scholarly journals Biochemical Changes in Patients with Combined Chronic Schistosomiasis and Viral Hepatitis C Infections

2000 ◽  
Vol 16 (3-4) ◽  
pp. 111-118 ◽  
Author(s):  
Fawzia A. Fahim ◽  
Amr Y. Esmat ◽  
Gehan K. Hassan ◽  
Abeer Abdel-Bary
Keyword(s):  
Liver Cirrhosis ◽  
Reference Group ◽  
Biochemical Changes ◽  
Hcv Infection ◽  
Serum Total Protein ◽  
Decompensated Liver Cirrhosis ◽  
Indirect Bilirubin ◽  
Viral Hepatitis C ◽  
Chronic Hcv ◽  
Normal Controls

This study was undertaken to assess the biochemical changes induced in chronic schistosomiasis and/or chronic HCV, as well as to pinpoint the most significant parameters which could be used as dependable indices for the differentiation of single and coupled infections with or without liver cirrhosis. The selected patients were allocated into 2 broad groups: GrII (Schistosomiasis) which was subdivided into 3 subgroups: GrII(a) schistosomal patients with hepatosplenomegaly; GrII(b) hepatosplenic schistosomal patients with decompensated liver cirrhosis; GrII(c) schistosomal patients with no organomegaly. GrIII (Combined) comprised 2 subgroups: GrIII(a) schistosomal-HCV infection with decompensated liver cirrhosis; GrIII(b) schistosomal-HCV infection without liver cirrhosis. For statistical comparison normal healthy subjects were taken as a reference group (Gr I). Results showed that schistosomal patients without organomegaly manifested non significant changes in all studied parameters compared to normal controls. Highly significant elevations in serum ALT, AST, ALP and GGT activities were recorded in all other subgroups but the highest levels are reported in GrIIb. AST/ALT and direct/indirect bilirubin ratios were highest in GrIIIa (1.17 ± 0.26, 1.54 ± 0.37, respectively). Serum total protein and albumin levels showed the highest reduction (33 and 59%) concomitantly with the highest increase inγ-globulin level (75%) in GrIII(a). Blood total iron was significantly reduced in GrII(a,b) (15.6 and 12%) (8.8%) bilirubin, GGT and AST in this order are good discriminators between the different subgroups in GrII. On the other hand, ALT, AST, albumin, ALP, GGT, protein and direct bilirubin are the most significant indices to differentiate chronic schistosomiasis and the combined group with/or without liver cirrhosis.

CHRONIC HCV-INFECTION AS A PREDICTOR OF DISEASE SEVERITY (case study)

2020 ◽  
pp. 79-82
Author(s):  
Nataliia Volodymyrivna Shepylieva ◽  
Alla Oleksandrivna Shvaichenko
Keyword(s):  
Viral Hepatitis ◽  
Hepatitis A ◽  
Health Sector ◽  
Global Strategy ◽  
Hcv Infection ◽  
Viral Hepatitis C ◽  
Incidence And Mortality ◽  
Chronic Hcv Infection ◽  
Chronic Hcv ◽  
Viral Hepatitis A

A global problem for humanity is the wide spread of HCV carriers worldwide. To address this, the WHO has developed a global strategy for the health sector to eliminate viral hepatitis and has set the following goals: to reduce the number of new cases of chronic hepatitis B and C by 90 % by 2030 as well as to reduce the quantity of death from these infections by 65 %. It is emphasized that the development of infectious or somatic disease on the background of chronic viral hepatitis requires a more careful approach and thorough medical correction, as their course and prognosis can be significantly aggravated. The case of viral hepatitis A, which occurred on a background of previously undiagnosed HCV infection and resulted in a death, has been described. Thus, previously undiagnosed HCV infection exacerbated the course of a self−eliminating disease, such as hepatitis A, and resulted in a death. Therefore, expanding the screening for viral hepatitis will allow identifying infected individuals and conducting antiviral therapy and preventive measures, which will reduce the incidence and mortality rates. Key words: viral hepatitis A, viral hepatitis C, chronic HCV−infection, diagnosis, treatment, outcome.

