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

Case-control studies were initiated to investigate possible risk factors (life style, etc.) for hepatocellular carcinoma (HCC) and liver cirrhosis (LC). One hundred and fifty-four patients with HCC and 97 patients with LC who had no evidence of HCC were compared with frequency-matched 298 control subjects. Chronic hepatitis B virus infection and histories of blood transfusion and familial liver diseases were highly and significantly associated with both HCC and LC. Heavy drinkers in their younger years showed about 2 to 3 times risk increase for HCC or LC as compared with non-drinkers. Smoking was suspected as a risk factor, but a dose-response relationship was not clear, and further investigations are needed. To study the factors in the development of HCC from LC, 120 HCC patients with LC were compared with LC patients. No significant factors were observed. Ex-drinkers among LC patients experienced a slightly decreased risk for HCC in contrast to some belief that ex-drinkers with LC have higher risk for HCC.
 ...
PMID:[Case-control studies of hepatocellular carcinoma and liver cirrhosis in relation to life style and other risk factors]. 215 92

Chronic hepatitis B infection is an important cause of cirrhosis and subsequent hepatocellular carcinoma in South Africa. The disease can now be prevented by vaccination, but second-generation genetically engineered vaccines still necessitate planned allotment. We have tested 29,312 black southern African mineworkers for hepatitis B surface antigen (HBsAg) to indirectly ascertain the relative prevalence of hepatitis B infection in diverse linguistic and ethnic groups. The overall prevalence of HBsAg in this cohort of predominantly rural men was 9.9%, but the prevalence in men from different regions varied from 5.5% to 14%. The relative prevalence in 200 magisterial districts was ranked; these percentage prevalences ranged from 0% to 17%. A significantly lower mean prevalence was detected in Southern Sotho subjects than in those from coastal districts (Nguni). Based on these data, we believe that there are perhaps 2 million hepatitis B carriers in South Africa. The collected data in this report could provide a basis for a broad-based vaccine campaign whereby hepatitis B vaccine could be targeted to high-priority districts initially. This strategy could rapidly reduce the critical mass of carriers, and hasten control of the disease.
 ...
PMID:Differences in the regional prevalence of chronic hepatitis B in southern Africa--implications for vaccination. 252 93

100 consecutive British chronic carriers of hepatitis B surface antigen seen in a London teaching hospital are described. 77 were male homosexuals and only 19 had either symptoms or signs of chronic liver disease. 27 had normal liver function tests and 69 of the remaining patients had minimal changes, chronic persistent hepatitis, chronic active hepatitis, cirrhosis, or hepatocellular carcinoma diagnosed on liver biopsy. The 4 remaining patients did not have a biopsy but did have abnormal liver function tests. Chronic hepatitis B virus infection was an important cause of these conditions. Most patients showed no clinical, biochemical, or histological change during a mean follow-up period of 44 months, and only 9.7% spontaneously seroconverted from hepatitis B antigen positivity to become anti-hepatitis B e antibody carriers. Although the prognosis is good in the medium term, 7 patients died from hepatocellular carcinoma.
 ...
PMID:Natural history of liver disease in chronic hepatitis B surface antigen carriers. Survey of 100 patients from Great Britain. 611 90

