Factors For Chronic Liver Disease Research Articles

Chronic Hepatitis C Virus Infection After Treatment for Pediatric Malignancy

AbstractSera of 658 patients who had completed treatment for pediatric malignancy were analyzed by a second-generation enzyme-linked immunosorbent assay and recombinant immunoblot assay test to assess the prevalence of hepatitis C virus (HCV)-seropositivity. All HCV-seropositive patients underwent detailed clinical, laboratory, virologic, and histologic study to analyze the course of HCV infection. One hundred seventeen of the 658 patients (17.8%) were positive for HCV infection markers. Among the 117 anti-HCV+ patients, 41 (35%) were also positive for markers of hepatitis B virus infection with or without delta virus infection markers, 91 (77.8%) had previously received blood product transfusions, and 25 (21.4%) showed a normal alanine aminotransferase (ALT) level during the last 5-year follow-up (11 of them never had abnormal ALT levels). The remaining 92 patients showed ALT levels higher than the upper limit of normal range. Eighty-one of 117 (70%) anti-HCV+ patients were HCV-RNA+, with genotype 1b being present in most patients (54%). In univariate analysis, no risk factor for chronic liver disease was statistically significant. In this study, the prevalence of HCV infection was high in patients who were treated for a childhood malignancy. In about 20% of anti-HCV+ patients, routes other than blood transfusions are to be considered in the epidemiology of HCV infection. After a 14-year median follow-up, chronic liver disease of anti-HCV+ positive patients did not show progression to liver failure.

Seroepidemiology of HBV and HCV in Bangladesh

Virus related liver diseases are important causes of morbidity in Bangladesh. We have reviewed the data of different authors to assess the magnitude of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in this country. HBV accounts for 35% acute viral hepatitis, 40.5% chronic liver disease, 36.5% hepatocellular carcinoma and 29.1% cases of post transfusion hepatitis. HCV accounts for 3.5% acute viral hepatitis, 24.1% chronic liver disease, 9.6% hepatocellular carcinoma and 6.8% cases of post transfusion hepatitis. Blood donors are not routinely screened for HBsAG except in a few selected centers. Twenty-nine percent of professional blood donors and 2.4% of voluntary blood donors are HBsAG carriers. Anti-HCV was found in 1.2% of professional blood donors and in no voluntary donors. HBsAG is positive in 7.5% of healthy adult jobseekers. In our series of acute viral hepatitis, there was no history suggestive of parenteral route of infection in 60% cases of HBV and 54% cases of HCV. In conclusion, HBV is the main aetiological factor for chronic liver disease in Bangladesh.

Gene expressions of c-met and hepatocyte growth factor in chronic liver disease and hepatocellular carcinoma

Background/Aims: The roles of c-met proto-oncogene and hepatocyte growth factor in human livers have not been shown. Methods: Gene expressions of both c-met and hepatocyte growth factor were quantified in livers with chronic active hepatitis and in cirrhotic livers with hepatocellular carcinoma as well as in normal controls, using competitive reverse transcription polymerase chain reaction. Results: C-met expression was significantly increased in chronic active hepatitis compared with control livers, and c-met expression in chronic active hepatitis correlated with serum alanine aminotransferase levels. Hepatocyte growth factor expression was increased in some patients with chronic active hepatitis compared with controls, and there was a significant correlation between c-met expression and hepatocyte growth factor expression. On the other hand, in hepatocellular carcinoma tissues, c-met expression was increased in some cases, while that in the surrounding non-carcinomatous tissues was similar to normal controls. Hepatocyte growth factor expression was not detected in the hepatocellular carcinoma tissues and was low in the surrounding non-carcinomatous tissues. Conclusions: These findings suggest that hepatocyte growth factor may be involved in the regeneration of hepatocytes via paracrine mechanism in chronic active hepatitis, while the regulation of c-met expression in hepatocellular carcinoma tissues may be independent of hepatocyte growth factor stimulation.

Prevalence of chronic liver disease in the general population of northern Italy: the Dionysos Study.

Data on the prevalence of chronic liver disease, derived from selected series of hospitalized patients or from mortality registers, underestimate the prevalence of chronic liver disease. The Dionysos Study is a cohort study that investigated for the first time the prevalence of chronic liver disease in a general population. All the citizens of two towns in northern Italy, Campogalliano and Cormons, aged 12 to 65 yr were contacted by letter. From March 1991 through March 1993, 6,917 of a total of 10,150 citizens were enrolled (compliance, 69%). The standardized protocol for each enrollee included (a) a color-illustrated food questionnaire on dietary habits and alcohol intake; (b) a detailed medical history, including questions on risk factors for chronic liver disease; (c) a physical examination; and (d) blood tests for AST, ALT, gamma-glutamyltranspeptidase, mean cell volume, platelet count and hepatitis B virus and hepatitis C virus markers. Signs suggestive of chronic liver disease were seen in 21.3% of the subjects, and who then underwent further liver function tests, upper abdominal ultrasonography and, when necessary, liver biopsy. Persistent signs of chronic liver disease were present in 17.5% of the subjects, including 1.1% with cirrhosis and 0.07% with hepatocellular carcinoma. The prevalence rates of hepatitis B virus and hepatitis C virus positivity (second-generation enzyme-linked immunosorbent assay) were 1.3% and 3.2%, respectively. Alcohol abuse was the etiological agent in 23%.(ABSTRACT TRUNCATED AT 250 WORDS)

