Hepatic histologic and immunohistochemical changes in chronic hepatitis B after prolonged clearance of hepatitis B e antigen and hepatitis B surface antigen

Article Abstract:

Hepatitis B is a severe inflammation of the liver. The hepatitis B virus (HBV) is generally transmitted by contact with blood; hospital workers, drug abusers, and homosexual men are at especially high risk. About 40 percent of patients with chronic hepatitis B respond to treatment with alpha interferon, a substance that impedes the replication of some viruses. In patients who respond, evidence of viral infection, such as the detection of the viral 'e' antigen or viral DNA, disappears from the blood over time. Likewise, antibodies against the hepatitis B virus surface antigen appear in the blood of some patients recovering after alpha interferon treatment. Less is known, however, about the changes that occur in the liver of such recovering patients. A study was conducted to compare liver biopsy specimens obtained prior to treatment with liver biopsy specimens taken after the disappearance of signs of infection in seven patients recovering from hepatitis B infection. The comparison demonstrated that pathological changes in the liver were improved after the clinical recovery and the disappearance from the blood of signs of chronic HBV infection. However, the comparison also revealed that the recovery process was quite slow. There was a clear-cut relationship between the observed decreased in liver damage and the interval between the disappearance of evidence of infection. An improvement in the liver tissue of about 50 percent was observed in patients whose virus disappeared more than two years previously. Only one of the patients had an apparently normal liver biopsy, and this patient had developed antibodies against HBV surface antigen 46 months previously. These observations indicate that obtaining a liver biopsy from patients recovering from hepatitis B is probably not necessary in the first year. Pathological changes are clearly present in the liver for at least two years after evidence of hepatitis B virus in the blood has disappeared. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Measurement, Physiological aspects, Hepatitis B, Hepatitis associated antigen, Hepatitis B e-antigen

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HFE Genotype in Patients with Hemochromatosis and Other Liver Diseases

Article Abstract:

A genetic mutation may be highly prevalent in patients with hemochromatosis, a hereditary form of disordered iron metabolism. Researchers tested 66 patients with hemochromatosis and 132 patients with other liver diseases for the HFE gene. Ninety-one percent of hemochromatosis patients had two copies of the mutated gene, while only 5% of the other patients had the mutation. Every patient with two copies of the particular HFE gene mutation had high concentrations of iron in the liver, but 15% did not meet the traditional diagnostic criteria for hemochromatosis. Genetic analysis may indicate hemochromatosis in patients with iron overload and liver disease but lacking other diagnostic symptoms.

United States, Demographic aspects, Genetic aspects, Genetic polymorphisms, Hemochromatosis

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Troglitazone-induced hepatic failure leading to liver transplantation: a case report

Article Abstract:

Troglitazone for the treatment of type 2 diabetes may cause severe liver damage in some patients. A 59-year-old woman treated with troglitazone for 3.5 months developed jaundice, bloody urine, and nausea and required hospitalization. Liver biopsy revealed massive liver damage, and the patient ultimately required liver transplantation. The FDA has received reports of three adverse troglitazone reactions which resulted in liver transplantation or death. The manufacturer now recommends monthly liver function tests during the first six months of troglitazone therapy.

Causes of, Complications and side effects, Drug therapy, Liver failure, Type 2 diabetes, Liver, Liver transplantation, Rezulin (Medication), Troglitazone

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