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Biomedical subjects

A Smedile

Publications and source records attributed to A Smedile.

At least 91 records · Page 5Linked to original sources
PubMed1986

Diagnostic and prognostic significance of the IgM antibody to the hepatitis delta virus.

The IgM class antibody to the hepatitis delta virus (HDV) was determined in different clinical categories of hepatitis B surface antigen carriers infected by the HDV (positive in the test for total antibody to HDV). The IgM antibody was found at high titers in each of 70 patients with inflammatory liver disease and at a low titer in one of six patients with inactive cirrhosis; it was not found in eight carriers with normal liver histology. The IgM antibody persisted in high titer over many years in patients with unremitting or progressive liver disease, but declined or disappeared before the homologous IgG antibody in the patients whose disease improved or resolved. Testing for IgM antibody to HDV distinguishes hepatitis B surface antigen carriers who have underlying inflammatory HDV liver disease from those with past HDV infection and provides prognostic information on the course of chronic HDV hepatitis.

Antibodies, Viral↗
PubMed1986

Fulminant hepatitis in asymptomatic hepatitis B surface antigen carriers in Greece.

Eleven male fulminant hepatitis (FH) patients (mean age: 47.7 +/- 16 years) positive for hepatitis B surface antigen (HBsAg) but negative for IgM antibody to hepatitis B core antigen (IgM anti-HBc) were admitted consecutively to the Athens Hospital for Infectious Diseases between May 1981 and November 1983. Because of the absence of IgM anti-HBc, determined by an enzyme immunoassay, these patients were considered to be HBsAg carriers with a superimposed acute hepatitis. Three of the 11 patients received immunosuppressive chemotherapy during the six months before the onset of the acute hepatitis. None of the patients was homosexual or a drug addict. Infection with hepatitis A virus (HAV), hepatitis B virus (HBV), or hepatitis delta virus (HDV) was detected with serologic markers and/or molecular hybridization techniques. Fulminant hepatitis was attributed to spontaneous reactivation of chronic hepatitis B in four patients, chemotherapy-induced reactivation of chronic hepatitis B in three patients, HDV superinfection in one patient and possible superinfection by non-A, non-B agent(s), HDV, or HDV-like agents in three patients. Reactivation of chronic hepatitis B was an important cause of apparent acute hepatitis in heterosexual male HBsAg carriers from an area with a high prevalence of HBV infection.

Acute Disease↗
PubMed1986

Treatment of chronic delta hepatitis with alpha-2 recombinant interferon.

The Hepatitis Delta Virus (HDV), a defective ribonucleic acid virus dependent on the Hepatitis B Virus (HBV) is a cause of severe liver disease that often leads to cirrhosis and death. Since the HDV finds in the HBV infection a biological niche in which to thrive indefinitely, the major victims of its infection are the carriers of HBsAg. Spontaneous resolution of chronic HDV hepatitis has been observed rarely and therapeutic attempts with steroids or azathioprine and levamisole have been discouraging. With the advent of recombinant DNA technologies several human alpha-interferons (IFNs) have been synthesized by genetic engineering and the availability of large amounts of the drug has dramatically altered the therapeutic prospects of viral hepatitis. In view of the wide range of biological activities of IFN, including inhibition of viral nucleic acid replication, we have tested the tolerance and the efficacy of this drug in chronic HDV hepatitis. The preliminary results of this study are reported.

Adult↗
PubMed1985

[Behavior of anti-HBc IgM in acute and chronic hepatitis].

Anti-HBV core IgM antibodies (anti-HBc IgM) were tested by RIA in the sera from 269 patients with acute viral hepatitis (AVH), from 39 patients with chronic HBSAg+ hepatitis (CH) at various stage of evolution, in 41 asymptomatic HBsAg carriers and in 30 healthy volunteers. Anti-HBc IgM were found in 100/108 HBsAg+ AVH, in 6/161 HBsAg--AVH, in 9/39 with CH and only 1 asymptomatic HBsAg carrier. Among the chronic patients with anti-HBc IgM, 3 were HBeAg+ and 6 were anti-HBe+. The test of anti-HBc IgM results useful in the early aetiological diagnosis of acute hepatitis since it is always positive in HBV acute hepatitis even in the subjects who early seroconvert to anti-HBs; the absence of anti-HBc IgM in the HBsAg+ acute hepatitis suggests other overinfecting agents. The presence of anti-HBc IgM in CH seems not to be related to an active viral replication.

Acute Disease↗
PubMed1985

Hepatitis delta virus (HDV) a cause of severe and fulminant acute hepatitis.

This report will briefly outline what has been learned since the hepatitis delta virus (HDV) was discovered. The molecular biology of HDV as well as the puzzling epidemiology are analyzed. A special attention is given to the clinical features of HDV liver disease, especially as a cause of fulminant hepatitis. The role of HDV in other severe liver diseases will be discussed.

Hepatitis B↗
PubMed1983

Epidemiologic patterns of infection with the hepatitis B virus-associated delta agent in Italy.

