Hcv Ebook

Alternative Hepatitis C Treatments

The therapeutic goals of Natural treatment for Hepatitis C are as follows: Decrease iral load Normalize liver enzyme levels. Enhance/regulate immune system function. Strengthen and promote healthy liver function. Protect the liver, prevent further damage. Virological response; i.e. viral clearance, viral reduction or elimination of the virus. Starve the virus by limiting levels of iron. Optimizing cellular levels of glutathione in the body, making detoxification of the liver possible and enhancing the immune system. Stimulate regeneration of the damaged liver cells. Use of antioxidants to combat the effects of free-radicals generated by the virus. Reduce inflammation. Slow viral replication. Replace all of the inflammation-damaged liver cells. Regulate immune function/prevent auto-immune problems. Cancer preventative measures. Reverse fibrosis to prevent and improve cirrhosis

Alternative Hepatitis C Treatments Overview


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Twelve Month Deferment Of Donors In Case Hepatitis Develops

(3) Donor who has had close contact with a patient with viral hepatitis. The type of contact that hospital personnel encounter in their routine work is not considered close contact and is not cause for rejection. Hospital personnel in areas where hepatitis is endemic (in renal dialysis units, and so forth) should be deferred for 6 months after employment in such areas. b. Any donor with a questionable history or one who has been implicated in more than one case of post-transfusion hepatitis should be referred to the blood bank physician for evaluation. d. Donors who are accepted should be made aware that there is possible risk to recipient and asked to report any illness developing within a few days of donation, and especially to report hepatitis that develops within 6 months.

Types Of Viral Hepatitis

Infectious hepatitis is known as type A. This form has an incubation period of 2 to 7 weeks with the average about 4 weeks. This is the milder form of the disease. Serum hepatitis is known as type B. The incubation time is from 1 to 6 months with the average running about 3 months. This type is more serious, with similar but more severe symptoms. There is another type that is termed nonA nonB. This type is caused by a virus which is neither A nor B. The incubation period is from 2 weeks to 3 1 2 months and it can resemble either type A or type B in severity.

Section Iii Prevention Of Hepatitis 312 Background

The incidence of hepatitis B associated with transfusion of blood and blood products has decreased significantly since the advent of methods of screening donors for the hepatitis B surface antigen (HBsAg) however, some risk of developing viral hepatitis after the transfusion of blood remains, even with the most sensitive currently available tests for detecting HBsAg, and with the use of volunteer blood donors. Measures designed to decrease further the incidence of post-transfusion hepatitis must be directed toward judicious utilization of blood, observation and follow-up of recipients of blood transfusion, exclusion of implicated blood donors, and further research into the etiology and pathogenesis of posttransfusion hepatitis C.

Recipient Followup For Posttransfusion Hepatitis

It is imperative that the blood bank be notified of every patient who develops hepatitis, within 2 weeks to 12 months, following transfusion. In addition to notification by the recipient, his family, or his physicians, there are other sources for obtaining information about hepatitis patients b. All reported cases of acute liver dysfunction after transfusion of blood or blood components should be investigated as possible post-transfusion hepatitis, unless known to be otherwise. Sample forms for evaluating patients with possible post-transfusion hepatitis and for evaluation of implicated donors are provided (see figures 3-4, 3-5, 3-6, and 3-7). c. A system for recording and reporting of all cases of known or suspected post-transfusion hepatitis is required by the AABB Standards. When a case of post-transfusion hepatitis is reported, all implicated donors must be identified and the facilities that collected the blood must be notified. It must be possible to trace a unit of blood and...

Hepatitisimplicated Donors And Those Found To Have Hepatitis B Surface Antigen Or Hepatitis C Virus

When a donor is implicated in a case of hepatitis, he should be recalled (see figure 3-4) and re-questioned in depth. b. A blood sample should be drawn and examined for bilirubin, serum alanine aminotransferase (SGPT), HBsAg, and HCV. Abnormal results in any of these tests may exclude the donor from future donations. When hepatitis develops after exposure to multiple units of blood and or blood components, it is not necessary to exclude all of the involved donors but they should be noted as having been implicated once. A donor implicated in a 1-unit transfusion or a donor implicated in more than one case of posttransfusion hepatitis involving multiple units should be permanently excluded from future donation (see figure 3-5).

Hepatitis B and C

A considerable number of studies have been conducted on this subject and on susceptibility to develop hepatocellu-lar carcinoma, which is associated with these infections. In addition, a number of small-scale studies have attempted to associate the response to antiviral therapy with genetic factors. Mutations in codons 52, 54, or 57 in exon 1 of the MBL gene reduces serum MBL levels and may be associated with an opsonic defect. An early analysis showed that a mutation in codon 52 is more common in white, but not Asian, patients with chronic hepatitis B virus (HBV) infection. However, the codon 54 mutation, which in the same study was associated with a greater depression of serum MBL, was not associated with disease.89 Subsequent studies were not able to associate MBL mutations with hepatitis B.32,90 An early study associated HLA-DRB1*1302 with transient HBV infection in Gambian adults and children.91 This association has been replicated in other populations, although a greater...

Hepatitis Tests

Hepatitis can be caused by bacteria, drugs, toxins, alcohol ingestion, and viruses. Five types of viral hepatitis have been identified A, B, C, D, and E. Although each type of hepatitis has similar clinical manifestations, they differ in etiology and outcome. Hepatitis A, B, and C are discussed in this chapter. Hepatitis A Hepatitis A, also known as infectious hepatitis, is caused by the hepatitis A virus (HAV). Hepatitis A is transmitted from person to person by the fecal-oral route. In developed countries, the disease is often present in day care centers that accept diapered children. It is worthy to note that most young children can remain asymptomatic, while adults will most frequently exhibit the usual symptoms including jaundice. Acute hepatitis A is diagnosed by identifying the presence of two specific antibodies directed against the hepatitis A virus. The first type of antibody is the IgM antibodies against hepatitis A virus (IgM anti-HAV). This antibody appears three to four...


Hepatitis is inflammation of the liver cells. It is produced usually by viral infection (especially hepatitis viruses A-E, CMV, EBV) Hepatitis may thus be a final common pathway for a variety of different liver insults. Sometimes, fulminant hepatitis occurs with no definable cause, so that it is likely that there are other as yet unidentified viruses, mutant viruses or toxins capable of producing this syndrome. About 5 20 of cases of acute and chronic hepatitis have no currently identifiable cause, prompting in particular a continuing search for viruses other than the main known five (A-E). Clinical features of hepatitis are variable and often extensive.

Toxic Hepatitis

Toxic hepatitis is hepatitis caused by the direct action of poison on the liver cells. These chemicals may be taken into the system by inhalation, ingestion, skin absorption, or injection. The chemicals can cause liver poisoning, a hepatitis-like reaction, an allergic reaction that inhibits the flow of bile (hypersensitivity cholestasis) or bile flow inhibited by steroids (steroid cholestasis). a. Causes. A direct toxic effect may be caused by carbon tetrachloride, insecticides, industrial solvents, various metallic compounds (i.e., arsenic, gold, mercury, iron), and hydrazine drugs such as isoniazid and halothane anesthetics. The latter two may produce a condition indistinguishable from that of acute viral hepatitis.

Hepatitis A

Treatment Supportive care follow up to determine continued presence of IIBsAg for at least 6 months as sign of chronic hepatitis vaccine available for prevention. Discussion Hepatitis B immune globulin plus hepatitis B vaccine are recommended for parenteral or mucosal exposure to blood and for newborns of HBsAg-positive mothers. The infection is divided into the prodromal, icteric, and convalescent phases 5 proceed to chronic hepatitis with increased risk for cirrhosis and hepatocellular carcinoma. Unlike hepatitis A, hepatitis B has a long incubation period (3 months). Hepatitis B virus is an enveloped, partially circular DNA virus of the hepadna family that contains a DNA-dependent DNA polymerase. The continued presence of HBsAg after infection has clinically resolved indicates a chronic carrier state. HEPATITIS B ACUTE Labs Direct hyperbilirubinemia markedly raised serum transaminase levels hepatitis B (HBV) serology negative enzyme immunoassay of antibodies to structural and...

Principles of Microbial Evolution and Classification

Simpler forms of self-replicating organisms include viru-soids and viroids.14,15 The former are satellite RNAs that are found encapsidated in the proteins encoded by their helper virus (e.g., hepatitis caused by the hepatitis D virus delta agent in conjunction with hepatitis B virus). The viroids are mostly plant pathogens that consist of single-stranded circular RNA molecules.

