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(Anatomy) (Health) Liver and Hepatitis

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PostPosted: Wed May 03, 2006 6:33 am    Post subject: (Anatomy) (Health) Liver and Hepatitis Reply with quote

John Wiley & Sons, Inc.
2 May 2006

Chronic hepatitis in pediatric liver transplant patients

A new study on the long-term outcome of children undergoing liver transplants found that chronic hepatitis (CH) was common and that it was not detectible using standard blood tests. The presence of autoantibodies (antibodies that attack the body's own tissues) in these patients indicates that although not fully understood, CH may be related to the immune response.
The results of this study appear in the May 2006 issue of Hepatology, the official journal of the American Association for the Study of Liver Diseases (AASLD). Published by John Wiley & Sons, Inc., Hepatology is available online via Wiley InterScience at http://www.interscience.wiley......epatology.

Children normally undergo liver transplants for diseases that do not recur and are potentially curable by the procedure. Although their long-term survival rates are over 80 percent, little is known about tissue changes that occur over time in these young patients. "An important question within the field of paediatriac liver transplantation is whether children who have undergone successful transplantation can expect a normal life expectancy or whether there will be a gradual decline in liver function and eventual graft loss," the authors write.

Led by Helen M. Evans of the Birmingham Children's Hospital in Birmingham, United Kingdom, the study involved children who received liver transplants at the hospital's Liver Unit between 1983 and 1996. Patients underwent standard liver function tests, sonograms and liver biopsies at approximately 1, 5 and 10 years following transplant, and autoantibodies were measured at 5 and 10 years. A total of 113 children had liver biopsies at the one year mark, 135 had biopsies after 5 years, and 64 underwent biopsies at 10 years.

The results showed that there was a decrease over time in the proportion of biopsies considered to be normal, with chronic hepatitis being the most common abnormality (22 percent at 1 year, 43 percent at 5 years, 64 percent at 10 years). While liver function tests at 5 years were not significantly different in children who had CH, the presence of autoantibodies was significantly higher at 5 and 10 years in children with CH (72 percent and 80 percent respectively). In addition, there was a strong association between the presence of CH and the development of progressive fibrosis (the formation of scar-like tissue). The authors note that "the finding of increasing fibrosis in children with chronic hepatitis has not been reported before and has potentially important implications for long term graft function."

The authors note that transient autoantibody production following transplant sometimes occurs during episodes of rejection. In addition, late rejection may be associated with tissue changes that are different to those normally seen in acute rejection but more closely resemble those seen in chronic viral or autoimmune hepatitis. "It is therefore possible that some cases of otherwise unexplained chronic hepatitis in the liver allograft may represent a form of late cellular rejection," the authors suggest.

The results of the present study indicate that important tissue abnormalities can be detected in biopsies obtained from children who are clinically well and have normal liver function tests, the authors state. "Screening for chronic allograft hepatitis using liver biochemistry is therefore not possible and may instead require regular measurement of autoantibodies," they conclude.

Article: "Progressive Histological Damage in Liver Allografts Following Pediatric Liver Transplantation," Helen M. Evans, Deirdre A. Kelly, Patrick J. McKiernan, Stefan G. Hübscher, Hepatology; May 2006 (DOI: 10.1002/hep.21152).


Questions to explore further this topic:

A review of the body systems

A review of the digestive system

What is the liver?

Videos, animations and illustrations regarding the liver


What are the different parts of the liver?

What are the functions of the liver?

How does one take care of one's liver?

How is your diet related to your liver?

What are the diseases of the liver?

What is cirrhosis of the liver?

Can alcohol damage the liver?

Can drugs damage the liver?

What is liver cancer?

What is liver transplantation?

What is viral Hepatitis?

What is Hepatitis A?

What is Hepatitis B?

What is Hepatitis C?

What is Hepatitis D?


What is Hepatitis E?


What is autoimmune hepatitis?


