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)

Recombinant alpha 2c-interferon was administered to 12 consecutive patients with fulminant viral hepatitis. The disease was caused by coinfection by HBV and HDV in seven patients, by HDV superinfection of a chronic HBV carrier in two, by HBV alone in two and by HAV in one. Eight patients were drug addicts. Interferon administration was initiated shortly after the onset of hepatic encephalopathy and no patient was in grade IV coma at the beginning of therapy. Ten patients died and only two survived. One of the survivors was an asymptomatic HBV carrier superinfected by HDV in whom treatment with interferon for 3 months did not prevent the development of chronic delta infection and liver cirrhosis. These results show that alpha 2c-interferon does not have significant therapeutic value in fulminant viral hepatitis, particularly if it is caused by HDV.
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PMID:Recombinant alpha 2c-interferon therapy in fulminant viral hepatitis. 369 64

Chronic hepatitis may develop after acute B-hepatitis or acute non A-non B-hepatitis, as well as after toxic liver damage. Microscopic examination after biopsy allows to differentiate between chronic persistent (CPH) and chronic active (CAH) hepatitis. CPH needs not to be treated, but just to be controlled. Immunosuppressive therapy with steroids, eventually combined with azathioprine, is recommended nowadays in HBsAg-negative CAH. It has been shown, that survival rates are higher in patients, when this therapy is applied during the early stage of the disease, than in patients without therapy; the development of cirrhosis of the liver however does not seem to be influenced by this therapy. Immunosuppressive treatment of HBsAg-positive CAH is still controversial. Antiviral therapy (anti-HBs-antibodies, interferon, adenine-arabinoside) or therapy using immunostimulation (transfer-factor, levamisole, BCG) are also still in an experimental state.
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PMID:[Therapy of chronic hepatitis (author's transl)]. 616 69

Chronic hepatitis can be subdivided in to two subgroups by new serological methods. Controlled prospective studies have shown that HBsAg-negative, autoimmune chronic active hepatitis (CAH), which is characterized by autoantibodies in the blood, responds favourably to prednisone therapy alone or in combination with azathioprine. Preliminary results seem to indicate, that the dosage used may be reduced slowly and therapy finally stopped after 3-4 years of treatment in most patients. If relapses occur, a lifelong therapy seems to be necessary. Prednisone alone or in combination with azathioprine does not influence the course of HBsAg-positive CAH and the development of cirrhosis. For that reason corticoids cannot generally be recommended in these patients. If there is however a severe course of the disease with frequent periods of necrotising inflammatory involvement prednisone therapy for a period of about 12 months may be helpful. Treatment with different compounds supposed to stimulate immunological processes like laevamisol and transfer factor has not yet produced any decisive improvement. Treatment with antiviral substances as interferon, abarinoside A-or chloroquine still needs to be investigated further.
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PMID:[Therapy of chronic hepatitis (author's transl)]. 616 95

The current status of therapy for chronic HBsAg positive hepatitis is reviewed. Corticosteroid therapy usually has little, if any, benefit; in fact, in addition to its customary side-effects, it may enhance viral replication. Corticosteroids are indicated only in the rare case of life-threatening HBsAg-positive severe chronic active hepatitis with immune features. Clinical studies on antiviral treatment are continuing. Today interferon, ARA-A, and acyclovir appear the most promising agents under investigation. Patients with HBeAg-positive chronic hepatitis should be referred to centers evaluating antiviral treatment, particularly in the case of progressive liver dysfunction, relapsing activity or psychological imbalance because of contagious blood. There are at present few prospects of eradicating hepatitis B virus in patients with HBsAg, antiHBe positive cirrhosis, who remain at risk of developing hepatocellular carcinoma. With the exception of the above-mentioned categories, patients with chronic HBsAg-positive hepatitis should be encouraged to pursue as normal a life as possible. To define the natural history of the disease more precisely, they should be followed carefully after being adequately informed about their disease and the proper preventive measures.
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PMID:Treatment of chronic hepatitis type virus B. 619 73

Ascites often appears as a complication of several illnesses. The therapy is essentially based on the use of low-sodium diet, plasma or albumin infusion, diuretics and low-dosed ACE-inhibitors. To use the simple paracentesis or special techniques as Rhodiascit or Lee Veen Shunt means not to resolve definitively the problem and sometimes to cause undesirable complications. The authors present a new therapeutic tactics that joins the use of technique of double filtration of ascitic fluid and reinfusion of concentrated proteins (DFAF) with the injection in the peritoneal cavity of beta-interferon and the venous infusion of ATIII. Twenty patients affected by hepatic cirrhosis with the presence of ascitic fluid not treatable with the usual therapy have been subjected to this treatment. All the patients showed an immediate improvement of the clinical situation. After one year of observation, we describe our results. Twelve patients needed a further treatment with the DFAF technique, two patients died for the original pathology and six patients just needed an adjustment of pharmacologic therapy.
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PMID:[Reinfusion ascites therapy: considerations after a year's experience]. 748 Sep 64

