1
|
Chirag R, Arun Babu T. Successful treatment of prolonged cholestasis following hepatitis A infection in a child with oral steroid therapy. BMJ Case Rep 2023; 16:e257477. [PMID: 38087479 PMCID: PMC10728917 DOI: 10.1136/bcr-2023-257477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
Hepatitis A is a common cause of acute infectious hepatitis in children, transmitted through the faeco-oral route. Although mostly self-limiting, cholestasis is a rare but known complication of acute hepatitis A in children. This report presents an adolescent girl who developed cholestatic features following hepatitis A infection and successful treatment with oral steroid therapy. Prolonged cholestasis jaundice (PCJ) is a known manifestation of hepatitis A infection, characterised by prolonged fever, pruritus and jaundice. While the exact mechanisms causing PCJ are not fully understood, immunological-mediated responses could play a role. Treatment options for PCJ are limited, and there is no currently accepted standard of care. Steroids have shown promise in treating PCJ, as observed in this case and a few other reported cases. When other therapies fail to alleviate symptoms, corticosteroids should be considered as a potential treatment option. However, further studies are required to conclusively establish their efficacy.
Collapse
Affiliation(s)
- Ravi Chirag
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Mangalagiri, Andhra Pradesh, India
| | - Thirunavukkarasu Arun Babu
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Mangalagiri, Andhra Pradesh, India
| |
Collapse
|
2
|
Sasaki-Tanaka R, Shibata T, Moriyama M, Kogure H, Hirai-Yuki A, Okamoto H, Kanda T. Masitinib Inhibits Hepatitis A Virus Replication. Int J Mol Sci 2023; 24:9708. [PMID: 37298659 PMCID: PMC10253910 DOI: 10.3390/ijms24119708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023] Open
Abstract
The hepatitis A virus (HAV) infection causes acute hepatitis. HAV also induces acute liver failure or acute-on-chronic liver failure; however, no potent anti-HAV drugs are currently available in clinical situations. For anti-HAV drug screening, more convenient and useful models that mimic HAV replication are needed. In the present study, we established HuhT7-HAV/Luc cells, which are HuhT7 cells stably expressing the HAV HM175-18f genotype IB subgenomic replicon RNA harboring the firefly luciferase gene. This system was made by using a PiggyBac-based gene transfer system that introduces nonviral transposon DNA into mammalian cells. Then, we investigated whether 1134 US Food and Drug Administration (FDA)-approved drugs exhibited in vitro anti-HAV activity. We further demonstrated that treatment with tyrosine kinase inhibitor masitinib significantly reduced both HAV HM175-18f genotype IB replication and HAV HA11-1299 genotype IIIA replication. Masitinib also significantly inhibited HAV HM175 internal ribosomal entry-site (IRES) activity. In conclusion, HuhT7-HAV/Luc cells are adequate for anti-HAV drug screening, and masitinib may be useful for the treatment of severe HAV infection.
Collapse
Affiliation(s)
- Reina Sasaki-Tanaka
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (T.S.); (M.M.); (H.K.)
| | - Toshikatsu Shibata
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (T.S.); (M.M.); (H.K.)
| | - Mitsuhiko Moriyama
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (T.S.); (M.M.); (H.K.)
| | - Hirofumi Kogure
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (T.S.); (M.M.); (H.K.)
| | - Asuka Hirai-Yuki
- Division of Experimental Animal Research, National Institute of Infectious Diseases, Tokyo 208-0011, Japan;
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Tochigi 329-0498, Japan;
| | - Tatsuo Kanda
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (T.S.); (M.M.); (H.K.)
| |
Collapse
|
3
|
Mei X, Zou J, Shi B, Qian Z, Yi Z. High-Resolution Genomic Profiling of a Genotype 3b Hepatitis C Virus from a Flare of an Occult Hepatitis Patient with Acute-on-Chronic Liver Failure. Viruses 2023; 15:v15030634. [PMID: 36992343 PMCID: PMC10059314 DOI: 10.3390/v15030634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023] Open
Abstract
Acute-on-chronic liver failure (ACLF) is defined as a syndrome of acutely decompensated cirrhosis in patients with chronic liver disease (CLD). Here we report an ACLF case caused by a flare of occult hepatitis C infection. This patient was infected with hepatitis C virus (HCV) more than a decade ago and hospitalized due to alcohol-associated CLD. Upon admission, the HCV RNA in the serum was negative and the anti-HCV antibody was positive, whereas the viral RNA in the plasma dramatically increased during hospitalization, which suggests an occult hepatitis C infection. Overlapped fragments encompassing the nearly whole HCV viral genome were amplified, cloned, and sequenced. Phylogenetic analysis indicated an HCV genotype 3b strain. Sanger sequencing to 10-fold coverage of the 9.4-kb nearly whole genome reveals high diversity of viral quasispecies, an indicator of chronic infection. Inherent resistance-associated substitutions (RASs) in the NS3 and NS5A but not in the NS5B regions were identified. The patient developed liver failure and accepted liver transplantation, followed by direct-acting antiviral (DAA) treatment. The hepatitis C was cured by the DAA treatment despite the existence of RASs. Thus, care should be taken for occult hepatitis C in patients with alcoholic cirrhosis. The analysis of viral genetic diversity may help to identify an occult hepatitis C virus infection and predict the efficacy of anti-viral treatment.
Collapse
Affiliation(s)
- Xue Mei
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Jingyi Zou
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200032, China
| | - Bisheng Shi
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Zhiping Qian
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Zhigang Yi
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200032, China
- Correspondence:
| |
Collapse
|
4
|
Sasaki-Tanaka R, Nagulapalli Venkata KC, Okamoto H, Moriyama M, Kanda T. Evaluation of Potential Anti-Hepatitis A Virus 3C Protease Inhibitors Using Molecular Docking. Int J Mol Sci 2022; 23:6044. [PMID: 35682728 PMCID: PMC9181686 DOI: 10.3390/ijms23116044] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/26/2022] [Accepted: 05/26/2022] [Indexed: 12/05/2022] Open
Abstract
Hepatitis A virus (HAV) infection is a major cause of acute hepatitis worldwide and occasionally causes acute liver failure and can lead to death in the absence of liver transplantation. Although HAV vaccination is available, the prevalence of HAV vaccination is not adequate in some countries. Additionally, the improvements in public health reduced our immunity to HAV infection. These situations motivated us to develop potentially new anti-HAV therapeutic options. We carried out the in silico screening of anti-HAV compounds targeting the 3C protease enzyme using the Schrodinger Modeling software from the antiviral library of 25,000 compounds to evaluate anti-HAV 3C protease inhibitors. Additionally, in vitro studies were introduced to examine the inhibitory effects of HAV subgenomic replicon replication and HAV HA11-1299 genotype IIIA replication in hepatoma cell lines using luciferase assays and real-time RT-PCR. In silico studies enabled us to identify five lead candidates with optimal binding interactions in the active site of the target HAV 3C protease using the Schrodinger Glide program. In vitro studies substantiated our hypothesis from in silico findings. One of our lead compounds, Z10325150, showed 47% inhibitory effects on HAV genotype IB subgenomic replicon replication and 36% inhibitory effects on HAV genotype IIIA HA11-1299 replication in human hepatoma cell lines, with no cytotoxic effects at concentrations of 100 μg/mL. The effects of the combination therapy of Z10325150 and RNA-dependent RNA polymerase inhibitor, favipiravir on HAV genotype IB HM175 subgenomic replicon replication and HAV genotype IIIA HA11-1299 replication showed 64% and 48% inhibitory effects of HAV subgenomic replicon and HAV replication, respectively. We identified the HAV 3C protease inhibitor Z10325150 through in silico screening and confirmed the HAV replication inhibitory activity in human hepatocytes. Z10325150 may offer the potential for a useful HAV inhibitor in severe hepatitis A.
