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Biomedical subjects

G Angarano

Publications and source records attributed to G Angarano.

At least 163 records · Page 9Linked to original sources
PubMed1980

[Markers of viral replication (HBeAg and DNA polymerase activity) in chronic uremia, HBsAg positive, hemodialysis patients].

The contagiousness of hepatitis B virus (HBV) carriers with end-stage renal disease undergoing chronic hemodialysis has been ascribed to an immunologic tolerance for HBV antigens, especially hepatitis B core antigen, supporting persistently high levels of virus replication. In this context hepatitis B e antigen and core-associated DNA polymerase (DNA P) activity have proved to be distinct markers of HBV replication. In order to evaluate the potential infectivity of these subjects, thirty-five HBsAg positive hemodialysis patients were studied for the presence of HBeAg/anti-HBe system correlating the results with serum DNA P activity. Twenty out of 35 patients were HBeAg positive (57%) and 21 DNA P positive (60%). A highly significant correlation (P less than 0,001) was recorded between detection of HBeAg and presence of serum DNA P activity. These findings confirm that the majority of hemodialysis patients carrying HBsAg show high levels of virus replication so that the determination of HBeAg and DNA P activity other than HBsAg is required for the identification of patients highly infectious.

Chronic Disease↗
PubMed1980

[Serologic diagnosis of acute hepatitis A. Refinement and evaluation of 3 methods of determining specific anti-HAV IgM].

A solid phase radioimmunoassay (RIA) procedure was developed and three methods for detection of IgM specific antibody to hepatitis A virus (anti-HAV IgM) were compared: triple antibody method, 2-MercaptoEthanol (2-ME) for IgM cleavage and Staphylococcal A Protein (StAP) for IgG absorption. Specificity and sensitivity of the tests were checked for evaluating acute and convalescent sera from 40 patients with serologically (seroconversion) diagnosed hepatitis A and 64 sera from patients with various acute viral diseases or with high titre of rheumatoid factor (RF). Specimens to be assayed for anti-HAV IgM were pretreated with 2-ME or StAP and tested by RIa using 125I labelled anti-HAV IgG. Triple antibody method showed to be more sensitive than other two methods giving false positive result in only one serum containing high levels of monoclonal RF. No significant difference in sensitivity and specificity was found between 2-ME and StAP procedure, but these methods were able to detect anti-HAV IgM for only two weeks after the onset of the disease, whereas triple antibody method gave positive results for at last seven weeks.

Antibodies, Viral↗
PubMed1980

[Non-A, non-B post-transfusion hepatitis. Serological survey of 85 patients with acute hepatitis following blood transfusion].

In a serological survey of 85 adult patients hospitalized for an episode of transfusion-associated hepatitis, 45 were reactive for hepatitis B surface antigen and therefore diagnosed as having hepatitis B. Forty HBsAg non reactive patients were examined for development of antibody to hepatitis A and B antigens, cytomegalovirus and Epstein-Barr virus. Three patients showed serologic evidence of hepatitis B and one for hepatitis A. None of the remaining 36 subjects developed serologic evidence of acute infection with the viruses tested during the study period, so that they were classified as having so-called NANB hepatitis. As reported in other studies, analysis of the incubation period showed that two subgroups of NANB hepatitis may be identified with short and long incubation period, so that it appears likely that at least two agents are implicated in NANB hepatitis. Our data confirm that also in our area a large proportion of transfusion-associated hepatitis is related to NANB agent(s) requiring additional measures for its prevention.

Acute Disease↗
PubMed1979

[Antinuclear antibody (anti-HBc) and liver pathology in acute and chronic virus B hepatitis].

HBsAg and anti-HBc, the antibody to core antigen of hepatitis B virion, were titrated by solid phase radioimmunoassay in 40 sera of HBsAg carriers with acute and chronic hepatitis and in 20 healthy subjects carrying anti-HBc alone or associated with anti-HBs. No correlation was found between HBsAg and anti-HBc titers in the single category of patients. In contrast, geometric mean titer of anti-HBc (ranging from 2(14) to 2(15)) of patients with chronic active hepatitis was significantly higher ( p = < 0.01) than that of patients with acute or chronic persistent hepatitis and healthy HBsAg carriers (ranging from 2(9) to 2(14)). Anti-HBc titer of 20 subjects without detectable HBsAg was less than 2(7). These data suggest that in subjects with persistent B virus infection, anti-HBc response is correlated with synthesis of viral genome rather than of surface antigens, so that a much higher titer of anti-HBc was detected only in patients with a more active liver disease.

