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Pathogenesis and treatment of autoimmune hepatitis and chronic viral hepatitis B and C.

Immune mechanisms play a role in autoimmune hepatitis which is considered as "idiopathic" inflammatory liver disease of unknown etiology. However, even chronic viral hepatitis B and C have also features suggesting the importance of immunopathogenesis in their development. This paper discusses the major genetical and immunological factors in the above-mentioned chronic liver diseases and briefly summarizes their therapeutic modalities.

From hepatitis B to hepatitis A and B prevention: the Puglia (Italy) experience.

The incidence of hepatitis B virus infection in Italy is 10 per 100, 000 population, with most cases occurring in young adults. Vaccination against hepatitis B has been compulsory since 1991 for all newborns and 12-year-olds. In the Puglia region, this programme has reduced the incidence of hepatitis B from 7.4 per 100,000 population in 1990 to 2.4 per 100,000 population in 1996. The number of notified cases of hepatitis B in Puglia decreased from 212 in 1992 to 73 in 1997. As 50% of these cases occurred in young adults, the main aim of the current vaccination programme is to achieve high cove…

[Epstein-Barr, hepatitis B and hepatitis C virus infections and their oncogenic potentials].

There are two ways of connecting Epstein-Barr virus (EBV) with the uncontrolled growth of EBV infected B lymphocytes: in case of evident imm … lower or higher percent, as well as the high titers of antibodies against specific virus antigens. Hepatitis B viral infection (HBVI) of specific chronic course and associated with intensified inflammation and mitotic activity is of one of the most important factors in the appearance of hepatocellular carcinoma. Although the integration of viral DNA in DNA …

Flutamide-induced toxic hepatitis. Potential utility of ursodeoxycholic acid administration in toxic hepatitis.

Flutamide is a nonsteroidal antiandrogen commonly used in the treatment of prostate cancer. Hepatic toxicity associated with flutamide has been reported with an incidence from less than 1% to about 5%. Ursodeoxycholic acid (UDCA), a hydrophilic bile acid, has been widely used in the treatment of cholesterol gallstones and of several liver diseases, but few data are now available concerning its use in the management of drug-induced hepatitis. The case of a patient who presented severe hepatitis with jaundice following use of flutamide is reported. UDCA treatment was started on admission and, co…

Azathioprine hepatitis in kidney transplant recipients. A predisposing role of chronic viral hepatitis.

Influence of viral liver diseases on the occurrence of azathioprine hepatitis was evaluated in 21 kidney transplant recipients. Diagnosis of azathioprine hepatitis was always based on jaundice, which disappeared after azathioprine withdrawal in 18 patients and after azathioprine dose reduction in 3 patients. Histopathological diagnosis of azathioprine toxicity was ascertained in 14 patients. Rechallenge with azathioprine performed in 4 patients, within 2-4 months after the first jaundice episode, resulted in relapse of jaundice in all cases. Viral hepatitis B virus and hepatitis C markers were…

[Heterogeneity of antimicrosomal autoantibodies in chronic hepatitis C virus infection and delta hepatitis].

Microsomal antigen autoantibodies are typical of type 2 autoimmune hepatitis, and a strong association with chronic hepatitis C virus (HCV) infection has been reported in certain geographical areas. These autoantibodies have been denominated LKM-1 to differentiate them from those associated with thienylic acid-induced hepatitis (LKM-2) and from those seen in patients with chronic delta hepatitis (LKM-3). To investigate the antigenic specificity of autoantibodies associated with chronic hepatitis C and delta, we analyzed 52 LKM-1 positive serum samples from patients with chronic hepatitis C and…

Hepatitis C virus antibodies in asymptomatic chronic carriers of hepatitis B surface antigen.

UNLABELLED: The objectives of the study were to evaluate the prevalence, incidence and clinical significance of antibodies to hepatitis C virus in HBsAg chronic carriers. The evaluation of stored sera was combined with the follow up of a cohort of cases observed in a referral-based university hospital. A total of 183 HBsAg asymptomatic chronic carriers were identified during routine screening and followed for a mean period of 3.8 years. Stored sera and sera obtained during follow-up were tested for anti-HCV using ELISA. Second-generation RIBA (Ortho) was used as a possible confirmatory test. D…

The epidemiology of Schistosoma mansoni, hepatitis B and hepatitis C infection in Egypt.

There appears to be no epidemiological association between Schistosoma mansoni infection, the intensity of S. mansoni infection or S. mansoni infection complicated by schistosome hepatic fibrosis and the presence of antibody to hepatitis B virus core antigen (anti-HBc), hepatitis B surface antigen (HBsAg), antibody to hepatitis C virus (anti-HCV) or antibody to both agents. This was the main conclusion of a population-based study of an entire village in the northern Egyptian Nile Delta. All 1850 villagers were invited to participate and serological, parasitological and ultrasound examinations …

Clinical and serological differentiation of autoimmune and hepatitis C virus-related chronic hepatitis.

Recent reports have focused on the difficulty in differentiating autoimmune hepatitis from chronic hepatitis C due to the high prevalence of anti-HCV in autoimmune hepatitis. The aim of this study was to identify clinical, biochemical, and serological variables that would help distinguish these two diseases. Pretreatment clinical and biochemical variables were compared from 17 patients with steroid-responsive autoimmune chronic active hepatitis and 62 patients with chronic hepatitis C. Serum samples from these patients were tested for autoantibodies and for anti-HCV by first- and second-genera…

Антитела от вируса гепатита С при остром и хроническом гепатите С.