Collapse
Affiliation(s)
- Reina Sasaki-Tanaka
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (M.M.); (T.K.)
| | - Kalyan C. Nagulapalli Venkata
- Department of Pharmaceutical and Administrative Sciences, Saint Louis College of Pharmacy, University of Health Sciences and Pharmacy, St. Louis, MO 63010, USA;
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi 329-0498, Japan;
| | - Mitsuhiko Moriyama
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (M.M.); (T.K.)
| | - Tatsuo Kanda
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (M.M.); (T.K.)
| |
Collapse
|
5
|
Lakxmi C B, Oomen AT, Pillai MG. Coinfection of enteric fever and hepatitis A. BMJ Case Rep 2022; 15:e246279. [PMID: 35131783 PMCID: PMC8823050 DOI: 10.1136/bcr-2021-246279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 11/04/2022] Open
Abstract
Poor sanitation and contaminated food and water are major risk factors for several infectious diseases like enteric fever and hepatitis A, but their coinfection is uncommon. Although the liver is frequently affected in typhoid fever, substantial hepatic dysfunction in an appropriately treated patient is uncommon. Our patient had high-grade fever with mild transaminitis and blood culture that grew Salmonella typhi Despite being treated with culture-sensitive antibiotic at adequate dosage, he developed jaundice and had worsening transaminitis (>1000 IU/L) which was suggestive of hepatotropic virus infection. Hepatitis A IgM was positive. He was treated appropriately with which clinical and laboratory parameters resolved.
Collapse
Affiliation(s)
- Bhagya Lakxmi C
- General Medicine, Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India
- General Medicine, Amrita Vishwa Vidyapeetham-Kochi Campus, Kochi, Kerala, India
| | - Akash Thomas Oomen
- General Medicine, Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India
| | - M Gopalakrishna Pillai
- General Medicine, Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India
| |
Collapse
|
6
|
Ghanem KZ, Mahran MZ, Ramadan MM, Ghanem HZ, Fadel M, Mahmoud MH. A comparative study on flavour components and therapeutic properties of unfermented and fermented defatted soybean meal extract. Sci Rep 2020; 10:5998. [PMID: 32265465 PMCID: PMC7138831 DOI: 10.1038/s41598-020-62907-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 03/18/2020] [Indexed: 02/05/2023] Open
Abstract
Microbial fermentation of plant material alters the composition of volatile and non-volatile plant natural products. We investigated the antioxidant, anticancer, and antiviral properties of extracts of defatted soybean meal fermented with Aspergillus fumigatus F-993 or A. awamori FB-133 using in vitro methods. Gas chromatography-mass spectrometry analysis of soybean meal fermented with A. awamori FB-133 and A. fumigatus F-993 identified 26 compounds with 11,14-octadecadienoic acid and methyl ester (63.63%) and 31 compounds with butylated hydroxytoluene (66.83%) and δ-myrcene (11.43%) as main constituents, respectively. The antioxidant activities of DSM extract were 3.362 ± 0.05 and 2.11 ± 0.02 mmol TE/mL, FDSM treated with A. awamori FB-133 were 4.763 ± 0.05 and 3.795 ± 0.03 mmol TE/mL and FDSM treated with A. fumigatus F-993 were 4.331 ± 0.04 and 3.971 ± 0.02 mmol TE/mL as determined by ABTS and FRAP assays, respectively. Both fermented extracts had better antioxidant activity than the unfermented extract as shown by multiple antioxidant activity assays. The concentration of fermented extracts required for 50% inhibition of cell viability was significantly lower than that of the unfermented extract when tested against the human liver cancer cell line HepG2 as shown by cell viability assays, indicating strong anticancer activity. The IC50 values for DSM, FDSM with A. fumigatusF-993 and FDSM with A. awamori FB-133 were27, 16.88 and 8.60 μg/mL, respectively. The extract of FDSM with A. awamori FB-133 showed the strongest anticancer activity, compared to DSM and FDSM with A. FumigatusF-993 extracts. Fermented extracts also reduced hepatitis A virus titres to a greater extent than unfermented extracts, thus showing strong antiviral property. Hepatitis A virus titres were reduced by 2.66 and 3 log10/0.1 mL by FDSM with A. fumigatusF-993 and FDSM by A.awamori FB-133, respectively, compared to DSM (5.50 log10/0.1 mL). Thus, the fermentation of soybean meal with A. fumigatusF-993 or A. awamori FB-133 improves the therapeutic effect of soybean extracts, which can be used in traditional medicine.
Collapse
Affiliation(s)
- Kadry Z Ghanem
- Nutrition and Food Science Department, National Research Centre, Dokki, Giza, Egypt
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Mohamed Z Mahran
- Nutrition and Food Sciences Department, Faculty of Home Economics, Menufyia University, Menufyia, Egypt
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Manal M Ramadan
- Chemistry of Flavour and Aroma Department, National Research Centre, Dokki, Giza, Egypt
| | - Hassan Z Ghanem
- Therapeutical Chemistry Department, National Research Centre, Dokki, Giza, Egypt
| | - Mohamed Fadel
- Microbial Chemistry Department, National Research Centre, Dokki, Giza, Egypt
| | - Mohamed H Mahmoud
- Nutrition and Food Science Department, National Research Centre, Dokki, Giza, Egypt.
- Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia.
| |
Collapse
|
7
|
Win NN, Kanda T, Ogawa M, Nakamoto S, Haga Y, Sasaki R, Nakamura M, Wu S, Matsumoto N, Matsuoka S, Kato N, Shirasawa H, Yokosuka O, Okamoto H, Moriyama M. Superinfection of hepatitis A virus in hepatocytes infected with hepatitis B virus. Int J Med Sci 2019; 16:1366-1370. [PMID: 31692913 PMCID: PMC6818197 DOI: 10.7150/ijms.32795] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 06/07/2019] [Indexed: 12/20/2022] Open
Abstract
Hepatitis A virus (HAV) infection is a major cause of acute hepatitis including acute liver failure. Hepatitis B infection (HBV) occurs worldwide, with the highest rates in Asian and African countries, and there are several reports that HAV infection may have a more severe clinical course in patients with chronic HBV infection. We previously demonstrated that Japanese miso extracts have inhibitory effects on HAV replication. In the present study, we examined the replication of HAV and HBV in a hepatocyte superinfection model and the inhibitory effects of Japanese miso extracts on both viruses. According to the results, HAV infection inhibited HBV replication in superinfected hepatocytes, and Japanese rice-koji miso extracts had inhibitory effects on HAV replication. Our findings provide useful information for clinicians in managing HAV infection in patients with chronic HBV infection.
Collapse
Affiliation(s)
- Nan Nwe Win
- Department of Molecular Virology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8677, Japan
| | - Tatsuo Kanda
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (T.K.)
| | - Masahiro Ogawa
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (T.K.)
| | - Shingo Nakamoto
- Department of Molecular Virology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8677, Japan
- Department of Gastroenterology, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8677, Japan
| | - Yuki Haga
- Department of Gastroenterology, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8677, Japan
| | - Reina Sasaki
- Department of Gastroenterology, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8677, Japan
| | - Masato Nakamura
- Department of Gastroenterology, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8677, Japan
| | - Shuang Wu
- Department of Gastroenterology, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8677, Japan
| | - Naoki Matsumoto
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (T.K.)
| | - Shunichi Matsuoka
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (T.K.)
| | - Naoya Kato
- Department of Gastroenterology, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8677, Japan
| | - Hiroshi Shirasawa
- Department of Molecular Virology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8677, Japan
| | - Osamu Yokosuka
- Department of Gastroenterology, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8677, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | - Mitsuhiko Moriyama
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (T.K.)