scholarly journals Fibrinogen-Fibrin Monomer Complexes in Cirrhosis of The Liver

1977 ◽  
Author(s):  
S. Coccheri ◽  
G. Palareti ◽  
M. Poggi ◽  
G. Oca
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Liver Biopsy ◽  
Plasma Samples ◽  
Severe Liver ◽  
Decompensated Liver Cirrhosis ◽  
Chronic Active Liver Disease ◽  
Fibrin Monomer ◽  
Cirrhotic Patients ◽  
Normal Controls

Positivity of paracoagulation tests in a previously studied group of 80 patients with chronic active liver disease did not exceed 5-10% of the cases. In the present study, plasma samples from 20 cases of decompensated liver cirrhosis, assessed by liver biopsy, were investigated by means of agarose cromatography. Fibrinogen related materials were measured immunologically and by Staphylococcal Clumping Test.First appearance of fibrinogen-like materials occurred at earlier fractions in cirrhotic patients in comparison with normal controls. The relative amount of soluble fibrin monomer complexes (SFMC) as referred to total fibrinogen was significantly increased. No correlation was found between the amount of SFMC and the severity of fibrinogen polymerisation defect.Circulating SFMC are therefore present in severe liver cirrhosis. However, DIC may not be the only proposed explanation for this finding.

scholarly journals Circulating Th1 and Th2 cytokines in patients with hepatitis C virus infection

1998 ◽  
Vol 7 (4) ◽  
pp. 295-297 ◽  
Author(s):  
X. G. Fan ◽  
W. E. Liu ◽  
C. Z. Li ◽  
Z. C. Wang ◽  
L. X. Luo ◽  
...  
Keyword(s):  
Hcv Infection ◽  
Th2 Cytokines ◽  
Th1 And Th2 Cytokines ◽  
Th1 Cytokine ◽  
Chronic Hcv Infection ◽  
Ifn Γ ◽  
Chronic Hcv ◽  
Th1 Cytokines ◽  
Normal Controls ◽  
Th1 And Th2

The imbalance of T-helper (Th) lymphocyte cytokine production may play an important role in immunopathogenes is of persistent hepatitis C virus (HCV) infection. To know whether an imbalance between Th1 and Th2 cytokines is present in chronic HCV infection, serum levels of Th1 cytokines , interferon gamma (IFN-γ ) and interleukin (IL)-2, and Th2 cytokines, IL-4 and IL-10, were measured using enzyme - linked immunosorbent as say in this study. Eighteen individuals with chronic HCV infection, 11 healthy subjects as normal controls and 10 chronic HBV infected patients as disease controls were observed. The results showed that the leve ls of Th2 cytokines (IL-4 and IL-10) were significantly increased inchronic HCV infected patients compared with normal controls (IL-4: 30.49 ± 17.55 vs . 14.94 ± 13.73, pg/ml,p<0.025; IL-10: 50.30 ± 19.59 vs. 17.87 ± 9.49, pg/ml,p<0.001). Similarly, the levels of Th1 cytokine, IL-2, was also elevated in individuals with chronic HCV infection when compared with normal controls (IL-2: 118.53 ± 95.23 vs . 61.57 ± 28.70, pg/ml,p<0.05). However, Th1 cytokine IFN-γ level was not significantly changed during HCV infection (IFN-γ: 28.09 ± 15.65 vs . 24.10 ± 15.61, pg/ml,p>0.05). Further more, the elevated levels of Th2 cytokines are greater than Th1 cytokines in HCV infection. Thus , the study indicates that an enhanced Th2 responses are present during chronic HCV infection, which may partly be responsible for the persistence of HCV infection.

scholarly journals Unsolved issues of pregnancy in liver cirrhosis

2019 ◽  
Vol 91 (4) ◽  
pp. 114-117
Author(s):  
A Iskrenov Kotzev ◽  
L Stoyanov Tanchev ◽  
Ch Savov Pavlov ◽  
S Yotov Tanchev
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Vital Signs ◽  
Abnormal Uterine Bleeding ◽  
Chronic Viral Hepatitis ◽  
Uterine Bleeding ◽  
Variceal Hemorrhage ◽  
Decompensated Liver Cirrhosis ◽  
Viral Hepatitis C ◽  
Life Threatening

