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)

The authors explored humoral and cellular immunity in 50 cases of alcoholic cirrhosis. The levels of the three serum immunoglobulins were greater than normal. IgM was significantly higher. The levels of antipolio antibodies (types I, II and III) were significantly higher in cirrhosis than in controls. The antistreptolysin and antistaphylolysin titers showed that the differences between levels found in cirrhosis and in controls were not significant. After taking the Sabin polio vaccine, variations in antipolio antibodies remained within normal limits, considering the high levels noted before taking the vaccine. Total serum complement was normal in 90% of the estimtions carried out. The results of the intradermal reactions were dissociated. Tuberculin skin tests were negative in 35% of cases of cirrhosis and in 14.3% of controls. In skin tests for candida and streptococcal antigen, differences between cirrhotics and controls were not significant. The absolute figure for blood lymphocytes per mm-3 was, in half the cases, less than normal.
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PMID:[Immunologic changes and infections in alcoholic cirrhosis]. 16 91

INTRODUCTION: Huanta is an interandean valley at 2,400 meters above sea level in the peruvian highlands. It is hyperendemic for HBV, and deaths related to HBV such a fulminant hepatitis, cirrhosis and hepatic carcinoma make up 8% of the total mortality. A pilot program of inmunization against HBV integrated with the Expanded Immunization Program (EPI) was established in 1994, so as to limit the incidence if HBV-HDV, and as a strategy to improve EPI coverages.MATERIALS AND METHODS: A total of 1,412 children under 1 year old and 5,175 children from 1 to 4 years old were scheduled for vaccination. Three doses of the recombinant DNA vaccine agains HBV were used for each child. The schedule was adapted to the EPI vaccination calendar. In children under a year the schedule was: newborns: BCG, Polio, HBVI; 2 months: Poliol DPTI, HBV2; 3 months: Polio 2, DPT2; 4 months: polio 3, DPT3, HBV3; 9 months: Measles. In the group of children from 1 to 4 years old, the schedule was: HBVI at child recruitment; HBV2: after 2 months of the first one, HBV3: after 6 month of the first one.RESULTS: One year after starting, 3 dose immunizations have been made in 1,386 (98.1%) children under one year old and 4,353 (84.1%) in children from 1 to 4 years old. No important side effects related to the HB vaccine have been recorded; one case of HAV and two of HBV occurred in children who were beginning their immunization schedule. The objective of improving vaccination coverage by the EPI was achieved; the coverage in children under one year old for DPT were 76% (1991), 64.5% (1992), 55.2% (1993), and as a result of the strategy the coverage was improved to 98.1%. The program efficacy is demonstrated by the significative reduction of the infection rates of children 3-4 years old in 1994 (24.4-30.4%) compared with the children infection rates of the same age in 1997 (2.3-5.1 %).CONCLUSION: Including the HBV vaccine within the EPI program in a hyperendemic area for HBV-HDV has improved the EPI coverages; the vaccination compaign strategy has shown its effectiveness and safety, showing impact in the reduction of infection rates.
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PMID:[IMPACT OF THE IMMUNIZATION PROGRAM INTEGRATED TO THE EXPANDED IMMUNIZATION PROGRAM(EPI) IN HUANTA,1994-1997] 1214 May 82

