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)

Serum samples from 226 patients covering a wide spectrum of liver disease were tested for antibodies to hepatitis C virus (HCV) using both first and second generation enzyme linked immunosorbent assays. Selected sera were also tested by peptide immunoassays, by the four-antigen recombinant immunoblot assay (RIBA II), and for viral genome by the polymerase chain reaction. Antibody to c100-3 was detected in 61% of patients with chronic non-A, non-B (NANB) hepatitis and/or 46.5% with presumed NANB-related cirrhosis by the first generation test. These figures increased to 77% and 58% when antibodies to recombinant structural and non-structural HCV antigens were sought by the second generation assay. Supplemental testing against peptide Sp75 and Sp65/sp67 confirmed that reactivity of sera by second generation assays was due to antibodies to the additional structural and non-structural antigens. Samples negative by the first generation assay were not confirmed by the supplemental assay using peptides Sp75 and Sp65/Sp67. HCV RNA was detected in 60% of the anti-HCV positive sera tested, most of which were also RIBA II positive. Our findings confirm that the introduction of the structural and non-structural antigens, especially the putative nucleocapsid protein, improves sensitivity of detection of antibodies to HCV, and facilitates diagnosis in patients with "cryptogenic" chronic hepatitis.
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PMID:Improved diagnosis of chronic hepatitis C virus infection by detection of antibody to multiple epitopes: confirmation by antibody to synthetic oligopeptides. 128 51

We analysed the presence of hepatitis C virus (HCV) antibodies in 566 patients undergoing liver biopsy. While over 20% of the patients were anti-HCV positive according to ELISA, only 13.8% had HCV antibodies when tested with a four-antigen recombinant immunoblot assay (RIBA 2). At the time of inclusion in the study, most patients were asymptomatic, irrespective of whether they were HCV-positive. Histological findings in anti-HCV-positive patients were chronic persistent hepatitis, chronic active hepatitis or cirrhosis in greater than 75% of cases. Only four of the patients who were anti-HCV-positive according to the RIBA 2 had autoimmune chronic active hepatitis. Risk behaviour could be identified in the majority of cases. Community-acquired sporadic cases were rare (12%). Of the 153 patients who died during follow-up, 23 subjects were anti-HCV positive. Although age- and sex-adjusted survival was not shorter in anti-HCV-positive patients than in anti-HCV-negatives, the risk of hepatocellular cancer was higher (P = 0.01). We conclude that HCV infection is associated with chronic liver disease, even when critical evidence of viral aetiology is slight. Truly sporadic cases are rare. Patients infected with HCV are at increased risk of developing hepatocellular cancer.
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PMID:Hepatitis C in chronic liver disease: an epidemiological study based on 566 consecutive patients undergoing liver biopsy during a 10-year period. 768 Jul 6

302 out of 712 (42%) consecutive polytraumatized ICU patients received ten or more units of stored blood during primary and/or intensive care (1982 to 1987) treatment. 120 of the 197 surviving patients with an average number of transfusions of 23 (10 to 89) units were followed up after a mean interval of 70 (20 to 104) months. Mean duration of continuous post-ICU hospital stay was 17 (2 to 160) weeks, mean number of additional operative procedures was three (0 to 23). Manifest hepatitis had not occurred, all samples were negative for HIV testing. In nine samples (7.5%), anti-HBc-antibodies were positive, while HBs-antigen was negative. Ten patients (8.3%) tested positive for anti-HCV-antibodies (one combined with positive anti-HBc). The rate of serologically positive samples increased with the number of blood units given, duration of overall hospital stay and/or number of secondary surgery; all these findings failed to prove statistically significant. The rate of seropositivity for anti-HBc-antibodies corresponded well with the rate found in voluntary donors in FRG. Manifest or chronic hepatitis B was not observed. As to hepatitis C, the incidence of seropositivity for anti-HCV was found tenfold higher than in healthy blood donors in FRG. The relevance of this result remains unclear, but might indicate chronic post-transfusional hepatitis with high risk of cirrhosis. Among the patients testing positive for anti-HCV, too, acute manifest hepatitis had not occurred. Recently developed RIBA kits might improve specificity and sensitivity of anti-HCV testing. Thus, the frequency of PTH-C could decrease considerably.
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PMID:[Massive and multi-transfusions in polytraumatized patients: long-term serologic markers of hepatitis B, hepatitis C and AIDS]. 166 86