| |
Collapse
|
8
|
Zakaria HM, Salem TA, El-Araby HA, Salama RM, Elbadry DY, Sira AM, Ali MA, Salem ME, Abd-Alaaty BM, Goda SS, Eltaras SM, Khalil FO, Abou-Zeinah SS, Sira MM. Steroid therapy in children with fulminant hepatitis A. J Viral Hepat 2018; 25:853-859. [PMID: 29397017 DOI: 10.1111/jvh.12873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 01/05/2018] [Indexed: 02/05/2023]
Abstract
Fulminant hepatic failure is a life-threatening disease. Hepatitis A virus (HAV) can cause fulminant hepatic failure and death in about 0.2% of cases. Extensive destruction of infected hepatocytes by immune-mediated lysis is thought to be the cause. We aimed to evaluate the use of steroid therapy in children with fulminant HAV. This study included 33 children with fulminant HAV in two groups. Steroid group: comprised of 18 children who received prednisolone (1 mg/kg/d) or its equivalent dose of methylprednisolone, and the nonsteroid group: comprised another 15 children who did not receive steroid therapy. Age and sex were matched for both groups (P > .05), and they were comparable regarding baseline clinical and laboratory characteristics. Of the steroid group, 15 patients survived and 3 died, while in the nonsteroid group, 4 patients survived and 11 died (P = .001). Of the living patients, 15 of 19 (78.9%) received steroids while only 3 of 14 (21.4%) of the dead patients received steroids (P = .001). Stepwise regression analysis showed that steroid therapy was the only independent variable associated with recovery (P = .001). Steroid therapy in children with fulminant HAV associated significantly with improved outcome and survival. Future studies on a larger population size are strongly recommended.
Collapse
Affiliation(s)
- H M Zakaria
- Pediatric Hepatology, Gastroenterology and Nutrition Department, National Liver Institute, Menofiya University, Menofiya, Egypt
- Department of Pediatrics, Quesna Central Hospital, Ministry of Health, Menofiya, Egypt
| | - T A Salem
- Pediatric Hepatology, Gastroenterology and Nutrition Department, National Liver Institute, Menofiya University, Menofiya, Egypt
| | - H A El-Araby
- Pediatric Hepatology, Gastroenterology and Nutrition Department, National Liver Institute, Menofiya University, Menofiya, Egypt
| | - R M Salama
- Pediatric Hepatology, Gastroenterology and Nutrition Department, National Liver Institute, Menofiya University, Menofiya, Egypt
| | - D Y Elbadry
- Pediatric Hepatology, Gastroenterology and Nutrition Department, National Liver Institute, Menofiya University, Menofiya, Egypt
| | - A M Sira
- Pediatric Hepatology, Gastroenterology and Nutrition Department, National Liver Institute, Menofiya University, Menofiya, Egypt
| | - M A Ali
- Pediatric Hepatology, Gastroenterology and Nutrition Department, National Liver Institute, Menofiya University, Menofiya, Egypt
| | - M E Salem
- Pediatric Hepatology, Gastroenterology and Nutrition Department, National Liver Institute, Menofiya University, Menofiya, Egypt
| | - B M Abd-Alaaty
- Pediatric Hepatology, Gastroenterology and Nutrition Department, National Liver Institute, Menofiya University, Menofiya, Egypt
| | - S S Goda
- Pediatric Hepatology, Gastroenterology and Nutrition Department, National Liver Institute, Menofiya University, Menofiya, Egypt
| | - S M Eltaras
- Pediatric Hepatology, Gastroenterology and Nutrition Department, National Liver Institute, Menofiya University, Menofiya, Egypt
| | - F O Khalil
- Department of Microbiology and Immunology, National Liver Institute, Menofiya University, Menofiya, Egypt
| | - S S Abou-Zeinah
- Pediatric Hepatology, Gastroenterology and Nutrition Department, National Liver Institute, Menofiya University, Menofiya, Egypt
| | - M M Sira
- Pediatric Hepatology, Gastroenterology and Nutrition Department, National Liver Institute, Menofiya University, Menofiya, Egypt
| |
Collapse
|
9
|
Abstract
Neonatal hepatitis with acute liver failure due to varied etiology including various infections is reported in the past. Scrub typhus as a cause of neonatal hepatitis has rarely been reported in literature. A high index of clinical suspicion is required for early diagnosis and timely treatment. Severity and prognosis of the disease varies widely because several different strains of Orientia tsutsugamushi exist with different virulence. Delayed diagnosis can result in complication and significant morbidity and mortality. Here, we report three cases of neonatal hepatitis with acute liver failure caused by scrub typhus to increase awareness.
Collapse
Affiliation(s)
- Shailja Vajpayee
- S M S Medical College, Sir Padampat Mother and Child Health Institute, J L N Marg, Jaipur, 302 017, India.
| | - R K Gupta
- S M S Medical College, Sir Padampat Mother and Child Health Institute, J L N Marg, Jaipur, 302 017, India
| | - M L Gupta
- S M S Medical College, Sir Padampat Mother and Child Health Institute, J L N Marg, Jaipur, 302 017, India
| |
Collapse
|
10
|
Kawaguchi T, Torimura T. [Diagnosis & treatment for hepatitis A]. Nihon Rinsho 2015; 73 Suppl 9:589-592. [PMID: 26846002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
11
|
Jiang X, Kanda T, Nakamoto S, Saito K, Nakamura M, Wu S, Haga Y, Sasaki R, Sakamoto N, Shirasawa H, Okamoto H, Yokosuka O. The JAK2 inhibitor AZD1480 inhibits hepatitis A virus replication in Huh7 cells. Biochem Biophys Res Commun 2015; 458:908-12. [PMID: 25704089 DOI: 10.1016/j.bbrc.2015.02.058] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 02/11/2015] [Indexed: 12/18/2022]
Abstract
The JAK2 inhibitor AZD1480 has been reported to inhibit La protein expression. We previously demonstrated that the inhibition of La expression could inhibit hepatitis A virus (HAV) internal ribosomal entry-site (IRES)-mediated translation and HAV replication in vitro. In this study, we analyzed the effects of AZD1480 on HAV IRES-mediated translation and replication. HAV IRES-mediated translation in COS7-HAV-IRES cells was inhibited by 0.1-1 μM AZD1480, a dosage that did not affect cell viability. Results showed a significant reduction in intracellular HAV HA11-1299 genotype IIIA RNA levels in Huh7 cells treated with AZD1480. Furthermore, AZD1480 inhibited the expression of phosphorylated-(Tyr-705)-signal transducer and activator of transcription 3 (STAT3) and La in Huh7 cells. Therefore, we propose that AZD1480 can inhibit HAV IRES activity and HAV replication through the inhibition of the La protein.
Collapse
Affiliation(s)
- Xia Jiang
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Tatsuo Kanda
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | - Shingo Nakamoto
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan; Department of Molecular Virology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Kengo Saito
- Department of Molecular Virology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Masato Nakamura
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Shuang Wu
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Yuki Haga
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Reina Sasaki
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Naoya Sakamoto
- Department of Gastroenterology and Hepatology, Hokkaido University, Sapporo, Japan
| | - Hiroshi Shirasawa
- Department of Molecular Virology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Osamu Yokosuka
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| |
Collapse
|
12
|
Abstract
Hepatitis A virus (HAV) is a faeco-orally transmitted picornavirus and is one of the main causes of acute hepatitis worldwide. An overview of the molecular biology of HAV is presented with an emphasis on recent findings. Immune evasion strategies and a possible correlation between HAV and atopy are discussed as well. Despite the availability of efficient vaccines, antiviral drugs targeting HAV are required to treat severe cases of fulminant hepatitis, contain outbreaks, and halt the potential spread of vaccine-escape variants. Additionally, such drugs could be used to shorten the period of illness and decrease associated economical costs. Several known inhibitors of HAV with various mechanisms of action will be discussed. Since none of these molecules is readily useable in the clinic and since the availability of an anti-HAV drug would be of clinical importance, increased efforts should be targeted toward discovery and development of such antivirals.
