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)

Pruritus is a common symptom of chronic cholestatic liver diseases but is considered rare in chronic hepatitis. We observed pruritus to be an unusually common complaint in patients with advanced chronic hepatitis C. We reviewed the records of 175 chronic hepatitis C patients to identify patients with severe, diffuse, unexplained pruritus; 12 consecutive prospective patients undergoing liver biopsy for chronic hepatitis C served as controls. Assessment included laboratory biochemical tests and assessment of liver pathology by stage, grade, hepatic activity index, and a bile duct score. Pruritus was present in nine (5.1%) patients. Serum AST, ALT, alkaline phosphatase, GGTP, total bilirubin, and ferritin were similar in pruritics and controls. Pruritics had higher serum bile acids (2028.4 +/- 223.1 mmol/liter vs 423.1 +/- 194.3, P < 0.001), higher transferrin saturation (57.5 +/- 6.8% vs 33.2 +/- 3.3, P < 0.01), and lower HCV RNA by bDNA (24.5 +/- 12.7 x 10(5) vs 172.7 +/- 54.1 x 10(5), P < 0.05). Pathology revealed cirrhosis in 6/9 (66.6%) pruritics vs 1/12 (8.3%) controls (P < 0.01). Pruritics had higher pathologic stage (3.7 +/- 0.2 vs 2.2 +/- 0.4, P < 0.01), grade (4.4 +/- 0.2 vs 2.1 +/- 0.2, P < 0.001), activity index (14.3 +/- 1.9 vs 8.6 +/- 1.9, P < 0.025), and bile duct score (7.6 +/- 0.6 vs 4.7 +/- 0.4, P < 0.01). Of eight pruritics treated with IFN-alpha2b, two had complete ALT response and one relapsed. Pruritus followed a relapsing course and only three patients partially responded despite a variety of interventions. In conclusion, pruritus is a common complication of advanced CHC. Its presence is associated with high serum bile acids, advanced pathology and bile duct abnormalities. The clinical course of pruritus is relapsing and response to therapy is inconsistent. These features suggest that pruritus in CHC has a pathogenesis that may vary from that of chronic cholestatic diseases.
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PMID:Pruritus in chronic hepatitis C: association with high serum bile acids, advanced pathology, and bile duct abnormalities. 914 69

We present 12 patients with CHC, 11 men and one woman, median age, 59.9 +/- 10.1 cared for in two hospitals from La Plata city. The median age, the predominance of men and presence of cirrhosis in the 75% are similar findings to European 41% of the patients, consulted of the CHC has increased in our environment. The fact that all the patients have been symptomatic at the moment of the consultation, that one of them had normal liver function tests and that only two of them had nodule of less than 5 cm of diameter, suggest advanced stage of the disease. At the same time, the median of survival of 8.3 +/- 9 (DS) months post-diagnosis and of 3.6 +/- 8 (DS) months post surgery. 90.9% had a risk factor to undergo CHC (alcohol, HBC, HCV). Because of one patient, the risk of hemodyalizer patients to have CHC is emphasized. Therefore, it is important to prevent and treat viral infections. In this study, the diagnosis of the echography was of 100% and the histologic corroboration was done by percutaneous biopsy with ultrasound or TC assessment. We observed that the levels of alpha-fetoprotein had a weak, negative correlation, not significative, with the diameters of the nodules. Although it is true that the size of the sample and the retrospective character of the investigation inhibits us to draw definitive conclusions, the behaviour of alfafetoprotein creates doubts about its value in the diagnosis and screening of the CHC.
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PMID:[Hepatocellular carcinoma: clinical and epidemiological characteristics]. 977 52

Measurement of antimitochondrial antibodies is established as a sensitive indicator for primary biliary cirrhosis, which has unfortunately limited diagnostic specificity. M2-antigen complex, consisted of four proteins of the inner mitochondrial membrane, has been found to be strongly associated with PBC. Clinical value of anti-M2 antibodies quantitative measurement with ELISA was analysed in 107 patients with carefully diagnosed liver diseases: acute viral hepatitis A, B, C (VHA, VHB, VHC; n = 41), chronic viral hepatitis B, C (CHB, CHC; n = 23), autoimmune hepatitis (AH; n = 6), liver cirrhosis (LC; n = 20), extrahepatic cholestasis (EC; n = 2) and primary biliary cirrhosis (PBC; n = 15). The highest values were found in PBC patients and varied from 92 to 167 U/l and dramatically exceeded normal range recommended by manufacturer (5 U/l). Mean value in this group (119.5 +/- 8.4 U/l) was significantly (p < 5 x 10(-8)) higher than in others, that varied from 1.3 +/- 0.2 up to 2.8 +/- 1.7 U/l in VHA and CHC groups respectively. Only two among 92 non-PBC patients have values over 10 U/l, but they reached only 15.8 (CHB) and 16.5 (CHC). Anti-M2 level in PBC patients demonstrated a significant positive correlation (r = 0.857) with the degree of liver insufficiency measured trough Child-Pugh score. From these data we can conclude, that quantitative measurement of anti-M2 antibodies with ELISA can serve as a very good screening for PBC, with 100% diagnostic sensitivity and specificity, if concentration of 20 U/l will be established as a pathognomic level.
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PMID:[Antibodies against M2-antigen in differential diagnosis of primary biliary cirrhosis]. 1096 9

