Hepatitis types

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)... 

Mizutani, T., Shinoda, M., Tanaka, Y., Kuno, T., Hattori, A., Usui, T., Kuno, N., and Osaka, T., Autoantibodies against CYP2D6 and other drug-metabolizing enzymes in autoimmune hepatitis type 2, Drug Metab. Rev., 37, 235, 2005. 

In contrast to the type I deiodinase which shows a high preference for rT4 over T4 as the substrate (Table II), the type II enzyme is somewhat more effective in the deiodination of T4 than of rT3 (Table III). Under the conditions tested, the Km value of T4 for the type II enzyme is three orders of magnitude lower than the Km of T4 for the type I deiodinase. The Km of rT3 for the type II deiodinase is somewhat greater than that of T4 and differs less from the Km of rT3 for the type I enzyme. The Umax of the conversion of T4 to T3 by the type II enzyme depends on the tissue and the thyroid status of the animal (see below). In cerebral cortex of hypothyroid rats [82] it is roughly one-thousandth of the maximum T3 production by the hepatic type I deiodinase of euthyroid animals determined under similar conditions [32]. The VmiJKm ratio of this reaction is, therefore, similar for the type II deiodinase of hypothyroid rat brain and the type I deiodinase of euthyroid rat liver and much greater than that for the hepatic enzyme of hypothyroid rats [86], In view of the reaction kinetics of the type II deiodinase (see below), it is questionable if the Vm,JKm ratios estimated in vitro also apply to physiological conditions with unknown cofactor availability. 

Francioni S, M Pastore, Alpha-fetoprotein and acute viral hepatitis type B, J. 

Horikawa N, Yamazaki T, Izumi N, Uchihara M. Incidence and clinical course of major depression in patients with chronic hepatitis type C undergoing interferon-alpha therapy a prospective study. Gen Hosp Psychiatry 2003 25(l) 34-8. 

To a varying extent, ANA are detectable in chronic active hepatitis (CAH), in mixed forms of CAH/PBC and particularly in lupoid hepatitis (autoimmune hepatitis type I) (in 80-100%) as well as in oxyphenisatin-in-duced CAH. Clinically relevant titres start at a serum dilution of 1 80. Level of the titre, pattern of fluorescence and in particular interaction with the complement system are relevant for the pathogenic valence of ANA. The determination of ANA and SMA is indicated when autoimmune hepatitis is in question. 

Schiraldi, O., Modngno, A., Miglietta, A., Fera, G. Prolonged viral hepatitis type A with cholestasis case report. Ital. J. Gastroenterol. 1991 23 364-366... 

Ealse-positive HCV tests are mainly found with autoimmunopa-thies, in particular autoimmune hepatitis type 2 (LMK-positive form). (298, 313, 331, 350, 353, 358, 404) In cases of HCV infection which cannot be established serologically the HCV RNA should be identified directly prior to commencement of INE therapy. In this way the danger of deterioration in patients with autoimmune hepatitis is eliminated. 

Vento, S., Garofano, T., Di Perri, G., Doici, L., Conda, E., Bassetti, D. Identification of hepatitis A virus as a trigger for autoimmune chronic hepatitis type 1 in susceptible individuals. Lancet 1991 337 1183-1187... 

Dienstag, XL., Rhodes, A.R., Bhan, A.K., Dvorak, A.M., Mihm, M.C.jr., Wands, XR. Urticaria associated with acute viral hepatitis type B. Studies of pathogenesis. Ann. Intern. Med. 1978 89 34-40... 

Seeff, L.B. Natural history of viral hepatitis, type C. Semin. Gastro-intest. Dis. 1995 6 20-27... 

Zanetti, A.R., Dawson, G.J. Hepatitis type E in Italy seroepidemio-logical survey. J. Med. Virol. 1994 42 318-320... 

Herzog, D., Rasquin-Weber, A.-M., Debray, D., Alvarez, R Subfulmi-nant hepatic failure in autoimmune hepatitis type 1 an unusual form... 

M. Autoimmune hepatitis type 1 after Epstein-Barr virus infection. 92. 

Ruiz-Mureno, M., Rua, M.J., Carreno, V, Quironga, J.A., Manns, M., Meyer zum Biischenfelde, K.-H. Autoimmune chronic active hepatitis type 2 manifested during interferon therapy in children. J. Hepatol. 1991 12 265 - 266... 

Vento, S., Cainelli, F., Ferraro, T., Concia, E. Autoimmune hepatitis type 1 after measles. Amer. J. Gastroenterol. 1996 91 2618 - 2620... 

Fattovich, G., Brollo, L., Giustina, G., Noventa, F., Pontisso, P., Alberti, A., Realdi, G., Ruol, A. Natural history and prognostic factors for chronic hepatitis type B. Gut 1991 32 294-298... 

Interferon alfa-2b Intron A (Schering-Plough) Hairy cell leukemia AIDS-related Kaposi s sarcoma chronic hepatitis, types B and C condylomata acuminata malignant melanoma follicular lymphoma non-Hodgkins lymphoma... 

Horikawa N, Yamazaki T, Sagawa M, Nagata T. A case of akathisia during interferon-alpha therapy for chronic hepatitis type C. Gen Hosp Psychiatry 1999 21(2) 134-5. 

Zanger U, Hauri H, Loeper J, Homberg J, Meyer U. Antibodies against human cytochrome P-450dbl in autoimmune hepatitis type II. Proc Natl Acad Sci USA 1988 85 8256-60. 

In acute phase, all hepatitis types are similar in clinical manifestations... 

Chaurasia, S.S., P. Gupta, A. Kar and P.K. Maiti. Lead-induced thyroid dysfunction in the fish Clarias batrachus with special reference to hepatic type I - 5 -monodeiodinase activity. Bull. Environ. Contam. Toxicol. 56 649-654, 1996. 

While cirrhosis has many causes (Table 37-1), in the United States excessive alcohol intake and chronic viral hepatitis (types B and C) are the most common causes. A breakdown of the indications for liver transplantation (Table 37-2) provides an estimate of the clinical frequency for each of the potential causes of cirrhosis, as transplant represents the deflnitive therapeutic strategy for cirrhosis. These data underestimate alcoholic liver disease, as these patients are often not considered suitable transplant candidates. 

C2. Campbell, E., Takahashi, Y., Abramovitz, M., Peretz, M., and Listowsky, I., A distinct human testis and brain mu-class glutathione S-transferase. Molecular cloning and characterization of a form present even in individuals lacking hepatic type mu isoenzymes. J. Biol Chem. 265, 9188-9193 (1990). 

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