Causes of Acute or Chronic Infections in Individuals

Of other infectious diseases or malnutrition, the acute infection will cause morbidity and potential mortality in the infected human host. Among otherwise healthy people, the immediate impact of the infection is the symptomatic acute illness. For some infections that have prolonged courses, their impact may also continue over many years. Chronic infections include most of those caused by helminthic parasites, which characteristically live for years persisting mycobacterial infections and retroviral infections (HIV-1, HIV-2, and human T-cell lym-photropic virus type 1). Finally, the sequelae of some infections can include the development of neoplasms. Examples include hepatomas associated with chronic hepatitis B and C viral infections, bladder tumors with urinary schistosomiasis, cholangiocarcinomas with biliary fluke infections, and gastric adenocarcinomas and lymphomas associated with Helicobacter pylori infections.

The Many Kinds of Viruses

The third class of viruses encodes the enzyme reverse transcriptase (RT), and these viruses have an RNA DNA step in their life cycle. The genetic information encoded by these viruses thus alternates between being present in RNA and being present in DNA. Retroviruses (e.g., HIV, family Retroviridae) contain the RNA phase in the virion they have a single-stranded RNA genome that is present in the virus particle in two copies. Thus, the replication of their genome occurs through a DNA intermediate (RNA DNA RNA). The hepadnaviruses (e.g., hepatitis B virus, family Hepadnaviridae) contain the DNA phase as their genome, which is circular and largely double stranded. Thus their genome replicates through an RNA intermediate (DNA RNA DNA). Just as the minus-strand RNA viruses and double-strand RNA viruses package their replicase proteins, the retroviruses package active RT, which is required to begin the replication of the genome in the virions. Although in many treatments the retroviruses are...

Principles of Transmission

Other important concepts are those of horizontal and vertical transmission. Horizontal transmission refers to spread of infection from individual to individual in a given population. In contrast, vertical transmission refers to spread of infectious agents from parent to offspring. The latter is important for the maintenance of some arboviruses and rickettsial organisms in their arthropod hosts. They are transmitted transovarially from the female arthropod vector to its offspring. Human pathogens, such as T. pallidum, cytomegalovirus, hepatitis B virus, and HIV-1, are also transmitted vertically.

Translation and Processing of Viral Proteins

Then scanned by the initiation complex, starting at the cap, and translation begins at a downstream AUG start codon that is present in a favorable context. However, some viruses, such as poliovirus and hepatitis C virus (genus Hepacivirus, family Flaviviridae), have uncapped mRNAs and use another mechanism for the intiation of translation. The 5' nontranslated region of poliovirus RNA, illustrated schematically in Fig. 1.14, is long more than 700 nucleotides. Within this 5' region is a sequence of about

Antigenantibody Reactions In Blood Group Serology

The first two methods are the most commonly used in blood group serology and will be discussed in more detail. Inhibition and absorption elution techniques, although not used every day in the routine blood bank, are used regularly in the forensic laboratory (for example, blood grouping of blood stains) and in reference laboratories. Absorption techniques lead to a decrease in antibody activity following treatment of a serum with RBCs having the appropriate antigens elution refers to the technique used to dissociate or remove antibody bound to sensitized RBCs. Precipitation, complement-fixation, and radioimmunoassay have been utilized more in blood banks in the last few years, particularly for the detection of hepatitis virus. Fluorescence has been used to demonstrate blood group antigens (for example, ABH) in tissues.

Persistent versus Chronic Infection

Chronic infection is a property of a group of cells or of an organism in which lytic infection is established in many cells, but many potentially susceptible cells escape the infection at any particular time, for whatever reason. The infection is not cleared and the continual appearance of susceptible cells in the population leads to the continued presence of replicating virus. One well-known example of a chronic infection in humans is HIV, in which the infection cannot be cleared by the immune system and virus continues to replicate. AIDS results when the immune system is finally overwhelmed by the virus. Hepatitis B and hepatitis C viruses are also well known for their ability to establish chronic liver infections that can persist for life.

Kcv has Distinct Sensitivity to K Channel Blockers

The well-known antiviral drug amantadine was found to block the M2 channel from influenza virus A (Wang et al., 1993) and the putative p7 channel from hepatitis C virus (Griffin et al., 2003) at micromolar concentrations. This cyclic amine is also a good inhibitor of Kcv conductance (Figure 2.2B). But the inhibition of Kcv by amantadine can not be interpreted in analogy to the action of the cyclic amine on the other viral channels. While the affinity of the M2 channel to amantadine is in the nanomolar range (Wang et al., 1993), Kcv has only a low affinity to this drug. In the case of Kcv, a K of 0.8 mM was obtained for the amantadine block in both oocytes and HEK293 cells (Gazzarrini et al., 2003). Furthermore it appears that other K+ channels are also inhibited by amantadine with a low affinity in the millimolar range (Blanpied et al., 1997). These results suggest that amantadine is not a specific antiviral drug but also acts as a genuine K+ channel blocker at high concentrations.

Permanent Deferment Of Donors

Donors with a history of viral hepatitis at any time (FDA regulations) or after age 10 per AABB Standards. b. Donors who have ever had a confirmed positive test for HBsAg. HBsAg stands for hepatitis B surface antigen (also called hepatitis-associated antigen (HAA)), the causal viral agent of serum hepatitis. d. Donors with the only unit of blood, blood component, or derivative administered to a recipient who within 6 months developed post transfusion hepatitis. NOTE Post transfusion hepatitis after multiple transfusions is not cause or exclusion of all donors. e. Donors who have present or past clinical or laboratory evidence of infection with hepatitis C or who have had a repeatedly reactive test for anti-HBc (hepatitis B Core) on more than one occasion.

Disorders Of The Intestines

There are two types of hepatitis, serum (or long-term incubation) and infectious (or short-term incubation). Infectious hepatitis is spread via the oral route and the danger of an epidemic exists in close environments such as military bases and hospitals. Serum hepatitis is transmitted by blood transfusion or by the use of an unsterilized syringe or dirty needle. The incubation period for hepatitis ranges from six weeks to six months. The type of hepatitis a patient has can be identified in some patients. There can be a wide variety of clinical symptoms and signs of hepatitis ranging from mild infection to death. The disease is usually centered in the liver and jaundice (yellow coloration of skin) is usually present along with hepatomegaly (enlarged liver). Liver damage may result in hepatitis. Most patients recover from hepatitis. Bed rest is usually required during the first phase of the disease. Hepatitis is viral in nature. Therefore, there is no specific treatment...

Aspartate Aminotransferase AST Serum Glutamic Oxaloacetic Transaminase SGOT

Increases in AST SGOT levels are most often associated with myocardial infarction and various liver diseases. In myocardial infarction, the level may increase from 4 to 10 times the normal amount, while liver disease may display levels of 10 to 100 times the normal range. Acute and chronic hepatitis, primary or metastatic liver cancer, alcoholic hepatitis, and Reye's syndrome produce increased AST levels.

Oral Contraceptive Side Effects

Against primary and secondary osteoporosis (due to hypogonadism, glucocorticoid excess, immobilization, hyperthyroidism, diabetes mellitus, or primary hyperparathyroidism). Estrogen supplementation is the first choice for prevention and treatment of osteoporosis in women who are postmenopausal. The mechanism of action is thought to be decreasing bone resorption by inhibiting the synthesis of interleukins such as IL-6 as well as retarding the bone-resorbing effects of PTH. Estrogen is contraindicated in pregnancy, breast cancer, or active hepatitis. Side effects include breast tenderness, migraines, and vaginal bleeding spotting. Long-term adverse effects include gallstones, breast cancer, and thrombophlebitis. Estrogen alone also increases the risk of endometrial cancer, and progesterone is often added to decrease this risk.

Human Chorionic Gonadotropin HCG

Consistently elevated Cortisol levels are found in patients with Cushing's syndrome and those individuals under the stress of trauma or surgery. Other conditions associated with an increased Cortisol level include hyperthyroidism, adrenal adenoma, and an overproduction of adrenocorticotropic hormone (ACTH). Decreased levels are seen in Addison's disease, hypopituitarism, hypothyroidism, hepatitis, and cirrhosis.

Interest In Eradication Is Revived

All manner of diseases and conditions have been proposed for eradication since 1980.15 Some of those mentioned include syphilis, tuberculosis, urban rabies, leprosy, hepatitis B, hunger, traffic accidents, measles, polio, and dracunculiasis.13,16 Enthusiasm for eradication initiatives stemmed, in part, from the belief that a highly visible, widely publicized eradication target is especially attractive to politicians and the public alike and will garner substantially more funds and support than will programs intended for disease control. Proponents reason that even if programs fail, more money will have been secured for public health and that some good will have been accomplished. Memories of the failed malaria program and the damage this did to the credibility of public health have been little appreciated.

Criteria For Assessing Candidate Diseases For Eradication

The recovered patient ceases to harbor the organism and desirably is immune to later reinfection. For those diseases in which the organism continues to be present in the body, either in its naturally infectious form or a latent one (e.g., hepatitis B, tuberculosis, varicella), there is little hope for eradication. An eradication effort in such instances would require an effort extending over a generation or more hardly a feasible proposition given the difficulties in sustaining international commitments to programs for more than 10 to 20 years.