146 patients (62 female, 84 male) with chronic hepatitis B and 80 patients (34 female, 46 male) with chronic hepatitis C were regularly examined in 1 to 2 year intervals with an average follow-up period of 12 years (mean). Each time patients were evaluated by physical examination, routine laboratory data, immunological and serological testing, ultrasonography, and laparoscopy and/or percutaneous liver biopsy. No patient of the study underwent immunosuppressive or antiviral treatment at any time.-The average time data in years are given as the median value (mean). Chronic hepatitis B: Histologic diagnoses and their long-term prognosis: Chronic persistent hepatitis (CPH) on first biopsy: 10% of cases complete recovery after 15 years, 70% progression to chronic active hepatitis (CAH) after 5 years; CAH: 30% advanced remission/complete recovery 8 years after the first diagnosis of CAH, 40% progression to liver cirrhosis after 5 years; liver cirrhosis: 50% advanced remission/recovery 4 years after the first diagnosis of cirrhosis, 5% developed a hepatocellular carcinoma (HCC) 11 years after the first diagnosis of cirrhosis. Natural history: In the 11 years following initial diagnosis of HBV-infection spontaneous recovery was observed in 49% of cases. In 3% of the patients the disease eventually caused death (1 x hemorrhage of oesophageal varices, 3x HCC after 14 to 20 years). Chronic hepatitis C: All patients were anti-HCV- and HCV-RNA-positive.-There was no spontaneous elimination of virus in any patient (maximal follow-up 27 years).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Long-term prognosis of chronic B and C viral hepatitis]. 750 Aug 7

Hepatocellular carcinoma (HCC) is among the 10 most common tumors in the world. However, incidence is not evenly distributed across the world. In many instances, the proximate cause for the tumor can be identified. Chronic hepatitis B infection is probably the most common cause, followed by chronic hepatitis C. Other important causes are alcoholic liver disease, hemochromatosis, alpha 1-antitrypsin deficiency, and other chronic liver diseases. Although proximate causes may be identifiable, pathogenesis remains uncertain. Factors that may be important include the presence of Aflatoxin B1 in food, genetic changes induced by the hepatitis B virus, and repeated rounds of necrosis and regeneration, also induced by hepatitis viruses. The genes involved and the mutations necessary for hepatic carcinogenesis are unknown, with the sole exception of the p53 gene, which is probably a late phenomenon. Screening for HCC is widely practiced despite the lack of evidence of improved survival. The screening tests used include alphafetoprotein levels and ultrasonography. Screening can identify small tumors; however, survival may not be improved, because the presence of cirrhosis may limit the number of patients who can undergo resections; recurrences or second primary tumors are common; and the presence of chronic liver disease means that survival may be limited anyway. There are many different forms of therapy available; unfortunately, most have not been compared in randomized controlled trials. Surgery remains the therapy of choice if feasible. All other therapy is palliative, including chemotherapy, chemoembolization, hepatic artery embolization, various forms of radiotherapy, and various forms of ablative therapy.
 ...
PMID:Hepatocellular carcinoma. 753 16

Chronic hepatitis B virus (HBV) infection is a serious problem because of its world wide distribution and possible adverse chronic sequalae such as cirrhosis and hepatocellular carcinoma. Over the past 20 years, many antiviral or immunomodulatory agents, or both, have been used in patients with chronic HBV infection. Among immunomodulatory agents, levamisole, BCG, picibanil and interleukin-2 have been shown to be ineffective. Corticosteroid therapy is also ineffective and can cause deleterious effects in chronic HBV infection. Thymosin-alpha 1 therapy is currently in phase III clinical trial. Among antiviral agents, acyclovir, dideoxynucleosides, suramin, zidovudine and ganciclovir have been shown to be ineffective and have intolerable side effects. While adenine arabinoside (Ara-A) and its monophosphate derivative (Ara-AMP) are effective agents if the treatment course is long enough, they have been withdrawn from investigative use because of their substantial neuromuscular toxicity. Interferon-alpha may directly inhibit HBV replication and enhance hepatocyte HLA class I antigen expression with subsequent increase of T-cell mediated cytotoxicity. Randomized, controlled clinical trials have shown that 25% to 50% of adult patients with elevated alanine transaminase (ALT) levels lost HBeAg and HBV-DNA when treated with IFN-alpha at a dose of 5MU daily or 10 MU three times a week for 3 to 6 months. In view of the fact that the response rate is far from satisfactory, particularly in Asian patients, combination therapies including interferon alpha with Ara-AMP, acyclovir, didoxynucleoside or interferon-gamma have been studied. Most forms of combination therapy have been shown to be of limited effect.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Drug therapy in patients with chronic type B hepatitis]. 754 84

