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Biomedical subjects

H C Thomas

Publications and source records attributed to H C Thomas.

At least 271 records · Page 15Linked to original sources
PubMed1985

Interactions between hepatotropic viruses in patients with haemophilia.

Infections with the hepatotropic viruses non-A, non-B (NANB), hepatitis B (HBV) and delta agent (HDV) are described in two patients with haemophilia. The first patient illustrates the phenomenon of interference following a simultaneous exposure to NANB and HBV. The second patient, a carrier of hepatitis B surface antigen (HBsAg), acquired superinfection with HDV which resulted in acute hepatitis progressing to chronic hepatitis. Liver disease seen in multitransfused haemophiliacs may be significantly different to that seen in other patients. As a consequence of the infusion of blood clotting factor concentrates, these patients become the site of complex viral interactions.

Child↗
PubMed1985

Mitozantrone as single agent therapy in hepatocellular carcinoma. A phase II study.

Thirty-five patients with hepatocellular carcinoma (HCC) have been treated with the Anthracenedione derivative, Mitozantrone. One complete and 5 partial responses were seen in 22 evaluable patients and in a further 4 patients tumour size remained static for lengths of time ranging from 13 to 42 weeks. Therapy was well tolerated. Bone marrow suppression was dose-limiting but easily managed by dose reduction. Other acute toxicity was rare, vomiting and hair loss being reported only once each. Cardiac 'events' occurred in 5 patients, 3 of whom had received high total cumulative doses of Mitozantrone. We conclude that Mitozantrone is of clinical benefit in HCC and that its usage is compatible with a good quality of survival. Its cardiotoxic potential requires further evaluation.

Adult↗
PubMed1985

Relationships between blood product exposure and immunological abnormalities in English haemophiliacs.

Amongst 160 English haemophiliacs treated with clotting factor concentrates, abnormalities of T lymphocyte subset distribution (characterized by low T4/T8 ratios and high total T8 counts), low in vitro phytohaemagglutinin stimulation and raised serum IgG levels, were more common in patients with haemophilia A than B, in patients who had received heavier blood product exposure, and in adults rather than children. A slight reduction in lymphocyte and platelet counts was found in 26% and 17% of patients. In the sample of patients tested, serum alpha 1-thymosin levels were often raised, but beta 2-microglobulin levels were usually normal. Fractionation procedures used to prepare clotting factor concentrates, and the amounts of concentrate used, are more likely to be causally related to these immunological abnormalities than the origins of source donor plasmas.

Adolescent↗
PubMed1985

High risk of non-A non-B hepatitis after a first exposure to volunteer or commercial clotting factor concentrates: effects of prophylactic immune serum globulin.

After a first exposure to factor VIII concentrates, 9/9 British patients treated with U.S.A.-derived commercial products, and 10/12 treated with British volunteer (NHS) products, developed acute non-A, non-B (NANB) hepatitis. Hepatitis following commercial products was more severe, and of shorter incubation. High previous exposure to NHS blood products seemed to prevent NHS but not commercial factor VIII-induced hepatitis; the latter was also not attenuated by administration of U.S.A.-derived commercial immune serum globulin (ISG). After a first exposure to NHS factor IX concentrates without ISG, 4/4 patients developed short incubation NANB hepatitis; one also contracted prolonged incubation hepatitis B. One patient treated with ISG and factor IX of proven infectivity did not develop hepatitis, suggesting protection by ISG. Observed differences between concentrates might be attributable to their content of different NANB agents, but dose-related effects could provide alternative explanations. This data provides a basis for comparative assessment of new products of possible reduced infectivity in only small numbers of patients.

Acute Disease↗
PubMed1985

Analysis of the antigenic composition of liver specific lipoprotein using murine monoclonal antibodies.

Eight monoclonal antibodies have been raised to antigenic determinants within the liver specific lipoprotein complex. Five of these determinants were species and the others non-species specific. No liver specific determinants were identified. Liver specific lipoprotein antigens recognised by the eight monoclonal antibodies were located either on the hepatocyte membrane and/or along the sinusoidal lining wall or in the cytoplasm of liver parenchymal cells. All antibodies but one reacted with the cell membrane of viable human hepatocytes. The molecular weights of four liver specific lipoprotein-determinants were determined by immunoprecipitation. These ranged from 22 000 to 164 000 daltons.

Adult↗
PubMed1985

Randomised controlled trial of adenine arabinoside 5'-monophosphate (ARA-AMP) in chronic hepatitis B virus infection.

A randomised controlled trial was conducted in 29 HBV carriers who had been HBs and HBe antigen positive for more than six months. Fifteen patients were treated with ARA-AMP 10 mg/kg/day given as intramuscular injections 12 hours apart for five days followed by 5 mg/kg/day for 23 days. The 14 controls received no treatment. Serum HBV-DNA polymerase, and HBV-DNA decreased in all patients during therapy. Six treated patients lost serum HBV-DNA polymerase, HBV-DNA and HBeAg, HBsAg concentrations decreased, and five developed anti-HBe. One of these six patients lost HBsAg and developed anti-HBs. No such changes were observed in the control group over a similar 18 month period of observation. A four week course of ARA-AMP inhibits HBV replication and in a significant minority of patients this is long lasting and is associated with a reduced level of inflammatory activity in the liver.