Pregnancy in patients with liver cirrhosis and portal hypertension occurs very rare, because of their significantly derailed reproductive functions. Тhe risks for the mother and the fetus are connected with worsening of the portal hypertension, progression of decompensated liver cirrhosis and development of its complications: liver failure, ascites, hepatorenal syndrome, hepatic encephalopathy and variceal hemorrhage, and with increased incidence of spontaneous abortions and abnormal uterine bleeding. The decision for continuation of the pregnancy in cirrhotic patients must be based on individual approach and a multidisciplinary team consisting of obstetricians, hepatologists, anesthesiologists, surgeons and hematologists must participate in the therapy. We are presenting a clinical case with 34 years old pregnant woman with Child-Pugh class C cirrhosis and untreated chronic viral hepatitis C. The patient was admitted in emergency with abortus imminens, vaginal bleeding, anemia, thrombocytopenia and impaired hemostasis. The pregnancy was interrupted in the Department of obstetrics and gynecology due to the high risk for mother’s life. Later the patient developed severe disseminated intravascular coagulation (DIC) syndrome with life-threatening uterine bleeding. The DIC syndrome and the bleeding were resolved after therapy in intensive care unit and the patient was discharged from the hospital with stable vital signs.

scholarly journals The efficacy and safety of direct-acting antiviral agents in patients with chronic HCV infection and UGT1A1*28 polymorphism

2020 ◽  
Vol 22 (1) ◽  
pp. 71-80
Author(s):  
S.P. Lukashyk ◽  
I.A. Karpov ◽  
M.G. Siniauskaya ◽  
N.G. Danilenko ◽  
L.A. Anisko ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Antiviral Agents ◽  
Hcv Infection ◽  
Efficacy And Safety ◽  
Svr12 Rate ◽  
Direct Acting Antiviral ◽  
Chronic Hcv Infection ◽  
Chronic Hcv ◽  
Direct Acting ◽  
Direct Acting Antiviral Agents

Objective. To determine the efficacy and safety of direct-acting antiviral agents (DAA) in patients with chronic HCV infection and UGT1A1*28 polymorphism. Materials and Methods. An open-label, non-randomized, observational study to assess efficacy and safety of DAA in patients (n = 143) with chronic hepatitis C (CHC) and liver cirrhosis and UGT1A1*28 polymorphism was performed. A total of 139 patients with chronic HCV infection were included in the efficacy analysis (absence of HCV RNA in blood by PCR) by the rate of sustained virologic response at week 12 (SVR12). Results. The SVR12 rate in patients with CHC and HCV-CP was 92.5% and 87.9%, respectively (p = 0.508), regardless of the presence of UGT1A1*28 polymorphism. The SVR12 rate in patients with chronic HCV infection and (TA)7/(TA)7 was 84.8%, with (TA)6/(TA)7 – 92.2% compared with (TA)6/ (TA)6 – 90,5% (p = 0.518). The rate of SVR12 in patients with CHC and (TA)7/(TA)7 or (TA)6/(TA)7 was 80% and 95%, respectively, with (TA)6/(TA)6 – 95.2%. The rate of SVR12 in patients with liver cirrhosis and (TA)7/(TA)7 or (TA)6/(TA)7 was 92.3% and 87.5%, respectively, with (TA)6/(TA)6 – 85.7%. The rate of SVR12 in patients with 12- and 24-week treatment duration was 88.2% and 96.6%, respectively (p = 0.30). As many as 96.2% of patients with the previous treatment with interferon and ribavirin had SVR12 compared to 88.5% of patients who have not previously taken antiviral drugs (p = 0.486). Grade 1 adverse events (AE) occurred in 24% of patients with chronic HCV infection treated with DAA; two patients developed Grade 4 AE. Conclusions. The treatment with DAA was shown to be effective and safe in patients with chronic HCV infection and UGT1A1*28 polymorphism.

Correlation Between Liver Cirrhosis and Risk of Cardiac Arrhythmias

2018 ◽  
Vol 69 (6) ◽  
pp. 1527-1532
Author(s):  
Veronica Calborean ◽  
Silvia Alina Miscoci ◽  
Octavian Istratoaie ◽  
Oana Galceava ◽  
Dragos Ovidiu Alexandru ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Liver Cirrhosis ◽  
Cardiac Arrhythmias ◽  
Hcv Infection ◽  
Hbv Infection ◽  
Alcoholic Liver Cirrhosis ◽  
Chronic Hbv Infection ◽  
Chronic Hcv Infection ◽  
Chronic Hbv ◽  
Chronic Hcv