The randomised clinical trials testing the effectiveness of interferon treatment on Chronic Hepatitis B patients were reviewed by means of meta-analysis. Twenty-two trials, published between 1987 and 1990, have identified where 1290 adult patients had been studied. Overall, interferon increased the rates of serum HBV-DNA clearance and amino-transferases normalization about 3 times at one year. However, when an analysis of internal consistency, clinical relevance and methodology of these studies was made, the trials were not sufficient to confirm the clinical effectiveness of the treatment since they had been planned for short-term assessment based on biochemical and viral end points alone. The link of these end points to other outcomes of more obvious clinical relevance (i.e. evolution to cirrhosis or deterioration of cirrhosis, death) is, in fact, questionable and thus the value of a meta-analysis based on currently available trials is uncertain as a source for practical guidelines. We conclude that the effectiveness of interferon in patients with chronic hepatitis B has yet to be confirmed by long-term prospective studies which assess the outcome by clinically meaningful end points such as cirrhosis, liver failure, or death.
 ...
PMID:Interferon treatment in patients with chronic hepatitis B: a meta-analysis of the published literature. 769 24

Hepatocellular carcinoma (HCC) is the most frequent primary malignancy of the liver, most prevalent in Asia and Africa but also showing a rising incidence worldwide. Chronic hepatitis B and C virus infection is the most important risk factor for HCC. More than half of the patients suffer from underlying liver cirrhosis. The prognosis is determined by tumor stage and residual capacity of the liver, the median survival being 0.9 to 12.8 months for patients receiving no specific treatment. In the East, early detection has been improved by screening programs which seem to be less valuable in the Western world.
 ...
PMID:[Current therapeutic strategies in hepatocellular carcinoma, Part 1]. 793 8

This article summarizes studies on hepatitis B in the Asian American population and includes prevalence rates among different Asian subgroups, routes of transmission, and sequelae of both perinatal and childhood-acquired hepatitis B virus infection. Rationale for use of hepatitis B immune globulin and hepatitis B vaccine for Asian infants and vaccine for children and seronegative adults is discussed also. Chronic hepatitis B, cirrhosis, and primary hepatocellular carcinoma in adults and screening for early detection of liver cancer are reviewed.
 ...
PMID:Hepatitis B virus infection in Asian Americans. 798 93

In an attempt to evaluate the long-term reciprocal impact of renal transplantation on hepatitis B virus infection, we analyzed the clinical, virologic, and pathologic features of 151 HBsAg-positive kidney transplant recipients. The spontaneous disappearance rates of HBsAg, HBeAg, and HBV DNA during a median follow-up of 125 months (range 1 to 320) were 3, 30.6, and 3%, respectively, figures lower than in the general population. A high rate of persistent viral replication (50%) and reactivation (30%) was noted. Noteworthy was the high frequency of histologic deterioration (85.3%), accompanied by cirrhosis in 28% and by hepatocellular carcinoma in 23% of the patients with cirrhosis. Co-infection by hepatitis C and B viruses was significantly associated with histologic worsening. Liver disease was the leading cause of death (36.6%), especially in patients with cirrhosis. Despite persistent viral replication, histopathologic deterioration, and liver-related overmortality, there were paradoxically no significant differences in the survival of these 151 HBsAg-positive compared with 1247 HBsAg-negative kidney recipients--however, allograft actuarial survival was better in the former than in the latter group (P=0.0006). Chronic hepatitis B infection is not a contraindication to renal transplantation in the absence of cirrhosis. The presence of cirrhosis should lead either to dialysis continuation or to a combined liver/kidney transplantation, in the absence of viral replication.
 ...
PMID:The long-term virologic and pathologic impact of renal transplantation on chronic hepatitis B virus infection. 875 32


1 2 3 4 5 6 7 8 9 10 Next >>