The aim of this study is to assess the long-term economic impact of treatment of chronic hepatitis B and C with interferon alfa. Estimates were made of the progression of the disease over a 30-year period using a transitional probability model. Cohorts of 1,000 hypothetical patients with either chronic hepatitis B or C treated with interferon alfa were compared with an untreated cohort. The costs were estimated for therapy, monitoring, and treatment of the disease, including transplantation. The cost-effectiveness of therapy was expressed in terms of cost per life saved, cost per year of life saved, and cost per quality-adjusted year of life saved. The analysis was extended to include the indirect costs to patients. The analysis included two rates of progression, two mortality rates, and discounted and undiscounted costs. Mortality in the treated group was lower, saving 18 to 31 lives in the hepatitis B virus (HBV) cohort and 13 to 22 lives in the hepatitis C virus (HCV) cohort. Fewer patients progressed to cirrhosis or decompensated cirrhosis. Discounted costs per year of life saved ranged from 2,142 pounds to 17,128 pounds. A cost-benefit analysis indicated excess benefits over costs when values for life were included in the analysis. The potential usefulness of interferon alfa on the clinical and economic outcome of treatment is indicated from the model. These findings together with the benefits that are likely to accrue from the reduction in infectious individuals suggest that this therapy has a role to play in public health policy to contain the impact of hepatitis.
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PMID:Treatment of chronic type B and C hepatitis with interferon alfa: an economic appraisal. 749 1

The methods for diagnosing hepatitis C virus infection have been evolving since the first-generation enzyme-linked immunosorbent assay antibody test was devised in 1989. In addition to assaying for serum antibodies against viral proteins, serum and liver tissue can be tested for viral RNA, evidence of ongoing viral replication. The improving ability to diagnose hepatitis C has furthered the understanding of the natural history of this infection. Acute hepatitis C results in chronic elevations of serum transaminase levels following nearly one half of cases. Cirrhosis complicates approximately 20% of chronic infections. Long-standing chronic hepatitis C may play a role in the pathogenesis of hepatocellular carcinoma. Sustained normalization of serum transaminase levels, often accompanied by a decrease in or disappearance of viral RNA, occurs in approximately 25% of patients with chronic hepatitis C who are treated with a 6-month course of recombinant interferon alfa. This treatment can occasionally be complicated by hematologic, endocrinologic, and psychiatric adverse effects but is usually fairly well tolerated. Whether interferon therapy will diminish the risk of cirrhosis or carcinoma is not yet known. This article reviews the diagnosis of chronic hepatitis C infection as well as the mechanisms of action, efficacy, and adverse effects associated with interferon alfa therapy.
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PMID:Chronic hepatitis C. Advances in diagnostic testing and therapy. 750 93

Chronic hepatitis C is common in Saudi Arabia and most often presents in an advanced stage. To assess the response of patients to interferon, a randomized placebo-controlled double-blind study was undertaken. All but 1 patient had cirrhosis or fibrosis before interferon. After a 24-week observation period patients received alpha 2a interferon, 3 mega units sc tiw or placebo for 24 weeks, then the opposite treatment for another 24 weeks followed by 24 weeks of observation. Liver biopsies were performed before and after each of the treatment phases. Twenty-two out of 24 patients completed the study. The mean alanine aminotransferase (ALT) levels fell from 150.7 +/- 118.7 units/l to 91.0 +/- 42.6 units/l after 6 months interferon treatment (P = 0.03) but only 3 patients (14%) had complete normalization of mean ALT levels and 4 (18%) had > 50% reduction. The mean hepatitis activity index fell from 12.2 +/- 2.6 immediately before to 11.6 +/- 2.5 just after interferon (P = 0.4). After interferon there was an insignificant raise in 6-month mean ALT. Hepatitis C virus-RNA was positive in all 17 patients tested and remained so after treatment. Side-effects were mild and well tolerated. Alpha interferon 3 mega units tiw for 24 weeks is not an effective treatment of histologically advanced chronic hepatitis C.
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PMID:Histologically advanced chronic hepatitis C treated with recombinant alpha-interferon: a randomized placebo-controlled double-blind cross-over study. 751 10

263 patients with chronic hepatitis C who received interferon therapy were followed up for an average 2.7 years after therapy. 36% of patients showed complete response, 16% of patients showed partial response, 48% of patients showed no response. 96 patients underwent liver biopsy after therapy and were observed long-term prognosis. 13 cases developed to liver cirrhosis. Histopathology before and after interferon, HCV-DNA probe before therapy were examined.
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PMID:[Long-term prognosis after interferon therapy in chronic hepatitis type C]. 752 25

The concentration of Hepatitis C Virus (HCV) in the blood is increased by alcohol drinking and decreased by abstinence. These facts suggested that alcohol abuse may enhance the replication of HCV. The effects of alcohol on HCV replication may be related to increased development of chronic hepatitis to liver cirrhosis and hepatocellular carcinoma in HCV marker positive heavy drinker. These results indicated that HCV positive heavy drinkers must keep abstinence and that these patients have to be treated with interferon.
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PMID:[Effects of interferon treatment in alcoholic liver injury]. 752 33


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