Hepatitis C virus (HCV) has been proposed to be a cofactor in the pathogenesis of cirrhosis in patients with chronic alcoholism. The demonstration of a different liver histological pattern in anti-HCV positive patients might provide additional evidence. We studied 164 patients with chronic alcoholism, and histologically proven cirrhosis. For all of them, serum samples were collected at the time of a liver biopsy and stored at -80 degrees C. Testing for anti-HCV antibodies was done using the Ortho Diagnostic Systems Anti-HCV ELISA test. Only reproducible results were considered positive. A semi-quantitative assessment of seven histological parameters was made independently on liver biopsy samples. In the study group, 29 patients (18%) had anti-HCV antibodies. When compared with anti-HCV negative patients, both groups had similar ALT and AST seric activities. Anti-HCV positive patients had a greater score of mononuclear cells infiltrate (0.71 +/- 0.57 vs 0.41 +/- 0.52; p less than 0.05) and a lesser score of alcoholic hepatitis (0.19 +/- 0.57 vs 0.74 +/- 0.74; p less than 0.005). The scores for steatosis, perisinusoidal and perinodular fibrosis, and hepatocellular necrosis were similar in the two groups. In anti-HCV positive patients, with a clearly positive recombinant immunobinding assay (RIBA, Chiron-Ortho Diagnostic Systems), a greater score for hepatic necrosis and a lesser one for fibrosis were demonstrated. Among the seven patients with active cirrhosis, six were anti-HCV positive. Therefore, HCV is likely to play a role in the pathogenesis of liver damage in a few patients with alcoholic cirrhosis, especially, those with active cirrhosis.
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PMID:Pathogenesis of liver cirrhosis in alcoholic patients: histological evidence for hepatitis C virus responsibility. 166 14

A second generation recombinant immunoblot assay to detect antibodies against Hepatitis C virus (RIBA II, Ortho Diagnostic Systems) was applied to 30 serum samples repeatedly reactive to ELISA anti-HCV c100-3, 11 from hemodialysis patients, 11 from patients with chronic hepatitis and 8 from patients with cirrhosis. The assay detects individual antibodies directed to 4 antigenic components of the C virus, 2 antigens, c100 and 5-1-1 contained in the original ELISA assay and 2 new antigens, c33c and c22-3 the latter structural in nature. From the total of 30 samples, 23 (77%) were reactive, 4 (13%) indeterminate and 3 (10%) non reactive to the RIBA II assay. Much variation was observed regarding the response to each individual antigen. c22-3 was the most frequently reactive with the highest intensity. RIBA II assay confirmed a high percentage of the reactive results with the ELISA c-100-3, serum samples that were non reactive to RIBA showed a low optical density with ELISA. c22-3 was the most sensitive antigenic component.
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PMID:[Antibodies against hepatitis C virus. Experience with a second generation test]. 172 13

Five Swedish patients with chronic hepatitis C were prospectively followed until hepatocellular carcinoma (HCC) developed. Hepatitis C virus (HCV) antibodies were analysed by a second generation anti-HCV ELISA and a recombinant immunoblot assay (RIBA-2) and viraemia by detection of serum HCV RNA by polymerase chain reaction. Four patients had post transfusion hepatitis and in one patient the source of infection was unknown. HCC developed after 8 to 23 years of mostly asymptomatic disease and all patients died. Four of them were repeatedly biopsied during follow-up and all had chronic active hepatitis. When HCC was diagnosed, cirrhosis was present in all 5. In 4 patients with available sera, anti-HCV was positive and confirmed with RIBA-2, whereof 2 were reactive only to the c-22 and c-33c epitopes. HCV-RNA was present in all sera when HCC was diagnosed. Thus, after prolonged disease duration these patients were still viraemic.
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PMID:Hepatitis C virus infection with progression to hepatocellular carcinoma: a report of five prospectively followed patients in Sweden. 750 21