High prevalence of viral infection in adults with homozygous and heterozygous alpha 1-antitrypsin deficiency and chronic liver disease.

To determine the prevalence of chronic liver disease in adults with homozygous (Pi ZZ) and heterozygous (Pi Z) alpha 1-antitrypsin deficiency and to assess the presence of other possible risk factors for the development of chronic active hepatitis and cirrhosis of the liver in these patients. Cross-sectional study. A referral-based university hospital. Consecutive patients (164) with the Pi ZZ and Pi Z phenotype with and without chronic liver disease. The presence of antibody to hepatitis C virus (anti-HCV) was determined using an assay incorporating synthetic peptide antigen from capsid protein (United Biomedical [UBI] assay) and a second-generation enzyme immunoassay (Abbott test); the presence of antibody to hepatitis B virus (anti-HBV) was determined using radioimmunoassays incorporating hepatitis B surface antigen (HBsAg) and hepatitis B core antigen (HBcAg); assays for antinuclear antibody and antimitochondrial antibody (M2 subtype) were also done, and alcohol abuse was assessed by history. Among patients with cirrhosis (32%), 62% were anti-HCV positive by the Abbott test (P = 0.006), and 41% were anti-HCV positive by the UBI assay (P = 0.007). Thirty-three percent of patients with cirrhosis had hepatitis B virus (HBV) infection (P = 0.01); 41% had a history of alcoholism; and 12% had features of autoimmune liver disease. Only five patients (9%) with cirrhosis had no other risk factor for chronic liver disease. Among patients with chronic active hepatitis (7%), 80% were anti-HCV positive by the Abbott test (P = 0.002), and 75% were anti-HCV positive by the UBI assay (P less than 0.001). Thirty percent of patients with chronic active hepatitis had HBV infection (P = 0.023); 18% had autoimmune hepatitis; and 8% abused alcohol. Only two patients (17%) had no additional risk factor for the development of chronic active hepatitis. Among patients with steatosis of the liver (48%), 5% were anti-HCV positive by the Abbott test, and none were anti-HCV positive by the UBI assay; 18% had serologic evidence of past HBV infection, and 28% abused alcohol. Among patients without chronic liver disease (13%), no viral infection could be found; 9% were alcoholics. Chronic liver disease in patients with alpha 1-antitrypsin deficiency is associated with a high prevalence of viral infection; this infection, rather than alpha 1-antitrypsin deficiency alone, may be the cause of the liver disease in such patients.

Hepatic morphologic findings and viral antigens in acute hepatitis B

In the course of a prospective clinical study, 26 liver biopsies were taken in 24 previously healthy patients with an uncomplicated acute hepatitis B (AHB) and a subsequent complete recovery (UR group). Serum transaminase levels were used to distinguish four AHB stages, as the variability in duration made time dependent staging less appropriate. As a reference, a second group of 22 liver biopsies from 7 patients from the same prospective clinical study who eventually developed chronic hepatitis (CH group) was included. Due to fluctuations of transaminase levels in this group the stages two and three could not be separated, stage four was not reached within the follow-up period of median 5 years. Histopathological criteria and the distribution patterns of hepatitis B surface (HBsAg) and core (HBcAg) antigens were studied. Piecemeal necrosis and bridging hepatic necrosis were a frequently occurring feature in the liver biopsies of the UR group taken during the stage of peak transaminase levels. In this respect, no differences could be demonstrated between the UR group and the CH group. The occurrence of these features in AHB thus appears to have no prognostic value as risk factor for chronic liver disease. In contrast, diffuse cytoplasmic (‘ground glass’) HBsAg localization was only found in stage 2/3 of the CH group. It is concluded that apart from ground glass cells, care must be taken to interpret any histopathological feature in AHB as risk factor of progression to chronicity without reference to the duration of illness. The possible significance regarding the host's immune mechanisms of some features that may persist during chronic liver disease is discussed.

Clinical and experimental studies on rheumatoidlike factor in chronic liver disease

Clinical and experimental studies on rheumatoidlike factor in chronic liver disease