Edward B Thorp and Thomas M Gallagher

Coronaviruses are widespread in the environment, infecting humans, domesticated and wild mammals, and birds. Infections cause a variety of diseases including bronchitis, gastroenteritis, hepatitis, and encephalitis, with symptoms ranging from being nearly undetectable to rapidly fatal. A combination of interacting variables determine the pattern and severity of coronavirus-induced disease, including the infecting virus strain, its transmission strategy, and the age and immune status of the infected host. Coronavirus pathogenesis is best understood by discerning how each of these variables dictates clinical outcomes. This chapter focuses on variabilities amongst the spike (S) proteins of infecting virus strains. Diversity of coronavirus surface proteins likely contributes to epidemic disease, an important and timely topic given the recent emergence of the human SARS coronavirus.

Reverse transcription

Reverse transcription takes place within a viral structure in the cytoplasm of the infected cell. In later chapters the process is considered in more detail for the retroviruses (Section 16.3.2) and for hepatitis B virus (Section 18.8.6). No viruses of prokaryotes are known to carry out reverse transcription.

Remarks And Discussion

This paper is an expanded revision of our earlier manuscript on analysing the hepatitis A virus data in Taiwan. We thank all reviewers for providing helpful comments and suggestions on the earlier versions and for pointing out some recent publications (references 28, 47, 60 and 61 ). We also thank one

Common Communicable Diseases

Viral hepatitis, venereal diseases, tuberculosis, and malaria are all examples of common communicable diseases which must be reported. Refer to your local SOP and AR 40-400, Patient Administration, for the current complete list of reportable diseases and the method of reporting. a. Viral Hepatitis (Types A, B, Non-A, and Non-B). Usually, the following information is reported in a special telegraphic report (2) Total number of cases that were determined to be hepatitis B surface antigen (HBsAg) positive, HBsAg negative, and in which HBsAg test results were unknown. (3) Total number of cases where hepatitis A (IgM) antibody test was positive (indicating recent infection), IgM antibody test was negative, and in which IgM test results were unknown.

S Functions During Coronavirus Entry

Several devastating animal pathogens such as transmissible gastroenteritis virus of swine and infectious peritonitis virus of cats. CarcinoEmbryonic Antigen-related Cell Adhesion Molecules (CEACAMs), immunoglobulin-like type I-oriented membrane glycoproteins that are prevalent in the liver and gastrointestinal tract, serve as receptors for the prototype member of the antigenic group 2 coronavirus mouse hepatitis virus (Dveksler et al., 1991 Godfraind et al., 1995). Receptors for group 3 coronaviruses, which include several bird viruses causing severe bronchitis in chickens and turkeys, are currently unknown.

Peptic Ulcerperforated

Alcoholic hepatitis gives rise to fibrosis (cirrhosis) of the liver, which increases portal vein resistance. With the development of portal hypertension (> 10 mmHg), there are portal-systemic anastomoses formed such as the left gastric-azygous (esophageal varices), the superior-middle and inferior rectal veins < r>

S Polymorphisms Affect Coronavirus Pathogenesis

Casais et al., 2003 Tsai et al., 2003). Correlating these alterations in virulence with the specific receptor-binding and membrane fusion functions of S proteins has just begun. Recent findings made in the Perlman laboratory have begun to establish these important relationships (Ontiveros et al., 2003). In this laboratory, two variants of the group 2 mouse hepatitis coro-navirus were identified with striking differences in neurovirulence, and using the established reverse genetics system, relative virulence was traced to a single S amino acid change, glycine 310 in virulent isolates, serine 310 associated with attenuation. This single difference had global effects on the overall stability of the S proteins, with gly310ser dramatically increasing the stable association of S1 and S2. Concomitant with this stabilization, membrane fusion activities were diminished. In particular, S proteins with the gly310 could mediate cell-cell fusion without the requirement for CEACAM triggering, while...

Applications to the SARS Coronavirus

16 scattered differences between murine-specific and laboratory-generated zoonotic forms of murine hepatitis coronavirus (Baric et al., 1997, 1999). Assigning xenotropic potential to a particular combination of these 11 mutations is a challenging but important undertaking. This might be accomplished by employing the approaches used successfully to identify correlates of murine hepatitis virus virulence. S cDNAs encoding SZ or SARS isoforms, as well as SZ SARS chimeras, can be easily constructed and then used to create recombinant coronaviruses. Tropism of the recombinants for human or animal cells can then be assessed using traditional virological methods. The next challenge will be to correlate S variations to alterations in receptor-binding or membrane fusion potentials. In all likelihood, the successful approaches will again be relatively traditional ones in which soluble S fragments SZ, SARS, and SZ SARS chimeras are developed as mimics of authentic coronaviruses and then used as...

Relevance to Antiviral Drug Developments

Finally, recent convincing evidence that the S proteins of the group 2 mouse hepatitis coronavirus carry out a class-1 fusion reaction (Bosch et al., 2003) make it probable that several coronaviruses including SARS-CoV will be sensitive to a HR peptide-based fusion inhibition. Peptides derived from the HR regions of structurally similar retroviruses and paramyxoviruses interfere with fusion by associating with complete spikes during the activation reaction, preventing the appropriate collapse into a coiled-coil bundle (Wild et al., 1994 Yao and Compans, 1996 see Figure 4.4). Similarly, a small 38-residue peptide representing mouse hepatitis virus HR2 powerfully inhibited both virus-cell and cell-cell fusion, reducing these activities by several logs when present at 10 M concentration (Bosch et al., 2003). These HR2 peptides block entry by binding transient intermediate conformations of the fusion protein, depicted in Figure 4.4B, C. It will therefore be important to know whether the...

Introduction to outcomes of infection for the host

In the previous few chapters we have looked at aspects of the virus replication cycle that culminate in the exit of infective progeny virions from an infected cell. When this is the outcome the infection is said to be productive. Virions may be released when the host cell lyses, or the cell may survive releasing virions for a period, which may be short, as in the case of HIV infection, or it may be long, as in the case of hepatitis B virus infection.

Start Care Of The Donor After Phlebotomy

STEP 6 Record on the donor's card if he leaves against advice to stay. The medical director of the blood bank must establish a mechanism to notify donors if he considers that any clinically significant abnormalities have been detected in either pre-donation evaluation or in post-donation laboratory tests, especially confirmed positive tests for hepatitis or syphilis.

Infection As A Preventable Cause Of Cancer

Infectious agents more generally.13 Until recently, infectious agents that cause cancer were termed rare and inconsequential. This view, though widely held 10 years ago, is now known to be erroneous. Worldwide, infection remains among the most important causes of cancer. The International Agency of Research on Cancer (IARC) estimates conservatively that 15.6 of all malignancies, and 21 in developing countries, are attributable to infectious agents.14 In some countries, the proportion is substantially higher. For example, in The Gambia in the late 1990s, 62.5 of malignancies in men affected either the liver (of which 84 were considered attributable to hepatitis B or C) or stomach (at least 55 estimated to result from Helicobacter pylori infection). In Gambian women, 57 of cancers affect the liver, stomach, or uterine cervix (95 attributable to human papillomavirus, HPV).5,15 In terms of overall mortality age-adjusted numbers, cancers of the stomach for men and cervix uteri for women...

Additional Abbreviations

Anti-HBc antibody to hepatitis B core antigen anti-HBe antibody to hepatitis B envelope anti-HBs antibody to hepatitis B surface anti-HCV antibody to hepatitis C virus HAV hepatitis A virus HBcAg hepatitis B core antigen HBeAg hepatitis B envelope antigen HBsAg hepatitis B surface antigen HBV hepatitis B virus HCV hepatitis C virus IgG antibodies against hepatitis A IgM antibodies against hepatitis A total antibody against hepatitis A

Medical consequences of longterm alcoholism Harmful effects

Women achieve higher blood alcohol concentrations than men after the consumption of equivalent doses per body weight. The most likely explanation for this is that there is a lower volume of distribution of alcohol in women because the solubility of alcohol is greater in water than in fat and women tend to have proportionally more fat and less body water than men. The higher blood alcohol concentration may cause greater organ toxicity than in men. Women tend to present with more severe liver disease (particularly alcoholic hepatitis) and do so after drinking less and over a shorter period of time than men. Women are more likely than men to die from cirrhosis.33 Women's brains may well be more sensitive to the deleterious effects of alcohol. One study has shown that alcoholic women show greater (reversible) gray and white matter brain shrinkage than alcoholic men, and that this maybe caused by differences in neuronal molecular responses however, these results are controversial.34

Section Ii Coagulation System Coagulation Factors

Fibrinogen, a plasma glycoprotein, is converted into fibrin in the presence of thrombin. The major source of fibrinogen is the liver. Bleeding due to a fibrinogen deficiency does not usually become manifest until the plasma concentration is below 75 mg per dl. Decreased levels of fibrinogen can be caused by several reasons -- decreased liver production is due to acute hepatitis or cirrosis fibrinolysins, which attack both fibrin and fibrinogen molecules and massive production of fibrin, as seen in disseminated intravascular coagulation (DIC). Replenishment can be achieved by administration of fresh frozen plasma or cryoprecipitates.