The present study correlated histopathology and diagnostic tests in hemodialysis patients with serologic markers for hepatitis C virus (HCV). Hepatitis C virus infection was found in 65 of 163 patients, as assessed by anti-c100-3 (ELISA 1), anti-c22-3, c33C (ELISA 2), and RIBA 2. Several histopathologic patterns were found in 33 liver samples from HCV-positive individuals: cirrhosis (n = 3), chronic active hepatitis (n = 14), chronic persistent hepatitis (n = 2), isolated hemosiderosis (n = 5), reactive hepatitis (n = 6), and others (n = 3). There was a positive correlation between time from the first aminotransferase peak and histologic damage (P = 0.015). However, the severity of liver disease did not correlate with the intensity of RIBA 2 positivity, mean levels or pattern of aminotransferases elevation, or markers of past hepatitis B virus infection. Moreover, aminotransferases were persistently normal in three patients with severe liver disease and were elevated in 10 patients with only mild changes. In 19 biopsied patients, the presence of plasma HCV RNA was examined by the polymerase chain reaction (PCR), which was positive in 15 of the 19 biopsy specimens. The ability of PCR positivity to predict the histologic severity of the disease was insufficient: four patients with minor liver damage had positive PCR and two patients with significant liver damage had negative PCR. No further correlations of PCR positivity were found with the other biochemical or immunologic markers of HCV infection.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Liver disease patterns in hemodialysis patients with antibodies to hepatitis C virus. 750 4

Thirty-nine of 61 prospectively followed patients who had had acute non-A, non-B hepatitis in 1978 were clinically reexamined in 1991 and tested for antibodies to hepatitis C virus (anti-HCV) with a second generation ELISA and RIBA and for HCV RNA by PCR. Acute hepatitis C was diagnosed in stored sera from 1978 in 24 patients, who were found still to be anti-HCV positive in 1991, and 16 of them were also HCV RNA positive. The majority of anti-HCV positive patients with or without HCV RNA had elevated serum ALT levels 13 years after onset of their acute hepatitis C. After 13 years follow-up, 1.6% of the patients had died of end-stage liver disease, 8% of anti-HCV positive patients had histologically confirmed liver cirrhosis, 79% of anti-HCV positive patients were judged to have chronic infection, whereas 21% seemed to have recovered. To conclude, we found that a majority of our patients with acute symptomatic hepatitis C continued to be viraemic 13 years after onset of hepatitis C, and that all continued to be anti-HCV positive by second-generation ELISA.
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PMID:Outcome of acute symptomatic non-A, non-B hepatitis: a 13-year follow-up study of hepatitis C virus markers. 750 44

The possible relationship between essential mixed cryoglobulinemias (EMCs) and hepatitis C virus (HCV) has been investigated in eight patients with type II EMCs and biochemical signs of liver damage, whose serum tested positive in the ELISA for anti-HCV. Sera were tested using the 2nd generation RIBA assay, while serum HCV-RNA was measured semiquantitatively by a RT-PCR in whole serum, cryoprecipitates and supernatants. In all patients a percutaneous liver biopsy and a bone marrow biopsy were performed. At liver biopsy, chronic active hepatitis and/or cirrhosis were present in 6 patients; in the remaining two, a lymphoplasmacytoid infiltration of elements positive for kappa light chains was found. In all patients a bone marrow biopsy showed a paratrabecular infiltration of monoclonal lymphoplasmacytoid elements similar to those found in the liver of the two patients described above. Antibodies against structural and non-structural HCV proteins were detectable in the serum of all patients. HCV-RNA was amplified from the whole sera, cryoprecipitates and supernatants: significantly higher concentrations were found in cryoprecipitates than in supernatants. Our results confirm the high prevalence of HCV infection and ongoing viral replication in patients with type II EMC and suggest the possible implication of HCV in EMC pathogenesis.
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PMID:Hepatitis C virus infection in type II essential mixed cryoglobulinemias. 750 42

Hepatitis C is an important complication of therapy with coagulation factor concentrates; in fact, more than 90% of post transfusion hepatitis is caused by hepatitis C. Evaluation of HCV antibodies has been carried out mainly with the ELISA method but this test generates false positive results. Therefore, we studied ninety coagulopathic patients with the aim of determining the prevalence of hepatitis C virus (HCV) antibodies using the ELISA and RIBA methods. Our study confirms that the ELISA method presents false positivities: of 60 ELISA positive patients, only 41 were confirmed by RIBA. We found a significant correlation between HCV positivity, ALT titre and the number of concentrates used annually. In conclusion, our data suggest that the RIBA test is a useful confirmatory method in ELISA HCV-positive patients. This fact is particularly important in coagulopathic patients, in whom progression of chronic hepatitis C to cirrhosis is elevated.
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PMID:Hepatitis C virus antibody in coagulopathic patients: ELISA and RIBA methods. 750 58


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