Collapse
Affiliation(s)
- Yannick Debing
- Rega Institute for Medical ResearchUniversity of LeuvenLeuvenBelgium
| | - Johan Neyts
- Rega Institute for Medical ResearchUniversity of LeuvenLeuvenBelgium
| | | |
Collapse
|
13
|
Alves AP, Moura DCS, Spolti GP. Co-infection with hepatitis A and leptospirosis in the Amazon region: report of two cases. Trop Gastroenterol 2011; 32:234-236. [PMID: 22332345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Aline Pinto Alves
- Federal University of Pará, Institute of Health Sciences, School of Medicine, Belém, Pará, Brazil.
| | | | | |
Collapse
|
14
|
Fallahian F, Alavian SM, Fallahian V, Zamani F. Impact of immunosuppression and chemotherapy on reactivation of viral hepatitis. Saudi J Kidney Dis Transpl 2010; 21:621-627. [PMID: 20587863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Chemotherapy drugs, biological medications that are used to treat cancer, may cause hepatic side effects. Patients with pre-existing viral hepatitis may be more susceptible to exacerbation of their underlying liver disease, and risk of drug-induced hepatotoxicity. We conducted a search on immunosuppression, and its impact on reactivation of viral hepatitis, using the electro-nic medical databases. Before starting chemotherapy, it is recommended to record the past history of liver disease and check for hepatitis B virus (HBV) and hepatitis C virus (HCV) serology. In immunosuppressed patients, radiation toxicity, graft versus host disease, hepatic veno-occlusive disease, acalculous cholecystitis, tumor infiltration, ischemia, other viruses such as CMV and her-pes virus, and systemic infection should also be considered. Transplant recipients with serologic evidence of previous infection with hepatitis B or C, or those who receive organs from a seropositive donor, should have viral load levels monitored before and after transplantation and, may also require treatment. We believe that there is a role for prophylactic use of antiviral treatment in patients at risk for HBV reactivation.
Collapse
Affiliation(s)
- Farahnaz Fallahian
- Iran Research Center of Gastroenterology and Liver Disease, Firuzgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | | | | | | |
Collapse
|
15
|
Abstract
This article summarizes the meta-analyses of interventions for viral hepatitis A, B, and C. Some of the interventions assessed are described in small trials with unclear bias control. Other interventions are supported by large, high-quality trials. Although attempts have been made to adjust for unclear bias control, analysis of publication bias and other biases is difficult when only few trials are available. It is possible that some of the meta-analyses presented in this article are biased. Furthermore, performing updated cumulative meta-analyses also may introduce random error.3,4 The extent and direction of bias may vary. On average, however, bias leads to overestimated intervention benefits.1 Accordingly, the benefit of some of the interventions suggested in this article may be exaggerated by systematic and random errors. Additional research including large, randomized trials is necessary to clarify the true intervention effects.
Collapse
Affiliation(s)
- Lise L Gluud
- Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
| | | |
Collapse
|
16
|
Mitra S, Karthik R, Balaji V, George IA, Kapil A, Abraham OC. Quinolone-resistant Salmonella enterica Serovar typhi presenting as acute fulminant hepatitis. J Assoc Physicians India 2009; 57:338-339. [PMID: 19702041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- S Mitra
- Department of Medicine Unit 1 and Infectious Diseases, Christian Medical College and Hospital, Vellore
| | | | | | | | | | | |
Collapse
|
17
|
Stiefelhagen P. [Symptoms--chronic course--therapy: differences in hepatitis types]. MMW Fortschr Med 2009; 151:12-14. [PMID: 19432242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
|
18
|
Ramos-Casals M, Cuadrado MJ, Alba P, Sanna G, Brito-Zerón P, Bertolaccini L, Babini A, Moreno A, D'Cruz D, Khamashta MA. Acute viral infections in patients with systemic lupus erythematosus: description of 23 cases and review of the literature. Medicine (Baltimore) 2008; 87:311-318. [PMID: 19011502 DOI: 10.1097/md.0b013e31818ec711] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Few studies have evaluated the impact of viral infections on the daily management of patients with systemic lupus erythematosus (SLE). We analyzed the etiology and clinical features of acute viral infections arising in patients with SLE and their influence on the diagnosis, prognosis, and treatment of SLE. Cases occurring within the last 5 years were selected from the databases of 3 large teaching hospitals. Acute viral infections were confirmed by the identification of specific antiviral IgM antibodies and subsequent seroconversion with detection of specific IgG antibodies. In autopsy studies, macroscopic findings suggestive of viral infection were confirmed by direct identification of the virus or viruses in tissue samples. We performed a MEDLINE search for additional cases reported between January 1985 and March 2008. We included 88 cases (23 from our clinics and 65 from the literature review) of acute viral infections in patients with SLE. Twenty-five patients were diagnosed with new-onset SLE (fulfillment of the 1997 SLE criteria) associated with infection by human parvovirus B19 (n = 15), cytomegalovirus (CMV; n = 6), Epstein-Barr virus (EBV; n = 3), and hepatitis A virus (n = 1). The remaining 63 cases of acute viral infections arose in patients already diagnosed with SLE: in 18 patients, symptoms related to infection mimicked a lupus flare, 36 patients, including 1 patient from the former group who presented with both conditions, presented organ-specific viral infections (mainly pneumonitis, colitis, retinitis, and hepatitis), and 10 patients presented a severe, multiorgan process similar to that described in catastrophic antiphospholipid syndrome-the final diagnosis was hemophagocytic syndrome in 5 cases and disseminated viral infection in 5. Twelve patients died due to infection caused by CMV (n = 5), herpes simplex virus (n = 4), EBV (n = 2), and varicella zoster virus (n = 1). Autopsies were performed in 9 patients and disclosed disseminated herpetic infection in 6 patients (caused by herpes simplex in 4 cases, varicella in 1, and CMV in 1) and hemophagocytic syndrome in 3. A higher frequency of renal failure (54% vs. 19%, p = 0.024), antiphospholipid syndrome (33% vs. 6%, p = 0.023), treatment with cyclophosphamide (82% vs. 37%, p = 0.008), and multisystemic involvement at presentation (58% vs. 8%, p < 0.001); and a lower frequency of antiviral therapy (18% vs. 76%, p < 0.001) were found in patients who died, compared with survivors. The most common viral infections in patients with SLE are parvovirus B19 (predominantly mimicking SLE presentation) and CMV (predominantly presenting in severely immunosuppressed patients). CMV infection may mimic a lupus flare or present with specific organ involvement such as gastrointestinal bleeding or pulmonary infiltrates. Other herpesviruses are common in immunosuppressed SLE patients and may produce a wide range of manifestations. Physicians should examine the pharynx, eyes, skin, and genitalia and should conduct serologic and molecular studies to improve early detection of viral infection in patients with SLE.
Collapse
Affiliation(s)
- Manuel Ramos-Casals
- From Laboratory of Autoimmune Diseases "Josep Font," Department of Autoimmune Diseases (MR-C, PB-Z) and Department of Infectious Diseases (AM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain; Department of Rheumatology (PA, AB), Hospital Córdoba, Córdoba, Argentina; Department of Rheumatology (GS), Homerton University NHS Foundation Trust, London, United Kingdom; and Lupus Research Unit (MJC, LB, DD'C, MAK), The Rayne Institute, King's College London School of Medicine at Guy's, King's and St Thomas' Hospitals, St Thomas' Hospital, London, United Kingdom
| | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Van Bambeke F. [The ABC of viral hepatitis]. J Pharm Belg 2008; 63:15-20. [PMID: 18479077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Viral hepatitis has long been under-diagnosed. Hepatitis A is an acute disease, while patients infected by hepatitis B and hepatitis C viruses are likely to develop chronical infections and severe complications (cancer, cirrhosis). The current treatment of hepatitis B and C consists in alpha interferon (preferably under its pegylated form), in combination with ribavirin for hepatitis C. The frequent and severe adverse effects of interferon-based therapy constitute, however, a major limiting factor (reactions at the injection site, flu-like syndrome, neurological disorders, ...). For hepatitis B, two alternatives are available so far, namely lamivudine and adefovir (used as a prodrug with highe oral bioavailability).