How To Clean Sterilize Equipment

Many infectious diseases, such as AIDS (see p. 399), hepatitis (see p. 172), and tetanus (see p. 182), can be passed from a sick person to a healthy person through the use of syringes, needles, and other instruments that are not sterile (this includes the instruments used for piercing ears, acupuncture, tattoos, or circumcision). Many skin infections and abscesses also start because of this. Any time the skin is cut or pierced, it should only be done with equipment that has been sterilized.

CDetection of Antibodies

Test for Identification of Units Possibly Transmitting Disease. All donor blood must be tested to detect units which might transmit diseases. Currently required tests include hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV), anti-hepatitis B core (anti-HBc), alanine aminotranferase (ALT), anti-human immunodeficiency virus-1 (anti-HIV-1), and anti-Human T-cell lymphotropic virus type I (anti-HTLV-I). All donor blood shall be tested for HBsAg, HCV, anti-HBc, ALT, anti-HIV-1 and anti-HTLV-I with reagents and techniques specified by the FDA, or approved equally sensitive and specified techniques. The blood component or unit of blood must not be used for transfusion unless the tests are negative or in the normal range. In an emergency situation, blood or components may be issued before the testing is performed but this fact must be conspicuous on the blood label. If the test is subsequently reactive, the recipient's physician must be notified.

Viral Glycoproteins that Modify Membrane Permeability

In addition to small hydrophobic viral proteins, there are other virus products that promote membrane permeabilization. This occurs with a number of virus glycoproteins (GP) that are known to increase cell membrane permeability, such as the human immunodeficiency virus gp41 (Chernomordik et al., 1994 Arroyo et al, 1995), the Ebola virus GP (Yang et al., 2000), the cytomegalovirus US9 protein (Maidji et al., 1996), the Vaccinia virus A38L protein (Sanderson et al., 1996), rotavirus VP7 and NS4 proteins (Charpilienne et al., 1997 Newton et al., 1997), the hepatitis C virus E1 protein (Ciccaglione et al., 1998), and the alphavirus E1 protein (Nyfeler et al., 2001 Wengler et al., 2003). Inducible expression of the hepatitis C virus E1 glycoprotein increases membrane permeability in bacterial cells. The ability of E1 to modify membrane permeability has been mapped to the carboxy terminus of the protein (Ciccaglione et al., 1998, 2001). Similar permeabilization was found with Escherichia...

Cutaneous Leukocytoclastic Angiitis

This is the most common cutaneous vasculitic lesion. It is an acute purpuric skin lesion, underlying which is an inflammation of the dermal postcapillary venules. Although primarily affecting the skin, it may also be associated with an arthralgia or glomerulonephritis. Etiologi-cally, there is some indication that viral agents such as hepatitis C virus may play a part. It can also result from drug therapy with certain agents such as sulfonamides or penicillin.

Human Immunodeficiency Virus HIV1 HIV2 Acquired Immunodeficiency Syndrome AIDS Test

Diagnostic and Clinical Significance of the Presence of Hepatitis B Antigens and Antibodies in the Serum Table 5-3. Diagnostic and Clinical Significance of the Presence of Hepatitis B Antigens and Antibodies in the Serum Hepatitis B surface antigen Hepatitis B surface antibody Immunity after receiving hepatitis B Hepatitis B core antigen Hepatitis B core antibody Present in chronic hepatitis Hepatitis A envelope antigen Hepatitis B envelope antibody

Pseudomembranous Colitis

With hepatitis B virus infections and with cirrhosis. There is a dramatic predisposition to this neoplasia in Africa and in parts of Asia it is the most common visceral neoplasia in African men. Causative theories include the carcinogenic action of aflatoxins on genetically susceptible individuals. Anatoxins are produced by the contamination of peanuts (staple food in many African countries) with the fungus Aspergillus favus.

Acquired toxoplasmosis

In immunocompetent individuals treatment is rarely needed however, in a rare patient whose symptoms are persistent, treatment should be as described for disseminated disease. Myocarditis, encephalitis, a sepsis syndrome with shock, and hepatitis are occasionally seen. In these patients, treatment should be given with pyrimethamine (100-mg loading dose and 25-50 mg d) and sulfadiazine or trisulfapyrimidines (4-8 g d) for 4-6 weeks. Folinic acid (5-10 mg d) should also be given. Infections acquired through a laboratory accident or blood transfusion should also be treated as described above.

Upregulation of B7H1 in Cancer and Chronic Viral Infections

Meanwhile, in human HIV (Day et al., 2006 Trautmann et al., 2006), HCV (Urbani et al., 2006) and HBV (Boni et al., 2007) patients, upregulation of PD-1 on viral-specific T cell and systematic upregulation of B7-H1 (Barber et al.,2006 Chen et al., 2007) are associated with T-cell dysfunction and disease progression. In all cases, blockade of B7-H1-PD-1 pathway improved viral-specific T-cell function in vitro, indicating a potentially valuable therapeutic manipulation to sustain immunity to viral infections.

Many concomitant extrahepatic syndromes

Have also been reported, most commonly in hepatitis B. There have been associated cryoglobulinemia especially in chronic HCV infection sicca syndrome especially in chronic HCV infection immune-mediated renal disease in chronic HBV and especially HCV infection. Hepatitis type A virus (HAV, infectious hepatitis virus) is an RNA virus transmitted by faecal contamination. Hepatitis type B virus (HBV, serum hepatitis) is a DNA virus usually transmitted by percutaneous inoculation of infected blood, but the virus in fact is present in many bodily fluids, so that for example venereal transmission is also common. Treatment is with immune globulin if given within one week of exposure, but the most appropriate management is prevention with recombinant hepatitis B vaccine. However, the use of this vaccine has become controversial in some countries following reports of both central and peripheral demyelination after its administration. Hepatitis type C virus (HCV, non-A, non-B or post-transfusion...

By Covalent Coupling of the Antigen see Notes 3 4 and

Antigens (hepatitis A, hepatitis B, diphtheria toxoid, tetanus toxoid, and sPf66 malaria synthetic peptide) are bound to IRIV surface by phosphatidylethanola-mine (PE) whose free amino group allows a covalent coupling. 3. In order to obtain a reduced antigen protein with free cysteine residues, the antigens are treated with 40 mmol 1 DL-dithiothreitol (DTT) for 5 min at 20 C. The DTT is removed using a Sephadex G10 column (Pharmacia LKB Biotechnology, Uppsala, Sweden) and OEG (Fluka Chemicals, Switzerland) is added at a final concentration of 100 mmol L. The evaporated PE-GMBS is then mixed with the antigen solution at appropriate ratios for 1 h, unbound GMBS is then captured by cysteine. The reactions are monitored by thin-layer chromatography. Additional PC and PE (final ratio 4 1) are added to the previously crosslinked PEGMBS and this mixture is dissolved in PBS containing 100 mM OEG. This solution is mixed with a A Singapore influenza OEG solution as described in the section for...

Preparation of Oligonucleotides Containing Cationic Virosomes see Note

Virosomes are prepared as described for the production of commercial IRIV-hepatitis A vaccine. Instead of PC and PE the cationic N- 1-(2,3-dioleyloxy) propyl -N,N,N-trimethyl-ammonium methylsulfate (DOTAP) is added to the influenza envelope glycoproteins (HA and NA) and phospholipids. Encapsulation of oligonucleotides into DOTAP-virosomes is performed as follows cat-ionic virosomes are added to each of the following oligodeoxy-nucleotide phosphorothioates (OPTs) antisense FITC.OPT, sense FITC-OPT, and FITC-OPT. These OPTs are dissolved and the solutions are then treated by sonica-tion for 2 min at 26 C. Nonencapsulated OPT are separated from the virosomes by gel filtration on a High Lead Superdex 200 column (Pharmacia, Uppsala, Sweden). The column is equilibrated with sterile PBS. The void volume fractions containing the DOTAP virosomes with encapsulated OPT is eluted with PBS and collected.

Vogt KoyanagiHarada Syndrome VKH

VKH is a multisystemic disorder involving eyes, ears, skin and meninges. It appears to be concentrated in certain racial and ethnic groups. The pathophysiology of VKH remains unclear. A specific antigen-driven immune response may occur in this disorder. However, the concept that VKH is a viral-induced disease has been attractive. EBV seems to be associated with VKH but molecular data are still needed before further conclusions are drawn 6 . Interestingly, atypical forms of VKH may occur in hepatitis C virus-infected patients treated with alpha interferon.

