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)

Approximately 50% of patients with chronic hepatitis C respond to treatment with interferon-alpha. The aim of this randomized controlled trial was to evaluate whether an increase in dose of interferon-alpha augments response rate. One hundred thirty-eight patients with newly diagnosed chronic hepatitis C received a three-month course of 3 MU IFN-alpha2b administered every two days. All patients were anti-HCV and HCV-RNA (PCR) positive. Prior to treatment, a liver biopsy was performed. Complete response was defined by normal serum ALT concentrations and disappearance of HCV-RNA. After three months, 60 nonresponders were randomized (stratified according to histology) either to continue 3 MU interferon-alpha2b every two days for another six months (group A, total dose: 410 MU) or to receive increasing doses of interferon-alpha2b (6 MU every two days for three months, followed by 10 MU every two days for three months) (group B, total dose: 870 MU). Serum ALT concentrations were measured monthly and HCV-RNA at three-month intervals. Liver biopsy was repeated six months after end of treatment. Pretreatment characteristics of the randomized patients were: group A: N = 30; male/female: 20/10; age: 54 +/- 10 years; CPH 9, CAH 8, cirrhosis 13; mean ALT 108 +/- 98 units/liter; group B: N = 30; male/female: 21/9; age: 57 +/- 15 years; CPH 10, CAH 9, cirrhosis 11; mean ALT 90 +/- 40 units/liter. At the end of treatment six patients in group B but none in group A became responders [P = 0.011 (Fisher's exact test), intent-to-treat analysis]. All six responders were noncirrhotics. High-dose interferon was not tolerated by six patients in group B. Noncompliance resulted in five dropouts in group A and one in group B. During the six-month follow-up, four of the six responders relapsed. A patient in group A with increased serum ALT concentration but negative HCV-RNA at the end of treatment became a full responder after six months. Of nonresponders to 3 MU interferon alpha2b every two days for three months, 20% responded to higher interferon doses, but none to continued standard dose. Prolonged treatment with interferon may be necessary to obtain a sustained response. However, treatment with higher-dose interferon was not tolerated in 20% of the patients.
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PMID:Dose increase augments response rate to interferon-alpha in chronic hepatitis C. 901 66

HCV is ubiquitous. In 50% of all cases it causes chronic hepatitis that often evolves into liver cirrhosis and hepatocellular carcinoma. Recently HCV has been classified in 5 genotypes by Okamoto. The purpose of this study is to evaluate the prevalence of 5 genotypes in Campania, a region of southern Italy, where the prevalence of anti-HCV antibodies ranges from 0.87 to 4%, and to evaluate the correlation between the HCV genotypes and the severity of histological damage. One-hundred- and-thirty-five anti-HCV positive patients were enrolled and tested by PCR to identify HCV-RNA. One-hundred-and-twenty-four patients resulted HCV-RNA positive. Genotyping was performed as described by Okamoto et al. with minor modifications of the specific primer to type III proposed by Silini et al. Eight patients were negative for all genotypes. Eight patients were positive for type I(1a), 61 for type II(1b), 39 for type III(2a), 11 for type IV(2b) and 1 for type V(3a). In 4 cases two different genotypes were present in the same sample [II(1b)-IV(2b), III(2a)-II(1b) twice, III (2a)-IV(2b)]. Histological evaluation of liver damage showed: CPH (22 cases), minimal CAH (56), severe CAH (31) and liver cirrhosis (15). There was no statistically significant correlation between the 5 genotypes and the severity of histological damage. Data on the prevalence of genotype II (1b) in Italy are similar to those reported for other European countries. The prevalence of genotypes in southern Italy is similar to that reported in the population of northern Italy.
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PMID:Prevalence of hepatitis C virus genotypes in southern Italy. 906 79