Acute Disease↗
PubMed1979

[Distribution of anti-HAV in a population sample from Puglia].

To investigate the prevalence and distribution of antibody to hepatitis A virus (anti-HAV), we tested by solid phase radioimmunoassay method 461 sera of selected people of Bari, according to age. In addiction, sera from cord blood of 11 newborns and their mothers at delivery were also investigated for anti-HAV. Taken together 64.4 per cent of subjects tested were found to be anti-HAV positive. The rate of antibody detection was strongly correlated with age. The prevalence were 4.5 per cent from 6 months to 3 years but gradually increased throughout childhood (from 35.6 to 80 per cent). Anti-HAV was detected in all cord blood samples from newborns whose mothers carried anti-HAV. These data suggest that circulation of hepatitis A virus in our area is very high, so that serological evidence of infection become evident in the majority of individuals during infancy.

Adolescent↗
PubMed1979

[Serodiagnosis of acute hepatitis A].

Hepatitis A antibody (anti-HAV) was detected by specific radioimmunoassay (RIA) method in sera from 10 patients with acute icteric hepatitis. Anti-HAV was detectable in many subjects very early before the onset of jaundice, but the diagnosis of type A hepatitis in all patients was confirmed by the demonstration of seroconversion during convalescence. Since the initial antibody detected by RIA is predominantly IgM, while IgG specific anti-HAV appears later reaching peak levels within 1 to 2 months, we treated serum specimens of these patients with 2-mercaptoethanol (2ME) in order to differentiate acute-from convalescent-phase hepatitis A sera. Inactivation of IgM fraction with 2ME produced a significant reduction of anti-HAV titer only in acute-phase sera, so that this procedure may be used for early diagnosis of acute type A hepatitis.

Acute Disease↗
PubMed1979

Persistence of e antigen as prognostic marker in acute hepatitis B.

Serial determinations of HBeAg and anti-HBe were made in sera of 155 selected patients with acute hepatitis B who were followed up for one to four years. In the early phase of hepatitis, HBeAg was present in 43 cases (27.7%) and anti-HBe in 12 cases (7.7%). Evaluation of the outcome of hepatitis showed that development of chronic hepatitis occurred in 11 out of 43 HBeAg positive patients, in 10 out of 100 HBeAg negative patients (P = less than 0.05) and in 2 out of 12 patients carrying anti-HBe. Nine out of 11 HBeAg positive chronic subjects showed persistent HBe antigenemia over two months, while the remaining 32 patients, who recovered completely, lost HBeAg within two to three weeks from the onset of the disease. These data suggest that the prognostic value of HBeAg in acute hepatitis patients may be taken into account when HBeAg persists in the serum and that anti-HBe does not invariably protect from the development of chronic hepatitis.

Acute Disease↗
PubMed1979

Radioimmunoassay in the detection of the hepatitis B e antigen/antibody system in asymptomatic carriers of hepatitis B surface antigen. Correlation with serum Dane particle associated DNA polymerase activity.

A radioimmunoassay for hepatitis e antigen (HBeAg) and antibody to e (anti-HBe) was developed and sera of 71 asymptomatic chronic carriers of hepatitis B surface antigen (HBsAg), in 44 of whom liver biopsy was obtained, were tested. In addition, testing for Dane particle associated DNA polymerase activity was performed in all sera. HBeAg was detected in 14 subjects (19.7%) and anti-HBe in 46 (64.8%). The highest proportion of HBeAg positivity (40%) was found among carriers with histological evidence of chronic hepatitis, whereas anti-HBe was present in 80% of carriers with normal liver histology, in 58% of carriers with non-specific reactive hepatitis and in 60% of carriers with chronic liver lesions. DNA polymerase activity was present in 92.8% of sera positive for HBeAg, in 13% of sera positive for anti-HBe, and in 9% of sera negative for both markers. Our results demonstrate that not all HBsAg carriers reactive to HBeAg show evidence of chronic hepatitis nor, conversely, that anti-HBe is invariably associated with the healthy carrier state of HBsAg. Finally, circulating Dane particles, as revealed by the presence of serum specific DNA polymerase activity, may also be present in anti-HBe positive sera other than those of some HBsAg carriers lacking both HBeAg and anti-HBe.

Carrier State↗
PubMed1979

[Prognostic value of alpha-foetoprotein in fulminant hepatitis (author's transl)].