Gases Respiratory Care

The answer is d. (Goodnough, Am J Surg 159 602-609, 1990.) Cytomegalovirus (CMV) is harbored in blood leukocytes. CMV infection is endemic in the United States, and its prevalence increases steadily with age. While acute CMV infection may cause transient fever, jaundice, and hepatosplenomegaly in cases of large blood donor exposures, posttransfusion CMV infection (seroconversion) is not a significant clinical problem in immunocompetent recipients, and therefore blood is not routinely tested for the presence of CMV Posttransfusion non-A, non-B hepatitis, however, not only represents the most frequent infectious complication of transfusion, but is associated with an incidence of chronic active hepatitis up to 16 and an 8-10 incidence of cirrhosis or hepatoma or both. The etio-logic agent in over 90 of cases of posttransfusion hepatitis has been identified as hepatitis C.

Family Hepadnaviridae

The hepadnaviruses include three viruses of mammals hepatitis B virus of primates (HBV), woodchuck hepatitis virus (WHV), and ground squirrel hepatitis virus (GSHV) and two viruses of birds duck hepatitis B virus (DHBV) and heron hepatitis B virus (HHBV) (Table 5.9). Other viruses are also known but have not been well studied. The mammalian viruses are closely related and share extensive nucleotide sequence identity (e.g., HBV and WHV are 60 identical in nucleotide sequence). The bird viruses form a distinct lineage (Fig. 5.23). They are closely related to one another but more distantly related to the mammalian viruses. As their names imply, all of the known hepad-naviruses are hepatotropic, infecting liver cells, and all can cause hepatitis in their native host. All have a very narrow host range that may be determined by the identity of the receptors used for entry. Hepatitis B virus HBV Ground squirrel hepatitis B virus GSHV Woodchuck hepatitis B virus WHBV Avihepadnavirus Duck...

Models based on infection via the carotid artery

The cat model has been used once to examine the effect of clindamycin in the treatment of ocular toxoplasmosis (Davidson et al., 1996). Paradoxically, clindamycin administration was associated with increased morbidity and mortality from hepatitis and interstitial pneumonia, which are characteristic of generalized toxoplasmosis. The reasons for

Prevention of HIV transmission

Can be done by testing their blood for HIV-specific antibodies (Chapter 2). The preparation of blood products for haemophiliacs can include treatment with lipid solvents and detergents to destroy the virions of HIV (and other enveloped viruses, such as hepatitis B virus). There is a risk of transmitting HIV, and several other viruses (e.g. hepatitis B and C viruses), if syringes and needles are used to inject more than one person. The use of 'auto-disable' syringes ensures that this cannot happen. This simple, but ingenious, invention results in the syringe plunger breaking if an attempt is made to use the syringe more than once.

The answers are 303d 304g 305b 306h 307a

(Kutty, 3 e, pp 762-765.) Most patients with CML have the Philadelphia chromosome t(9,22) and the bcr abl fusion protein. Mucosa-associated lymphoid tissue (MALT) tumor has been shown to be secondary to H. pylori. Squamous cell carcinomas of the anus, penis, and cervix have been linked to human papillomavirus (HPV). Hepatitis B and C and hemochro-matosis are the major risk factors for hepatocellular carcinoma. Other risk factors include aflatoxin exposure and being from the Far East or Africa (high-incidence areas). Cigarette smoking is the most consistently observed risk factor for pancreatic cancer. Schistosomiasis is associated with squamous cell carcinoma of the bladder. Patients with BRCA1 gene on chromosome 17 present with breast cancer at a young age with a family history of breast or ovarian cancer. Vinyl chloride exposure is a risk factor for hemangiosarcoma of the liver. Patients with colonic polyps are at risk for developing colon cancer. Villous adenomas are more likely to...

Introduction to hepadnaviruses

The hepadnaviruses got their name because they cause hepatitis and they have DNA genomes. They are known as hepatitis B viruses (HBVs) and are classified in the family Hepadnaviridae. Some members infect mammals and some infect birds examples include wood-chuck HBV and heron HBV. The best-known hepad-navirus is that which infects humans it is commonly referred to as HBV, and is of major importance as an agent of disease and death. Duck HBV, on the other hand, is non-pathogenic in its natural host.

Chapter Summary continued

Acute viral hepatitis can be due to any of the hepatitis viruses. Chronic viral hepatitis can be caused by hepatitis viruses B, C and D. Hepatitis viruses vary in the nature of the virus and the manner in which they are spread. Hepatitis A virus is spread by the fecal-oral route and usually causes mild acute hepatitis. Hepatitis B virus is spread parenteral and by sexual contact and may cause acute hepatitis, chronic < hepatitis, cirrhosis, and hepatocellular carcinoma. Hepatitis C is spread by the parenteral and sexual routes i and may cause acute hepatitis, chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Hepatitis D is a defective virus that requires hepatitis B as a coinfection or superinfection to produce severe disease, which may take the form of acute hepatitis, chronic hepatitis, or cirrhosis. Hepatitis E vims is spread by the fecal-oral route and causes acute hepatitis that may be severe in infected pregnant women. Alcoholic liver disease can produce steatosis,...

Icosahedral ssDNA phages

Icosahedral ssDNA phages belong to the family Microviridae (from the Greek micros, 'small'). Such phages provided the first evidence for overlapping genes and revealed the economy of genetic coding, which is a feature of several small viruses, including hepatitis B virus (Section 18.6) and the ssRNA phages (Section 19.2). Studies on replication of these phages led to the discovery of rolling circle replication and to the identity of various genes encoding proteins for host DNA replication. 9X174 has been most extensively studied.

The Use of MF59 as a Vaccine Adjuvant

Vaccine. (In one case (*), where alum vaccines have been shown to be ineffective, the ratio of titers obtained with MF59 to that obtained with antigen alone is presented.) The principal conclusion to be drawn from this data is that MF59 is a significantly more potent adjuvant than the aluminum salts for most of the antigens tested in a variety of animal models. The enhancement of titer typically falls in the range from 5 to 40X. Most of the antigens used for development of MF59 were soluble recombinant truncates of viral surface glycoproteins (HIV gp120, HSV gD2, CMV gB, HCV E2). Significant activity has been demonstrated with glycoconjugate antigens (Hib, MenC) (15). MF59 has shown dramatic effects with two particulate antigens influenza HA (14) and (HBsAg) (16). No systematic trends have yet been established for antigenic characteristics that determine the degree of efficacy of MF59, though some very poorly soluble antigens have not shown good titers in this system (data not shown)....

Other Viral Ion Channels and Blockers

One of the earliest antiviral drugs, amantadine (amantadine-1), and also remantadine (a-methyl-1-adamantanemethanamine) (Davies et al., 1964 Hoffmann, 1973) are known to target the viral proton channel M2 from influenza A (Wang et al., 1993), with the latter especially used in chemoprophylaxis and therapy of influenza A. Its site of blocking is assumed to be within the lumen of the pore with residues such as Val-27, Ala-30, and Ser-31 involved (Duff and Ashley, 1992 Pinto et al., 1992 Duff et al., 1993). For a detailed review, see Chapter 8 by Y. Tang et al., this book. Also NB, an influenza B membrane protein forming ion channels, can be blocked by amantadine (Sunstrom et al., 1996 Fischer et al., 2001). However, the binding constants proposed for blocking are too high to propose NB as a potential target. The short viral membrane protein p7 from Hepatitis C virus also exhibits ion channel activity (Griffin et al., 2003 Pavlovic et al., 2003). For this channel, amantadine seems to...

Type 2 Transglutaminase and Cell Death

TG2 has been shown to have an important role in the maintenance of tissue integrity following cell stress or injury 2, 64 . Its role in tissue repair, as a response to loss in tissue homeostasis following trauma, is well documented 64 . The participation of the enzyme has been proposed in various degenerative diseases leading to severe tissue damage characterized by cell death and accumulation of insoluble protein aggregates both at intracellular and extracellular level 64, 65 . These diseases include, between others, various types of liver damages. A liver pathology characterized by accumulation of intracellular aggregate is the alcoholic hepatitis. The characteristic of this disease is the formation of Mallory Bodies that are cytoplasmic deposits of cytokeratin proteins, and TG2 has been shown to participate in their cross-linking 66 . In hepatic diseases characterized by fibrotic tissue formation, TG2 has been shown to participate in ECM cross-linking. In acute hepatic failure,...

