infection led to serious clinical and histological forms of chronic liver disease in most cases: chronic active hepatitis and cirrhosis of the liver in 89.5% of the cases, and chronic persistent hepatitis in only 19.5% of the cases.
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PMID:Epidemiological characteristics of HBV and HDV chronic liver diseases. 751 96

The authors describe the results of prospective research on the HBeAg-anti-HBe system in 81 HBV patients and on HBV+ HDV chronic liver disease in 19 patients who were treated at Slavonski Brod Medical Centre. They analyze the correlation between various epidemiological groups of patients, liver disease activity and the condition of the HBeAg-anti-HBe system in chronic HBV and HDV infection. A clear correlation was established between the presence of HBe antigen and the patients' youth, the pathological alanin aminotransferase values and pathohistological liver findings. In as many as 64.4% of the HBeAg-positive patients the active chronic liver disease process was verified. However, this pathological activity was also verified in 36.4% of the HBeAg-negative patients with chronic HBV infection. Moreover, anti-HBe was found more often in the serum of the hepatitis D infected patients (68.4%). Serious forms of chronic liver disease were found in all of the HDV-positive patients with the anti-HBe finding in serum. However, chronic active hepatitis or cirrhosis of the liver was found in only 23.5% of the HBeAg-positive patients suffering from HDV infection. We should point out that the HBeAg-anti-HBe system does not have an absolute value in the estimation of histological liver changes and in the prognosis of chronic liver disease for individual patients.
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PMID:The HBe antigen-antibody system and its relationship to epidemiological, histological and biochemical findings in patients with HBV+ HDV chronic liver diseases. 751 2

We designed a multicenter cross-sectional study to evaluate the role of alcohol abuse, the hepatitis viruses and other pathogenic factors in cirrhosis and hepatocellular carcinoma. A total of 1,829 consecutive cirrhosis patients, with or without HCC, was enrolled over 6 mo in 21 centers throughout Italy. The etiological categories and diagnostic criteria were preestablished. The median age of the patients was 59 yr (range, 13 to 85 yr); 63.6% of the patients were graded as Child class A, 23.4% as Child class B and 13% as Child class C. Hepatitis C virus antibodies were found in 72.1% of cases (47.7% alone, 21.2% with alcohol abuse, 3.2% with hepatitis B virus); HBsAg was present in 13.8% (4.2% alone, 3.2% with hepatitis D virus, 3.2% with hepatitis C virus, 3% with alcohol abuse), alcohol abuse with no concomitant viral infection was recorded in 8.7%, primary biliary cirrhosis was found in 1.8%, other causes were found in 1.4% and cryptogenic cirrhosis was only present in 5.3%. Hepatocellular carcinoma was detected in 11.9% of patients (217 cases). The presence of hepatocellular carcinoma was more frequent in males than females (14.7% vs. 7.3%; p < 0.001) and increased with worsening Child class (8.3% in Child class A, 16.9% in Child class B, 19.9% in Child class C, p < 0.001). The highest prevalences of hepatocellular carcinoma were observed in hepatitis B virus infection, with or without alcohol abuse (20% and 16%, respectively) and in hepatitis C virus cirrhosis, with or without alcohol abuse (16% and 10.3%, p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pathogenic factors in cirrhosis with and without hepatocellular carcinoma: a multicenter Italian study. 752 73

Eighty-nine Sahelian African patients with chronic active hepatitis (CAH) (14), cirrhosis (49), hepatocellular carcinoma (HCC) (26), and 47 controls were tested for hepatitis B virus (HBV, hepatitis B surface antigen [HBsAg]) and hepatitis D virus (HDV, anti-HDV antibody). Seventy-three percent of the patients were positive for HBsAg versus 29.8% of the controls (P < 0.0001). With anti-HDV test, 55.0% of the patients were positive versus 17.0% of the controls (P < 0.0001). To assess the prevalence of antibody to hepatitis C virus (HCV), we used an enzyme-linked immunosorbent assay for screening (anti-HCV2): 19.1% of the patients were positive versus 6.4% of the controls (P < 0.05). An association between HBsAg and anti-HDV-positive test results was found in 46.1% of the patients versus 6.4% of the controls (P < 0.0001). A combination of HBsAg and anti-HCV2-positive test results was found in 13.5% of the patients versus 2.2% of the controls (P < 0.05). Anti-HDV and anti-HCV2 test results were positive in 13.5% of the patients versus 2.2% of the controls (P < 0.05). Triple-positive test results (HBsAg, anti-HDV, and anti-HCV2) were found in 11.2% of the patients but in none of the controls (P < 0.025). Triple-negative test results were found in 14.6% of the patients versus 57.4% of the controls (P < 0.0001). The predominant association of the chronic HBV infection with CAH, cirrhosis, and HCC is confirmed in Sahelian Africa. The HDV superinfection (chronic HBV plus HDV infections) may be a major etiology.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hepatitis B, C, and D virus infections in patients with chronic hepatitis, cirrhosis, and hepatocellular carcinoma: a comparative study in Niger. 753 42

