Integrin up-regulation in chronic liver disease: relationship with inflammation and fibrosis in chronic hepatitis C

There is accumulating evidence that the coagulation system is involved in the process of fibrogenesis in chronic liver disease. Recent studies postulated a possible connection between plasmatic hypercoagulability and progression of fibrosis. The aim of the study was to investigate disorders of the coagulation system in patients with chronic hepatitis C having different extent of hepatic fibrosis well defined by liver histology. A total of 62 patients with chronic hepatitis C were recruited and categorized into 2 groups according to their histological fibrosis stage : mild/moderate fibrosis group (F0-F3 group, n = 30) and extensive fibrosis/cirrhosis group (F4-F6 group, n = 32). The control group consisted of 31 healthy individuals. The following hemostatic assays were evaluated: antithrombin III (AT), protein C (PC) activity, activated partial thromboplastin time, prothrombin time, plasma fibrinogen as well as conventional liver function test. The PC level exhibited a significant reduction in both patient groups when compared to the normal control group (89.25% ± 10.05% and 48.33% ± 15.86% vs 111.86 ± 10.90; P < .001 and P < .001). The PC was found to be the strongest associated factor to histological fibrosis stage ( r = –.834; P < .0001). Univariate and multivariate analysis showed that AT ( P = .003) and PC ( P = .0001) were the most important factors associated with advanced fibrosis. The PC ( P = .001) was found to be the only predictor of mild fibrosis. In conclusion, PC deficiency occurs in an early stage of liver fibrosis. The severity of deficiency is proportional to extent of fibrosis. The PC may have a key role in linking hypercoagulability with hepatic fibrogenesis in chronic liver disease.

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Influence of depression on the quality of life in patients with chronic hepatitis C

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1110645p ◽

2011 ◽

Vol 139 (9-10) ◽

pp. 645-650

Author(s):

Sladjana Pavic ◽

Neda Svirtlih ◽

Jasmina Simonovic ◽

Dragan Delic

Keyword(s):

Quality Of Life ◽

Chronic Hepatitis ◽

Liver Disease ◽

Hepatitis C ◽

Chronic Liver Disease ◽

Chronic Hepatitis C ◽

Cognitive Dysfunction ◽

Chronic Liver ◽

Hamilton Depression Scale

Introduction. Chronic hepatitis C reduces the quality of life in patients causing fatigue, loss of self-confidence, reduced working capacity, development of depression, emotional problems, and cognitive dysfunction. Objective. The aim of the study was to identify the presence of depression in patients with chronic hepatitis C, predicting factors for its expression, and the impact of depression on the quality of life in these patients. Methods. During the prospective study, we used the Hamilton depression scale to investigate the presence of depression, generic 36-Item Short Form Health Survey (SF-36) and Chronic Liver Diseases Questionnaire (CLDQ) to examine the quality of life in 100 patients with chronic hepatitis C, 30 patients with chronic hepatitis B, 30 patients with chronic liver disease non- viral aetiology and 50 healthy persons. Results. A significantly higher presence of depression, and cognitive dysfunction in patients with chronic hepatitis C were noted as compared to the healthy individuals (p=0.00). In relation to non-viral patients with chronic liver disease, depression was significantly less present (p=0.004). Depression was rare in younger patients. The largest number of patients with chronic hepatitis C was without depression. The presence of depression caused deterioration of the physical and mental components of the quality of life. Multivariate analysis showed that the most significant positive predictive factor for the presence of depression was married life (B=0.278; SE=0.094; p=0.004). Conclusion. The presence of depression was more often in patients with chronic hepatitis C viral infection compared to healthy population and was correlated with decline in the quality of life. Depression is more pronounced in the elderly and intravenous drug addicts. The lowest depression is expected in patients who are not married.

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Performance and Validation of Chronic Liver Disease Questionnaire-Hepatitis C Version (CLDQ-HCV) in Clinical Trials of Patients with Chronic Hepatitis C

Value in Health ◽

10.1016/j.jval.2016.02.005 ◽

2016 ◽

Vol 19 (5) ◽

pp. 544-551 ◽

Cited By ~ 27

Author(s):

Zobair M. Younossi ◽

Maria Stepanova ◽

Linda Henry

Keyword(s):

Clinical Trials ◽

Chronic Hepatitis ◽

Liver Disease ◽

Hepatitis C ◽

Chronic Liver Disease ◽

Chronic Hepatitis C ◽

Chronic Liver ◽

Chronic Liver Disease Questionnaire ◽

Disease Questionnaire

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Hepatitis B vaccine efficacy in patients with chronic liver disease by hepatitis C virus