RIIoD Immune Globulin HumanrhIG

RhIG is supplied as sterile, clear, and injectable for intramuscular administration into the mother within 72 hours after delivery if she meets the above criteria. It is a highly concentrated solution of lgG anti-Rh0(D) (about 300 ug of anti-Rho(D) globulin) derived from human plasma. RhIG, like other immune serum globulin preparations, does not transmit hepatitis.

Pia Villa and Pietro Ghezzi

The pathogenesis of endotoxic shock (1) endotoxin induces the production of TNFa, in vivo and in vitro, at an early time (3-5) (2) administration of TNFa to laboratory animals reproduces almost all the effects of LPS and in particular fever, hypertrigliceridemia, hypotension, and death (4). Furthermore, increased serum TNFa levels were measured in human volunteers treated with low doses of LPS, thus suggesting the relevance to man of the studies in animal models (6). TNFa has also been shown to be a mediator responsible for the initiation of the lethal toxicity of LPS in animals treated with a low dose of LPS and d-galactosamine, a liver-specific transcription inhibitor that increases the sensitivity to LPS itself (7,8). Unlike the response to high-dose LPS alone, death in this model is a direct result of hepatocyte apoptosis (9), which causes fulminant hepatitis, with TNFa and p55 TNF-receptor signaling playing an essential role.

Satellites And Satellite Viruses

SsRNA satellites Hepatitis 8s virus Hepatitis B virus Various plant viruses Various plant viruses Various plant viruses Although satellites are quite common among plant viruses, they are almost unknown among animal viruses. The difference seems to lie in the means by which plant viruses are transmitted. It is very common among plant viruses to have the genome divided among two or more segments that are separately encapsidated into different particles, a situation that does not occur among animal viruses. Evidently, the mechanisms by which plant viruses are transmitted allow the infection of a plant, and of individual cells within a plant, by multiple particles that together constitute a virus or that constitute a virus and its satellites. Transmission of animal viruses between hosts or among the cells of a host does not appear to allow multiple infections with sufficient frequency to maintain virus systems that are constituted by multiple particles, with the exceptions of hepatitis 8...

Types Of Biological Agents

Viruses are submicroscopic pathogens composed of nucleic acid that invade living cells, take over the cell's reproductive function, causes the cell to reproduce the virus, and eventually destroys the cell. Viruses are often transmitted to humans by arthropods, rodents, monkeys, and other humans. Examples of viral diseases include hemorrhagic fever, viral hepatitis, and smallpox.

Glucose6phosphate Dehydrogenase Deficiency

Treatment Nonpharmacologic therapy involves patient education, avoidance of contact sports, avoidance of aspirin and other NSAIDs (due to antiplatelet aggregating effect), orthopedic evaluation and physical therapy, and hepatitis vaccination. Factor VIII supplementation is effective in controlling spontaneous and traumatic hemorrhage. Desmopressin may be used prophylacti-cally in patients with mild hemophilia, prior to minor surgical procedures. Aminocaproic acid may be used to stop bleeding that is unresponsive to factor VIII or desmopressin.

Symptoms And Pathology

This disease is characterized by random necrosis of liver cells. An inflammatory mononuclear collects in the liver lobule and sinusoids of involved areas. In most instances of nonfatal viral hepatitis, regeneration of the liver begins almost with the onset of the disease. The damaged cells and their contents eventually are removed by phagocytosis and enzymatic reaction and the liver return to normal. There are several factors that will influence the course and severity of the disease. The virulence of the virus is a prime factor. The stronger the virus, the stronger the disease. Prior hepatic damage is also a factor. If the patient has sustained liver damage before exposure to the virus, this will make the disease more severe. Some people seem to have natural barriers or immunity to the virus. Care following the appearance of the symptoms will also affect the course of the disease. Mostly viral hepatitis is a mild disease and complete recovery is the rule. During the course of the...

Treatment And Nursing Care

Diet and activity should be adjusted to the clinical condition of the patient. The extremely ill patient will not want ambulation and may have nausea and vomiting so severe as to require supplements with 10 percent glucose solution. After gradually increasing ambulation, the patient may return to normal activity when he is asymptomatic and the liver tenderness has subsided. There is no specific medical treatment for viral hepatitis. Good general care is required. Pay attention to good oral hygiene, skin care, and elimination. Encourage fluids by mouth if nausea is not a problem. It may be necessary to entice the patient to eat. He may resist eating at first but eventually he will recover his appetite. When the appetite has returned to normal, a diet high in calories, proteins, and moderate carbohydrates is usually ordered. Fats may or may not be limited and vitamins may be given. For the patient with fulminant hepatitis, the common complications are hepatic coma, renal failure, and...

Hepatocellular carcinoma

Hepatocellular carcinoma (liver cancer) accounts for four to five per cent of cancer cases in the world. A number of factors are implicated as causative agents, including consumption of mould toxins in food, and two viruses hepatitis B virus (HBV) and hepatitis C virus (HCV). The other virus associated with liver cancer, HCV, is a flavivirus (Figure 21.5). It is the only class IV virus (plus-strand RNA virus) that is known to be oncogenic. Its genome is not found routinely in the cancer cells, in contrast to the other human oncogenic viruses. Both HBV and HCV elicit immune responses when they infect the body. In some individuals the immune response successfully eliminates the infection, but in many cases the infection persists for life, as discussed in Section 18.2 for HBV. As far as HCV is concerned, it is estimated that about 80 per cent of individuals who become infected are unable to eliminate the infection and that about 175 million people in the world are infected. In some...

B Pediatric Transfusions

(2) Premature and newborn infants usually require very small volumes of blood, such as 30 to 60 ml of WB or RBCs, although an additional 30 ml is required to fill the administration set. In some hospitals, this has led to the use of syringe transfusions from walking donors. Syringe transfusions are not desirable because (1) the donor medical history is usually inadequate, (2) pretransfusion testing of donor blood is usually not performed, (3) compatibility testing is usually not performed, (4) proper ratio of anticoagulant is often not used, (5) no filters are used for administration, (6) identification systems are often inadequate, and (7) risk of CMV hepatitis or AIDS from untested blood.

The answers are 480c 481a 482b 483e 484d

(Howard, pp 829-830.) The following table presents the patterns of hepatitis B virus serologic markers observed in various stages of infection with HBV. The diagnosis of HBV infection is usually based on three tests hepatitis B surface antigen, antibodies to surface antigen, and antibodies to core antigen. Tests are available, however, for e antigen and antibodies to e antigen. A variety of testing methods are available and include enzyme immunoassay, radioimmunoassay, hemagglutination, latex agglutination, and immune adherence. The delta agent has recently been described. The delta agent exacerbates infection with HBV, apparently in a synergistic manner. Commercial tests are now available for the delta agent.

Destruction of virus infectivity

Inactivated (killed) virus vaccines (Section 24.3) are made from preparations of virulent viruses, so it is essential that all infectivity is destroyed. Blood products, such as clotting factors for haemophiliacs and immunoglobulins, are treated to destroy any viruses (e.g. HIV, hepatitis viruses) that might be present in the donated blood. Continuing the theme of human and animal health, water supplies that are free from pathogenic viruses (and other micro-organisms) are of fundamental importance, so water treatment procedures must include processes that destroy these agents. The same applies to the treatment of swimming pool water.

Introduction to virus vaccines

Effective vaccines are in use to protect against diseases caused by many viruses such as polio, rubella, rabies and foot and mouth disease. This chapter will describe the various categories of virus vaccine that are in medical and veterinary use, and will outline some aspects of their manufacture. Effective vaccines have yet to be developed against many other viruses, including HIV-1, hepatitis C, Ebola and the herpes simplex viruses. Those involved in virus vaccine research face many difficulties, such as multiple antigenic variants of target viruses and the requirements for high standards of safety. Some vaccines that have been developed have not been accepted for widespread use because of safety concerns. The great need for new vaccines has spawned

Use Of Viruses As Expression Vectors

Hepatitis C virus (HCV) does not grow in cultured cells to titers sufficient to allow studies on the expression of viral proteins. The only experimental model for the virus is the chimpanzee, which severely restricts the number and nature of experiments that can be done. Thus, most of what we know about the expression of the HCV genome has been obtained through expression of parts of the genome by virus vectors, often by recombinant vaccinia virus. These studies have resulted in an understanding of the two viral proteases within the HCV genome, the processing pathway through which the polyprotein translated from the genome is processed, the function of the viral IRES, and the function of the viral replicase, among other results. The use of virus vectors means that such studies on HCV can be conveniently conducted in mammalian cells under conditions that are related to the natural growth cycle of the virus. such as vaccinia virus or the yellow fever 17D virus, both of which have been...