Soluble HLA-class I and CD8 molecules were determined by sandwich ELISA in patients with viral-induced hepatic disorders. As a whole, the patients with hepatic disorders (acute hepatitis: AH; chronic hepatitis: CH; liver cirrhosis: LC; hepatocellular carcinoma: HCC) showed higher sHLA-class I and sCD8 levels than normal controls (P < 0.001). AH patients had the highest sHLA-class I levels (mean, 3513 +/- 2112 ng/ml), followed by CH (2896 +/- 1290 ng/ml), LC (2293 +/- 1266 ng/ml), and HCC (2221 +/- 1212 ng/ml) sCD8 levels wer highest in AH, followed by HCC, LC, and CH, in that order. Among histologically defined C virus-positive patients, sHLA-I levels were higher in those with chronic active hepatitis (CAH) 2A (3802 +/- 1124 ng/ml) than in those with chronic persistent hepatitis (CPH; 2200 +/- 711 ng/ml; P < 0.01), the levels then decreased as the disease progressed (CAH2B, 3564 +/- 1783 ng/ml, LC, 2376 +/- 1265 ng/ml). In contrast, sCD8 values showed little difference among the disorders. sHLA-class I levels showed a positive correlation with sCD8 values both in whole patients and in patients with AH (P < 0.01), but no correlation was shown, in any patients, with biochemical parameters such as GPT and GOT. These findings, taken together, suggest that hepatic destruction is not the only cause of sHLA-class I production, but that sHLA-class I levels, together with sCD8 levels, may reflect immunological activity in hepatic disorders.
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PMID:Serum concentrations of soluble HLA-class I and CD8 forms in patients with viral hepatic disorders. 921 47

A rare case of "wild-type" HBV cirrhosis (CHIL A/HBeAG+/HBV-DNA+) with complete response to IFN treatment after 3 successive series based on different types of IFN is reported. In this patient, HBeAg and HBV-DNA negativization after the second treatment with r-alpha-2b-IFN was observed and after the third treatment with lymphoblastoid-IFN HBcAb,-IgM negativization simultaneously with ALT persistent normalization. Over one year after the interruption of the last treatment, HBV clearance with HBsAg elimination and HBsAb, seroconversion was observed. The effectiveness of IFN was histologically confirmed with decrease of the piecemeal necrosis in the liver and presence of light fibrosis whereas the results of 3 previous histological evaluations showed: 1) CPH (1985); 2) CAH lightly active with initial signs of cirrhotic evolution (1988); 3) CAH with presence of nodular cirrhosis in the liver (1991). In particularly selected cases the possibility of a favourable response to the series of IFN treatment is stresses even in more advanced chronic "wild" HBV forms in which there is not evidence of mutants in the viral population.
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PMID:[Complete response to IFN in a case of typical HBV cirrhosis]. 941 37

We studied the age- and sex-specific prevalence of hepatitis C virus (HCV) infection and aminotransferase abnormalities as well as histological changes in the liver associated with HCV infection. Of the eligible 3,707 inhabitants aged 6 years and older in an HCV infection epidemic area 2,382 (64.3%) were examined. The anti-HCV positivity rate was 20.7% on average and increased according to age. Age was the most potential risk indicator for anti-HCV positivity by multiple stepwise regression analysis. The HCV RNA positivity rate in females with anti-HCV was significantly lower than that in males. However, as the age of females increased, the HCV RNA positivity rate became higher. The proportion of subjects with aminotransferase abnormalities among HCV RNA-positive subjects was significantly lower in females than males. Aminotransferase abnormalities significantly increased with age in females. In subjects with abnormal aminotransferase levels, nearly half of the HCV RNA-positive females were aged 50 or older and also nearly half of the male subjects showed CAH2B or liver cirrhosis, while most of the HCV RNA-positive females younger than 50 exhibited histological findings consistent with CPH. In conclusion, age was the principal risk indicator for HCV infection in this area. Females, especially those younger than 50, both biochemically and histologically showed less severity of HCV infection than males. Gender and age might have effects on the outcome of HCV related liver disease.
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PMID:A cohort study of hepatitis C virus (HCV) infection in an HCV epidemic area of Japan: age and sex-related seroprevalence of anti-HCV antibody, frequency of viremia, biochemical abnormality and histological changes. 1022 Jul 37


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