Recent articles on liver and hepatitis

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PostPosted: Fri Mar 02, 2007 9:25 am    Post subject: Sweat may pass on hepatitis B in contact sports Reply with quote

BMJ Specialty Journals
2 March 2007

Sweat may pass on hepatitis B in contact sports

Sweat may be another way to pass on hepatitis B infection during contact sports, suggests research published ahead of print in the British Journal of Sports Medicine.

Hepatitis B virus attacks the liver and can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death.

The research team analysed blood and sweat samples from 70 male Olympic wrestlers for evidence of hepatitis B infection (HBV).

The wrestlers, who were all aged between 18 and 30, were all asked about injuries, as blood-borne infection is a common route of transmission.

Over a third said they had had bleeding or weeping wounds during training and competition. And almost half said that they had had an episode of bleeding during other activities.

None of the wrestlers had active HBV infection, as evidenced by a lack of antibodies to the virus.

Nevertheless, the virus itself was found in the blood of nine (13%), suggesting that they had hidden or occult infection, says the author. This is perfectly plausible, given that intense training temporarily suppresses a normal immune response, she says.

Eight (11%) also had particles of the virus present in their sweat, and levels of the virus found in the blood closely matched those found in the sweat.

The findings prompt the author to suggest that sweat, like open wounds and mucous membranes, could be another way of transmitting the infection.

Some sporting bodies have ruled that HIV testing should be mandatory for all contact sport competitors, but no such recommendations have been made for HBV, says the author.

Yet HBV is far more transmissible, because much higher levels of the virus are found in the blood and it is not as fragile as HIV, she says, calling for HBV testing and vaccination for all wrestlers at the start of their career.
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PostPosted: Wed Apr 18, 2007 8:00 pm    Post subject: Researchers find hepatitis A and hepatitis C attack same pro Reply with quote

University of Texas Medical Branch at Galveston
18 April 2007

Researchers find hepatitis A and hepatitis C attack same protein to block immune defenses

GALVESTON, Texas -- Despite the fact that they both infect the liver, the hepatitis A and hepatitis C viruses actually have very little in common. The two are far apart genetically, are transmitted differently, and produce very different diseases. Hepatitis A spreads through the consumption of fecal particles from an infected person (in pollution-contaminated food or water, for example), but hepatitis C is generally transmitted only by direct contact with infected blood. Hepatitis A produces fever, nausea and abdominal pain that can last for weeks, but rarely lead to death; hepatitis C, by contrast, often spends decades quietly damaging the liver, until a victim’s only hope for survival is an organ transplant.

According to researchers at the University of Texas Medical Branch at Galveston (UTMB), though, these two otherwise unrelated liver viruses have one important thing in common: a trick for avoiding destruction by the immune system. Both dodge immune attacks by attacking the same protein — an essential link in a chain of molecular signals that triggers antiviral responses.

"With 30,000-plus proteins in the cell, it’s really remarkable that these two very different viruses have chosen to strike at the same one," said Dr. Stanley Lemon, director of UTMB’s Institute for Human Infections and Immunity and National Institutes of Health-funded Hepatitis C Research Center. Lemon is senior author of a paper on the research appearing online this week in the Proceedings of the National Academy of Sciences. "This identifies the protein — called MAVS, for mitochondrial antiviral signaling protein — as extremely important for the survival of any virus in the liver."

MAVS proteins project from tiny structures called mitochondria, which are found in large numbers in each liver cell. When specialized receptor molecules detect viruses in the cell, they dock with the MAVS proteins, thereby triggering a sequence of signals ending with the production of interferon beta— a potent inhibitor of virus replication. Recent research has shown that hepatitis C generates a protein called NS3/4A that chops up MAVS, interfering with immune signaling and possibly providing the cover the virus needs to survive so long in the liver. Now, Lemon and his group have demonstrated that hepatitis A does the same thing with a different protein, known as 3ABC.

"Hepatitis A never manages to establish a long-term infection like hepatitis C even though it also destroys MAVS," Lemon said. "This suggests that the degradation of this cell protein is not the main reason that hepatitis C becomes persistent. These results thus provide a new perspective on the chronicity of hepatitis C, which is a highly relevant virus clinically."

