Chronic viral hepatitis

Table 4 Treatment of viral infections other than chronic viral hepatitis and HIV with type I IFNs...

In conclusion, IFNs have proven to be invaluable tools in the fight against chronic viral hepatitis. In these indications, their antiviral properties play a major role and it remains unclear whether their immunomodulatory properties are also important. Disappointing results obtained with purely immunomodulatory molecules, such as interleukins or Toll-like receptor agonists suggest that, if immunomodulation plays any role, potent inhibition of viral replication is also needed. The role of IFNs in the treatment of viral infections other than hepatitis B and C remains elusive. 

A broad and vigorons T cell response generally accompanies elimination of HBV as well as HCV infection. By contrast, patients with chronic hepatitis B or C tend to have late, transient, or narrow T cell responses. In a long-term follow-up of HBV-infected patients receiving HPC transplants from HBV-immune individuals, 20 of 31 recipients cleared their HBV infection (Hui et al. 2005). In principle, these results encourage the development of adoptive T cell transfer strategies for the treatment of chronic viral hepatitis. However, it is still controversial whether induction of an efficient T cell response is the cause or the consequence of viral clearance. Furthermore, T cell responses do not only contribute to virus control but also to disease pathology (Rehermann and Nascimbeni 2005). 

Chronic hepatitis (disease lasting longer than 6 months) is usually associated with hepatitis B, C, and D. Chronic viral hepatitis may lead to the development of cirrhosis, which may induce end-stage liver disease (ESLD). Complications of ESLD include ascites, edema, jaundice, hepatic encephalopathy, infections, and bleeding esophageal varices. Therefore, prevention and treatment of viral hepatitis may prevent ESLD. 

Woo, M. and Burnakis, T. 1997. Interferon-alpha in the treatment of chronic viral hepatitis-B and viral hepatitis... 

Cirrhosis has many causes (Table 21-1). In the United States, excessive alcohol intake and chronic viral hepatitis (types B and C) are the most common causes. 

Chronic alcohol consumption Chronic viral hepatitis (types B, C, and D)... 

Hairy cell leukemia Genital warts AIDS-related Kaposi s sarcoma Non-A non-B hepatitis Hepatitis B Malignant melanoma Chronic viral hepatitis C Follicular lymphoma with chemotherapy June 1986 June 1988 Nov. 1988 Feb. 1991 July 1992 Dec. 1995 March 1997 Nov. 1997... 

It was shown experimentally that Grinization protects the emergence of certain complications of antiviral therapy and diminishes extracellular destruction caused by viral hepatitis. Thrombocytopenia is one of the extracellular demonstration of chronic viral hepatitis C that hinders the use of... 

The Algorithm of Grinization Mix and Grinization Pro Use for Patients with Chronic Viral Hepatitis C during Antiviral Therapy Realization... 

There are four variants of the Grinization Mix and the Grinization Pro use for patients with chronic viral hepatitis C during antiviral therapy realization. 

Hoofnagle,J.H.,andA.M.DiBisceglie,5 erc>-logic diagnosis of acute and chronic viral hepatitis. Semin Liver Dis, 1991.11 73-83. 

Insulin antibodies were also found in six of 58 patients treated for chronic viral hepatitis (542) and that was associated with signs of insulin allergy in one patient (SEDA-19, 335). 

Gottrand F, Michaud L, Guimber D, Ategbo S, Dubar G, Turck D, Farriaux JP. Influence of recombinant interferon alpha on nutritional status and growth pattern in children with chronic viral hepatitis. Eur J Pediatr 1996 155(12) 1031-4. 

Wong V, Fu AX, George J, Cheung NW. Thyrotoxicosis induced by alpha-interferon therapy in chronic viral hepatitis. Clin Endocrinol (Oxf) 2002 56(6) 793-8. 

Fattovich G, Giustina G, Favarato S, Ruol A. A survey of adverse events in 11,241 patients with chronic viral hepatitis treated with alfa interferon. J Hepatol 1996 24(1) 38 17. 

Mofredj A, Howaizi M, Grasset D, Licht H, Loison S, Devergie B, Demontis R, Cadranel JF. Diabetes mellitus during interferon therapy for chronic viral hepatitis. Dig Dis Sci 2002 47(7) 1649-54. 