Continue with Exercises

What causes hepatitis 3. The agent for serum hepatitis can be transmitted by other than parenteral route. It is probably spread by the_. 4. List the three major points about hepatitis that concerns the military point of view. 6. Hepatitis follows a seasonal pattern with more cases occurring and . 7. Serum hepatitis is known as_while infectious hepatitis 8. Another type of hepatitis is termed_because it is caused 9. Hepatitis is characterized by random necrosis of_. 10. Several factors that influence the course and severity of infectious hepatitis are 11. What are the two stages of infectious hepatitis 13. What are the complications that may arise from infectious hepatitis 14. Although there is no specific medical treatment for infectious hepatitis, the following steps are necessary for good general care 15. The feces and blood of patients with acute hepatitis must be considered 16. If disposable needles and syringes are not available for use with the hepatitis 18....

Check Your Answers on Next Page

Hepatitis is an inflammation of the liver. (para 4-1) 2. Hepatitis can be caused by infectious agents that include certain viruses, bacteria, other infectants, toxic agents, and an excessive use of alcohol. (para 4-1) 4. How easily can hepatitis be transmitted from one person to another What is the morbidity rate for this disease What loss of man-hours can be expected because of hepatitis (para 4-3) 13. Relapse, prolonged viral hepatitis, cholestasis hepatitis, submassive necrosis or fulminant hepatitis. (para 4-8) 17. Serum hepatitis. (para 4-11) 22. Educate drug addicts to the dangers of unsterilized syringes and needles. Avoiding the use of unnecessary blood and blood products by physicians. Autoclaving all surgical instruments meticulously before reuse. Administering the hepatitis B vaccine that is now being tested. (para 4-15) 24. Toxic hepatitis. (para 4-17)

Records Of Transfusion Complications

Federal regulations require that fatalities attributed to transfusion complications, for example, hemolytic reactions or viral hepatitis, and transfusion associated AIDS, be reported to the Bureau of Biologics of the Food and Drug Administration. In addition, records must be kept of reports of transfusion complications (including those investigated) and cases of transfusion-associated hepatitis (including those confirmed as type B) and transfusion associated AIDS for periodic reporting to this Bureau (see figures 3-1 and 3-2).

Alphabetical List of Tests

Imaging Hematocrit Hemoglobin Hepatitis A Hepatitis B Hepatitis C Herpes Simplex High-Density Lipoprotein Histoplasmosis Holter Monitor Test Human Chorionic Gonadotropin Human Immunodeficiency Virus Hyaline Casts, Urine Hysterosalpingography Indirect Coombs' Test Insulin

Treg Functional Inactivation

A molecule constitutively expressed by Treg and associated to their function is CTLA-4. The blockade of CTLA-4 does not result in Treg depletion, but in their expansion in lymph nodes (Quezada et al., 2006) nevertheless, in some instances, it inhibits their suppressive function. In the model of inflammatory bowel disease, Treg suppression of colitogenic T cells is inhibited by CTLA-4 blockade. Since such inhibition is lost in the case CTLA-4 knock-out Treg are targeted, the experiment indicates that Treg-associated CTLA-4 was responsible for immuno-suppression in the gut (Read et al., 2006). Conversely, when used as adjuvant in cancer immunotherapy, CTLA-4 blockade has been shown to improve the immune response even in mice previously depleted of Treg (Sutmuller et al., 2001). In line with this evidence, Allison's group has recently demonstrated that CTLA-4 blockade, in conjunction with GM-CSF-based vaccination, modifies the intratumor balance between Treg and T effectors, restoring...

Generation and Maintenance of TCell Anergy and Exhaustion

Functionality of antigen-specific CTL was observed. In a chronic-infection mouse model of LCMV, one highly invasive lab-derived LCMV clone will cause prolonged infection with detectable viremia in blood and multiple peripheral organs. PD-1 was dramatically upregulated on CTL in response to the viral infection, and its expression was maintained during chronic infection, while B7-H1 is persistently expressed on spleen cells. These infected mice have not only a significant decrease in the number of antigen-specific memory CD8 T-cell population, but also a functional impairment of their remaining memory T cells. Interestingly, blockade of B7-H1 PD-1 pathway by monoclonal antibodies against B7-H1 or PD-1 increased proliferation of several virus-specific CTL clones, restored CTL function and reduced viral burden (Barber et al.,2006). More importantly, persistent upregulation of PD-1 is also observed on HIV, HCV and HBV viral-specific CTLs in chronically infected patients and correlates with...

Viroids And Virusoids

Viroids are small, circular RNA molecules that do not encode any protein and that are infectious as naked RNA molecules. Sequenced viroids range from 246 to 375 nt and possess extensive internal base pairing that results in the RNA being rod-like and about 15 nm long. A partial listing of viroids is given in Table 7.1. All known viroids infect plants. However, hepatitis 8, which infects humans, has many viroid-like properties and may be related to viroids. Many viroids are important agricultural pathogens, whereas others replicate without causing symptoms. Viroids are often transmitted through vegetative propagation of plants, but can also be transmitted during agricultural or horticultural practices in which contaminated instruments are used. Some viroids can be transmitted through seeds and at least one viroid is transmitted by an aphid.

APrenatal Treatment Intrauterine Transfusion

(1) Intrauterine transfusion carries a high risk of fetal mortality and, therefore, must be performed only, after careful evaluation of the problem by trained and experienced physicians. Red blood cells less than 5 days old may be used for intrauterine transfusion. Many physicians prefer to use frozen deglycerolized red cells because the risk of hepatitis and graft-vs-host disease may be reduced. The red cells should be group O and compatible with the mother's serum. Once initiated, such transfusions are usually repeated every 2 weeks until delivery.

Infections That Cause Cancer

Many infectious agents have been posited to cause cancer. The IARC biannually reviews epidemiologic and basic science information on putative cancer-causing agents. It then classifies these agents as definite, probable, possible, or unlikely causes of cancer. To date, they have carried out extensive evaluations of liver flukes, schistosomes, H. pylori, hepatitis viruses, human herpesvirus 8 (HHV-8), HPV, HTLV, human immunodeficiency virus (HIV), and Epstein-Barr virus (EBV Table 12-1). Viruses Hepatitis B Hepatitis C Oncogenic viruses such as EBV, HTLV-1, HHV-8, and human papillomaviruses may lead more directly to cancer by integration of viral oncogenes or oncogene promoters into nuclear DNA. Resultant viral oncoproteins may for instance interact with and inactivate host tumor suppressor proteins such as p53, uncoupling normal growth control processes and leading to cellular transformation.27,28 Oncogenic viruses may also induce production of cell growth factors, stimulating the host...

Best Remedy For Gastro Patient

Hepatitis C virus is most commonly transmitted by 290. The percentage of patients with acute hepatitis C who go on to have chronic disease is 291. The extent of liver damage done by chronic hepatitis B or C infection can best be gauged by evaluating b. Hepatitis 320. Which term characterizes the frequency of chronic disease following hepatitis A infection d. Positive hepatitis B surface antigen 323. Previously, you treated a 44-year-old man, a former intravenous drug abuser, for acute hepatitis C infection. Several months later, it is clear that the patient has chronic hepatitis and may need therapy with interferon. Which long-term complications of hepatitis C infection must you discuss so that the patient can make an informed decision about treatment a. Hepatitis A b. Any viral hepatitis d. Hepatitis B and hepatitis C e. Hepatitis B, but not hepatitis C 325. Protective vaccines are available for which of the following hepatitis viruses c. Consistent with alcoholic hepatitis that...

Glucose 6Phosphate Dehydrogenase Deficiency

Persons with mutations that partially destroy G6PDH activity may develop an acute, episodic hemolysis. Certain mutations affect the stability of G6PDH, and, because erythrocytes cannot synthesize proteins, the enzyme is gradually lost over tune and older red blood cells lyse. This process is accelerated by certain drugs and, in a subset of patients, ingestion of fava beans. In the United States, the most likely cause of a hemolytic episode in these patients is overwhelming infection, often pneumonia (viral and bacterial) or infectious hepatitis.

Creatine Kinase CK Creatine Phosphokinase CPK

An increase in the isoenzyme LDH-1 is a sensitive and distinctive indicator of myocardial infarction, and is also seen in red blood cell hemolysis, cerebrovascular accident, and muscular dystrophy. Increased LDH-2 levels also indicate myocardial infarction, cerebrovascular accident, muscular dystrophy, and lymphoproliferative disorders. Pulmonary infarction, renal necrosis, acute pancreatitis, and malignant lymphoma are associated with LDH-3 increases. LDH-4 increases can be caused by hepatitis, renal necrosis, acute glomerulonephritis, and infectious mononucleosis. Elevated LDH-5 levels are found in liver trauma, muscular dystrophy, and skeletal muscle trauma. Figure 3-2 displays the patterns of LDH isoenzymes associated with myocardial infarction, pulmonary infarction, and liver disease.

