• Title/Summary/Keyword: chronic hepatitis

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Strategy to Overcome Drug Resistance That Develops during Treatment of Chronic Hepatitis B in Children

  • Hong, Suk Jin;Choe, Byung-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.15 no.2
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    • pp.63-73
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    • 2012
  • Development of antiviral resistance to lamivudine is the most important factor for the treatment failure. It is necessary to establish proper guidelines to overcome drug resistance for children with chronic hepatitis B. Primary treatment with lamivudine should be considered if patients are in immune-clearance phase and have persistently elevated ALT levels more than twice the upper limit of normal value. Before initiating the therapy, careful consideration of the patient's status is required to exclude abnormal liver function tests due to other causes. The treatment option should be carefully decided to suppress the viral replication effectively. To obtain good compliance, clinicians should educate patients and their parents. Appropriate monitoring for virologic breakthrough and genotypic resistance is important in deciding to change the treatment plan. Sequential monotherapy should be avoided and a combination of drugs in other categories is recommended. New antiviral agents, such as entecavir and tenofovir, which have high potency and high genetic barrier, are soon expected to be available for use with children.

A case of chronic autoimmnune hepatitis, Jaundice by integration treatment of korean traditional medicine and western medicine (한양방결합요법에 의한 자가면역성 만성 활동성 간염, 고빌리루빈혈증 1례 보고)

  • Yang, Ju-No;Choi, Seung-Hoon;Ahn, Kyoo-Seok;Shim, Bum-Sang
    • Journal of Korean Traditional Oncology
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    • v.10 no.1
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    • pp.99-106
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    • 2005
  • Objective: This study was done to treat autoimmune chronic active heaptitis Jaundice patient. Method: I analyzed the medical records of a case of autoimmune chronic active hepatitis Jaundice who had been treated with korean traditional medicines from 1 December 2003 through 6 July 2004. Result: Following the korean traditional medicine method, during taking medicine the hematological markers (aspartate transferase(AST), alanine aminotranferase(ALT), Total bilirubin(T.bili)) were effectively controled.

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Acute-onset chronic inflammatory demyelinating polyneuropathy following hepatitis A virus infection

  • Jung, Eui Sung;Kim, Ye Sel;Min, Ju-Hong;Kang, Kyusik;Lee, Jung Ju;Park, Jong-Moo;Kim, Byung-Kun;Kwon, Ohyun
    • Annals of Clinical Neurophysiology
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    • v.19 no.1
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    • pp.50-53
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    • 2017
  • An infection is less likely to elicit chronic inflammatory demyelinating polyneuropathy (CIDP) than Guillain-$Barr{\acute{e}}$ syndrome. We here report a case of acute-onset CIDP following hepatitis A virus infection and briefly comment on the potential mechanisms regarding the induction and chronicity of autoimmunity after a viral infection.

Management of hepatitis C viral infection in chronic kidney disease patients on hemodialysis in the era of direct-acting antivirals

  • Ko, Soon Young;Choe, Won Hyeok
    • Clinical and Molecular Hepatology
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    • v.24 no.4
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    • pp.351-357
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    • 2018
  • The advent of novel, direct-acting antiviral (DAA) regimens for hepatitis C virus (HCV) infection has revolutionized its treatment by producing a sustained virologic response of more than 95% with few side effects and no comorbidities in the general population. Until recently, ideal DAA regimens have not been available to patients with severe renal impairment and end-stage renal disease because there are limited data on the pharmacokinetics, safety, and efficacy of treatment in this unique population. In a hemodialysis context, identifying patients in need of treatment and preventing HCV transmission may also be a matter of concern. Recently published studies suggest that a combination of paritaprevir/ritonavir/ombitasvir and dasabuvir, elbasvir/grazoprevir, or glecaprevir/pibrentasvir successfully treats HCV infection in chronic kidney disease stage 4 or 5 patients with or without hemodialysis.