Collapse
Affiliation(s)
- F Van Bambeke
- Unité de Pharmacologie cellulaire et moléculaire, Université Catholique de Louvain, avenue Mounier 73, 1200 Bruxelles. francoise.
| |
Collapse
|
20
|
Fuoti M, Pinotti M, Villa MC, Miceli V, Celano MR, Amoruso C, Carnelli V, Nebbia G. [Hepatitis type A with atypical course]. Pediatr Med Chir 2008; 30:48-50. [PMID: 18491680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Hepatitis A virus infection is usually asymptomatic in children. Classic symptomatic forms and atypical clinical manifestations are known. We report a paediatric case of hepatitis A with marked cholestasis, treated with steroids, and with an unusual prolonged course.
Collapse
Affiliation(s)
- M Fuoti
- Clinica Pediatrica De Marchi, Fondazione Policlinico, Mangiagalli e Regina Elena, Università degli Studi di Milano
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Matanina NV, Reĭzis AR. [Peripheral blood lymphocyte apoptosis in children with viral hepatites A, B, C and effect of ursodeoxycholic acid preparations]. Eksp Klin Gastroenterol 2008:106-110. [PMID: 19145924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Apoptosis plays an important role in the pathogenesis of viral hepatitis (VH), affecting not only hepatocytes but also immune cells. However, the occurrence of apoptosis in peripheral blood lymphocytes (PBL) during the course of VH in children has not been described. The aim of this study was to measure the level of PBL apoptosis during VH in children, and to test its possible correction by ursodeoxycholic acid (UDCA). Apoptosis was determined by flow cytometry using propidium iodide (PI) staining for hypodiploid cells. The apoptosis of PBL is closely correlated with the severity and progression of hepatitis A, B and C in children. Furthermore, the improved course and outcomes of the disease following UDCA treatment are associated with the reduction of PBL apoptosis.
Collapse
|
22
|
Atabek ME, Pirgon O. Unusual cardiac features in cholestatic hepatitis A in an adolescent: Improvement with corticosteroid treatment. J Infect 2007; 54:e91-3. [PMID: 16769122 DOI: 10.1016/j.jinf.2006.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2006] [Revised: 04/25/2006] [Accepted: 05/02/2006] [Indexed: 10/24/2022]
Abstract
Hepatitis A is one of the most frequent infectious liver diseases affecting children worldwide. Extra-hepatic manifestations of acute hepatitis A virus are rare in pediatric age group. We report a case of a 16-year-old, otherwise healthy adolescent who had viral hepatitis A with cardiac manifestations. The patient is the first pediatric case of hepatitis A with a combination of hypotension, persistent bradycardia and progressive cholestasis.
Collapse
Affiliation(s)
- Mehmet Emre Atabek
- Department of Pediatrics, Faculty of Medicine, Selcuk University, Konya, Turkey.
| | | |
Collapse
|
23
|
Perrella A, Atripaldi L, Bellopede P, Patarino T, Sbreglia C, Tarantino G, Sorrentino P, Conca P, Ruggiero L, Perrella O. Flow cytometry assay of myeloid dendritic cells (mDCs) in peripheral blood during acute hepatitis C: Possible pathogenetic mechanisms. World J Gastroenterol 2006; 12:1105-9. [PMID: 16534853 PMCID: PMC4087904 DOI: 10.3748/wjg.v12.i7.1105] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To asses the expression of myeloid dendritic cells (CD11c+) subset during acute HCV hepatitis and its possible involvement in natural history of the infection.
METHODS: We enrolled 11 patients with acute hepatitis C (AHC) (Group A), 10 patients with acute hepatitis A (AHA) (as infective control-Group B) and 10 healthy donors (group C) in this study. All patients underwent selective flow cytometry gating strategies to assess the peripheral number of the myeloid dendritic cells (mDCs) to understand the possible role and differences during acute hepatitis.
RESULTS: Eight of 11 patients with acute HCV hepatitis did not show any increase of mDCs compared to healthy individuals, while a significant decrease of mDCs was found in absolute cell count (z = -2.37; P < 0.05) and percentage (z= -2.30; P < 0.05) as compared with AHA. On the contrary, The remaining three patients of the group A had a higher mDCs number and percentage as occur in group B. Interestingly, after six months, those patients did not show any increase of mDCs subset were chronically infected. while the three subjects with an increase of peripheral mDCs, as in HAV acute infection, resolved the illness.
CONCLUSION: The lack of increase of mDCs during acute hepatitis C might be an important factor involved in chronicization of the infection.
Collapse
Affiliation(s)
- Alessandro Perrella
- Department Infectious Disease and Immunology, Hospital D.Cotugno, Via E.A. Mario 35 , Zip code 80131, Naples, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Ballauff A, Eggert A. [Intraabdominal and hepatic infections in pediatric cancer patients]. Klin Padiatr 2005; 217 Suppl 1:S101-9. [PMID: 16288356 DOI: 10.1055/s-2005-872504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Common complications involved in treating pediatric patients with cancer are bacterial, viral and fungal infections of the gastrointestinal tract including esophagitis, gastritis, duodenitis, colitis and hepatobiliar infections. In many cases there are multiple factors that predispose these patients to gastrointestinal infections, such as granulocytopenia, T-cell dysfunction, and mucosal damage. In addition, newer therapies have changed the spectrum of infection that is seen in these patients. The profound T-cell suppression associated with therapies such as stem cell transplantation has led to the emergence of previously rare infections including cytomegalovirus and adenovirus. This article provides the recommendations of the Infectious Diseases Working Party of the German Society for Pediatric Infectious Diseases (DGPI) and the German Society for Pediatric Hematology/Oncology (GPOH) for diagnosis, prevention, and management of local as well as invasive infections of the gastrointestinal tract.
Collapse
Affiliation(s)
- A Ballauff
- Universitätsklinikum Essen, Kinderklinik, Pädiatrische Gastroenterologie und Hepatologie.
| | | |
Collapse
|
25
|
Abstract
A 31-year-old woman developed necrobiotic xanthogranuloma (NXG), a thickened choroid, and syncytial giant cell hepatitis, a previously unreported association. NXG and syncytial giant cell hepatitis may have a common autoimmune pathogenesis.
Collapse
Affiliation(s)
- Radgonde Amer
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
| | | | | | | |
Collapse
|
26
|
Abstract
AIM: We report a case with a prolonged course of hepatitis A, with alanine aminotransferase (ALT) higher than 500 IU/L for more than 2 mo.
METHODS: A middle-aged woman had an elevated IgG level of more than 2000 mg/dL, positive anti-nuclear antibodies (ANA) and anti-smooth muscle antibodies (ASMA), but no evidence of persistent hepatitis A virus (HAV) infection. Liver biopsy findings were compatible with prolonged acute hepatitis, although acute onset of autoimmune hepatitis could not be ruled out.
RESULTS: It was assumed that she developed a course of hepatitis similar to autoimmune hepatitis triggered by HAV infection. Ursodeoxycholic acid (UDCA) treatment was initiated and a favorable outcome was obtained.
CONCLUSION: We describe a case of a middle-aged woman who showed a prolonged course of acute hepatitis A mimicking autoimmune hepatitis. Treatment with UDCA proved to be effective.