Hepatitis C has received far more research attention than hepatitis A in recent years, according to Lemon, largely because of hepatitis C’s chronic nature and the lack of a vaccine against it. But while better sanitation has driven a decline in hepatitis A cases in the United States, Lemon said, "It’s a significant risk for many people traveling overseas, because they fail to receive the vaccine." Hepatitis A has also been the cause of large food-borne outbreaks in the U.S. in recent years, including one in Pennsylvania that caused three deaths in otherwise healthy adults.

Media Hotline: (409) 772-6397

For more information or to schedule an interview or request a digital photo, please call the media hotline.

Other authors of the PNAS paper include lead author and former UTMB postdoctoral fellow Yan Yang, research associate Yuqiong Liang, graduate students Lin Qu and Zeming Chen, associate professor MinKyung Yi and assistant professor Kui Li. Funding for this research was provided by the National Institutes of Health, the American Liver Foundation, the James W. McLaughlin Endowment and the Effie and Wofford Cain Foundation.

The University of Texas Medical Branch at Galveston
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PostPosted: Mon Apr 30, 2007 8:24 am    Post subject: Toward a banana-based vaccine for hepatitis B Reply with quote

Toward a banana-based vaccine for hepatitis B
30 April 2007
Biotechnology Progress

Bananas have emerged as the best candidate to deliver a bite-sized vaccine for hepatitis B virus (HBV) to millions of people in developing countries, according to an article scheduled for the June 1 issue of ACS' Biotechnology Progress, a bi-monthly journal co-published with the American Institute of Chemical Engineers.

In the article, India's V. A. Bapat and colleagues update and review worldwide research on efforts to genetically engineer plants as biofactories for the production of vaccines. They focus on transferring genes to produce HBV vaccine, noting that there already are 350 million carriers of hepatitis B worldwide, with 1 million new cases annually. An estimated 75 million -100 million of those infected individuals may die from liver cirrhosis or liver cancer as a result, the article adds.

The authors explain that plant-based production of an oral hepatitis B vaccine has economic and other advantages over the existing injectable vaccine. Researchers so far have successfully engineered several plants — including banana, potato, lettuce, carrot, and tobacco — to produce HBV vaccines. They explain why banana appears to be the ideal production and delivery vehicle for HBV vaccine, and the further research and development needed to exploit bananas in the global battle against HBV.

ARTICLE #4 FOR IMMEDIATE RELEASE "Production of Hepatitis B Surface Antigen in Recombinant Plant Systems: An Update"

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PostPosted: Fri May 25, 2007 8:39 am    Post subject: Hepatitis B patients' understanding of infection and treatme Reply with quote

University of California - Los Angeles
24 May 2007

Hepatitis B patients' understanding of infection and treatment deficient

Many patients with chronic hepatitis B are deficient in their understanding of the lifelong disease and often do not comply with the drug regimens necessary to control it, according to a new UCLA survey that suggests improved patient involvement in disease management decisions could be the key to fixing this problem.

The national survey — funded by Idenix Pharmaceuticals and Novartis Pharma AG and presented May 20 during the annual Digestive Diseases Week conference in Washington, D.C. — indicates that patient involvement in disease management decisions need to be improved, which could result in better adherence to drug regimens and improved clinical outcomes.

“The results of this study are very compelling and are a wake-up call to physicians caring for hepatitis B patients that we need to educate our patients more about risk factors, modes of transmission and expectations regarding antiviral therapy,” said Dr. Steven-Huy Han, associate clinical professor of medicine and surgery in the division of digestive diseases at the David Geffen School of Medicine at UCLA and a consultant for both Idenix and Novartis.

The study was based on responses from 301 adult chronic hepatitis B patients on antiviral therapy. Of those, 24 percent were on interferon treatment. Most of these patients were males between the ages of 31 and 50, with about half being of Asian descent. In addition, 64 percent were from the mid-Atlantic or Pacific regions of the United States. The study was based on Internet interviews, supplemented by telephone interviews, conducted between September and November 2006.