Qualitative Research Investigating Patterns of Health Care Behavior among Korean Patients with Chronic Hepatitis B (B형 간염 환자의 건강관리 양상 탐색을 위한 질적 연구)

  • Yang, Jin-Hyang;Cho, Myung-Ok;Lee, Hae-Ok
    • Journal of Korean Academy of Nursing
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    • v.39 no.6
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    • pp.805-817
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    • 2009
  • Purpose: This ethnograpy was done to explore patterns of health care behavior in patients with chronic health problems. Methods: The participants were 15 patients with chronic hepatitis B and 2 family members. Among the patients 4 had progressed to liver cirrhosis and liver cancer. Data were collected from iterative fieldwork in a department of internal medicine of I hospital. Data were analyzed using text analysis and taxonomic methods. Results: Illness and disease, relationship between health care givers and clients, and communication patterns between health professions and clients were discussed as the context of health care behavior. Health care behavior of the participants was categorized by its focus: every day work centered, body centered, organ centered, and pathology centered. Conclusion: Participants' health care behavior was guided by folk health concept and constructed in the sociocultural context. Folk etiology, pathology, and interpretation of one's symptoms were influencing factors in illness behavior. These findings must be a cornerstone of culture specific care for the chronic diseases.

The Natural Killer Cell Response to HCV Infection

  • Ahlenstiel, Golo
    • IMMUNE NETWORK
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    • v.13 no.5
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    • pp.168-176
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    • 2013
  • In the last few years major progress has been made in better understanding the role of natural killer (NK) cells in hepatitis C virus (HCV) infection. This includes multiple pathways by which HCV impairs or limits NK cells activation. Based on current genetic and functional data, a picture is emerging where only a rapid and strong NK cell response early on during infection which results in strong T cell responses and possible subsequent clearance, whereas chronic HCV infection is associated with dysfunctional or biased NK cells phenotypes. The hallmark of this NK cell dysfunction is persistent activation promoting ongoing hepatitis and hepatocyte damage, while being unable to clear HCV due to impaired IFN-${\gamma}$ responses. Furthermore, some data suggests certain chronically activated subsets that are $NKp46^{high}$ may be particularly active against hepatic stellate cells, a key player in hepatic fibrogenesis. Finally, the role of NK cells during HCV therapy, HCV recurrence after liver transplant and hepatocellular carcinoma are discussed.

Evaluation of the Frequency of the IL-28 Polymorphism (rs8099917) in Patients with Chronic Hepatitis C Using Zip Nucleic Acid Probes, Kerman, Southeast of Iran

  • Iranmanesh, Zahra;Mollaie, Hamid Reza;Arabzadeh, Seyed Alimohammad;Zahedi, Mohammad Javad;Fazlalipour, Mehdi;Ebrahimi, Saeede
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1919-1924
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    • 2015
  • Polymorphisms in the region of the interleukin IL-28 gene on chromosome 19 have been related with clearance of hepatitis C virus (HCV), a major human pathogen responsible for chronic hepatitis, cirrhosis and hepatocellular carcinoma. About 3% of the world's population is infected with HCV. The long-term response to therapy is influenced by many host and viral factors, and recent evidence has indicated that some host genetic polymorphisms related to IL-28 are the most powerful predictors of virological response in patients with HCV. This study assessed frequency of the IL-28 polymorphism (rs8099917) in 50 patients (39 men and 11 women) with chronic hepatitis C using ZNA probe real time PCR new method. All patients were tested for genotype of HCV and the HCV viral load. In parallel, the levels of SGOT, SGPT and ALK enzymes were assessed. Treatment using Peg-interferon alpha with ribavirin was conducted for patients and subsequently samples were collected to detect any change in viral load or liver enzyme rates. The overall frequency of the TT allele is 74%, TG allele 20% and GG allele 6% and the percent of patients who had T allele was 84%. Clear reduction in viral load and liver enzymes was reported in patients with the T allele. Especially for genotype 1 which is relatively resistant to treatment, these alleles may have a role in this decline. In conclusion, we showed that IL-28 polymorphism rs8099917 strongly predicts virological response in HCV infection and that real-time PCR with Zip nucleic acid probes is a sensitive, specific and rapid detection method for detection of SNPs which will be essential for monitoring patients undergoing antiviral therapy.