To assess the epidemiology of infection with the delta agent associated with hepatitis B virus, sera from 1314 carriers of the hepatitis B surface antigen (HBsAg) and 687 patients with hepatitis B collected in 1978-1981 from different regions of Italy were tested for delta antigen and antibody to the antigen (anti-delta), and the characteristics of delta-positive patients were analyzed. Anti-delta was found in each center participating in the study, indicating that delta infection has spread throughout Italy. Its prevalence was higher in carriers in southern Italy and in those with chronic hepatitis. In northern Italy, delta infection predominated among southern emigrants in industrial towns but also among parenteral drug addicts with hepatitis B virus infection. The prevalence of delta markers was variable and generally low in acute hepatitis B, suggesting that in Italy self-limited forms of delta infection occur sporadically or by limited outbreaks. Delta infection appears to be endemic in southern Italy but a new epidemiologic event in northern Italy, where it was probably introduced by southern emigrants and is presently exceeding its ethnic confinement to spread selectively in communities of drug addicts. Presumably, the endemicity of delta is maintained by transmission of this agent from carrier to carrier of the HBsAg.

Adolescent↗
PubMed1983

Delta hepatitis in inapparent carriers of hepatitis B surface antigen. A disease simulating acute hepatitis B progressive to chronicity.

Infection with the hepatitis B surface antigen (HBsAg)-associated delta agent (delta) was determined in a series of Italian patients with a diagnosis of acute hepatitis B (HBsAg-positive) progressive to chronicity. Twenty-two of 27 (81%) and 12 of 18 (67%) patients collected, respectively, in Naples and Cagliari, where delta is highly endemic, developed immunoglobulin M antibody to delta and/or rising titers of immunoglobulin G anti-delta during the initial acute phase of the disease. In each of them, anti-delta increased to a high-titered plateau indicative of chronic delta infection. Delta markers were found in none of the 13 patients collected in Siena, where the prevalence of delta infection is low. The great majority of the patients with anti-delta and a progressive form of HBsAg-positive hepatitis lacked the IgM antibody to hepatitis B core antigen. They were presumably unrecognized carriers of HBsAg who became infected by delta and developed hepatitis induced by this agent. In areas where delta is endemic, it may represent the true cause of seemingly type B hepatitis progressing to chronic HBsAg-positive liver disease.

Carrier State↗
PubMed1982

Influence of delta infection on severity of hepatitis B.

The prevalence of serum markers of primary delta infection was determined in 532 patients with acute benign hepatitis B seen in Italy, and in 111 patients with fulminant hepatitis B seen in Italy, France and England. Patients with fulminant hepatitis had significantly higher prevalence of delta markers (43/111, 39%) than did those with benign hepatitis (101/532, 19%). In 25 of the 43 patients with delta-positive fulminant hepatitis, serum markers indicated a primary hepatitis B infection while in the remaining 18, IgM antibody to hepatitis B core antigen was absent, indicating that hepatitis B preceded superinfection with the delta agent. The increased morbidity of HBsAg hepatitis with delta infection may result from the cumulative simultaneous exposure to hepatitis B virus and delta, or from superinfection of HBsAg carriers with delta.

Acute Disease↗
PubMed1982

Multicentre study of prevalence of HBV-associated delta infection and liver disease in drug-addicts.

To assess the epidemiological and pathogenic effects of infection with the hepatitis-B-virus (HBV)-associated delta agent in addicts who take drugs parenterally, 225 symptomless addicts from Italy and 261 addicts with HBsAg-positive hepatitis from Italy, Denmark, Switzerland, and Ireland were tested for delta antigen (delta-Ag) and its antibody (anti-delta) by radioimmunoassay. 79 liver biopsy specimens from HBsAg-positive addicts were also tested for intrahepatic delta-Ag by immunofluorescence. Anti-delta was found in 9 (27%) of 33 of the symptomless HBsAg-positive addicts, in 13 (8%) of 156 of those without HBsAg but with anti-HBs, and in none of those negative for HBV markers. The prevalence of serum delta-Ag or anti-delta among addicts with HBsAg-positive hepatitis was 64% (104/161) in Italy, 44% (8/18) in Denmark, 33% (11/33) in Switzerland, and 31% (15/49) in Ireland. 32 of the 79 (40%)liver biopsy specimens from HBsAg-positive addicts showed positive delta-Ag immunofluorescence. Delta infection occurring simultaneously with HBV infection is common and possibly a major cause of liver disease in drug addicts who receive drug parenterally. The spread of delta infection in drug-using communities is not confined to one country, and the drug habit may represent the major means by which delta agent spreads in areas of the Western world where this infection is not endemic.

Adult↗
PubMed1982

Radioimmunoassay detection of IgM antibodies to the HBV-associated delta (delta) antigen:" clinical significance in delta infection.