Among the findings:

36 percent of respondents mistakenly thought the virus could be spread through sharing utensils.
80 percent were aware of the long-term consequences of the hepatitis B virus.
Half of the respondents erroneously believed a cure existed for the chronic virus, though just more than 60 percent had been in treatment for about a year.
31 percent said they knew specific names of hepatitis B virus tests, but only half knew what the tests measured.
85 percent felt that measuring virus levels was important, though 27 percent didn’t know if their physicians took those measurements.
37 percent did not discuss treatment goals with their physicians, yet 88 percent of these respondents felt they should be doing this.
51 percent felt involved in treatment decisions.
54 percent were unsure why the drugs they were taking had been chosen.

Respondents also admitted frequently missing doses or taking them at the wrong time. For instance, 12 percent admitted not complying once per month; 7 percent once every two weeks; 7 percent once a week; 7 percent two to three times per week; 1 percent four to six times per week; and 4 percent once per day. Also, 9 percent thought that missing one or two doses didn’t matter.

Other researchers on this study were Lisa Griffith of Idenix Pharmaceuticals and Tzvetelina Westphalen of Novartis Pharma AG.
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PostPosted: Wed Jul 25, 2007 10:14 am    Post subject: Korean mummies may provide clues to combat hepatitis B Reply with quote

The Hebrew University of Jerusalem
25 July 2007

Korean mummies may provide clues to combat hepatitis B

Mummies that have recently been unearthed in South Korea may provide clues on how to combat hepatitis B, according to Prof. Mark Spigelman of the Kuvin Center for the Study of Infectious and Tropical Diseases at the Hebrew University of Jerusalem.

This is the first time that samples of hepatitis B have ever been found on a mummified body. When the virus was discovered in the liver of a 500 year old child, researchers at Dankook University and Seoul National University invited Hebrew University Prof Spigelman to South Korea to verify the findings.

Spigelman and the Liver Unit at Hadassah University Hospital-Ein Kerem in Jerusalem are now part of an international team to conduct research on the mummies, bringing together experts from Dankook University, Seoul National University and University College London.

Spigelman known for his pioneering studies of ancient diseases (palaeoepidemiology) found on mummified bodies from Hungary to Sudan, in his quest to provide answers to the development of diseases affecting us today, such as tuberculosis, leishmania and influenza. The South Korean mummies are particularly well preserved, and could provide crucial information in the evolution of the hepatitis B virus.

An international killer

Hepatitis B causes liver problems and can lead to liver cancer or liver failure, killing approximately one million people each year.

In South Korea, the need to manage the virus is particularly significant, as twelve percent of the population are hepatitis carriers (compared with a world average of five percent). In China, the virus is one of the leading causes of cancer.

Korean mummies?

Until recently, no one even knew that mummies existed in Korea. Korea's ancient tradition of ancestor worship and the belief that at death, the soul rises up and the body has to go back to its natural components, without interference by external elements, meant that mummification was in fact anathema in Korean culture. However, with the take-over of the neo-Confucianist Joseon Dynasty in 1392, changes were made to the former Buddhist burial practices.

The burial process involved laying the body on ice for three to thirty days during mourning, placing the body inside an inner and an outer pine coffin, surrounded by the deceased's clothes, and the covering he coffin in a lime soil mixture. "In some cases, this inadvertently resulted in extremely good natural mummification," says Spigelman.

The building boom in South Korea has meant that many cemeteries have had to be relocated. It is this process which led to the discovery of the mummified bodies.

Know your enemy

The researchers intend to study the genome of the 500 year old virus to see if there have been any significant changes over this time. Spigelman asks: "Five hundred years ago, was it hepatitis B" Could it be that later on, it split from 'X' and became A and B" Was it already evolved" That's what we don't know."

"This is a 'know your enemy' expedition to see if we can get information that can help today's - and tomorrow’s - sufferers," says Spigelman. He believes that knowing what a virus did 500 years ago helps us understand what it will do as it continues to evolve, and will ultimately alter the practice of public health officials in combating it.
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