Fabris P, Betterle C, Greggio NA, Zanchetta R, Bosi E, Biasin MR, de Lalla F. Insulin-dependent diabetes mellitus during alpha-interferon therapy for chronic viral hepatitis. J Hepatol 1998 28(3) 514—7. 

Milk thistle has been used to treat acute and chronic viral hepatitis, alcoholic liver disease, and toxin-induced liver injury in human patients. Milk thistle has most often been studied in the treatment of alcoholic hepatitis and cirrhosis. In both of these disorders, outcomes have been mixed and reports include significant reductions in markers of liver dysfunction and in mortality, as well as no effect. In acute viral hepatitis, studies have generally involved small sample sizes and have shown mixed outcomes of improved liver function (eg, aminotransferase values, bilirubin, prothrombin time) or no effect. Studies in chronic viral hepatitis and toxin-induced injury have also been of small size but have reported mostly favorable results. Parenteral silybin is marketed and used in Europe as an antidote in Amanitaphalloides mushroom poisoning, based on favorable outcomes reported in case-control studies. 

Primary liver cancer, or HCC, is a rare type of cancer in Western countries, but occurs frequently in Africa and Asia. HCC is often the sequel to chronic viral hepatitis, cirrhosis, nutritional deficiencies, or specitic toxins. More common types of cancer occurring in the liver are metastatic diseases, which originate mainly from primary gastrointestinal tumors. For the growth of these and other solid tumors, sprouting of the vascular system, called angiogenesis, is essential to provide an adequate blood supply to the tumor cells. Nutrients and oxygen are needed for the proliferation of tumor cells [134-136],... 

M. Guido, M. Rugge, L. Chemello, G. Leandro, G. Fattovich, G. Giustina, M. Cassaro, and A. Alberti, Liver stellate cells in chronic viral hepatitis the effect of interferon therapy, J. Hepatol. 24 301-307 (1996). 

Acute hepatitis induced by intranasal cocaine, with transient increases in liver enzymes, has been reported in three HIV-positive patients (202). All had non-active chronic viral hepatitis with normal immunological status one was seropositive for hepatitis B virus and two were positive for hepatitis C virus. A few days after intranasal cocaine use, serum transaminases rose to high values, and two of the patients had fever, stiffness, sweats, and hepatomegaly. Alcohol and hepatotoxic agents were ruled out. Within a few days, the clinical and laboratory signs of hepatitis improved in all three cases. 

In a study of 67 patients with chronic viral hepatitis, the self-administered Minnesota Multiphasic Personality Inventory (MMPI), which determines the patient s psychological profile, significantly correlated with the clinical evaluation and was a sensitive and reliable tool for identifying patients at risk of depressive symptoms before the... 

Suicidal ideation or suicidal attempts have been reported in 1.3-1.4% of patients during interferon alfa treatment for chronic viral hepatitis or even within the 6 months after withdrawal (347,348), but the excess risk related to interferon alfa is not known. 

Scalori A, Apale P, Panizzuti F, Mascoli N, Pioltelli P, Pozzi M, Redaelli A, Roffi L, Mancia G. Depression during interferon therapy for chronic viral hepatitis early identification of patients at risk by means of a computerized test. Eur J Gastroenterol Hepatol 2000 12(5) 505-9. 

Janssen HL, Brouwer JT, van der Mast RC, Schalm SW. Suicide associated with alfa-interferon therapy for chronic viral hepatitis. J Hepatol 1994 21(2) 241-3. 

Ams PA, Adedoyin A, DiBisceglie AM, et al. Mephenytoin disposition and serum bile acids as indices of hepatic function in chronic viral hepatitis. Clin Pharmacol Ther 1997 62 527—37. 

Autoimmune hepatitis Chronic viral hepatitis Non-alcoholic steatohepatitis (NASH)... 

Ryder S D, Beckingham IJ 2001 Chronic viral hepatitis. British Medical Journal 322 219-221 Sharara A I, Rockey D C 2001 Gastroesophageal variceal haemorrhage. New England Journal of Medicine 345 669-681... 

---