A sensitive radioimmunoassay was developed for specific detection of IgM antibodies to the hepatitis b virus-associated delta antigen. The test is based on the selective absorption of IgM by anti-IgM fixed on a solid phase. Transient primary IgM anti-delta responses with no conversion to a secondary IgG response were observed in acute self-limited delta infection. IgM anti-delta was invariably found in hepatitis B surface antigen (HBsAg) carriers with active delta infection and liver disease, while it was absent in HBsAg-positive or negative individuals with anti-delta of IgG class but without liver damage or intrahepatic delta antigen. IgM anti-delta appears useful in defining the epidemiology of acute delta infection and in the serological diagnosis of active delta disease from nonpathogenic or past delta infection.

Antibodies, Viral↗
PubMed1982

Radioimmunoassay detection of IgM antibodies to the hepatitis B core antigen in HBsAg liver disease.

A radioimmunoassay is described for detection of IgM antibody to the hepatitis B core antigen. The assay is based on the selective absorption of IgM immunoglobulins from test serum by anti-IgM fixed on a solid phase, followed by incubation with HBcAg and radiolabeled anti-HBc of IgG type. IgM anti-HBc was found in high titers in all the patients with acute hepatitis B; in two of four patients whose acute hepatitis progressed to chronicity, IgM anti- HBc disappeared in 4-6 months despite continuing HB viremia. IgM anti-HBc was also found in low titers in 19% of the patients with chronic HBV infection. No relation was noted between the presence of IgM anti-HBc and clinical or serological categories of chronic carriers of the HBsAg. The antibody was not found in carriers with hepatitis caused by superinfection with the hepatitis A virus or the HBV-associated delta agent. IgM anti-HBc is a marker of a recent HBV infection. Its absence in HBsAg-positive individuals with acute hepatitis should rise suspicion that the patients are carriers of the HBsAg experiencing disease caused by factors other than the HBV.

Antibodies, Anti-Idiotypic↗
PubMed1981

Enzyme-linked immunosorbent assay for detection of antibody to the hepatitis B surface antigen-associated delta antigen.

A blocking enzyme-linked immunosorbent assay (ELISA) was developed for specific detection of antibody to the hepatitis B surface antigen-associated delta antigen. The sensitivity of ELISA was intermediate between that of previously described immunofluorescence and radioimmunological assays for anti-delta. Performance of ELISA was simple and required only ordinary and inexpensive laboratory equipment.

Antibodies, Viral↗
PubMed1981

Infection with the delta agent in chronic HBsAg carriers.

To establish the mechanism of progression to chronicity of the HBsAg-associated delta infection, serum hepatitis B virus and delta markers were tested in five babies born to HBsAg-positive mothers with anti-delta, in 42 follow-up patients with acute hepatitis B virus and delta hepatitis, and in collections of sera from 8 HBsAg carriers with anti-delta. Evidence of delta infection was found in the baby born to a mother with serum HBeAg and in none of the four babies born to mothers with anti-HBe. Hepatitis was self-limited in the 42 patients acutely infected by hepatitis B virus and delta agent; none developed persistent HBs-antigenemia and the majority displayed transient anti-delta of IgM class. In seven HBsAg carriers high titers of anti-delta developed during the follow-up; coincident with the rise of the antibody, aminotransferase elevation occurred in five previously asymptomatic carriers and persisted in three of them. No sign of infectious hepatitis B virus replication was detected in five of the carriers throughout the follow-up, and all of them had anti-HBe before the rise of anti-delta and of aminotransferase. HBsAg carriers with diminished hepatitis B virus synthesis appear to be at high risk of developing chronic delta infection and disease when exposed to the delta-infectious serum of other carriers.

Adult↗
PubMedDate not supplied

Type D hepatitis: the clinical significance of hepatitis D virus RNA in serum as detected by a hybridization-based assay.

Hepatitis D virus is a defective human pathogen that requires hepatitis B virus for its replication. A hybridization-based assay for the 1.75 kb RNA genome of hepatitis D virus was developed using as probe a radiolabeled transcript of a cloned cDNA fragment (pKD3 hepatitis D virus DNA). Sera from 120 chronic carriers of HBsAg with confirmed hepatitis D virus infection were analyzed for the presence of hepatitis D virus RNA. Serum hepatitis D virus RNA was detected in 43 of 74 (58%) patients with chronic liver disease; some patients were positive for hepatitis D virus RNA in multiple samples over a period of several years. Serum hepatitis D virus RNA was present in 17 of 28 (61%) patients during the acute phase of clinical hepatitis and was not detected after recovery from acute disease or in 18 asymptomatic chronic HBsAg carriers with antibody to hepatitis D virus. The presence of hepatitis D virus RNA correlated with other known markers of active hepatitis D virus replication; all chronic active liver disease patients with serum hepatitis D virus RNA were positive for antihepatitis D antigen IgM, and 34 of 37 (92%) had hepatitis D antigen in their liver biopsy specimens. The assay for hepatitis D virus RNA provides a direct and noninvasive method for the detection of hepatitis D virus in serum and will be useful in the study of the natural history of type D hepatitis, the identification of chronic hepatitis D virus carriers likely to transmit hepatitis D virus and the selection and monitoring of patients for potential antiviral therapy.

Acute Disease↗