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  • Electronic Resource  (4)
  • Human immunodeficiency virus  (3)
  • Akute Leberinsuffizienz  (1)
  • 1
    ISSN: 1437-160X
    Keywords: Hepatitis B virus ; Human immunodeficiency virus ; Interferon alpha ; Chronic hepatitis ; Hepatitis B ; Vaccination
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Hepatitis B virus and the human immunodeficiency virus are similarly transmitted. Individuals with preexisting HIV infection have a higher chance to become HBsAg carriers than do anti-HIV negative persons. Cytotoxic T cells with specificity for HBcAg, that are under the control of HBcAg-specific helper T cells, are responsible for liver injury. There is good evidence that HIV infection lowers inflammatory activity, is associated with milder liver histology, high levels of viral replication and low seroconversion rates. In addition interferon alpha therapy is less effective in anti-HIV positive subjects. The immune response against HBsAg is helper T-cell dependent and vaccination against hepatitis B is of low effectiveness. In addition, vaccination against hepatitis B may activate the HIV disease and is, therefore, presently not to be recommended.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1440
    Keywords: Human immunodeficiency virus ; AIDS ; Anti-HIV ; Anti-p41 ; Anti-p24
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Diagnosis of infection with the human immunodeficiency virus (HIV) relies on the demonstration of antibody to this virus. Occasionally, the combined analysis of sera using ELISA and western blot reveals false-positive results. We have compared a newly developed test to detect antibodies to the core (anti-p24) and surface (anti-p41) proteins of HIV with the established tests described above. Anti-p24 and anti-p41 were negative in three individuals positive for anti-HIV by ELISA and immunoblot; they had a low risk to acquire HIV infection and were clinically and immunologically normal and suspected false positive previously. In 62 individuals at risk, anti-p41 was always positive while anti-p24 was negative in 24/62 individuals including all but one patient with AIDS. The data indicate that this new test may replace the western blot as a reliable, widely available, and standardized confirmatory assay. In addition, preliminary evidence needs to be confirmed that quantitative analysis of anti-p24 might be of prognostic value in the course of HIV infection.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1440
    Keywords: Human immunodeficiency virus ; Hepatitis B virus ; Interferon-α ; Corticosteroid
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 48-year-old male patient was admitted with acquired immunodeficiency syndrome (stage III, Centers for Disease Control 1993) and viremic hepatitis B. Blood CD4 count was 15/μl. Discontinuation of prednisolone, previously prescribed by the patient's family practitioner because of elevated liver enzymes, resulted in severe hepatitis (alanine aminotransferase 〉 300U/1). Administration of interferon-α, (9 × 106U s.c. 3 × weekly) was initiated. Serum markers of viral replication disappeared, and aminotransferase levels returned to normal within a few weeks. The patient's serum was found negative for HBsAg after 3 months. Immunohistochemical analysis of liver biopsies before and during interferon therapy showed disappearance of all hepatitis B virus antigens and a marked reduction in inflammatory activity. Hepatitis B virus seroconversion remained stable until the patient died from the syndrome 2 years later. This case shows that in spite of severe HIV-associated immune deficiency with CD4 counts constantly below 100/μl, interferon-α can lead to sustained serological and histological improvement of viremic hepatitis B. Previous administration and discontinuation of cortisone may have helped to reach this effect.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 337 (1974), S. 235-243 
    ISSN: 1435-2451
    Keywords: Acute Hepatic Failure ; Symptomatic Therapy ; Causal Therapy ; Akute Leberinsuffizienz ; Symptomatische Therapie ; Kausale Therapie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Das Leberversagen kann als partielle und globale Insuffizienz auftreten. Die Therapie der akuten Leberinsuffizienz richtet eich nach Ätiologie und Verlauf. Als symptomatische Behandlung stehen im Vordergrund: Senkung des Blutammoniums, Beeinflussung von Störungen im Elektrolyt- und Wasserhaushalt, Ausgleich von Koagulationsstörungen, Überwachung der respiratorischen und zirkulatorischen Homoiostase. Die Frage, was kann für die Leber selbst getan werden, wird anhand der heute eingesetzten Verfahren besprochen. Weder Corticosteroidbehandlungen noch Austauschtransfusionen haben sichere Erfolge gebracht. Große Probleme sind z. Z. noch mit dem temporären Leberersatz sowie der heterotopen und orthotopen Lebertransplantation verbunden. Prospektive Studien zur Klärung einer Effektivität von Cortison und/oder Anti-HBAg-Plasma sind nicht abgeschlossen.
    Notes: Summary Hepatic failure can be divided into two main types, (1) partial and (2) total insufficiency. The treatment of acute hepatic failure depends on the etiology and course of the illness. Symptomatic therapy is concentrated on hyperammoniaemia, water and electrolyte metabolism, impaired coagulation, and homeostasis of the respiratory tract and of the circulation. Possible ways of improving liver regeneration have been discussed exhaustively; corticosteroids and exchange transfusion have not proved as effective as expected. The temporary substitution of the liver and heterotopic and orthotopic liver transplantation remain major problems. Controlled trials on the effectivity of high dosages of corticosteroids and/or anti-HBAg immunoglobulin are in progress.
    Type of Medium: Electronic Resource
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