No abstract available.
History, 20th Century ; Humans ; Immunosuppression/history ; Korea ; Organ Transplantation/*history

Herpes zoster in childhood is uncommon, but it is more common in association with immunosuppression. Maternal varicella infection during pregnancy and varicella occurring in the newborn represent risk for childhood herpes zoster. However, some controversies persist on risk factors, diagnosis, and the natural history of childhood disease. We report a 10-year-old healthy boy with shingles and review the risk factors, prognosis, and treatment of pediatric zoster.
Chickenpox ; Child ; Herpes Zoster ; Humans ; Immunosuppression ; Infant, Newborn ; Natural History ; Pregnancy ; Prognosis ; Risk Factors

Kaposi sarcoma (KS) is a multifocal proliferative vascular tumor often caused by human herpes virus 8. Among the four subtypes of KS, classic KS (CKS) is usually chronic, persisting over many years, but is not life threatening. Because the natural history of KS varies, many kinds of therapeutic option for CKS are available and their assessment may be difficult. We experienced three cases of CKS showing HHV-8 positive in biopsy, no history of immunosuppression and HIV infection, normal chest X-ray, no metastasis, and successfully treated with intralesional injection of Pegylated Interferon-alpha2a (Peg-IFN-alpha2a). After an intralesional Peg-IFN-alpha2a injection of 180 mcg/0.5 ml was administered once a week for 4 months, the size and induration of the lesions reduced greatly and the colors faded away. Histopathological examination of the resolved lesions did not show any evidence of KS with negative HHV-8 results. To the best of our knowledge, this is the first report in the literature for the treatment of CKS with intralesional Peg-IFN-alpha2a injection.
Biopsy ; Herpesvirus 8, Human ; HIV Infections ; Humans ; Immunosuppression ; Injections, Intralesional* ; Interferon-alpha* ; Natural History ; Neoplasm Metastasis ; Sarcoma, Kaposi* ; Thorax

HBV is the most common etiology of both liver cirrhosis and hepatocellular carcinoma in Korea. Despite much progress made, the currently available antiviral therapies cannot eradicate or eliminate this virus. Hence, the benefits and risks of antiviral therapy should be carefully evaluated on an individual basis and within the context of the clinical situation. The ultimate goals of treatment are to decrease the mortality from liver disease. The benefits of antiviral therapy come from prevention of progression of liver disease. Understanding the natural history of chronic HBV infection is a key step in the decision making process to treat patients with chronic HBV infection. Generally, chronic hepatitis B patients in the immune tolerant phase and immune inactive phase are not recommended to undergo antiviral treatment, except for those patients in special conditions (e.g., immunosuppression or anticancer chemotherapy). Chronic hepatitis B patients in the immune active phase are recommended for antiviral therapy. For patients with liver cirrhosis, treatment should be considered when serum HBV DNA is detectable regardless of the serum level of ALT.
Carcinoma, Hepatocellular ; Decision Making ; DNA ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Immunosuppression ; Korea ; Liver Cirrhosis ; Liver Diseases ; Mortality ; Natural History ; Risk Assessment

HBV is the most common etiology of both liver cirrhosis and hepatocellular carcinoma in Korea. Despite much progress made, the currently available antiviral therapies cannot eradicate or eliminate this virus. Hence, the benefits and risks of antiviral therapy should be carefully evaluated on an individual basis and within the context of the clinical situation. The ultimate goals of treatment are to decrease the mortality from liver disease. The benefits of antiviral therapy come from prevention of progression of liver disease. Understanding the natural history of chronic HBV infection is a key step in the decision making process to treat patients with chronic HBV infection. Generally, chronic hepatitis B patients in the immune tolerant phase and immune inactive phase are not recommended to undergo antiviral treatment, except for those patients in special conditions (e.g., immunosuppression or anticancer chemotherapy). Chronic hepatitis B patients in the immune active phase are recommended for antiviral therapy. For patients with liver cirrhosis, treatment should be considered when serum HBV DNA is detectable regardless of the serum level of ALT.
Carcinoma, Hepatocellular ; Decision Making ; DNA ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Immunosuppression ; Korea ; Liver Cirrhosis ; Liver Diseases ; Mortality ; Natural History ; Risk Assessment

PURPOSE: The natural history of renal transplant recipients with positive HBs Ag is still unclear and unpredictable. Liver-related morbidity and mortality after long-term immunosuppression need clinical challenges. We retrospectively investigated the clinical outcome of pre-transplant HBs Ag positive renal recipients in a single transplant center located in endemic area. METHODS: After excluding post-transplant de novo HBV infected, and peri-transplant anti-hepatitis C virus positive recipients, the clinical outcome of 1,816 recipients was examined by the nature of pre-transplant HBs Ag positivity. RESULTS: Pre-transplant HBs Ag positivity was documented in 61 recipients (M/F=47/14). During mean follow up of 71.61+/-54.14 months, 24 recipients died (6 by infection, 12 by hepatic failure, 2 by hepatocellular carcinoma, 2 by other malignancies, 1 by suicide, 1 by gastrointestinal bleeding). In 14 recipients (58.3%), death was related to liver-associated reasons. The 10-year patient survival rates in HBs Ag negative and positive groups were 90.0% and 62.6%, respectively (P<0.0001). The 10-year graft survival rates in HBs Ag negative and positive groups were 82.0% and 55.6%, respectively (P<0.0001). When pre-transplant HBV DNA viral load by PCR was positive or when the level of post-transplant HBV-DNA viral load flared up, we started lamivudine therapy since 1997. Seventeen recipients received daily 100 mg lamivudine. The mean duration of patients survival with (n=17) and without (n=44) lamivudine therapy was 104.3+/-45.6 and 59.0+/-51.2 months, respectively (P= 0.003). The 10-year patient survival rates in patients with and without lamivudine therapy were 80.7% and 55.4%, respectively (P=0.0698). CONCLUSION: Overall patient and graft survival in patients with positive pre-transplant HBs Ag was lower than negative recipients. Although, statistically not significant, lamivudine therapy showed a marginally positive impact on the survival of patients with pre-transplant positive HBs Ag.
Carcinoma, Hepatocellular ; DNA ; Follow-Up Studies ; Graft Survival ; Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Humans ; Immunosuppression ; Kidney Transplantation* ; Lamivudine ; Liver Failure ; Mortality ; Natural History ; Polymerase Chain Reaction ; Retrospective Studies ; Suicide ; Survival Rate ; Transplantation ; Viral Load