Adult↗
PubMed1985

Clinical and histological features of delta infection in chronic hepatitis B virus carriers.

One hundred and six consecutive chronic hepatitis B virus (HBV) carriers were studied for the prevalence of delta markers in serum and tissue, and the clinical and histological features of those with and without delta infection were compared. Twenty (18.9%) patients were positive for anti-delta in serum or delta antigen in the liver or both. They presented at a younger age (30.3 v 38 years). All of them were symptomatic at the time of biopsy, in contrast to 35% of patients without delta infection who were not symptomatic. Those with delta infection had higher serum transaminase values and showed more severe liver damage on biopsy: chronic active hepatitis in 45% and cirrhosis in 55%. There was more pronounced disease activity both within the parenchyma and in the portal and periportal zones. The histological diagnosis of the 86 patients without delta infection included minimal disease (10%), chronic persistent hepatitis (9%), chronic active hepatitis (62%), and cirrhosis (19%). Delta infection in chronic HBV carriers is associated with a more active and progressive liver disease.

Adolescent↗
PubMed1985

Psychosocial impact of chronic infection with hepatitis B virus on British patients.

The effects of chronic infection with hepatitis B virus (HBV) on the lives of 40 British patients were studied by means of a questionnaire. The aspects considered were: social, sexual, and family life, physical and psychological health, and work. Thirty six patients considered their lives to have been affected, nine mildly, 14 moderately, and 13 severely. The aspects of life most affected were: sexual (13), psychological (11), physical (5), work (3), social (2), and family (2). Most of the problems encountered were related to infectivity. The availability of vaccines against HBV and of successful antiviral treatment have solved some of the problems, but it remains important for the medical profession to be aware of the multifaceted impact of the carriage of HBV.

Adult↗
PubMed1985

Viruses and immune reactions in the liver.

The immunopathology of hepatitis B and delta virus infections of the liver are reviewed. It is clear there are several antigen/antibody systems of importance in acute and chronic HBV infection. Antibodies to HBs, HB core/HBe and antibodies to Dane specific determinants are involved in virus neutralisation. Elimination of virus infected hepatocytes is dependent on recognition of viral determinants in association with HLA proteins on the infected hepatocytes by cytotoxic T cells. The HLA protein display is modulated by exposure to interferon and may regulate the cytotoxic T cell and NK lytic processes. During chronic HBV infection there is evidence of failure of interferon activation of the infected liver cells so that viral protein synthesis is not decreased and there is no enhancement of HLA protein display. These complex interactions between the virus and the immune system determine the heterogeneity of the clinical syndromes seen in patients infected with this agent. The delta virus replicates only in patients with co-existent HBV infection. The agent is cytopathic and therefore always produces liver disease. When there is delta virus superinfection in a carrier of chronic HBV, there is an acceleration of the rate of progression of the liver disease. The presence of delta infection results in IgM and IgG anti-delta responses.

Cytopathogenic Effect, Viral↗
PubMed1984

Non-A, non-B hepatitis occurring in agammaglobulinaemic patients after intravenous immunoglobulin.

Acute non-A, non-B hepatitis developed in twelve patients with primary hypogammaglobulinaemia during treatment with intravenous gammaglobulin prepared by Cohn fractionation of pooled plasma. The illness was clinically and histologically identical to the short-incubation non-A, non-B, hepatitis observed in haemophilic patients receiving factor VIII concentrates. Most of the patients were symptomless, but 10 months after onset ten of the twelve still had abnormal liver function. The occurrence of non-A, non-B hepatitis in agammaglobulinaemics indicates that humoral mechanisms are not essential for production of hepatocyte necrosis in this infection. This outbreak emphasises the need for a screening test to identify the agent in blood products, and shows that Cohn fractionation of plasma does not always inactivate the agent. Furthermore, the finding that the virus can be transmitted in IgG concentrates suggests either that the general population has a very low level of antibodies to the putative virus or that such antibodies are not virus-neutralising.

Agammaglobulinemia↗
PubMed1984

The removal of hepatitis B virus from factor VIII concentrates by fractionation on ethylene maleic anhydride polyelectrolyte.

Chromatography with a solid-phase polyelectrolyte based on ethylene maleic anhydride polyelectrolyte (EMA PE) has been shown to remove a large proportion of hepatitis B surface antigen (HBsAg), including hepatitis B virus (HBV) particles, from contaminated cryoprecipitate. This process may reduce the risk of transmission of HBV infection when factor VIII concentrates are administered.

Blood↗