The aim of this study was to assess the serum concentration of F1 + 2 in patients with liver cirrhosis developed during HCV infection and in patients with chronic hepatitis C infection. The study group consisted of 52 patients hospitalised at the Department of Infectious Diseases of Medical University of Lublin, Poland. Among them, 18 patients (8 men and 10 women), aged 19-59 years, had a stable liver cirrhosis and 34 patients (21 men and 13 women), aged 20-41 years, were diagnosed with chronic hepatitis C infection. The control group consisted of 25 healthy individuals (13 men and 12 women), aged 19-60 years. The serum concentration of F1 + 2 was determined by the immunoenzymatic assay Enzygnost F1 + 2 micro. There were no statistically significant differences observed in serum concentration of F1 + 2, both in patients with stable cirrhosis and with CHC, compared to controls. However, in 16.7% of patients with cirrhosis and in 35.3% of patients with CHC elevated serum levels of F1 + 2 were observed.
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PMID:Concentration of prothrombin fragment 1 + 2 (f1 + 2) in patients with liver cirrhosis and chronic hepatitis C infection. 1614 40

Clinical and morphological features of chronic hepatitis B (CHB), C (CHC), and B+C (CHB+C) were studied in 283 renal graft recipients. High total bilirubin serum levels were detected significantly more often in CHB and CHB+C patients vs. CHC patients. High ALT activity was noted in 65% of CHB patients and only in 45% of CHC patients (p = 0.003). Stable low activity of hepatitis prevailed in renal recipients; it was noted in 56.7% of CHB patients, 66.2% of CHC patients, and 62% of CHB+C patients. The character of pathomorphological liver changes in chronic viral hepatitis was studied in 53 renal graft recipients using puncture biopsy. Histopathological activity index (HAI, Knodell R.G. et al., 1981) witnessed a more severe liver lesion in CHB vs. CHC and CHB+C. Thus, inflammatory activity in CHB was found to be minimal or low in 13 patients, and moderate or high in 11 patients, whilst a minimal or low activity in CHC or CHB+C was found in 16 and 10 patients, respectively, and a moderate activity was detected only in two and one, respectively (p = 0.016 and 0.024 compared with CHB). Advanced hepatic fibrosis or cirrhosis was significantly more frequent (p = 0.006) in CHB patients (eight out of 24) than in CHC ones (none out of 18). The rate of advanced sclerotic changes in CHB+C was lower (one out of 10 patients) than that in CHB, and similar to CHC. Thus, clinico-morphological manifestations were more prominent in renal graft recipients with CHB vs. CHC.
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PMID:[Chronic hepatitis B and C in renal graft recipients]. 1713 55

Since 2004, pegylated interferon (P-IFN) in combination with ribavirin has become the optimal choice of therapy for chronic hepatitis C virus (HCV) infection. IFN a-2b suppresses HCV replication and restores elevated serum aminotransferase levels, leading to improvements in the histological changes in the livers of patients with chronic hepatitis C. Unfortunately, P-IFN has several adverse effects, including pneumonitis. This complication has been reported in the treatment of malignant diseases and CHC. We report a patient with interstitial pneumonitis thought to be caused by an IFN-based treatment in an unusual scenario of a patient with HCV-related Child-Pugh stage A cirrhosis, who experienced dyspnea, fever, and cough after 12 months of treatment with P-IFN a-2b. Her lung injury and pulmonary symptoms did not disappear despite discontinuation of IFN and the administration of corticosteroid. We concluded that the patient developed a fatal interstitial pneumonitis associated with P-INF a-2b therapy.
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PMID:Interstitial pneumonitis associated with pegylated interferon alpha-2b therapy for chronic hepatitis C: case report. 1837 74