Collapse
Affiliation(s)
- Rintaro Mikata
- Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
| | | | | | | | | | | |
Collapse
|
27
|
Karagöz G, Ak O, Ozer S. The coexistence of hepatitis A and infectious mononucleosis. Turk J Gastroenterol 2005; 16:102-4. [PMID: 16252202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Hepatitis A is an acute, self-limited disease that spreads predominantly by the fecal-oral route. Hepatitis A characteristically has an acute, sudden influenza-like onset with a prominence of myalgia, headache, fever and malaise. Infectious mononucleosis is an acute illness characterized clinically by sore throat, fever and lymphadenopathy. The virus usually spreads from person to person by close contact with nasopharyngeal secretions. In this case the coexistence of both diseases in the same patient is found interesting.
Collapse
Affiliation(s)
- Gül Karagöz
- Department of Infectious Diseases and Clinical Microbiology, Kartal Training and Research Hospital, 81327 Kartal, Istanbul, Turkey.
| | | | | |
Collapse
|
28
|
Xu JH, Yu YY, Si CW, Zeng Z, Wang QH, Luo DD, Zhou YX, Zeng MD, Qiao GY, Yao JL, Lu WL. Promoting hepatic growth factor in the treatment of heavy type hepatitis and severe chronic hepatitis: a multicenter clinical study. Hepatobiliary Pancreat Dis Int 2004; 3:381-5. [PMID: 15313673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The mortality rate of heavy type hepatitis is high. No special treatment is available except general treatment. This multicenter clinical study was designed to observe the safety and efficacy of promoting hepatic growth factor (PHGF) in the treatment of heavy type hepatitis and severe chronic hepatitis. METHODS 347 patients with heavy type hepatitis and 324 with severe chronic hepatitis were subjected to administration of 120 microg of PHGF per day for 4 weeks on the basis of general treatment. Those who were being effectively treated would last additional 2 to 4 weeks. Blood routine, urine routine, blood urea nitrogen (BUN), blood creatinine (Cr), blood ammonia, alpha fetoprotein (AFP), electrolyte, alanine transaminase (ALT), aspartate transaminase (AST), serum total bilirubin (TBIL), serum direct bilirubin (DBIL), prothrombin time activity (PTA), total protein (TP) and albumin (ALB) were detected in the patients before treatment, 2 weeks after treatment, and at the end of the treatment. Any side-effect would be recorded. RESULTS In the patients with severe chronic hepatitis, the total effective rate of the treatment was 88.9%. The levels of ALT, AST and TBIL decreased significantly (P<0.001), whereas those of PTA and ALB increased significantly (P<0.001), and the level of AFP increased slightly. In patients with heavy type hepatitis, the total effective rate of this treatment was 78.4%, and patients at different stage showed different results. The total effective rates of patients with early, medium and terminal stage heavy type hepatitis were 89.9%, 84.8% and 27.5%, respectively. No severe side-effect was shown. CONCLUSION PHGF is effective and safe in the treatment of patients with heavy type hepatitis and severe chronic hepatitis. But it should be administered early in patients with heavy type hepatitis so as to get better curative effects.
Collapse
Affiliation(s)
- Jing-Hang Xu
- Department of Infectious Diseases, First Hospital of Beijing University, Beijing 100034, China.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Abstract
The hepatitis viruses A to E are biologically and clinically heterogeneous: hepatitis A and E are transmitted faecal-orally and never lead to chronic infection. In contrast, the other viruses-B, C, D-are transmitted parenterally and are the leading causes of chronic viral infections in humans worldwide. Highly efficient vaccines are available against hepatitis A and B. The therapeutic armamentarium for chronic hepatitis B and C has significantly expanded during the last several years. Two nucleoside analogues, lamivudine and adefovir, have been licensed for the treatment of chronic hepatitis B and can be used for patients in whom interferon would be contra-indicated such as decompensated cirrhotics. Standard therapy for chronic hepatitis C is a combination of a pegylated interferon-alpha and ribavirin, which can lead to sustained viral clearance in more than 50% of treatable patients. Patients with decompensated cirrhosis can be treated by liver transplantation which offers a 5-year-survival of greater than 80%.
Collapse
MESH Headings
- Antiviral Agents/administration & dosage
- Antiviral Agents/adverse effects
- Drug Therapy, Combination
- Germany
- Hepatitis A/diagnosis
- Hepatitis A/drug therapy
- Hepatitis A/prevention & control
- Hepatitis A/transmission
- Hepatitis A Vaccines/administration & dosage
- Hepatitis B/diagnosis
- Hepatitis B/drug therapy
- Hepatitis B/prevention & control
- Hepatitis B/transmission
- Hepatitis B Vaccines/administration & dosage
- Hepatitis B, Chronic/diagnosis
- Hepatitis B, Chronic/drug therapy
- Hepatitis B, Chronic/prevention & control
- Hepatitis C, Chronic/drug therapy
- Hepatitis C, Chronic/prevention & control
- Hepatitis D/drug therapy
- Hepatitis D/prevention & control
- Hepatitis, Viral, Human/diagnosis
- Hepatitis, Viral, Human/drug therapy
- Hepatitis, Viral, Human/prevention & control
- Hepatitis, Viral, Human/transmission
- Humans
- Interferons/administration & dosage
- Interferons/adverse effects
- Prognosis
- Reverse Transcriptase Inhibitors/administration & dosage
- Reverse Transcriptase Inhibitors/adverse effects
- Risk Factors
- Treatment Outcome
Collapse
Affiliation(s)
- H M Diepolder
- Medizinische Klinik und Poliklinik II, Ludwig-Maximilians-Universität München, Klinikum Grosshadern.
| |
Collapse
|
30
|
Abstract
The biannual HEP DART conference in Hawaii provided an intimate setting for members of the viral hepatitis community to exchange ideas and information. The leaders in clinical research and drug development gathered with scientists to discuss the recent advances in a field dedicated to understanding and treating hepatitis. The topics ranged from the basic science of pathogenesis and therapeutic models, to the next generation of hepatitis B and hepatitis C virus inhibitors, to the important therapeutic information gleaned from the latest clinical trials. The therapeutic considerations for special populations, such as those co-infected with HIV, those with decompensated liver diseases or difficult-to-treat genotypes, as well as those patients who have failed treatment, emerged as critical clinical topics under discussion.
Collapse
Affiliation(s)
- Anneke K Raney
- Valeant Pharmaceuticals International, Drug Discovery R & D, Costa Mesa, CA 92626, USA.
| | | | | |
Collapse
|
31
|
Affiliation(s)
- Deirdre Kelly
- Liver Unit, Birmingham Children's Hospital, United Kingdom
| |
Collapse
|
32
|
Abstract
AIM: To investigate the effect of N-acetyl cysteine (NAC) on acute viral hepatitis (AVH).
METHODS: We administered 200 mg oral NAC three times daily (600 mg/day) to the study group and placebo capsules to the control group. All patients were hospitalized and diagnosed as AVH. Blood total and direct bilirubin, ALT, AST, alkaline phosphatese, albumin and globulin levels of each patient were measured twice weekly until total bilirubin level dropped under 2 mg/dl, ALT level under 100 U/L, follow up was continued and then the patients were discharged.
RESULTS: A total of 41(13 female and 28 male) AVH patients were included in our study. The period for normalization of ALT and total bilirubin in the study group was 19.7 ± 6.9 days and 13.7 ± 8.5 days respectively. In the control group it was 20.4 ± 6.5 days and 16.9 ± 7.8 days respectively (P > 0.05).
CONCLUSION: NAC administration effected neither the time necessary for normalization of ALT and total bilirubin values nor duration of hospitalization, so we could not suggest NAC for the treatment of icteric AVH cases. However, our results have shown that this drug is not harmful to patients with AVH.
