ISSN:1660-8151    

DOI:10.1159/000186894

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Five viruses are responsible for the vast majority of cases of viral related hepatitis. They have been named hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV), hepatitis E virus (HEV). The more recent literature concerning the viral structure, the epidemiology, the serological identification, the clinical course and the prevention of each type of hepatitis is reviewed. HBV is not directly cytopathic. Hepatitis is a consequence of the destruction of the virus-infected cells. The efficient elimination of the virus relies on the viral antigenic determinants (HBs, pre-S1, pre-S2, HBc, HBe) and on the immune system of the host. The viral persistence may be caused by defect of the host immunity (interferon production, T and B lymphocyte function) or by factors related to the virus such as a genome mutation (lack of HBe formation). Some evidence suggesting an immunopathogenetic mechanism also for HCV, HDV and HAV is reported.

ISSN:1660-8151    

DOI:10.1159/000186895

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

In these years, more light has been brought into the field of hepatitis viruses, particularly with regard to their biology and etiopathogenesis. Besides, first attempts of specific therapy have been done, thanks to the introduction of interferons. This paper wants to give the main guidelines of up-to-date diagnosis and treatment of hepatitis supported by viral infection.

ISSN:1660-8151    

DOI:10.1159/000186896

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Patients with post-transfusion, community-acquired or hemodialysis-acquired non-A, non-B hepatitis (NANBH) were tested for antibody to hepatitis C virus (HCV) during acute-phase and resolving or chronicized illness. HCV appears to be involved in most cases of post-transfusion and hemodialysis-acquired NANBH, but only in 40% of community-acquired NANBH. Second generation HCV antibody assays are more specific and sensitive, favoring early detection of HCV seroconversion and identification of HCV-antibody-positive individuals years after exposure to the virus.

ISSN:1660-8151    

DOI:10.1159/000186897

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The prevalence of anti-hepatitis C virus (HCV) in dialysis setting is still a nonstandard datum. In particular, it is not known of the phenomenon is stable or increasing or decreasing, even in a given geographical area. We studied the behavior of anti-HCV prevalence during a 12-month follow-up in 415 hemodialysis patients treated at a single institution and belonging to a limited geographical area with standard HCV endemic. Point prevalence of anti-HCV has shown a tendency to growth linked in part of the incidence of infection, in part to new positivities in patients already on dialysis treatment. More than 50% of the new HCV-positive patients, had no history of classical parenteral transmission of the virus. These findings suggest that HCV infection is a phenomenon on the increase in dialysis units and that dialysis treatment emerges as an independent risk factor in contracting infection.

ISSN:1660-8151    

DOI:10.1159/000186898

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The epidemiology of non-A, non-B hepatitis (NANBH) is still incomplete. To define the prevalence of antibodies against the main causative agent of NANBH, the hepatitis C virus (HCV) and the role of some risk factors, we tested sera from 269 patients on chronic dialysis at the hemodialysis units in our region in central Italy. We utilized the recently developed serological assay. Twenty-nine hemodialysis patients (13.3%) and 3 peritoneal dialysis patients (4.8%) were anti-HCV positive. Of these, 13 (40.6%) had antibodies to hepatitis B core antigen (anti-HBc) indicating prior hepatitis B infection. The anti-HCV seropositive patients had been on dialysis longer than the seronegative ones; they had received more transfusions than the others but without a significant difference. The prevalence rate of anti-HCV was statistically significantly higher among hemodialysis patients utilizing the same dialysis equipment for the previous 12 months.

ISSN:1660-8151    

DOI:10.1159/000186899

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

35 dialysis patients underwent anti-HBV vaccination. We classified patients in responders or non-responders using an anti-HBs titer of 50 UI/l as the discriminating serum level and tried to assess whether the antibody response bears any relationship with the nutritional status. 26 patients (74%) reached the target atb titer, which was maintained during follow-up (average 360 UI/l). The weak response in the other 9, with values never exceeding 20 UI/l, was short-lived. Anthropometric and impedenziometric parameters were higher in responders than in nonresponders, but the difference did not reach statistical significance. We conclude that the atb titer which discriminates uremics in responders or not must be > 50 UI/l and that the nutritional status may interfere with the seroconversion rate, but this conclusion needs to be validated in a wider population.

ISSN:1660-8151    

DOI:10.1159/000186900

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

From 1986 to 91,174 dialysis patients were studied. The prevalence of previous HBV infection and of chronic carriers was 33.3 and 4.6%, respectively. Immunization rate after vaccination (3 doses) was 63%. In 1991, we proposed a vaccination with 4 doses and recommend a 6-monthly anti-HBs evaluation to assess the timing of any booster dose needed.

ISSN:1660-8151    

DOI:10.1159/000186901

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

We studied the seroprevalence of antibodies to hepatitis C virus (HCV Ab) in a cohort of 229 chronic hemodialysis patients followed by 6 Dialysis Units in the Milan area. HCV Ab was present in 51 (22.3%) of 229 examined patients. Previous blood transfusions and surgery did not clearly influence HCV seroconversion, whereas duration of dialysis treatment seems to be strictly related to HCV Ab positivity.

ISSN:1660-8151    

DOI:10.1159/000186902

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

136 patients on hemodialysis, 89 males and 47 females, were studied; we evaluated the index of hepatic function (SGOT and SGPT) and antibodies against HCV. We observed 42 cases of increased transaminases classified as non-A, non-B (NANB) hepatitis. Antibodies against HCV were present in 40 patients. Among 42 patients with NANB hepatitis. 31 (73.8%) presented anti-HCV antibodies. No significant clinical or laboratory difference exists between anti-HCV-positive and -negative patients with NANB hepatitis. The distribution of patients who present anti-HCV antibodies is similar in post-transfusional and sporadic forms.

ISSN:1660-8151    

DOI:10.1159/000186903

出版商:S. Karger AG    

年代:1992

数据来源: Karger