Serum concentrations of alpha-foetoprotein (AFP) were measured sequentially by radioimmunoassay in 32 patients with fulminant hepatitis and coma, 22 of whom died. Levels were significantly elevated in 100% of patients who survived and in 7 out of 22 patients (38.5%) who died (P = less than 0.005). In the survivors the rise of AFP levels was found early after the development of coma and subsequently in all serum samples obtained during acute phase of illness. In 2 of 7 fatal cases who had raised AFP levels and the more protracted illness, AFP levels fall after 6 days. The high levels of serum AFP observed in severe forms of hepatitis may represent active hepatocyte regeneration after extensive hepatic necrosis. Although the correlation between survival and serum concentration of AFP is not absolute, our finding indicate that the rise in serum of this protein in patients with massive hepatic necrosis may be considered a favorable prognostic sign.

Adolescent↗
PubMed1978

[Role of chronic HBsAg carriers in intrafamilial diffusion of hepatitis B virus infection].

To assess the hepatitis B virus infection risk to household contacts exposed to HBsAg-positive chronic carriers, 169 family members of 20 healthy carriers of HBsAg and of 12 with chronic hepatitis were followed up prospectively for two to five years. All family members are investigated for the presence of serum HBsAg/antiHBs system and for the presence of liver disease. Our results indicate that the family contacts of HBsAg carriers with evidence of chronic liver disease are at greater risk of exposure to HBV than the contacts of healthy carriers and that acquisition of HBsAg is more common among males than among females. Evidence of exposure to HBsAg is very frequent in young age with a striking rise between 10 and 20 years. On the contrary acquisition of anti-HBsAg is more common after 40 years of age. These data suggest that persistent circulation of HBV in a family of chronic HBsAg carrier increases the risk of infection in household contacts and that HBV is eliminated in a more infective form from the carriers with chronic liver disease.

Adolescent↗
PubMed1977

[Behavior and clinical significance of the eAg/ anti-e system in carriers of HBsAg].

An investigation has been carried out in 315 patients with acute and chronic HBsAg positive and negative hepatitis in order to study the relationship between a new recently identified antigen/antibody system designed eAg/anti-e and HBV pathology. eAg was detected in sera of 37,8% patients with acute hepatitis who recovered normally and of 65% patients with acute protracted hepatitis and circulating HBSAg. eAg was not found in the serum of any of 52 cases of acute HBsAg negative hepatitis. Prevalence of eAg positivity was also demonstrated especially in patients with more severe forms of chronic hepatitis. Anti-e was not found in any of 20 patients with acute protracted hepatitis, but in 40% of subjects with acute hepatitis who recovered, in 54,5% of asymptomatic HBsAg carriers and in 30% of patients with chronic persistent hepatitis. Our results confirm the specific association between eAg/anti-e system and hepatitis B infection and indicate that eAg determinant is associated with continuing activity and chronicity of hepatitic process. In contrast, anti-e is correlated with normal recovery of acute hepatitis, but it may be indicative also of asymptomatic carriage of HBsAg and of non-progressive liver disease.

Acute Disease↗
PubMedDate not supplied

Circulating immune complexes in HBsAg-positive and HBsAg-negative chronic liver diseases.

Circulating immune complexes (CIC) were investigated by the fluid-phase C1q-binding test in serum samples from 131 subjects with various clinical types of HBsAg-positive and HBsAg-negative chronic hepatitis diagnosed on both clinical and laboratory criteria, including liver biopsy; serum samples from 28 asymptomatic HBsAg carriers and 75 healthy controls were also examined. The results of these findings were correlated with the liver damage and the clinical course of the disease. CIC were detected in all categories of chronic hepatitis with a significant prevalence only in patients with liver cirrhosis. No correlation was found between the levels of CIC, the presence of circulating HBsAg, and active inflammation or necrosis in any of the different types of chronic hepatitis. In contrast, a highly significant correlation was found between the prevalence of CIC and a more severe prognosis in patients with CAH and liver cirrhosis. The findings suggest that the presence of CIC is not specific for a given type of chronic liver disease and that they do not play any role in the pathogenesis of liver damage. The correlation observed between the presence of CIC and an unfavourable course of chronic liver disease suggests that CIC may modify the host's immune defence mechanisms.

Antigen-Antibody Complex↗
PubMedDate not supplied

Seroprevalence of Kaposi's sarcoma-associated herpesvirus/human herpesvirus 8 in several regions of Italy.