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032004000300008 ◽

2004 ◽

Vol 41 (3) ◽

pp. 180-184 ◽

Cited By ~ 23

Author(s):

Angelo Alves de Mattos ◽

Eliana Buksztejn Gomes ◽

Cristiane Valle Tovo ◽

Cláudio Osmar Pereira Alexandre ◽

José Oscar dos Reis Remião

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C Virus ◽

Liver Disease ◽

Hepatitis C ◽

Virus Infection ◽

Hepatitis B ◽

Chronic Liver Disease ◽

Chronic Hepatitis C ◽

Hepatitis C Virus Infection ◽

Chronic Hepatitis C Virus

BACKGROUND: Considering the immunosuppression of patients with chronic liver disease, their response to vaccination is discussed in literature. AIMS: To evaluate the response of hepatitis B vaccine in patients with chronic hepatitis C virus infection. METHODS: This is a prospective study in which 85 patients with chronic hepatitis C virus infection (46.8 ± 9.4 years, 44.7% males) and 46 healthy adults (36.7 ± 11.1 years; 39.1% males) were evaluated. Confirmation of hepatitis C virus was obtained by the technique of polymerase chain reaction. Viral load was determined by the branched DNA method in 74 patients, and genotype was determined by sequencing in 73 patients. All patients and healthy adults received three doses of Engerix B® vaccine IM (at 0, 30 and 180 days). Serological responses to the vaccine were divided into three categories: seroprotection, when anti-HBs was >100 mUI/mL; seroconversion, when anti-HBs was 10-99 mUI/mL, and non-reagent, when anti-HBs was <10 mUI/mL. RESULTS: The response of hepatitis B vaccine as determined 1 month following dose 3 was seroprotection in 37.7%, seroconversion in 17.6% and non-reagent in 44.7% among patients and 84.8%, 13.0%, 2.2%, respectively in healthy adults. The number of non-reagent responses was significantly higher among those patients with chronic liver disease. Sixty-five patients with chronic hepatitis were compared to 20 compensated cirrhotic patients in concern to the response to vaccine, but no difference was found. The response to vaccine in patients with genotypes 2 or 3 (n = 40) was better than in those with genotype 1 (n = 33). Response was not related to serum HCV-RNA concentration. CONCLUSION: The number of non-responders was higher in patients with chronic hepatitis C virus infection, irrespective of histological status and viral load. It is suggested that such patients should receive a double dose of vaccine, particularly the ones with genotype 1.

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EPIDEMIOLOGICAL ASPECTS OF HEPATOCELLULAR CARCINOMA IN A REFERRAL CENTER OF MINAS GERAIS, BRAZIL

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032013000200015 ◽

2013 ◽

Vol 50 (2) ◽

pp. 97-100 ◽

Cited By ~ 6

Author(s):

Fernanda Maria Farage OSÓRIO ◽

Gabriel Martin LAUAR ◽

Agnaldo Soares LIMA ◽

Paula Vieira Teixeira VIDIGAL ◽

Teresa Cristina Abreu FERRARI ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Chronic Hepatitis ◽

Liver Disease ◽

Hepatitis C ◽

Chronic Liver Disease ◽

Chronic Liver ◽

Ethanol Injection ◽

Referral Center ◽

Ethanol Abuse ◽

Underlying Chronic Liver Disease

Context Studies on epidemiology of hepatocellular carcinoma and modalities of therapy used to treat this condition are scarce in Brazil. Our aim was to characterize hepatocellular carcinoma according to etiology of the underlying chronic liver disease, and treatment modalities, in a referral center in Brazil. Methods All cases of hepatocellular carcinoma registered in the Department of Pathology during a 12-year period (1998-2010) were included. Demographic data, etiology of the underlying liver disease and treatment performed were collected. Results This case series included 215 patients, mean age 57.3 (± 14.1) years, 164 (76.2 %) male. Virus C and virus B infection were detected in 88 (43%) and 47 (23%) patients, respectively. Ethanol abuse alone or combined with other etiologies was identified in 64 (32%) individuals. Schistosomiasis was found in 18 (9%) patients. Liver transplantation was the treatment of choice in 112 (51%) patients. This procedure was more frequently performed in hepatitis C virus-related hepatocellular carcinoma (70%) than B virus-related hepatocellular carcinoma (17%). Tumor resection was performed in 40 (18%) individuals, ethanol injection or thermo ablation in 18 (14%), and chemoembolization in 14 (7%). In 40 (19.4%) patients no treatment was performed and this percentage remained constant over the years. Conclusions Chronic hepatitis C, followed by ethanol abuse and chronic hepatitis B were the leading causes of underlying chronic liver disease associated with hepatocellular carcinoma. The results show a trend of increasing incidence of hepatocellular carcinoma; however, the proportion of untreated patients remained constant over the analyzed period.