Стандартизованная иммунная система, доступная на коммерческой основе, не позволяет обнаруживать антитела против гепатита С (IgM антиHCV). Поэтому была проведена оценка различных "внутренних" ферментов иммуномассы. Эти оценки значительно различаются по чувствительности, однако во всех из них их специфичность представляется удовлетворительной. Типичная реакция антител IgM на антигены HCV обычно встречается почти у всех пациентов с острым гепатитом C. Эта реакция на антитела редко предшествует появлению IgG анти-HCV, и она сохраняется в течение нескольких месяцев на высоком уровне. В 50-80% случа

Совпадение в аннотации оригинала
A standardized commercially available immunoassay is not available for detection of IgM antibodies against hepatitis C virus antigens (IgM anti-HCV). Therefore, different "in-house" enzyme immunoassays have been assessed. These assays vary greatly in sensitivity, but specificity seems satisfactory in all of them. A typical IgM antibody response to HCV antige…

[The hepatitis C virus--principal causative agent in non-A, non-B hepatitis].

The diagnosis of non-A, non-B (NANB) hepatitis was based on the exclusion of hepatitis A and B infection and other known causes of hepatitis, such as other viruses, alcohol and toxic effects. More recently, an RNA has been isolated from a NANB-infected chimpanzee serum and with its aid a polypeptide antigen was produced by molecular biological methods. Antibodies to this antigen--as part of the infectious agent, called hepatitis C virus (HCV)--were detected in the sera of infected patients. Studies with this antigen/antibody system proved, the HCV is responsible for the majority of posttransfu…

[Clinical characteristics and prognostic criteria in alcoholic hepatitis and alcoholic hepatitis with cirrhosis].

A comparative study of clinical and biological features and of the immediate prognosis was made in 46 patients with alcoholic hepatitis and 19 patients with alcoholic hepatitis with liver cirrhosis. The presence of cirrhosis has different clinical manifestations and a more intense alteration of albumin, prothrombin, total bilirubin and immunoglobulins (p less than 0.01). The development of ascites, encephalopathy and hepatorenal syndrome (p less than 0.05) and albumin, prothrombin and total bilirubin values at admission (p less than 0.01) were the best parameters to identify the patients with …

Serial passage of hepatitis delta virus in chronic hepatitis B virus carrier chimpanzees.

Five consecutive passages of hepatitis delta virus in hepatitis B virus carrier chimpanzees were performed in order to further characterize the infectious and pathogenic nature of this naturally occurring defective virus. Three animals received identical inocula at fourth passage in order to assess individual animal variation as a factor in the course of infection and disease. Acute hepatitis delta virus infection occurred in all hepatitis B virus carrier chimpanzees as demonstrated by coincident intrahepatic hepatitis delta antigen, serum hepatitis delta antigen and serum hepatitis delta viru…

Natural history of acute hepatitis B surface antigen-positive hepatitis in Greek adults.

We prospectively followed up 821 adults with acute viral hepatitis hospitalized at the Athens Hospital for Infectious Diseases between May 1981 and May 1983. Radioimmunoassays for the detection of serologic markers of hepatitis A virus, hepatitis B virus, and hepatitis delta virus, and molecular hybridization techniques for the detection of serum hepatitis B virus deoxyribonucleic acid and hepatitis delta virus ribonucleic acid were used. Based on the results of an enzyme immunoassay for the detection of immunoglobulin M antibody to hepatitis B core antigen (Corzyme-M), 563 cases were diagnose…

Hepatitis B markers and risk factors for hepatitis B in liver biopsy patients.

As part of a study of all patients undergoing liver biopsy in 6 Toronto teaching hospitals from February 1, 1981 to January 31, 1982, participants had hepatitis B marker (HBV) studies and were interviewed concerning, among other things, potential hepatitis B exposure risk factors. All analyses were conducted by sex. Of 376 males, and 342 females participating in the study, complete data were available on 243 (65%) males and 230 (67%) females. Information was obtained on country of birth, race, previous exposure to hepatitis, previous blood transfusions, sexual preference, use of intravenous dr…

Hepatic and non-hepatic hydrothorax in pediatric ascites.

BACKGROUND: Hydrothorax in the presence of ascites is a serious condition, but it is not well studied, particularly in pediatrics. We aim to identify risk factors for having hydrothorax, compare morbidity and mortality, and report the prevalence of hepatic hydrothorax and non-hepatic hydrothorax in pediatric patients with diagnosis of ascites and hydrothorax. METHODS: This is a retrospective study of pediatric patients under 22 years of age with both ascites and hydrothorax. Hydrothorax was categorized into hepatic and non-hepatic hydrothorax. Demographic data and clinical data including asci

[Characterization of hepatic blood flow in hepatic cirrhosis].

Comparative investigation of hepatic blood flow in patients, suffering hepatic cirrhosis in compensated and decompensated stage, was performed. Characteristic peculiarities of arterial and portal hepatic blood flow were revealed, what has important diagnostic significance and must be taken in account while choosing methods of surgical and miniinvasive treatment of patients.