Bile duct cells and hepatocytes differentiate from the same hepatic progenitor cells. To investigate the possible association of viral hepatitis B and C with intrahepatic cholangiocarcinoma (ICC), we conducted a retrospective case-control study using univariate and multivariate logistic analyses to identify risk factors for ICC. Besides hepatic lithiasis (25.6%; P<0.001), seropositivity for hepatitis B surface antigen (37.5% of all ICC patients; odds ratio (OR) =4.985, P<0.001) and seropositivity for hepatitis C antibodies (13.1%; OR=2.709; P=0.021) are the primary independent risk factors for ICC. Cirrhosis exerted synergic effects on the development of ICC. We compared the age distributions of viral-hepatitis associated ICC to that of viral hepatitis-associated hepatocellular carcinoma (HCC). The mean age of ICC patients with viral hepatitis B (56.4+/-11.1 years) were 9 years younger than that of ICC patients with viral hepatitis C (65.6+/-9.17 years), similar to that observed in HCC. The incidence ratio of HCC : ICC : CHC (combined hepatocellular cholangiocarcinoma) in our population was 233 : 17 : 1 consistent with the theoretic ratio of hepatocyte number to cholangiocyte number in the liver. Our findings indicated that both viral hepatitis-associated ICC and HCC shared common disease process for carcinogenesis and, possibly, both arose from the hepatic progenitor cells.
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PMID:Viral hepatitis-associated intrahepatic cholangiocarcinoma shares common disease processes with hepatocellular carcinoma. 1943 94

The aim of the study was to compare results of dopplerography characterizing hepatic and splenic blood flow at different stages of chronic viral hepatitis B and C and correlate them with histological findings and sclerosis. The study included 79 patients of whom 45 had chronic hepatitis B (CHB) and 34 hepatitis C (CHC). The most sensitive dopplerographic characteristics proved to be congestion index, liver vascular index, and hepatic hypertension index that started to change significantly at minimal activity of hepatitis and greatly deteriorated after development of liver cirrhosis. In both cases venous blood flow was affected more seriously than arterial one. Hepatic hyperperfusion progressed faster in CHC than in CHB. Dopplerographic characteristics correlated with histologic activity index, its components, and sclerosis index. Hence, the possibility of using dopplerographic studies for the evaluation of hepatic and splenic vasculature and indirect assessment of morphological changes in the liver.
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PMID:[Splenorectal blood flow in chronic viral hepatitis B and C]. 2001 52

The study aimed to clarify whether vascular endothelial growth factor mRNA (VEGF mRNA) and TNFa mRNA in the HCC tissues on top of HCV with and without cirrhosis obtained from specimens after curative hepatic resection has a prognostic value and recurrence predictive value compared to other tumor criteria. A total of 160 patients were studied. The preoperative laboratory, radiological and staging to patients was done. Using in situ hybridization technique, VEGF mRNA and TNFa mRNA were determined in liver tissues of, 10 controls, 50 with HCC, 50 with HCV without cirrhosis and 50 HCV with cirrhosis. The results showed that in HCC cases there was positive correlation between increasing age, loss of weight, INR and AFP but not in other cases of CHC with or without cirrhosis. AFP, vascular invasion, encapsulation, tumor size and grade and platelet count were related to patients outcome and recurrence of tumor after follow up of most cases for 3 years. The expression of VEGF in liver tissues was proportional to progress of viral hepatitis to cirrhosis with more expression in cases progressed to malignant changes. More expression of VEGF in HCC was more evident with intense expression in cases with Vascular and capsular invasion and higher level of AFP. Expression of TNF alpha mRNA and VEGF mRNA shows increasing expression with positive correlation to progression of viral hepatitis to cirrhosis with more positive with cases developed HCC.
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PMID:Prognostic value of TNF a mRNA and VEGF mRNA expression in patients with chronic hepatitis C genotype-4, with and without cirrhosis and hepatocellular carcinoma to predict disease outcome. 2124 58

The characteristics and response rate to pegylated interferon and ribavirin (PEG-INF + RBV) of patients with chronic hepatitis C infected with genotype 5 are poorly documented. A meta-analysis of two large phase III/IV prospective randomized clinical trials conducted in Belgium in patients with chronic hepatitis C (n = 1,073 patients) was performed in order to compare the response to antiviral therapy of hepatitis C virus (HCV) genotype 5 with that of other HCV genotypes. A subset of HCV-1 infected patients selected from within the study database were selected to match the HCV-5 sample for known prognostic factors. In Belgium HCV-5 is responsible for a significant minority of cases of chronic hepatitis C CHC (4.5%) and is characterized by a more advanced age (58.4 years), a high frequency of cirrhosis (27.7%), a specific mode of HCV acquisition, and a particular geographic origin (66.7% of patients from West Flanders). The primary comparative analysis showed that response to treatment with PEG-INF + RBV of HCV-5 is similar to HCV-1 and lower compared to HCV-2/3. The analysis of the matched patient subgroup demonstrates that the HCV-5 "intrinsic sensitivity" to PEG-IFN + RBV therapy is identical to HCV-1, with a sustained virological response of 55% in both groups. In contrast to previous publications, this meta-analysis suggests that HCV-5 response to treatment is closer to HCV-1 than to HCV-2/3 and suggests that in Belgium HCV-5 infection should be treated with the same antiviral regimen as HCV-1.
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PMID:Efficacy of interferon-based antiviral therapy in patients with chronic hepatitis C infected with genotype 5: a meta-analysis of two large prospective clinical trials. 2141 90


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