Collapse
Affiliation(s)
- Huseyin Gunduz
- Department of Internal Medicine and Cordiology, Izzet Baysal Medical Faculty, Izzet Baysal University/Bolu, Turkey.
| | | | | | | | | | | |
Collapse
|
33
|
Abstract
PURPOSE OF REVIEW This review compares and contrasts the natural history and treatment of hepatitis B and C virus infections in three principal populations of immune compromised individuals: (1) patients co-infected with HIV; (2) patients with liver failure secondary to hepatitis B or C virus infection who undergo liver transplantation, and (3) patients with hepatitis B or C virus infection who undergo anticancer chemotherapy. RECENT FINDINGS Chronic liver disease resulting from hepatitis B or C virus infection progresses more rapidly in patients co-infected with HIV than in HIV negative patients. Treatment protocols for antiviral therapy are, however, similar to those used in immunocompetent individuals and although few long-term results are available, the efficacy of interferon and ribavirin therapy in hepatitis C virus/HIV infection and lamivudine in HIV/hepatitis B virus infection has been proven in the short-term. Perhaps the most important consideration is the timing of administering treatments to co-infected patients. For patients with well preserved CD4 counts and hepatitis C virus/HIV co-infection, the hepatitis infection should be treated as early as possible to avoid drug interactions of hepatitis C virus antivirals with antiretroviral therapy. Also, response to hepatitis C virus treatment appears better when treatment is administered in the context of preserved immune function. Conversely, in hepatitis B virus/HIV co-infection, hepatitis B virus antivirals are best administered with anti-retroviral therapy, thus preventing the selection of HIV viral species which may be resistant to the drugs used for hepatitis B virus. Improved graft and patient survival after liver transplant and with anticancer chemotherapy in hepatitis B virus infected patients has been proven using lamivudine prophylaxis. However, although therapy for hepatitis C virus recurrence after liver transplantation would seem rational, limited success with current treatment protocols has been achieved. SUMMARY Although the prognosis of hepatitis B and C virus infections in the immune compromised may be inferior to that of immunocompetent individuals, such patients should have full evaluation of their viral hepatitis, and antiviral therapy should be considered.
Collapse
|
34
|
Delwaide J. Postexposure management of hepatitis A, B or C: treatment, postexposure prophylaxis and recommendations. Acta Gastroenterol Belg 2003; 66:250-4. [PMID: 14618959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Although there is no consensus on the best management of acute hepatitis C or on optimal strategy of follow-up after potential contamination, certain guidelines can nevertheless be proposed for the care of these patients in practice. It is now recommended that acute hepatitis C be treated by interferon monotherapy in the presence of a C viremia, detectable by polymerase chain reaction, and an elevation of the transaminases. The earlier the treatment is started after appearance of symptoms, the more effective it is. Management of a potentially contaminated individuals consists of screening for the C virus as early as the fifteenth day after the potentially contaminating act and, in the case of virus transmission, starting interferon treatment as soon as elevation of the transaminases appears. No special precautions are to be taken by the person potentially contaminated for avoiding possible secondary C virus transmission during the follow-up period. In the case of acute hepatitis B, antiviral treatment should not be started, in view of the high percentage of spontaneous recoveries and the potentially negative effect of treatment on the chances of spontaneous recovery. Post-exposure prophylaxis by anti-hepatitis B immunoglobin injections and/or vaccination should be considered after evaluation of the hepatitis B surface antigen status of the source and of the vaccination and vaccine-response status of the exposed person. The classic scheme for selecting the most appropriate postexposure prophylaxis is reminded. In post-exposure prophylaxis for hepatitis A virus, although there have been no studies comparing the effectiveness of vaccination with that of immunoglobin injections, it is at present proposed to provide only vaccination. The target groups eligible for post-exposure prophylaxis are evoked.
Collapse
Affiliation(s)
- Jean Delwaide
- Service de gastroentérologie, CHU Sart Tilman, 4000 Liège.
| |
Collapse
|
35
|
Affiliation(s)
- Douglas T Dieterich
- Department of Gastroenterology, New York University School of Medicine, New York, New York 10001, USA
| |
Collapse
|
36
|
Ressel GW. CDC releases 2002 guidelines for treating STDs: Part II. Human papillomavirus and hepatitis. Am Fam Physician 2002; 66:1996, 1999. [PMID: 12469970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
|
37
|
Nogaller AM. [Hepatology at the turn of centuries]. Klin Med (Mosk) 2002; 80:13-7. [PMID: 12416218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Current achievements in clinical hepatology according to literature, materials of the congresses and symposia, rich personal medical and research experience are reviewed.
Collapse
|
38
|
|
39
|
Koçak N, Saltik IN. The effect of ursodeoxycholic acid in children with prolonged hepatitis A virus infection that may be a trigger factor for autoimmune hepatitis. Am J Gastroenterol 2001; 96:610-1. [PMID: 11232728 DOI: 10.1111/j.1572-0241.2001.03577.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
40
|
Abstract
The challenge of viral hepatitis has been acknowledged and confronted in the last decade. Significant progress in prevention of infection with HAV and HBV may eradicate these serious infections from the United States and other parts of the world in the coming decades. Application of prophylactic strategies to children will be a major mechanism in accomplishing this task. The quest for potent antiviral medications continues. The next critically important development will be ways to prevent new HCV infections and to treat the millions of already infected individuals at risk for the serious consequences of this disease. For pediatricians, realizing these goals requires a greater understanding of perinatal HCV transmission, use of vaccines for prevention of viral hepatitis, and identification of HCV-infected children who are likely to benefit from new therapeutic strategies as they become available.
Collapse
MESH Headings
- Antiviral Agents/therapeutic use
- Child
- Child, Preschool
- Hepatitis A/diagnosis
- Hepatitis A/drug therapy
- Hepatitis A/prevention & control
- Hepatitis A/virology
- Hepatitis B/diagnosis
- Hepatitis B/drug therapy
- Hepatitis B/prevention & control
- Hepatitis B/virology
- Hepatitis C/diagnosis
- Hepatitis C/drug therapy
- Hepatitis C/prevention & control
- Hepatitis C/virology
- Hepatitis, Viral, Human/diagnosis
- Hepatitis, Viral, Human/drug therapy
- Hepatitis, Viral, Human/prevention & control
- Hepatitis, Viral, Human/virology
- Humans
- Immunization Schedule
- Infant
- Infant, Newborn
- Viral Hepatitis Vaccines/therapeutic use
Collapse
Affiliation(s)
- M M Jonas
- Department of Pediatrics, Harvard Medical School, and the Division of Gastroenterology, Children's Hospital, Boston, Massachusetts, USA.
| |
Collapse
|
41
|
Sridharan S, Mossad S, Hoffman G. Hepatitis A infection mimicking adult onset Still's disease. J Rheumatol 2000; 27:1792-5. [PMID: 10914871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Fever, rash, and arthritis may be components of the prodrome of viral hepatitis. In the absence of jaundice and abnormal liver function tests, this form of polyarthritis is easily confused with primary autoimmune diseases. Whereas the association of systemic illness with musculoskeletal symptoms and numerous viral infections is well known, such an association with hepatitis A has only been rarely reported. We describe a case of hepatitis A infection mimicking adult onset Still's disease, and review the pathogenesis and differential diagnosis of Still's disease and the extraarticular manifestations of hepatitis.
Collapse
Affiliation(s)
- S Sridharan
- Department of Rheumatic and Immunological Diseases, The Cleveland Clinic Foundation, Ohio 44195, USA.
| | | | | |
Collapse
|
42
|
Abstract
Here we present an unusual case of a 23-year-old, otherwise healthy man who had a biphasic form of viral hepatitis A with a combination of two variants, the relapsing and cholestatic forms. One month after resolution of the first phase of acute hepatitis A, he was readmitted with jaundice and intense pruritus. During hospitalization, his serum bilirubin level increased to 50.2 mg/dL, with a slight increase in the other levels of liver enzymes. He was treated with ursodeoxycholic acid and later with corticosteroid therapy, resulting in resolution of symptoms and improvement of his liver function tests after 2 weeks. Medication therapy seems to be justified in markedly symptomatic patients with relapsing hepatitis.
