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)

Six months alpha IFN therapy was efficient for chronic viral hepatitis C in 31% patients after six months and in 17% after one year. Cirrhosis, low serum albumin or prealbumin levels and elevated IgA seric level were non responsiveness predictive factors.
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PMID:[Chronic viral hepatitis C and interferon: results after a year and predictive factors of response (a multivariate study with 35 patients)]. 800 8

In a long-term study (27 months) of patients affected by C-virus active hepatitis we have evaluated the effect of decreasing the dose of interferon by 50% and by 75% with respect to the initial efficacious dose (6 MU tiw). Sixty patients received recombinant interferon alpha-2b(r-IFN- alpha-2b) 6 MU tiw for two months followed by 3 MU for seven months (Group A), and 60 patients received r-IFN alpha-2b 6 MU tiw for two months followed by 1.5 MU for seven months (Group B). Three patients in group B failed to return to follow-up and were not considered in subsequent evaluations. Side effects such as to cause suspension of treatment occurred only during the first two months of the study at 6 MU of interferon (3 patients in group A and 6 in group B). During the two months at 6 MU, transaminase values returned to normal in 94 patients (80%). At the end of follow-up, 49 of these patients (42% of the 117 patients examined; or 48.3% in group A and 35.1% in group B) had normal transaminase levels. In no case did the anti-HCV test become negative. On a reduced dose of interferon, relapses occurred more frequently in group B (21.4%) than in group A (9.6%), but the difference was not significant. No difference between responders and non-responders, including relapsing patients, was observed in relation to gender, age, presence of cirrhosis, presence of B-virus antibodies and initial levels of serum transaminase.
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PMID:Long-term follow-up evaluation in HCV chronic hepatitis treated with alpha-2b interferon. A comparison of two protocols. 802 1

The patient was a 25-year-old male doctor, who had pricked his finger with a needle contaminated with blood from a 69-year-old male patient with liver cirrhosis (HCV-Ab positive, genotype II). He was informed from the blood bank that his blood was positive for anti-HCV and his GPT being 148 IU/l on the 65th day after exposure. He was admitted on February 16, 1993 and received a liver biopsy, which was consistent with acute viral hepatitis. His genotype was the same (type II) with the donor patient. IFN-alpha-2b of total doses of 656 Megaunits resolved the hepatitis completely and the HCV-RNA became negative as early as two weeks after starting IFN therapy. Liver biopsy after IFN therapy showed convalescence of acute hepatitis. The progression of acute hepatitis C to chronicity could be prevented by interferon therapy even in unfortunate cases of HCV transmission by needlestick. In conclusion, accidental needlestick should be followed for at least six months, and serum GPT and second-generation anti-HCV ELISA tests are recommended for all infected personnel.
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PMID:[A case of needlestick-induced acute type C hepatitis]. 805 46

Interferon-alpha (IFN-alpha) has become an important drug for the treatment of chronic viral liver diseases. However, the action of IFN-alpha remains unclear. We investigated whether human recombinant IFN-alpha modulates serum concentrations of hyaluronic acid (HA) and type III procollagen aminoterminal propeptide (P-III-NP) in 56 patients with chronic hepatitis-B under IFN-alpha therapy. IFN-alpha increased the HA serum level in 44 of 46 patients and, after cessation of treatment, HA serum levels returned to the pretherapy levels. The increase of HA serum level was higher in patients with active cirrhosis (aC) than in patients with chronic persistent hepatitis (CPH) and in patients with severe inflammation compared to those with moderate inflammation. Interestingly, HA serum concentration was unrelated to IFN dose and was of no predictive value for therapy response. In contrast, IFN-alpha increased significantly the P-III-NP serum level in patients with aC only. During follow-up, P-III-NP serum level decreased late in responders in parallel to the decrease of serum level of liver enzymes, in non-responders it was without significant change. The first dose of IFN induced a significant increase in HA serum level in each of 10 patients but in none of four healthy volunteers. In contrast, P-III-NP serum concentrations were not influenced by the first IFN-alpha dose. We conclude that: (1) immunstimulation with IFN-alpha induces a rapid increase of HA serum level in patients with chronic hepatitis B but not in normal persons; (2) IFN-alpha increases P-III-NP serum level only in patients with active liver cirrhosis; (3) measurement of HA and P-III-NP serum levels does not help predict response to IFN-alpha, and (4) HA serum level may be used as a compliance indicator.
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PMID:Interferon-alpha 2a increases serum concentration of hyaluronic acid and type III procollagen aminoterminal propeptide in patients with chronic hepatitis B virus infection. 808 11