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Chronic Hepatitis C in Western Canada: A Survey of Practice Patterns among Gastroenterologists in Alberta and British Columbia

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2014/651717 ◽

2014 ◽

Vol 28 (1) ◽

pp. e1-e4 ◽

Cited By ~ 1

Author(s):

Rohit Pai ◽

Alnoor Ramji ◽

Samuel S Lee ◽

Winnie W Wong ◽

Eric M Yoshida

Keyword(s):

British Columbia ◽

Chronic Hepatitis ◽

Liver Disease ◽

Hepatitis C ◽

Chronic Liver Disease ◽

Chronic Hepatitis C ◽

Virological Response ◽

Practice Patterns ◽

Rapid Virological Response ◽

Referral Patterns

OBJECTIVE: To survey gastroenterologists in British Columbia and Alberta with regard to awareness of chronic hepatitis C virus (HCV) management and practice patterns among physicians who treat and do not treat HCV-infected patients.METHODS: An anonymous two-page mail survey was distributed to actively practicing adult gastroenterologists in British Columbia and Alberta. Among physicians who treated HCV patients, respondents answered assessment of fibrosis pretreatment, measurement of rapid virological response, prescription of protease inhibitors (PIs), barriers to using these agents and referral patterns. For those who did not treat HCV, referral of patients for treatment and to whom was assessed.RESULTS: Seventy-seven of 166 individuals completed the survey (46% response rate). Most (49%) practiced in academic or large community (42%) settings. Chronic liver disease comprised <25% of individual practice in 71%. Forty-eight (62%) treated HCV and two-thirds prescribed a PI. Barriers to prescription included unfamiliarity (six of 16), lack of allied health (five of 16) and few suitable patients (seven of 16). Pretreatment liver biopsy was performed by 33% (16 of 48) and 69% (33 of 48) used noninvasive measures. Rapid virological response was measured in 83% (40 of 48). Referral patterns changed in 46% (22 of 48) of physicians who treated HCV. All respondents who did not treat HCV referred patients for consideration, with 90% (26 of 29) made to hepatologists.CONCLUSIONS: Chronic liver disease comprised <25% of practice in the majority of surveyed respondents. Among those who treated HCV, one-third have not prescribed a PI. Barriers to prescription and referral pattern changes are noted by those currently treating patients with HCV infection.

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Serum Markers of Iron Metabolism in Chronic Liver Diseases

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2018.251 ◽

2018 ◽

Vol 6 (6) ◽

pp. 1010-1016 ◽

Cited By ~ 4

Author(s):

Mariana Penkova Radicheva ◽

Albena Nikolaeva Andonova ◽

Hristina Tancheva Milcheva ◽

Nadejda Gospodinova Ivanova ◽

Silviya Georgieva Kyuchukova ◽

...

Keyword(s):

Chronic Hepatitis ◽

Liver Disease ◽

Hepatitis C ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Chronic Hepatitis C ◽

Fatty Liver Disease ◽

Serum Markers ◽

Chronic Liver ◽

Nonalcoholic Fatty Liver

BACKGROUND: Disorders in the metabolism of iron in the direction of iron overload are observed not only in primary hemochromatosis but also in some chronic liver diseases other aetiology. Elevation of serum iron, ferritin and transferrin saturation is reported in nonalcoholic fatty liver disease and alcohol, chronic hepatitis C and liver cirrhosis.AIM: Aim of the study was to evaluate and compare the frequency of the iron serum markers in patients with various chronic liver diseases.MATERIAL AND METHODS: The study included a total of 246 persons -186 patients with chronic liver disease without cirrhosis (-115 men, women -71; average age of 50.41 ± 12.85, from 23 to 77 years) and 60 healthy controls (-30 men, women -30, middle-aged 50.50 ± 11.31, from 29 to 83 years). Medical history, physical examination and demographic data including height, weight, laboratory and instrumental studies were performed.RESULTS: The highest incidence of elevated serum iron, transferrin saturation and ferritin and decreased serum hepcidin found in cases of alcoholic liver disease (ALD), nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis C (CHC).CONCLUSION: Finally, analysis of the changes in serum markers of iron metabolism shows that the difference between healthy and sick with liver disease is primarily due to changes in alcoholic and nonalcoholic fatty liver disease, particularly steatohepatitis, and chronic hepatitis C.

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