Diabetes Mellitus ; etiology ; Hepatitis, Viral, Human ; complications ; Humans ; Insulin Resistance

Hepatitis, Viral, Human ; complications ; Humans ; Thrombocytopenia ; etiology ; therapy

Hepatitis, Viral, Human ; complications ; surgery ; Humans ; Liver Cirrhosis ; etiology ; surgery ; Liver Failure ; surgery ; Liver Transplantation

To determine the prevalence and clinical relevance of HGV infection in dialysis patients, we performed a cross-sectional study of 61 HD patients and 79 Continuous Ambulatory Peritoneal Dialysis (CAPD) patients. HGV-RNA was identified by reverse-transcription (RT) polymerase chain reaction (PCR) assay with primers from the 5'-untranslated region of the viral genome. The prevalence of HGV infection was similar in HD and CAPD patients (9.8% vs. 12.7%), while that of HCV infection was significantly higher in HD patients compared to CAPD patients (16.4% vs. 1.3%, p < 0.05). The mean age (49.2 +/- 13.4 vs. 46.7 +/- 13.0 years), male to female ratio (2.4:1 vs. 1.3:1), history of transfusion (62.3% vs. 49.4%), history of hepatitis (27.9% vs. 26.6%), mean ALT level during the previous 6 months (22.4 +/- 37.9 vs. 14.0 +/- 7.4 IU/L), and the prevalence of HBsAg (8.2% vs. 6.3%) showed no difference between HD and CAPD patients. In both HD and CAPD patients, the presence of HGV RNA was not related to age, sex, duration of dialysis, history of transfusion, history of hepatitis, or to the presence of HBV or HCV markers. There was no significant difference in the clinical and biochemical data between patients with isolated HGV infection (n = 12) and patients without viremia (n = 106). The clinical feature of patients coinfected with HGV and HBV (n = 2), or HGV and HCV (n = 2) seemed to be similar to those of patients with isolated HBV (n = 8) or HCV (n = 9) infection. In conclusion, the prevalence of HGV infection was not different between HD and CAPD patients, and HGV infections did not seem to be associated with clinically significant hepatitis. The routes of HGV transmission, other than transfusion or contamination during HD procedure, were suspected.
Female ; Hepatitis Agents, GB*/genetics ; Hepatitis C/genetics ; Hepatitis C-Like Viruses/genetics ; Hepatitis, Viral, Human/virology ; Hepatitis, Viral, Human/genetics ; Hepatitis, Viral, Human/etiology* ; Human ; Male ; Middle Age ; Peritoneal Dialysis, Continuous Ambulatory/adverse effects* ; Prevalence ; RNA, Viral/analysis ; Renal Dialysis/adverse effects* ; Viremia/genetics

OBJECTIVETo explore the pathogenesis of thrombocytopenia in viral hepatitis.

METHODS84 viral hepatitis patients and 20 healthy controls were divided into three groups: Group A: 48 viral hepatitis patients with thrombocytopenia; Group B: 36 viral hepatitis patients with normal platelet count; and Group C: 20 healthy controls. Serum thrombopoietin (TPO) levels were measured in all subjects by enzyme linked immunosorbent assay. The levels of PAIg, PAIgG, PAIgA, PAIgM were detected in all subjects by flow cytometry. Spleen size was assessed in all subjects by abdominal color ultrasound B Scan. Bone marrow cells were examined in 74 subjects with bone marrow punctures.

RESULTSSerum thrombopoietin level was lower in group A than in group C and in group B. Serum TPO levels were correlated with platelet counts in the patients with advanced liver diseases. PAIg, PAIgG levels were significantly higher in group A than in group B and in group C. An inverse correlation was found between platelet counts and PAIg levels. An inverse correlation was also observed between platelet counts and PAIgG levels. The incidence of splenomegaly was significantly higher in group A (77.1%) than in group B (47.2%), while group C had no splenomegaly. An inverse correlation between spleen size and platelet count was observed (r = -0.581). There were 4 patients in group A with hypoplasia of bone marrow karyocytes, but there were no such cases in groups B and C.

CONCLUSIONSTPO level decreasing in patients with severe liver function impairments correlates with thrombocytopenia in advanced liver diseases. Autoimmune mechanism mediated by PAIg may play an important role in thrombocytopenia associated with viral hepatitis. Splenomegaly is the influencing factor leading to thrombocytopenia in viral hepatitis. Patients with chronic liver diseases had bone marrow depression, which may be a factor inducing thrombocytopenia in patients with viral hepatitis.

Adolescent ; Adult ; Aged ; Female ; Hepatitis, Viral, Human ; blood ; complications ; Humans ; Male ; Middle Aged ; Splenomegaly ; etiology ; Thrombocytopenia ; etiology ; Thrombopoietin ; blood

OBJECTIVETo discuss features of onset of chronic severe viral hepatitis (CSH).

METHODSThe patterns of onset of 520 cases of CSH were analyzed by SPASS and STATA software.

RESULTS1. Within less than 10 days, less than 2 weeks, 2 to 4 weeks, 4 weeks to 6 months, 10.4%, 18.1%, 17.1% and 64.8% of 520 cases deteriorated into severe hepatitis respectively. 2. There were no definite predisposing factors in more than 40% cases. There were 1 to 3 or more predisposing factors in more than 30% cases. The incidence of concurrent infection was the highest (P<0.01). 3. The pathogenic basis in more than 50% cases was cirrhosis. 4. Hepatic encephalopathy did not occur in more than 50% of the cases. Ascites occurred in more than 75% of cases. Hepatic encephalopathy first occurred in less than 5% cases and ascites in more than 10% of cases. 5. The latest time for occurrence of hepatic encephalopathy was later than the time of deteriorating into severe hepatitis.