The outcome of hepatitis D virus (HDV) superinfection varies among patients and in different geographical areas. To find out whether HDV genotype affects outcome, we used a simple genotyping method based on restriction-fragment length polymorphism with enzymes XhoI and SacII for cleavage of PCR products of the HDV genome. Of samples from 88 patients studied, the genotypes of 61 were confirmed by two methods--analysis with both enzymes or by combined restriction-enzyme and direct sequencing analyses--with consistent results. No genotype III HDV was detected among these patients. The majority of patients with acute HDV infection (35/41 [85%]) had genotype II HDV. Among the 41 patients with acute infection, four of six with genotype I had fulminant disease compared with two of 35 with genotype II. Among patients in chronic stage, cirrhosis or hepatocellular carcinoma were found in 12 of 18 with genotype I HDV and eight of 29 with genotype II. Thus genotype II was the predominant HDV genotype in this study in Taiwan. Genotype II HDV was less frequently associated with fulminant hepatitis at the acute stage or with an unfavourable long-term clinical outcome at the chronic stage than was genotype I.
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PMID:Genotyping of hepatitis D virus by restriction-fragment length polymorphism and relation to outcome of hepatitis D. 756 29

The association between viral hepatitis and pregnancy is not common, nevertheless it has been described that hepatitis is the most frequent cause of jaundice in pregnant women. In this article the current knowledge on the perinatal repercussions of the different types of viral hepatitis are reviewed. Hepatitis A is rare during pregnancy and is not associated with perinatal risk. Hepatitis B virus (HBV) can be transmitted transplacentally, 20 per cent of the children infected by this route will develop liver cirrhosis or carcinoma in the adult age, so the infants of HBsAg carrier mothers must be immunized at born. The perinatal transmission of hepatitis C virus has been proved but the repercussion in the fetus or newborn is unknown. Hepatitis D virus can only be transmitted from mother to child together with HBV. Hepatitis E has been associated with a mortality of 10 to 40 per cent in pregnant women.
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PMID:[The behavior and perinatal impact of viral hepatitis in pregnancy]. 771 69

A multicenter longitudinal study was performed to assess the survival of hepatitis B surface antigen positive compensated cirrhosis, primarily in relation to hepatitis B virus replication and hepatitis delta virus infection, and to construct a prognostic index based on entry characteristics. This cohort study involved nine university medical centers in Europe. Three hundred and sixty-six Caucasian HBsAg positive patients with cirrhosis who had never had clinical manifestations of hepatic decompensation were enrolled and followed for a mean period of 72 months (6 to 202 months). Inclusion criteria were biopsy-proven cirrhosis, information on serum hepatitis B e antigen and antibody to hepatitis D virus at the time of diagnosis and absence of complications of cirrhosis. At entry 35% of the patients were HBeAg positive, 48% of the patients tested were HBV-DNA positive and 20% anti-HDV positive. Death occurred in 84 (23%) patients, mainly due to liver failure (45 cases) or hepatocellular carcinoma (23 cases). The cumulative probability of survival was 84% and 68% at 5 and 10 years, respectively. Cox's regression analysis identified six variables that independently correlated with survival: age, albumin, platelets, splenomegaly, bilirubin and HBeAg positivity at time of diagnosis. According to the contribution of each of these factors to the final model, a prognostic index was constructed that allows calculation of the estimated survival probability. No difference in survival of hepatitis D virus infected and uninfected patients was observed. Termination of hepatitis B virus replication and/or biochemical remission during follow up correlated with a highly significant better survival. These data show that in compensated cirrhosis B, hepatitis B virus replication, age and indirect indicators of poor hepatic reserve and established portal hypertension significantly worsen the clinical course of the disease, whereas hepatitis D virus infection does not influence the prognosis. The highly significant improvement in life expectancy following cessation of hepatitis B virus replication and biochemical remission favors antiviral therapy in those patients with a guarded prognosis, as estimated by a prognostic index.
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PMID:Survival and prognostic factors in 366 patients with compensated cirrhosis type B: a multicenter study. The Investigators of the European Concerted Action on Viral Hepatitis (EUROHEP). 781 13

The histological features of chronic viral hepatitis differ according to etiological agent and replicative phases. Thus, in chronic HBV hepatitis with a high level of HBV replication the histological lesion is generally mild. During the seroconversion phase, a lobular lesion is present in the liver biopsy followed by amelioration of the disease. Chronic delta hepatitis is very aggressive histologically, progression to cirrhosis is frequent, and sanded nuclei are often observed in liver biopsies of patients with anti-HIV. In contrast, chronic hepatitis C shows a milder histological picture and immunohistochemical techniques to detect HCV-Ag in the liver tissue should be developed. In summary, the majority of cases of chronic viral hepatitis have distinctive histological features that may be identified in liver biopsies.
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PMID:Liver biopsy and the etiologic diagnosis of chronic hepatitis. 838 84

Hepatitis B is a parenterally and sexually transmitted disease of global importance. It associates with hepatitis D in a consistent proportion of cases. The disease most frequently runs a subclinical and anicteric course, with a significant number of cases that become chronic. Chronic hepatitis may progress to cirrhosis or cancer. The strategies by which hepatitis B and hepatitis D can be diminished and eventually eliminated are: immunization, measures to prevent exposure to infective blood or blood derivatives and education (in particular awareness that hepatitis B is a sexually transmitted disease).
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PMID:Clinical types of HBsAg-positive hepatitis. 848

Twenty-three children, aged 3 to 15 years, with chronic delta hepatitis have been followed for 5 to 12 years to evaluate long-term outcome. Although 83% of patients had chronic active hepatitis when first seen, with cirrhosis in 26%, the clinical and biochemical features of the disease remained reasonably stable during observation; liver histologic findings, obtained in 14 patients, worsened in only two.
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PMID:Long-term evolution of chronic delta hepatitis in children. 849 53


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