ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

In the majority of instances acute viral hepatitis resolves totally without sequelae. Fulminant hepatitis is a highly lethal lesion but 20 to 25 per cent of patients, principally young patients, survive. Survivors do not appear to develop chronic liver disease. Persistent viral hepatitis follows acute icteric hepatitis, both type B and non-B, in 10 to 12 per cent of patients. Six long-term HBSAg carriers demonstrated HBSAg clearance after 14-73 months. Chronic active viral hepatitis often progresses to cirrhosis. This progressive hepatitis appeared as a sequelae of acute icteric type B hepatitis in 3 per cent of 429 patients. In patients with chronic active type B hepatitis, low titers of HBSAg are common.

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Acute viral hepatitis has several identifiable morphologic components but the major categories are (1) cytopathic, (2) inflammatory, and (3) regenerative. Each category has independently variable characteristics. Extreme alterations related to severity of disease, alteration of immune response, or pre-existing liver disease may result in diagnostic difficulties for the pathologist. In contrast to the usual concept, patients who survive fulminant viral hepatitis rarely, if ever, develop cirrhosis and those who have severe hepatic necrosis from hepatitis also do not usually develop serious sequelae of that disease except in the older age group where the difficulty is in impaired regeneration (IR).The usual criteria for the diagnosis of chronic active hepatitis or chronic aggressive hepatitis need a thorough review since many of the variations of acute viral hepatitis result in histologic patterns that might be considered to be chronic aggressive hepatitis using the previous definitions; yet such patients recover without developing chronic liver disease. Chronic active hepatitis, a progressive hepatic disorder, is characterized by changes in the distribution of necrosis and regeneration within the lobule from that usually observed in acute viral hepatitis.Persistent viral hepatitis,a development in 10 to 12 per cent of adult patients after icteric acute disease, is characterized by a “cobblestone” hepatocellular change that resembles continued regeneration, focal hepatocytolysis, and often portal lymphoid hyperplasia. Apparently with time, these histologic features fade and the incidence, in type B PVH, of “ground glass” HBSAg laden cells increases. This may reflect a continued adaptation of host and virus to one another.

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The clinical, biochemical and histological features in nine asymptomatic HBSAg carriers, 15 patients with symptomatic HBSAg-positive chronic active hepatitis (CAH), and 20 patients with HBSantigenemia persistent for five months or longer following a documented attack of acute viral hepatitis were compared, and contrasted with those in 67 patients with HBSAg-negative CAH. The findings were remarkably similar in all groups. However, young males predominated in all three HBSAg-positive groups, whereas most HBSAg-negative cases of CAH were in middle-aged women. Moreover, in the latter group, the lesions tended to be more extensive and more commonly were accompanied by smooth muscle antibody, antinuclear antibody and LE cells, and extrahepatic manifestations, such as ulcerative colitis, arthritis, pleurisy and pericarditis.

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The Veterans Administration is currently conducting a collaborative study in three hospital-based drug treatment clinics to evaluate asymptomatic parenteral drug addicts for evidence of hepatic disease. Preliminary data are presented on 347 patients who have completed at least three months of follow-up evaluation. On admission, abnormal serum transaminase values were demonstrated in one half, HBSAg in 7 per cent, and anti-HBSin 59 per cent. The frequency of these findings increased during the follow-up evaluation, only 19 (5.5 per cent) remaining entirely free of one or more of these abnormalities. Definable hepatologic disease (acute or chronic hepatitis, alcoholic hepatitis) developed in 46 per cent of the patients, However, among 60 of them subjected to liver biopsy, a poor correlation was noted between the clinical and histologic diagnoses. In particular, routine liver function and immunologic tests did not discriminate between histologically detected chronic active and chronic persistent hepatitis. However, HBSAg was present significantly more frequently in those with chronic active hepatitis. Wide variability of histologic diagnoses was seen among patients subjected to more than one biopsy, apparent progression and regression of the lesion being noted. This demonstrates the hazard of attempting to assign a prognosis to the disease on the basis of a single liver biopsy specimen, and suggests that repeated biopsies should be mandatory for the evaluation of chronic liver disease in drug addicts.

