Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hepatitis B virus (HBV) is at the origin of severe liver diseases like chronic active hepatitis, liver cirrhosis and hepatocellular carcinoma. There are some groups of patients with high risk of generation of HBV mutants: infected infants, immunosuppressed individuals (including hemodialysis patients), patients treated with interferon and lamivudine for chronic HBV infection. These groups are the target for molecular investigations reviewed in this paper. The emergence of lamivudine- or other antiviral-resistant variants, rises concern regarding long term use of these drugs. Infection or immunization with one HBV subtype confers immunity to all subtypes. However, reinfection or reactivation of latent HBV infection with HBV mutants have been reported in patients undergoing transplant and those infected with HIV. Mutations of the viral genome which are not replicative incompetent can be selected in further course of infection or under prolonged antiviral treatment and might maintain the liver disease. Four open reading frames (ORF) which are called S-gene, C-gene, X-gene and P-gene were identified within the HBV genome. Mutations may affect each of the ORFs. Mutated S-genes were described to be responsible for HBV-infections in successfully vaccinated persons, mutated C-genes were found to provoke severe chronic liver diseases, mutated X-genes could cause serious medical problems in blood donors by escaping the conventional test systems and mutated P-genes were considered to be the reason for chemotherapeutic drug resistance. This paper reviews molecular, immunological and clinical aspects of the HBV mutants.
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PMID:Molecular, immunological and clinical properties of mutated hepatitis B viruses. 1200 75

The hepatitis D virus (HDV), also called delta virus, is a small circular RNA virus. The HDV is dependent on the hepatitis B virus (HBV) and can cause infection in normal individuals with hepatitis B or yet, superinfect chronic HBV carriers. Three genotypes have already been cloned and sequenced. Infection with HDV has a worldwide distribution and a high HDV endemicity has been documented in the western Amazon region, in Brazil. It has been estimated that 18 million people are infected with this virus amongst the 350 million carriers of the HBV around the world. The HDV transmission and risk factors for infection are similar to those for HBV infection. The diagnosis is based on the immunohistological identification of HDAg in the liver and detection of IgM and IgG anti-HD in serum using RIA or EIA. The clinical course of hepatitis D is variable. Fulminant disease occurs more commonly in hepatitis B and D than in other forms of acute viral hepatitis. Chronic HDV infection is usually associated with severe histological changes in the liver and with a rapidly progressive course, that can lead to cirrhosis, liver failure and death. Treatment of chronic hepatitis D is currently unsatisfactory and interferon alpha is the only agent found to have some effect on the course of chronic hepatitis. Orthotopic liver transplantation is indicated for terminal cases of cirrhosis. Prophylaxis for HDV infection is possible by vaccination against the hepatitis B virus.
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PMID:[Hepatitis D]. 1201 28

BACKGROUND: Hepatitis B virus is the cause of acute disease and several chronic conditions, such as chronic hepatitis, cirrhosis and liver cancer.In 1982, hepatitis B vaccine was developed. Since 1984, many immunization programs against hepatitis B were implemented in several countries and 15 years later we can visualize some epidemiological changes in those countries.OBJECTIVE: To review the papers published about the results of hepatitis B immunization programs in several countries from Asia, Africa, Europe (Italy) and Peru, since 1984.METHODS: Pertinent literature was identified in MEDLINE (1980-2000) and references quoted in published papers. RESULTS: The impact of vaccination against hepatitis B over the incidence of acute disease, chronic carriers, hepatitis B virus prevalence and hepatocarcinoma incidence, was anayzed.The following results were obtained: In Afragola (Italy), a reduction of acute disease incidence from 63 cases/100,000 population before the vaccination (1983), to 3 cases/100,000 population after the vaccination (1997), was obtained HBsAg carriers rate decreased: From 13.4% to 3.7% in the general population and from 6.8% to 0.7% in infant population.Infection prevalence: From 66.9% to 34.2% in general population. In Taiwan:HBsAg carriers rate decreased: From 10.0% to <1.0% in children from 1 to 10 years old.Infection prevalence: From 38.0% to 16.0% in children under 13 years old. In Peru:Infection prevalence: From 24.4-30.4% to 2.3-5.1% in children of 3 and 4 years old. In Senegal:HBsAg carriers rate decreased: From 18.7% to 2.2% in children. In Gambia:HBsAg carriers rate decreased: From 10.0% to 0.6% in children.Finally, the hepatocarcinoma incidence in children from 6 to 14 years old, decreased from 0.70/100,000 children to 0.36/100,000 (p<0.01) in Taiwan.CONCLUSION: The results of these studies support the hypothesis that the vaccination against the hepatitis B virus infection reduce the incidence of acute disease, carriers rate, prevalence of the infection and hepatocarcinoma incidence.
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PMID:[HEPATITIS B.VACCINATION IMPACT ON ACUTE DISEASE,CHRONIC CARRIERS AND HEPATOCARCINOMA INCIDENCE] 1214 May 76