The China GAVI Hepatitis B Immunization Project was initiated in 2002 with the signing of a Memorandum of Understanding between GAVI and the Government of China. The Project was one of the three (China, India, and Indonesia) GAVI-initiated special projects done to support countries too large to receive full GAVI support for hepatitis B vaccine and safe injections. The Project in China was designed by the Chinese Government and partners to deliver free hepatitis B vaccine and safe injections to all newborns in the 12 Western Provinces and Poverty Counties in 10 Provinces of Central China (1301 Counties with approximately 5.6 million births per year), eliminating the gap in immunization coverage between wealthier and poorer regions of China. The project budget (USD 76 million) was equally shared by GAVI and the Chinese Government. Initially planned for 5 years, two no cost extensions extended the project to 2011. Although China produced hepatitis B vaccine, before the project the vaccine was sold to parents who were also charged a "user fee" for the syringe and vaccine administration. Basic Expanded Program on Immunization (EPI) vaccines such as BCG, DTP, Polio, and measles vaccines were provided free to parents, although they were charged a user fee. Vaccines were sold by China CDC Offices at provincial, prefecture, county level and township hospitals, and village doctors received a substantial portion of their income from the sale of hepatitis B and other vaccines. The result of charging for hepatitis B vaccine was that coverage was relatively high in Eastern and wealthier counties in Central China (~80-90%), but was much lower (~40%) in Western China and Poverty Counties where parents could not afford the vaccine. The Project was administered by the China MOH and China CDC EPI program, and two Project Co-managers, one from the Chinese Government and the other an international assignee, were chosen. The project had an oversight Operational Advisory Group composed of the Chinese Government, WHO, UNICEF, and GAVI. The initial targets of the project as delineated in the initial MOU for the Project areas (HepB3 coverage will reach 85% at the county level, >75% of newborns at the county level will receive the first dose of hepatitis B within 24h of birth, and all immunization injections will be with auto disable [AD] syringes) were substantially exceeded. The differential in vaccine coverage between wealthier and poorer parts of China was eliminated contributing to a great improvement in equity. With additional contributions of the Chinese Government the Project was accomplished substantially under budget allowing for additional catch up immunization of children under 15 years of age. More than 5 million health workers were trained in how to deliver hepatitis B vaccine, timely birth dose (TBD), and safe injections, and public awareness of hepatitis B and its prevention rose significantly. TBD coverage was expedited by concurrent efforts to have women deliver in township clinics and district hospitals instead of at home. The effective management of the Project, with a Project office sitting within the China EPI and an Operational Advisory Group for oversight, could serve as a model for other GAVI projects worldwide. Most importantly, the carrier rate in Chinese children less than 5 years of age has fallen to 1%, from a level of 10% before the inception of the Project. Liver cancer, one of the major cancer killers in China (250,000-300,000 annual estimated deaths), will dramatically decline as immunized cohorts of Chinese children age. While hepatitis C and non-alcoholic liver disease also exist in China and can lead to liver cancer and cirrhosis, the majority of liver disease in China is hepatitis B related and therefore preventable. The authors believe that China's success in preventing hepatitis B is one of the greatest public health achievements of the 21st century. Work remains to be done in several key areas. There are still pockets of home births in rural provinces where a TBD is difficult to deliver, and China is strengthening its policy of screening pregnant women for HBsAg and delivering HBIG plus vaccine to newborns of HBV carrier mothers. Approximately 10% of the adult population of China remain chronic carriers of hepatitis B virus and cannot be helped by the vaccine, so prevention of liver cancer and cirrhosis in those groups remains a future challenge for China.
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PMID:The inception, achievements, and implications of the China GAVI Alliance Project on Hepatitis B Immunization. 2433 Oct 15

The burden of infectious diseases both before and after liver transplantation is clearly attributable to the dysfunction of defensive mechanisms of the host, both as a result of cirrhosis, as well as the use of immunosuppressive agents. The present document represents the recommendations of an expert panel commended by the Italian Association for the Study of the Liver (AISF), on the prevention and management of infectious complications excluding hepatitis B, D, C, and HIV in the setting of liver transplantation. Due to a decreased response to vaccinations in cirrhosis as well as within the first six months after transplantation, the best timing for immunization is likely before transplant and early in the course of disease. Before transplantation, a vaccination panel including inactivated as well as live attenuated vaccines is recommended, while oral polio vaccine, Calmette-Guerin's bacillus, and Smallpox are contraindicated, whereas after transplantation, live attenuated vaccines are contraindicated. Before transplant, screening protocols should be divided into different levels according to the likelihood of infection, in order to reduce costs for the National Health Service. Recommended preoperative and postoperative prophylaxis varies according to the pathologic agent to which it is directed (bacterial vs. viral vs. fungal). Timing after transplantation greatly determines the most likely agent involved in post-transplant infections, and specific high-risk categories of patients have been identified that warrant closer surveillance. Clearly, specifically targeted treatment protocols are needed upon diagnosis of infections in both the pre- as well as the post-transplant scenarios, not without considering local microbiology and resistance patterns.
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PMID:Management of infections pre- and post-liver transplantation: report of an AISF consensus conference. 2438 27