Hepatic expression of interferon-alpha (IFN-alpha) was examined by immunohistochemistry in 90 Chinese patients (M/F 67:23, age: 14-69) with a spectrum of hepatitis B virus (HBV)-related chronic liver diseases. Immunoreactive IFN-alpha was detected in sinusoidal cells in 79 patients (88%) and in mononuclear cells in 59 patients (65.6%). Patients with active liver diseases (chronic active hepatitis, active cirrhosis, N = 55) had a higher level of IFN-alpha expression compared to patients with inactive histology (N = 35; sinusoidal cells, P < 0.01; mononuclear cells, P < 0.01). Cytoplasmic HBsAg, nuclear HBcAg, and cytoplasmic HBcAg were detected in 79 (88%), 42 (47%), and 23 (27%) patients respectively. Expression of IFN-alpha in mononuclear cells correlated with the expression of cytoplasmic HBcAg (P < 0.05) but not with nuclear HBcAg or cytoplasmic HBsAg. When the patients were divided into four different phases according to the natural history of chronic HBV infection, patients in the active liver disease phase had higher IFN-alpha expression compared to the immunotolerant and late phase patients (P < 0.01). Using double immunohistochemical staining, both IFN-alpha and cytoplasmic HBcAg were frequently detected near inflammatory infiltrates but no correlation existed between the hepatic expression of HBsAg and IFN-alpha. These data indicate that IFN-alpha is expressed in the liver in HBV-related active liver diseases and that the reported suboptimal production of IFN-alpha by PBMC in HBV-related chronic active liver diseases may be due to a redistribution of the IFN-alpha-producing mononuclear cells into the liver, the site of inflammation.
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PMID:Hepatic expression of interferon-alpha in chronic hepatitis B virus infection. 808 12

The aim of this study was to compare the effects of two different therapeutical regimens of IFN alpha-2a in patients with HCV related chronic liver disease. Eighty one patients with HCV chronic hepatitis with or without cirrhosis entered the study; 42 and 39 patients were treated with 3 or 6 MU IFN, respectively. The results show that: 1) 25/39 (64.1%) patients treated with 6 MU and 21/42 (50.0%) patients treated with 3 MU had a complete response defined as a decline in serum ALT levels to the normal range during therapy; 2) complete response to 6 MU treatment was observed independently of the presence or absence of cirrhosis; in the 3 MU group, a complete response was observed in 31.6% of patients with CAH + cirrhosis as compared with 68.2% of those with CAH alone (p < 0.03); and 3) at 1 year after the end of the treatment we observed persistent ALT normalization in 40.6% and 28.2% of patients treated with 6 or 3 MU, respectively, and absence, of HCV viraemia (HCV-RNA) in 7/10 patients with CAH and in 2/7 patients with CAH + cirrhosis, mostly in patients treated with 6 MU. In conclusion, 6 MU IFN dose is more effective than 3 MU in reducing disease activity in HCV chronic hepatitis, specially in patients with CAH + cirrhosis.
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PMID:Recombinant human interferon alpha-2a therapy for chronic hepatitis C with or without cirrhosis: comparison of 3 or 6 MU for 1 year. 812 95

Chronic hepatitis C is one of the major causes of liver cirrhosis and seems to play a role in the pathogenesis of primary liver cancer. So far, no effective therapy--with the exception of some antiviral agents--was available for this disease. Interferon-alpha (IFN-alpha) therapy results in about half of patients in a normalisation of liver transaminases within 4 weeks. Placebo-controlled studies confirm that in about 40% of patients IFN therapy achieves complete remissions. Frequently termination of IFN therapy is followed by a relapse. Therefore higher IFN doses and longer and/or repeated therapy cycles are currently investigated in order to improve treatment results. Furthermore, IFN-alpha is combined with other therapeutic principles. The possible usefulness of IFN-alpha for treatment of acute hepatitis C is under investigation.
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PMID:[Interferon therapy in hepatitis C]. 827 73