Hepatic cirrhosis is the most common cause of ascites. It is caused by liver failure leading to complex interrelated circulatory and renal changes resulting in retention of sodium and water and portal hypertension localising that sodium and water in the peritoneum. Ascites is an important development in cirrhosis as it implies a generally poor long term prognosis. Investigation is important as ascites is not always dueto cirrhosis, may bethe consequence of complications of cirrhosis such as hepatocellular carcinoma, and may be associated with infection which is fatal if untreated. Most patients respond to treatment with sodium restriction and diuretic drugs. This treatment takes time, and increasingly doctors use therapeutic paracentesis with sodium restriction and diuretics to prevent recurrence of ascites. Paracentesis, however, is not without complications, and it is particularly important to give colloid replacement to prevent hypovolaemia which can lead to renal failure. Patients who do not respond to this treatment may be helped by a TIPSS procedure or a peritoneovenous shunt. However, these patients usually have very poor liverfunction and the possibility of fiver transplantation should be considered. Infection is a very serious complication of ascites (spontaneous bacterial peritonitis) and carries a generally poor prognosis.Antibiotic prophylaxis is important to prevent recurrence and liver transpiantation shoulcl be considered.
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PMID:[ASCITES IN HEPATIC CIRRHOSIS: RECOGNITION INVESTIGATIONAND TREATMENT] 1221 41

Infection with hepatitis B and/or hepatitis C virus is strongly associated with hepatocellular carcinoma (HCC). HCC likely develops through a sequence of chronic inflammation to fibrosis to cirrhosis and, eventually, dysplasia. Medical therapies aimed at the prevention of HCC are predicated on the interruption of this sequence by means of antiviral therapy. In this review, the authors summarize the available experience with prophylactic medical therapies and a number of questions that remain unanswered. Overall, although it appears that interferon-alpha therapy is beneficial in the prevention of HCC in patients with viral hepatitis, more experience is required before definitive recommendations can be made.
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PMID:Role of antiviral therapy in the prevention of hepatocellular carcinoma. 1235 36

Infection with hepatitis B virus may develop into a chronic carrier state, which may result in chronic hepatitis, cirrhosis and hepatocellular carcinoma, but the exact mechanism of the development of hepatocellular carcinoma is still not known. The question is whether it is hepatitis B virus itself or the cellular changes due to persistent hepatitis B virus infection that cause malignant changes? The purpose of this article was to describe the natural history of hepatitis B virus infection together with epidemiological, serological, and molecular data that show a connection between chronic hepatitis B virus infection and the development of hepatocellular carcinoma.
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PMID:[Hepatitis B--a viral oncogene?]. 1255 16