OBJECTIVE: To study the seroprevalence of Kaposi's sarcoma-associated herpesvirus/human herpesvirus type 8 (KSHV/HHV-8) in 779 Italian blood donors. STUDY DESIGN/METHODS: Sera were tested for antibodies to a latency-associated nuclear antigen (LANA) and a capsid related protein encoded by ORF65. RESULTS: Among all Italian donors, 17.7% and 18.7% had antibodies to LANA and ORF65 protein, respectively, and 24.1% had antibodies to at least one antigen. KSHV/HHV-8 seroprevalence was higher in the Po valley and in Sardinia than close to the sub-Alpine Veneto region, Tuscany, or Apulia. KSHV/HHV-8 seroprevalence was almost equally distributed between men and women but increased in the older age groups. CONCLUSIONS: The regional differences and age distribution in seroprevalence agree partially with the incidence of classic KS in Italy. The rarity of classic KS in KSHV/HHV-8-infected subjects and the equal gender distribution of seroprevalence suggest that other cofactors may contribute to KS development in human immunodeficiency virus type 1 (HIV-1)-uninfected individuals.

Adolescent↗
PubMedDate not supplied

Genotype and phenotype resistance: an overview.

Drug resistance is a major factor contributing to the failure of antiretroviral therapy. The rapid turnover of the human immunodeficiency virus type 1 (HIV-1) and the error-prone reverse transcriptase both contribute to the extensive emergence of resistant variants. The understanding of resistance and cross-resistance patterns is essential for the appropriate selection of treatment regimens for HIV-infected individuals. Although genotypic and phenotypic assays of drug resistance are not currently recommended for routine use, preliminary data has emphasized the role of resistance testing in guiding the choice of initial antiretroviral therapy, in explaining reasons for failure, and in selecting subsequent therapy for patients failing their current regimen. This article reviews the advantages and disadvantages of currently available resistance assays, as well as mechanisms and patterns of resistance and cross-resistance.

Drug Resistance↗
PubMedDate not supplied

Anti-nef antibodies and other predictors of disease progression in HIV-1 seropositive injecting drug users.

A cross-sectional and retrospective longitudinal study has been conducted in three Italian infectious disease centres to evaluate the role of anti-nef antibodies and other markers (HIV-1 p24 antigen, p24 Ag; Beta 2-microglobulin, B2-M; and number of CD4+ lymphocytes) as predictors of disease progression in HIV seropositive injecting drug users (IDUs). The selected patients were: 1) HIV-seropositive IDUs in different stages of HIV infection; 2) HIV-seropositive IDUs who had developed AIDS, from whom serial serum samples were available during the asymptomatic stage, and 3) HIV seropositive IDUs who remained asymptomatic through a follow-up period of the same duration as the patients who developed AIDS. Absence of anti-nef antibodies was associated with symptomatic HIV infection. A significant association between the absence of anti-nef antibodies, the presence of p24 Ag, high levels of B2-M, a number of CD4+ lymphocytes less than 500/ml at first visit and disease progression was found. Subjects who were persistently positive for antibody to nef were less likely to develop AIDS than those who were transiently or persistently negative. This difference was statistically significant (p = 0.03). The results of this study show that absence or disappearance of anti-nef antibodies may be used as predictor of disease evolution in HIV seropositive IDUs. This study also confirms the usefulness of other markers, such as p24 Ag, B2-M and number of CD4+ lymphocytes previously shown to be predictive of rapid disease progression for predicting the course of HIV seropositive IDUs.

AIDS-Related Complex↗
PubMedDate not supplied

[Ogilvie's syndrome: clinical reality or nosographic error?].

The authors report their experience in the management of Ogilvie's syndrome, a rare form of large bowel acute pseudo-obstruction. The study includes fifteen cases of the disease. There were ten males and five female, with a mean age of sixty-two years (range 45-92). Three patients were only treated with medical and conservative measures, one with unsuccessful colonoscopy and twelve (two with colonic perforation) underwent laparotomy. The surgical procedures performed were tube cecostomy (40%), colonic resection with primary anastomosis (27%) and exploratory laparotomy with decompression (13%). The overall morbidity and mortality rate were respectively 0 and 13%. Our epidemiological, clinical and therapeutic results are similar to those reported in the international literature. The pathophysiology of the syndrome is still unknown. It can be "idiopathic" or can complicate other diseases or surgical procedures (urological and gynaecological procedures mostly). Plain abdominal roentgenogram is the most useful diagnostic test, but colonoscopy may be an alternative diagnostic (and therapeutic) weapon. Conservative treatment is the method of choice but when the cecal diameter is more than 12 cm. (impending perforation), when the colon is perforated or when medical measures are unsuccessful, surgical procedure is compulsory. The age of the patient, cecal size, delay in colonic decompression are the most important prognostic factors. Even with a proper management, the prognosis is severe and the mortality rate is high (3-50%).

Aged↗