Collapse
Affiliation(s)
- C M Rachima
- Recanati Center for Medicine and Research, Rabin Medical Center, Petach-Tikva, Israel
| | | | | |
Collapse
|
43
|
Ridolfo AL, Rusconi S, Antinori S, Balotta C, Galli M. Persisting HIV-1 replication triggered by acute hepatitis A virus infection. Antivir Ther 2000; 5:15-7. [PMID: 10846587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
We report the case of two patients in whom acute hepatitis A was associated with a marked and prolonged increase in human immunodeficiency virus type 1 (HIV-1) viral load. Although in one patient the rise in HIV-1 RNA might also have been related to the interruption of antiretroviral therapy, we also observed a similar pattern in the other patient who had a stable undetectable plasma viraemia prior to acute hepatitis and never received treatment with anti-retrovirals. Our observation supports the hypothesis that immune activation that is induced by acute hepatitis A virus (HAV) infection may trigger HIV-1 replication. This highlights the importance of maintaining antiretroviral therapy throughout the acute phase of hepatitis A and of preventing HAV infection through active immunization.
Collapse
Affiliation(s)
- A L Ridolfo
- Institute of Infectious Diseases and Tropical Medicine, Luigi Sacco Hospital, University of Milan, Italy
| | | | | | | | | |
Collapse
|
44
|
Affiliation(s)
- A G Moiseenok
- Laboratory of Coenzymes, Institute of Biochemistry of the National Academy of Sciences, Grodno, Belarus
| | | | | | | | | |
Collapse
|
45
|
Uchaĭkin VF, Luchshev VI, Zharov SN, Kovalev OB, Ipatova OM, Tikhonova EG, Torkhovskaia TI, Kniazhev VA, Dunaevskiĭ OA, Archakov AI. [New domestic phospholipid preparation "Fosfogliv" as an effective treatment for patients with acute viral hepatitis]. Klin Med (Mosk) 2000; 78:39-42. [PMID: 10881509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Patients with acute viral hepatitis B, A and mixed hepatitis B + C were treated in two independent clinics with phosphogliv--a new hepatoprotective drug based on polyunsaturated phosphatidylcholine and glycyrrhizic acid salt. Phosphogliv removed some symptoms of intoxication (nausea, weakness, jaundice, etc.) quicker than basic therapy. Among biochemical hepatitis markers, serum bilirubin level was most responsive to phosphogliv. Standard therapy decreases bilirubin by 30% on the average for 5 days, phosphogliv reduces bilirubin for one more week to half those values observed in control patients. At that point low aminotransferase activities were seen in phosphogliv treated patients. No side effects were seen. The new hepatoprotector phosphogliv which repairs biomembranes represents drugs of new generation compared to phospholipid drug essential.
Collapse
|
46
|
Zviarynski IU, Zavodnik LB. The effect of folic acid on the drug metabolizing liver function in man with viral hepatitis. Exp Toxicol Pathol 1999; 51:455-7. [PMID: 10445416 DOI: 10.1016/s0940-2993(99)80040-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The investigations were carried out on 31 patients (16 men and 15 women, at the age of 20-50) with viral hepatitis. The all patients were divided at two groups. The first group (12 man) received usual treatment (diet, corsil), the second group (19 man) received in addition to the base treatment folic acid (5 mg per day, 10 days). It was found, that at patients with viral hepatitis was decreased the activity of monooxygenase system of liver. So, period of semielimination (T1/2) of antipyrine (AP) was greater in 1,4 time, area under the pharmacokinetic curve - 1,5 time and clearance was below by 39% than in volunteers (29 man). On day of treatment only by corsil, the rate of elimination of AP and clearance were increased by 34 and 31% (p < 0.05) respectively, T1/2 was decreased by 23% (p < 0.05) and area under the pharmacokinetic curve - 17 %. On 10 day of treatment by corsil with folic acid (5 mg per day), the rate of elimination of AP and clearance was increased by 43% (p < 0.05), area under the pharmacokinetic curve and T 1/2 were decreased by 30 and 33% (p < 0.05) respectively. The positive effect of folic acid in treatment of hepatitis at restoration period may be cause participating its derivatives in de novo nucleotide synthesis.
Collapse
Affiliation(s)
- I U Zviarynski
- Laboratory of Biochemical Pharmacology, Institute of Biochemistry, Grodno, Belarus.
| | | |
Collapse
|
47
|
Affiliation(s)
- J D Bornstein
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | | | | |
Collapse
|
48
|
Affiliation(s)
- R S Koff
- Department of Medicine, MetroWest Medical Center, Framingham, MA 01702, USA
| |
Collapse
|
49
|
Abstract
In total, 5889 cases of hepatitis A virus infection were reported during an outbreak in Puglia, a region of Southern Italy, in 1996. The primary cause of the outbreak was consumption of contaminated food (raw shellfish, vegetables, etc.), with a contributory risk factor of person-to-person transmission. A detailed questionnaire was completed by 250 randomly selected patients to obtain information sufficient to calculate the direct and indirect costs of the outbreak for the individual patient, the National Health Service (NHS) and society as a whole. A conversion rate of $US1 = 1530 Italian lire (L) has been used throughout the study since this was the average exchange rate in 1996. For the individual patient with hepatitis A virus infection, the mean cost was L1.013 million ($US662), which was equivalent to 6.6% of the mean annual income of the employed patients. The total cost of the outbreak to the NHS was L23.98 billion ($US15.67 million), which was equivalent to 0.4% of the total public health expenditure in the region in 1996. The total cost of the outbreak to society (individual patient, NHS and third parties combined) was L37.406 billion ($US24.45 million), corresponding to 0.04% of the gross domestic product of the entire region in 1996, with a mean cost per patient of L6.35 million ($US4150) from a societal perspective. The majority of patients (86.3%) were 11 to 30 years of age, reflecting the increasing susceptibility of younger patients to hepatitis A virus infection in recent decades. These economic and demographic data provide important information for the evaluation of preventive strategies including public education, sanitation and immunisation, so as to optimise the use of local health resources.
Collapse
Affiliation(s)
- C Lucioni
- Istituto di Economia Sanitaria, Milano, Italy.
| | | | | | | |
Collapse
|
50
|
Abstract
Hepatitis virus A (HVA) is a worldwide sporadic disease but its effects on pharmacokinetics and individual drug responses have not been studied. In this study, the 7-hydroxycoumarin (7OHC) excretion test used in vivo as a bioindex of hepatic CYP2A6 activity was performed in 20, previously healthy, acute jaundice HVA patients. Volunteers with an acute HVA were treated with one p.o. administration of 5 mg coumarin (Venalot). Among the patients, 11 were children (6-10 years; two girls and nine boys), the rest (15-40 years old) consisted of two men and seven women. Urinary excretion of 7OHC was measured after overnight fasting in four fractions: 0 h before any medication (to detect if any basal 7OHC excretion exits), and after a 5-mg coumarin capsule p.o., 0-2, 2-4 and 4-8 h fractions were collected and urine volumes were recorded. Urinary excretion of 7-hydroxycoumarin occurred to a similar extent in healthy adults and children. The first 2-h 7OHC excretion was decreased by 26% (P < 0.05) and total (0-8 h) 7OHC excretion was decreased by 37% (P<0.01) among HVA-positive adults (age range 15-40 years) compared with the values obtained from healthy volunteers. In 11 HVA-positive children (age 6-10 years), the first 2-h 7OHC excretion was only 20% (P < 0.0001) and the total 7OHC excretion 28% (P < 0.0001) of the value observed in healthy controls. These results suggest that (i) an acute HVA decreases the metabolic clearance of drugs such as coumarin which are rapidly metabolised by CYP2A6 and (ii) this decrease is even more prominent in children. Such metabolic responses may be of clinical importance and may also interfere with other drug therapy in these patients.
Collapse
Affiliation(s)
- M Pasanen
- Department of Pharmacology and Toxicology, University of Oulu, Finland.
| | | | | | | | | | | |
Collapse
|