Hepatitis C virus (HCV) has dominated the field of hepatology for the past 25 years, and its cure in the majority of treated patients is one of the greatest achievements in all of medicine. However, the latter has led to the belief by some that HCV research should be shelved for other, more pressing areas. The mission for HCV eradication is far from accomplished. As a historical reference, we should consider that disease elimination has required vaccination with all previously controlled infections including smallpox and polio and that simple, effective treatment is not sufficient in most infections to lead to substantial control. Syphilis is the best example, for which a single dose of penicillin (which literally costs pennies and that we have had since 1945) is curative in early stages. Not only have we not eradicated syphilis, rates of infection have increased in many places within the United States in recent years. Most HCV-infected subjects are unaware of their infection, remaining at risk for transmission to others and disease progression, including cirrhosis and hepatocellular carcinoma. In the era of highly effective direct-acting antivirals (DAAs), many questions pertaining to HCV remain, but they are more complex and difficult to answer. Here, I provide my perspective on some of these salient issues: the residual risk for disease progression after sustained virologic response, the optimal approach to current DAA failures, the impact of targeting people who inject drugs with DAAs, vaccine prospects, and application of neutralizing HCV glycoprotein antibodies. (Hepatology 2017;65:341-349).
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PMID:"Hep C, where art thou": What are the remaining (fundable) questions in hepatitis C virus research? 2764 Aug 81

Since the late 1940s, mass vaccination programs in the USA have contributed to the significantly reduced morbidity and mortality of infectious diseases. To assist the evaluation of the benefits of mass vaccination programs, the number of individuals who would have suffered death or permanent disability in the USA in 2014, had mass vaccination never been implemented, was estimated for measles, mumps, rubella, tetanus, diphtheria, pertussis, polio, Haemophilus influenzae type b (Hib), hepatitis B, varicella, and human papillomavirus (HPV). The estimates accounted for mortality and morbidity trends observed for these infections prior to mass vaccination and the impact of advances in standard of living and health care. The estimates also considered populations with and without known factors leading to an elevated risk of permanent injury from infection. Mass vaccination prevented an estimated 20 million infections and 12,000 deaths and permanent disabilities in 2014, including 10,800 deaths and permanent disabilities in persons at elevated risk. Though 9000 of the estimated prevented deaths were from liver cirrhosis and cancer, mass vaccination programs have not, at this point, shown empirical impacts on the prevalence of those conditions. Future studies can refine these estimates, assess the impact of adjusting estimation assumptions, and consider additional risk factors that lead to heightened risk of permanent harm from infection.
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PMID:Measuring the Benefits of Mass Vaccination Programs in the United States. 3300 80

Pakistan's hepatitis C virus (HCV) burden is one of the highest in the world. Around eight million people live with HCV in Pakistan according to a National Hepatitis Survey. Most HCV-infected people are unaware of their infection status culminating in delayed diagnosis and treatment, progressing to end stage liver disease, cirrhosis, and hepatocellular carcinoma (HCC), thereby raising the disease load for a developing country with limited resources. Blood transfusions and injections with reused syringes lead to increased HCV rates in Pakistan. According to a survey viral infections like hepatitis C, hepatitis B and HIV were not screened in more than half of the blood transfusions done in Pakistan. Hepatitis C elimination requires financial support from the local government and private organizations, commitment from civil societies across the world and a dedicated political will. Without defining effective planning and strategy it is our fear that it could become the second Polio for Pakistan.
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PMID:Hepatitis-C Infection: Are we really committed to eliminate? Could it become the second Polio for Pakistan? 3323 8