CONCLUSIONS1. Gradual deterioration into CSH was found in all the 520 cases. 2. The predisposing factors, pathogenic bases, incidence and occurring time of hepatic encephalopathy, firstly occurring complication and so on in CSH are not the same as those in acute and subacute severe hepatitis. Therefore, CSH should be independently named and the study of CSH should be strengthened.

Adolescent ; Adult ; Aged ; Ascites ; etiology ; Child ; Female ; Hepatic Encephalopathy ; etiology ; Hepatitis, Chronic ; complications ; Hepatitis, Viral, Human ; complications ; Humans ; Liver Cirrhosis ; etiology ; Male ; Middle Aged ; Prospective Studies

OBJECTIVETo explore the etiology and clinical characters of hepatitis caused by non-hepatotropic virus.

METHODS68 non-hepatotrophic viral hepatitis patients with negative anti-HAV-anti-HEV were diagnosed by detecting antibodies of anti-HSV IgM, anti-EBV IgM, anti-CMV IgM, anti-CSV IgM and anti-ANA, anti-mitochondrion antibody. Their clinical symptoms and signs were compared with that of acute viral hepatitis patients at the same time.

RESULTSAmong the 68 patients, 9 were infected by HSV, 12 by EBV, 8 by CMV, 14 by CSV, and the other 13 patients and 12 patients were positive for anti-ANA and anti-mitochondrion antibody, respectively. 35 of 43 non-hepatotrophic viral hepatitis patients were infected in winter and spring season. Their clinical symptoms and signs were milder than that of acute viral hepatitis patients.

CONCLUSIONLiver damage and dysfunction may be the prominent phenomenon during HSV, EBV, CMV and CSV infection, just like that of acute viral hepatitis but with milder clinical symptom and signs.

Adult ; Antibodies, Viral ; blood ; Cytomegalovirus ; immunology ; Female ; Hepatitis, Viral, Human ; etiology ; virology ; Herpesvirus 4, Human ; immunology ; Humans ; Immunoglobulin M ; blood ; Male ; Simplexvirus ; immunology

Alcoholism ; complications ; China ; Congresses as Topic ; Fatty Liver ; epidemiology ; etiology ; Hepatitis, Viral, Human ; complications ; Humans ; Metabolic Syndrome ; complications ; Risk Factors

OBJECTIVETo study the pathogenic effect of hepatitis G virus (HGV) infection on hepatic failure.

METHODSUsing the RT-PCR and EIA techniques to detect HGV RNA and anti-HGV in sera of hepatic failure patients and compare them with their liver function and mortality rates.

RESULTSThere was no significant difference about the positive rates of HGV among acute hepatic failure, subacute hepatic failure and chronic hepatic failure groups (X(2)=2.54, P>0.05). The level of ALT in HGV-positive group was slightly lower than that in HGV-negative group. The concentration of bilirubin and globulin was higher in HGV-positive group than HGV-negative group, and the concentration of albumin in HGV-positive group was significantly lower than that in HGV-negative group (t=2.59, P<0.05). The mortality rate in HGV-positive group was significantly lower than that in HGV-negative group (X(2)=4.68, 0.01

CONCLUSIONSThe virulence of HGV is mild, and the HGV infection does not aggravate hepatic failure.

Adult ; Female ; Flaviviridae Infections ; complications ; GB virus C ; pathogenicity ; Hepatitis, Viral, Human ; complications ; Humans ; Liver Failure ; etiology ; Male ; Middle Aged

OBJECTIVETo investigate and compare the therapeutic effect of umbilical cord blood stem cell transplantation (UCBSCT) or adult fresh plasma in severe viral hepatitis liver failure with/without heart damage, and to study the effect of UCBSCT on liver lesions in rats.

METHODS83 severe hepatitis patients with/without heart damage were included in the study between January 1994 and June 2003. The patients were treated with UCBSCT or given adult plasma transfusions. The therapeutic effect was evaluated by serial determination of liver function and myocardium enzymes in all patients before and after the treatment. The model of experimental hepatic failure was constructed in SD rats by injecting carbon tetrachloride. Then, the rats were given normal saline, neonate cord blood serum or neonate cord blood stem cells respectively. The expression of human AFP and Alb in SD rat livers was detected by immunohistochemistry; and human special DNA was detected by PCR.

RESULTSThe UCBSCT group had much better effects in the improvement of liver function than the adult plasma group had, no matter whether the patients had heart damage or not. Moreover, UCBSCT can decrease heart impairment of the patients. The animal experiment demonstrated that AFP and Alb positive cells were present in the neonate cord blood stem cell group after 21 days and 1 month; human special DNA was detected by PCR in these SD rat livers.

CONCLUSIONUCBSCT displayed good therapeutic effects on severe viral hepatitis and improvement of heart injury of the patients. The rat liver immunohistochemistry indicated that neonate cord blood stem cell application can decrease the liver damage and increase hepatocellular regeneration. Human umbilical cord blood stem cells can differentiate into liver cells in acute damaged SD rat livers.

Aged ; Cardiomyopathies ; etiology ; surgery ; Cord Blood Stem Cell Transplantation ; Female ; Hepatitis, Viral, Human ; complications ; surgery ; Humans ; Liver Failure ; etiology ; surgery ; Male ; Middle Aged