Perforated Gastric Ulcer

Alcoholic hepatitis gives rise to fibrosis ( CIRRHOSIS) of the liver, which increases portal vein resistance. With the development of portal hypertension (> 10 mmHg), there are portal-systemic anastomoses formed such as the left gastric-azygous (esophageal varices), the superior-middle and inferior rectal veins (hemorrhoids), the paraumbilical-inferior gastric (navel caput medusae), and the retroperitoneal-renal vein system.

How do viruses cause cancer

Most virus-induced cancers develop after a long period of persistent infection with an oncogenic virus for adult T cell leukaemia this period is exceptionally long (around 60 years). The virus infections persist in their hosts in spite of immune responses, such as the production of virus-specific antibodies. Some persistent infections are latent for much of the time (e.g. EBV and KSHV), with only small numbers of virus genes expressed. Others, including HBV and HCV infections, are productive. Both of the latter viruses are able to evolve rapidly (Chapter 20), and this probably allows them to keep one step ahead of acquired immune responses. Although many humans are persistently infected by viruses that are potentially oncogenic, only small percentages develop virus-linked cancers. Relatively few people develop EBV-related tumours, though over 90 per cent of adults worldwide are infected with the virus. About three per cent of women persistently infected with one of the high-risk...

Alanine Aminotransferase ALT Serum Glutamic Pyruvic Transaminase SGPT

Alanine aminotransferase (ALT), also known as serum glutamic pyruvic transaminase (SGPT), is an enzyme that behaves as a catalyst in various bodily functions. This enzyme is found predominantly in liver cells, with lower concentrations present in the heart, muscle, and kidney. Since ALT is so closely associated with the liver, variations in serum levels are used to diagnose liver disease and to monitor treatments for hepatitis or other liver disorders. Liver diseases associated with increased ALP levels include obstruction of biliary ducts and obstructive jaundice, hepatitis, liver cancer, cirrhosis, and infectious mononucleosis. In order to confirm liver-related diseases, elevated alkaline phosphatase levels must be correlated with other liver function tests.

Chemical Analysis of Urine

Bilirubin in the urine is seen in diseases such as hepatitis, obstructed biliary tract, or other liver disorders. The presence of bilirubin can also indicate liver damage caused by exposure to toxins or drugs. Variations from Normal. An increase in urobilinogen levels can be seen in cirrhosis of the liver, acute hepatitis, pernicious and hemolytic anemias, and hemorrhage. The absence of urobilinogen may indicate an obstructive disorder of the biliary duct system.

Examples of Modern Vaccine Adjuvants Used in Animals and

Thus, adjuvants administered repeatedly as nonspecific enhancers of immune response are largely excluded. Immunopotentiating agents administered to humans separately in time or location from the vaccine may be impractical for vaccinating large numbers of persons, and potentially unsafe because of their physiological effects on the entire body. They may have a role, however, in immunizing a small number of high-risk, immunocompetent individuals, such as renal dialysis patients at risk for hepatitis B or the very elderly at risk of influenza. Examples of such whole body adjuvants used in humans to augment vaccines include Na diethyldithiocarbamate (13), thymosin alpha one (14), loxoribine (15), granulocyte-macrophage stimulating factor (16,17), cimetidine (18), and dehydroepiandrosterone sulfate (19). The results of such trials to date have been disappointing. Hepatitis B virus core*

Historical Background

Adjuvants Vaccine

FIA has been included in veterinary, as well as human, vaccines. The veterinary vaccines included vaccines against foot-and-mouth disease (5), equine influenza virus (6), hog cholera (7), rabies (8), parainfluenza 3 (9), Newcastle disease (10), and infectious canine hepatitis (11). In cattle, FIA was inefficient in combination with herpesvirus (12). In humans, FIA was used for a period of about two decades, particularly with vaccines against influenza virus (13), tetanus toxoid (14), and killed polio-myelitis virus (15), whereas it failed to increase vaccine efficacy when used with adenovirus (16) and trachoma (17).

Subcourse Md0588 Environmental Diseasesinjuries I Introduction

This subcourse on environmental disease and injuries includes sections on venomous snake bites, spider bites, insect stings and bites, anaphylactic shock, poisonous marine animals, and hepatitis. The identification of types of snake bites and types of venoms is the main concern of the section on snakes. The snakes described here will be found mainly in the United States. For those soldiers assigned to other parts of the world, supplementary information will be provided by proper persons when an assignment is made. It is not possible to include all species of snakes and their varieties in this subcourse. A LAC-USC Guide for Snake Venom Poisoning is included at the end of the first lesson. The spiders that are identified can be as lethal as some types of snakes, but many of the insects are not. These insects are included because they are medically important, in terms of pain and the possibility of an allergic reaction. Many people can show an allergy that will progress to anaphylactic...

RNA ribozymes and DNAzymes

Using the structural information from naturally-occuring ribo-zymes, scientists have designed artificial ribozymes that will recognize and cut specific messenger-RNA in cells. For instance, one such molecule uses a fragment of the hammerhead ribozyme which, like anti-sense RNA, recognizes a small section of the targeted messenger-RNA through complementary base-pairing, just as in Fig. A6(a). The messenger-RNA and ribozyme fragment co-fold to form an active ribozyme, which then cuts the messenger-RNA. For example, a hammerhead ribozyme has been designed to cleave the messenger-RNA that codes for a regulatory protein that is expressed aberrantly in breast cancer. When introduced into breast cancer cells in culture, that ribozyme restores a normal, non-cancerous lifetime to those cells. Other ribozymes have been used to target and destroy the messenger-RNA from HIV and hepatitis C virus which stops these viruses from growing within the cell.

Immunopotentiating Reconstituted Influenza Virosomes

Twenty years after the discovery of the immunological adjuvant properties of liposomes (25) and the ensuing multitude of related animal immunization studies (26), liposomes as adjuvants have come of age (27,28) with the first liposome-based vaccine against hepatitis A being licensed for use in humans. Vaccines based on novasomes (nonphospholipid biodegradable, pausilamellar vesicles formed from single-chain amphiphiles, with or without other lipids) have also been licensed for the immunization of fowl against Newcastle disease virus and avian reovirus (29). Fig. 4. Computergraph of fusion event between IRIV carrying two hepatitis A particles and the endosomal membrane at pH 5.0. Note the change of conformation of the HA-trimer, which is a prerequisite for exposing the internalized fusion peptide and induction of fusion. Fig. 4. Computergraph of fusion event between IRIV carrying two hepatitis A particles and the endosomal membrane at pH 5.0. Note the change of conformation of the...

Polypharmacy As A Means To Offset Nausea Induced By D Febrifuga

Of specific interest is the fact that G. glabra is one of the traditional means of treating malaria in Ayurveda, the classical health care system of India (Sharma, 1999). Liquorice is also known to have gastrointestinal effects and is used in Ayurvedic medicine to treat gastric and duodenal ulcers (www.herbmed.org). It has been found in purified form to stimulate and accelerate gastric mucus formation and secretion (van Marle et al., 1981). These gastrointestinal effects of liquorice would suggest some effect on nausea. In clinical research in Japan, glycyrrhizin, the aqueous extract of liquorice root, has been shown to prevent hepatotoxic responses to chemicals and is used in treating chronic hepatitis (Shibayama, 1989). It also reduces the side effects, including nausea, resulting from chemotherapy in postoperative breast cancer patients (Akimoto et al., 1986). Liquorice is also known to have synergistic effects with other ingredients of plant-based medicines (Williamson, 2001) and...

Epidemiology The Spread Of Viruses From Person To Person

Therapeutic blood transfusion, use of hypodermic injections, and intravenous drug use are methods of spread of many blood-borne viruses. HIV and hepatitis B (family Hepadnaviridae) and C (genus Hepacivirus, family Flaviviridae) viruses, for example, are commonly spread among drug users through sharing of contaminated needles. Transfusion with contaminated blood is still possible despite diagnostic tests to identify infected blood products. In developed countries, the blood supply is screened for HIV and hepatitis B and C viruses, as well as other viral agents for which tests exist, but in developing countries contaminated blood is often still a major problem. Blood-borne viruses that are not arboviruses are often spread sexually as well as by the methods above, but in some cases it is not clear how the viruses were spread before the introduction of blood transfusion and hypodermic needles. Many viruses are transmitted by sexual contact. Virus may be present in warts in the genital...

Plasma Coagulation Factor Tests

An increase in the Pro Time is also seen in hemorrhagic disease of the newborn, liver diseases such as alcoholic hepatitis, biliary obstruction, and salicylate poisoning. Salicylate poisoning is most often caused by excess ingestion of aspirin or oil of wintergreen. Variations from Normal. An increase in fibrinogen is associated with diseases such as hepatitis, multiple myeloma, cancer, nephrosis, rheumatic fever, tuberculosis, and septicemia. Given the serious nature of each of these diseases, it seems that the increased fibrinogen levels do not trigger any specific or unique medical intervention. Decreased fibrinogen levels present an entirely different picture.