There are few studies analyzing the correlation between liver cirrhosis and cardiac arrhythmias. Still, factors triggering cardiac arrhythmias occur in many instances in liver cirrhosis.We studied a cohort with patientsdiagnosed with liver cirrhosis hospitalized to Cardiology Department, to the County Hospital of Craiova, between January 2017 and January 2018. We wanted to study the frequency of cardiac arrhythmias at the patients diagnosed with liver cirrhosis and also to evaluate several associated factors.The frequency of cardiac arrhythmias in the presence of risk factors was analysed using x2 test and statistical models.We analized multiple variable including demographics and clinical and biochemical characteristics, frequency of type of arrhythmias and evaluation of the associated factors like diabetes mellitus, hypertension, hypercholesterolemia, hypertriglyceridemia ,hyper/hypokalemia and hyper/hyponatremia. From our group, after exclusion criteria, we have a total of 34 patients with alcoholic liver cirrhosis, 37 patients with chronic HCV infection and 36 patients with HBV infection. From 34 patients with alcoholic liver cirrhosis, 23 patients presented atrial fibrillation(67.65%), from 37 patients with chronic HCV infection 21 were diagnosed with atrial fibrillation(56.76%) and from the patients with HBV infection 19 patients were known with atrial fibrillation(52.78%).We have encounter atrial flutter at 2 patients (5.56%) with chronic HBV infection. Atrial extrasystole was found at 7 patients with chronic HBV infection (19.44%), 4 patients with chronic HCV infection (10.81%) and 1 patients with alcoholic liver cirrhosis (2.94%). Ventricular extrasystole was found at 12 patients with chronic HBV infection (33.33%), 3 patients with chronic HCV infection (8.11%) and 5 patients with alcoholic liver cirrhosis (14.71%).We have also correlate the arrhythmias with different biochemical variables from our cohort. In our study there were many association between hepatic cirrhosis and cardiac abnormalities, which is concordant to reports from literature. Compared to population without liver cirrhosis, the prevalence of arrhythmias was increased in our cohort.

scholarly journals Non-invasive methods for the diagnosis of liver fibrosis in chronic HCV-infection

2021 ◽  
Vol 13 (1) ◽  
pp. 58-65
Author(s):  
A. I. Fazul’zyanova ◽  
A. K. Husainova ◽  
S. V. Tkacheva ◽  
F. M. Yakupova
Keyword(s):  
Liver Cirrhosis ◽  
Liver Fibrosis ◽  
Antiviral Therapy ◽  
Prognostic Significance ◽  
Hcv Infection ◽  
Direct Acting Antiviral ◽  
Chronic Hcv Infection ◽  
Chronic Hcv ◽  
Direct Acting ◽  
Severe Fibrosis

Objective: to study the values of fibrosis indices and transient elastometry in patients with chronic HCV infection who received antiviral therapy.Materials and methods: The study included 64 patients with chronic HCV infection who received antiviral therapy with direct-acting antiviral drugs or a combination of peginterferon and ribavirin.The fibrosis indices AAR, APRI and FIB-4 were calculated before the start of therapy and 6 months after its completion. Values of AAR>1, APRI≥1,5, and FIB-4≥1,45 were considered indicators of severe fibrosis. We studied the dynamics of fibrosis indices and elastometry values depending on the treatment regimen, their correlation and the prognostic significance of fibrosis indices in relation to elastometry.Results. Among patients treated with direct-acting antiviral drugs, a sustained virologic response was achieved in 100%, and peginterferon-containing regimen – in 85%. Elastometry and APRI and FIB-4 indices decreased in both groups. In patients without liver cirrhosis, the average elastometry after treatment decreased from 9,5±1,7 kPa to 6,7 ± 1.4 kPa (p = 0,0006). In patients with liver cirrhosis, the median of elastometry decreased from 20 to 11,7 kPa (p = 0,0006), the median of APRI decreased from 2,09 to 0,61 (p = 0,005), FIB-4 from 3,95 up to 2,22 (p = 0,022). The prognostic significance of FIB-4 in relation to elastometry before treatment was 81%, after – 82%.Conclusion. Successful etiotropic therapy leads to an improvement in values of liver fibrosis indices and transient elastometry in patients with HCV infection, including liver cirrhosis, regardless of the treatment regimen. The FIB-4 index showed the highest sensitivity and prognostic significance in determining severe fibrosis.

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