Forty patients with chronic viral hepatitis or active cirrhosis (33 anti-HCV positive) entered a recombinant human alpha 2A interferon randomized trial. Twenty-one subjects were treated with 6 million units (MU) three times per week for 6 months. Nineteen were not treated. Six months later in 12 patients of the treated group (60% of the evaluable 20) with normalized serum aminotransferases levels (responders), fibrogenesis serum markers (NPIIIP and laminin) were significantly lower than baseline. In the untreated patients and in non-responders NPIIIP and laminin were unchanged. Semi quantitative histological evaluation (allotting scores for inflammation, necrosis and fibrosis) confirmed a significant improvement of necro-inflammation in the responders. These data suggest that alpha-IFN treatment may decrease stimuli for fibrogenesis by reducing liver inflammation and necrosis, thus preventing evolution to cirrhosis.
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PMID:alpha-Interferon in the treatment of chronic viral hepatitis: effects on fibrogenesis serum markers. 834 Jun

Interferons have been used to treat chronic hepatitis owing to their antiviral properties. However, now interferons are recognized to inhibit collagen production. Because fibrosis has been associated with liver damage and dysfunction, the effects of interferon-alpha 2b on biliary obstruction-induced cirrhosis were investigated. Obstructive jaundice was induced in male Wistar rats (ca. 200 g) by double ligation and division of the common bile duct. Control rats were sham operated. Interferon-alpha 2b (IFN-alpha; 1000 000 IU per rat) was administered subcutaneously daily after surgery. The animals were sacrificed after 4 weeks of bile duct ligation (BDL) or sham operation. Bilirubins and serum enzyme activities of alkaline phosphatase and gamma-glutamyl transpeptidase (determined as markers of liver damage) increased several-fold after BDL. Erythrocyte and hepatocyte plasma membrane Na+/K+- and Ca2+-ATPase activities decreased significantly in the BDL group. Administration of IFN-alpha to BDL rats resulted in a partial normalization of serum markers of liver damage. The normal activity of both ATPases on erythrocyte and hepatocyte plasma membranes was completely preserved by IFN-alpha. It is concluded that interferons possess interesting hepatoprotective effects not related to their antiviral properties but probably associated with their antifibrogenic effect.
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PMID:Interferon-alpha preserves erythrocyte and hepatocyte ATPase activities from liver damage induced by prolonged bile duct ligation in the rat. 860 32

The high worldwide prevalence of chronic viral hepatitis, as well as its progressive course, have led to the performance of multiple clinical studies. The natural history of the disease is different depending on the infecting virus; thus, the evolution to liver cirrhosis and/or hepatocellular carcinoma for the hepatitis B, C and delta (D) viruses in chronic hepatitis is 15, 20 and 75%, respectively. Different therapeutic agents have been used in attempts to modify the natural course of these diseases, interferon-alpha (IFN alpha) having proved to be the most effective. In 30 to 50% of patients, treatment with IFN alpha has achieved inhibition of viral replication, as well as normalisation of aminotransferase levels. Moreover, in a majority of patients, histological improvement is observed, principally in piece-meal necrosis and portal inflammation. The dosage currently recommended for treatment of chronic hepatitis B is 30 to 35MU weekly for a minimum of 4 months; when there is a co-existing delta virus infection, the total dosage employed should be greater. For hepatitis C, the minimum effective dosage is 9MU weekly, and a treatment duration of 12 months is recommended. The administration of IFN alpha produces a series of dose-dependent adverse effects, which are reversible on suspension of the medication. The most frequent of these adverse reactions is the 'flu-like' syndrome, which is self-limited and generally well tolerated. Secondary haematological alterations (leucopenia and thrombocytopenia) are the most frequent cause of reduction in dosage or suspension of treatment, although the latter is not normally necessary. The proportion of patients requiring dosage modification or suspension of treatment fluctuates between 5 and 15%. Taking the evolution of chronic hepatitis into account, there can be no doubt that all patients with this disease should be offered treatment. At present, the drug of choice is IFN alpha, as it slows disease progression and it is generally well tolerated.
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PMID:Risks and benefits of interferon-alpha in the treatment of hepatitis. 878 18


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