Drug use and related injection practices determine an excess mortality in drug abusers compared to the general population adjusted for age and gender. HIV/AIDS and overdose are the most important causes of death among injecting drug users; however, excess mortality is also due to other causes, such as cirrhosis and endocarditis. Infections have a great impact on the health of injection drug users. Viral infections, such as HIV, HCV, and HBV, are the most important ones, but bacterial and fungal infections, and, to a lesser extent, protozoal infections, are also common. In depth knowledge of drug-related morbidity and mortality causes is important to improve clinical skills and to implement control activities.
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PMID:[Infections and other causes of mortality correlated with drug addiction]. 1264 81

Hepatitis C in patients with chronic renal failure. Infection with hepatitis C virus (HCV) is a common complication in those patients under chronic dialysis. Prevalence varies from 8% to 65 percent. Immunization against hepatitis A and B for renal patients is always recommended, especially in countries with high prevalence of this type of hepatitis. Interferon as the only antiviral treatment is recommended for patients with chronic renal failure and chronic hepatitis who depend on dialysis. Viral hepatitis is the first cause of morbidity and mortality among renal recipients. Prevalence varies between 4 and 38%, depending on the geographic area. Infection with HCV usually begins before the transplant, although the patient is sometimes infected during the transplant because the donor organs carry the virus. The chronic HCV infection dosen't seem to affect the survival rate of the patient or the organ, compared to the survival rate in patients without the infection. Chronic hepatitis C without cirrhosis is not a contraindication for renal transplant, but cirrhosis is. Liver failure is the cause of death in 8-28% of renal transplant recipients infected with hepatitis C virus.
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PMID:[Viral hepatitis C in patients with renal disease]. 1271 63

Infection with Listeria monocytogenes is rare with a reported annual incidence of 4.4 cases/million individuals. Epidemiological data have identified certain groups to be higher risk of developing listeriosis, including neonates, pregnant women, adults older than 60 years of age, individuals afflicted with hematologic malignancies, acquired immunodeficicency syndrome, cirrhosis, and those receiving corticosteroid therapy and organ transplants. Within this last group, multiple cases have been described following bone marrow and renal transplantation, but only a few following liver transplantation. We report a case of a 66-year-old woman presenting with Listeria monocytogenes bacteremia at 32 months following orthotopic liver transplantation.
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PMID:Infection with Listeria monocytogenes following orthotopic liver transplantation: case report and review of the literature. 1282 1

Infection with hepatitis C virus (HCV) is a major cause of transfusion-associated hepatitis, cirrhosis and hepatocellular carcinoma. The present study was conducted with an objective to evaluate the prevalence of anti-HCV antibody in New Delhi, India using a large number of healthy voluntary blood donors. A total of 15,898 healthy voluntary blood donors were subjected to anti-HCV testing (using a commercially available third generation anti-HCV ELISA kit) and 249 were found to be reactive for anti-HCV antibody, yielding an overall prevalence of 1.57%. No significant difference was found between the HCV positivity rate of male (1.57%; 238/15,152) vs. female (1.47%; 11/746) donors, family (1.58%; 213/13,521) vs. altruistic (1.51%; 36/2377) donors and first-time (1.55%; 180/11,605) vs. repeat (1.61%; 69/4293) donors. The age distribution of anti-HCV reactivity showed a maximum prevalence rate of 1.8% in the age group of 20-29 years. In addition, there was a clear trend of decreasing positivity for anti-HCV with increasing age and this trend was statistically significant. The results of the present study show that the prevalence of anti-HCV antibodies in the healthy voluntary blood donors of New Delhi, India is considerably higher than the reported seroprevalence of HCV in majority of the industrialized nations and this represents a large reservoir of infection capable of inflicting significant disease burden on the society. In addition, donors of New Delhi, India showed a trend of decreasing seroprevalence with increasing age, possibly implying a higher exposure rate to HCV in younger subjects.
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PMID:The prevalence of hepatitis C virus antibodies among the voluntary blood donors of New Delhi, India. 1295 45


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