Current Role of Lamivudine Regarding Therapeutic Response and Resistance in Children with Chronic Hepatitis B

  • Hong, Suk Jin;Kim, Yeo Hyang;Choe, Byung-Ho;Park, Hyo Jung;Tak, Won-Young;Kweon, Young-Oh
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.2
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    • pp.80-88
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    • 2013
  • Purpose: To identify the predictive factors of long-term therapeutic response or resistance to lamivudine treatment in children and adolescents with chronic hepatitis B. Methods: Eighty one children and adolescents with chronic hepatitis B were included, who received lamivudine treatment for at least 6 months. Their condition was monitored for at least 12 months (12-88 months) thereafter. Twenty one (25.9%) were preschool children ($age{\leq}6$). For patients who had developed HBeAg seroconversion or breakthrough, univariate and multivariate analyses were used to identify the effects of age, gender, pretreatment alanine aminotransferase (ALT) and hepatitis B virus DNA levels. Results: HBeAg seroconversion occurred in 49 (60.5%) of the 81 patients after the initiation of the lamivudine therapy. In 65 patients whom were monitored for over 24 months, the seroconversion rate was significantly higher in younger patients (p=0.040), especially in those patients of preschool age ($age{\leq}6$, p=0.031). The seroconversion rate was significantly higher in higher pretreatment ALT (p=0.003). The breakthrough occurred in 21 (25.9%) of the 81. The breakthrough rate was lower in younger aged patients ($age{\leq}6$), and with higher pretreatment ALT levels, but no significant difference. Conclusion: Younger age is a good predictor of HBeAg seroconversion in children with long-term lamivudine treatment as well as high pretreatment ALT levels.

Single Nucleotide Polymorphism of Interferon Lambda-4 Gene is not Associated with Treatment Response to Pegylated Interferon in Thai Patients with Chronic Hepatitis B

  • Limothai, Umaporn;Wasitthankasem, Rujipat;Poovorawan, Yong;Tangkijvanich, Pisit
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5515-5519
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    • 2015
  • The single nucleotide polymorphism (SNP) ss469415590 in the interferon lambda-4 (IFNL4) gene has recently been reported to have an association with treatment response in chronic hepatitis C. However, any importance of the SNP in association with response to pegylated interferon (PEG-IFN) therapy in patients with chronic hepatitis B (CHB) is unclear. We retrospectively analyzed data for Thai patients with CHB treated with PEG-IFN for 48 weeks. Virological response (VR) for HBeAg-positive CHB was defined as HBeAg seroconversion plus HBV DNA level <2,000 IU/mL at 24 weeks post-treatment. VR for HBeAg-negative CHB was defined as an HBV DNA level <2,000 IU/mL at 48 weeks. The SNP was identified by real time PCR using the TaqMan genotyping assay with MGB probes. A total 254 patients (107 HBeAg-positive and 147 HBeAg-negative) were enrolled in the study. The distribution of TT/TT, ${\Delta}G/TT$ and ${\Delta}G/{\Delta}G$ genotypes was 221 (87.0%), 32 (12.6%) and 1 (0.4%), respectively. Patients with non-TT/TT genotypes had significantly higher baseline HBV DNA levels than patients with the TT/TT genotype. In HBeAg-positive CHB, 41.2% of patients with TT/TT genotype versus 50.0% with non-TT/TT genotype achieved VR (P=0.593). In HBeAg-negative CHB, the corresponding figures were 40.3% and 43.5%, respectively (P=0.777). There was no significant correlation between the SNP genotypes and HBsAg clearance in both groups of patients. In summary, ss469415590 genotypes were not associated with response to PEG-IFN in Thai patients with HBeAg-positive and HBeAg-negative CHB.

Clinical Study of Chronic Hepatitis and Liver Cirrhosis Treated with Sodalgeonbitang-gamibang (소달건비탕가미방 투약 후 호전된 만성간염을 동반한 간경변 환자 1례)

  • Baek Dong Gi;Hwang Sang Il;Rhim Eun Kyung;Lee Yun Jae;Kim Dong Woung;Shin Sun Ho;Kim Hong Jun;Moon Goo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.1
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    • pp.306-309
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    • 2004
  • Liver cirrhosis is caused by virus, alcohol, toxins, drugs and chronic hepatitis. Clinical symptoms of liver cirrhosis are severe fatigue, nausea, fever, dyspepsia, anorexia, RUQ pain, jaundice, ascites. We applied oriental medicines to patient who had chronic hepatitis and liver cirrhosis. Sodalgeonbitang-gamibang has been used to treat hepatitis and liver cirrhosis because of its beneficial effects. The patient symptoms began to improve after about one month of treatment. After medication we could find remarkable effect on clinical symptoms and blood test. So we hope that this clinical study is helpful in treat a patient with hepatic disease.