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Recent evidence indicates that viral hepatitis is sometimes associated with the production of extrahepatic tissue injury. Hepatitis B virus (HBV) infection is most commonly incriminated but non-type B hepatitis may also be involved. Three types of syndromes have been recognized. First, a serum sickness-tike prodrome consisting of skin eruptions, urticaria, and polyarthralgias or arthritis may occur from one to six weeks prior to the onset of hepatitis in 15 to 20 per cent of patients and usually disappears by the time the patient becomes jaundiced. There is extensive evidence that circulating immune complexes are responsible for these symptoms. Second, about 30 to 40 per cent of patients with typical polyarteritis nodosa have persistent hepatitis B surface antigenemia (HBSAg). Circulating immune complexes composed of HGSAg, antibody, and complement have been demonstrated together with deposits of immune complexes at sites of vascular injury. Third, an immune complex type of glomerulonephritis may occur following hepatitis B virus infection, usually in association with chronic active hepatitis. Thus there is impressive evidence that hepatitis viruses, especially HBV, may produce a variety of extrahepatic manifestations in which the mechanism of pathogenesis involves an immunologic process rather than direct viral invasion and cytopathogenicity.

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The frequency distribution of HBSAg in different parts of the world reveals a relatively high frequency among healthy members of population groups inhabiting areas of high incidence of liver cell carcinoma. Similar high frequencies of HBSAg are also found in those areas where macronodular cirrhosis is relatively common and is usually complicated by liver cell carcinoma. In geographic areas with low incidence of liver cell carcinoma and macronodular cirrhosis, a relatively low frequency of HBSAg is usually encountered in the population. The frequency of HBSAg is relatively higher in patients with liver cell carcinoma with or without cirrhosis than in comparable controls. The subtypes of the antigen do not correlate with the incidence of liver cell carcinoma and there is also no correlation between alpha fetoprotein and HBSAg in the presence of liver cell carcinoma. HBSAg is very rarely detected in patients with micronodular cirrhosis or in liver cell carcinoma which may be its complication. It would appear that HBSAg is necrogenic in the liver and is capable of producing hepatic necroses or hepatitis which may progress to macronodular cirrhosis. The areas of hepatic necroses may either progress to liver cell carcinoma or the resultant macronodular cirrhosis may be complicated by carcinoma. The oncogenic potential of HBSAg requires further studies.

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Progress in research on hepatitis type A has begun to accelerate because of the recent discovery of an antigen associated specifically with hepatitis type A infection and the development of tests for antibody to the antigen. Hepatitis A antigen is associated with 27 nm virus-like particles found in the liver and stool of animals experimentally infected with hepatitis type A and in the stool of humans experimentally or naturally infected with the virus. The density of the particulate antigen when isolated from the liver is 1.34, but antigen particles with densities ranging from 1.32 to 1.40 have been detected in stool. However, antigens from the liver and from the stool appear to be antigenically related.Using immune electron microscopy as a serologic tool for detecting antibody to hepatitis A antigen, we detected antibody in convalescent sera from 100 per cent of patients experimentally or naturally infected with hepatitis type A. In contrast, patients with hepatitis type B or non-B hepatitis not epidemiologically compatible with a diagnosis of hepatitis type A did not have a serologic response to hepatitis A antigen. Antibody was found in approximately 50 per cent of normal individuals tested; the frequency was directly related to age. By the use of immune electron microscopy for the detection of hepatitis A antigen and antibody, the temporal relationship of antigen, antibody and liver damage was determined in experimentally infected humans and chimpanzees. On the basis of serologic comparisons, hepatitis type A does not appear to be related to experimental hepatitis caused by the GB agent of Deinhardt, nor is the hepatitis A antigen serologically related to the fecal antigen of Cross.

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID