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Biomedical subjects

K Krogsgaard

Publications and source records attributed to K Krogsgaard.

At least 55 records · Page 3Linked to original sources

Delta infection and hepatitis B virus replication in Danish patients with fulminant hepatitis B.

The presence of hepatitis B virus and delta agent markers was investigated in 41 patients referred during the years 1970-1985 with fulminant hepatitis classified as type B or non-A non-B and compared to findings in patients with uncomplicated hepatitis B and chronic hepatitis B infection. 13 patients had no markers of hepatitis B and delta infection and were classified as non-A non-B hepatitis. The remaining 28 patients were all HBsAg and IgM anti-HBc positive and 14 (50%) had evidence of delta infection. In contrast, only 13/71 patients (18%) with acute benign hepatitis B had evidence of delta coinfection (p less than 0.005). This corresponds to an odds ratio of 4.5 for development of fulminant hepatitis among patients with hepatitis B and delta coinfection. In 100 chronic HBsAg carriers 29% were positive for delta markers. 12 of the delta infected patients with fulminant hepatitis were positive for total antibody to the delta antigen, and 2 were delta antigen positive. Three were HBeAg positive/anti-HBe negative. None had hepatitis B virus DNA. Among the 14 patients without delta infection, hepatitis B virus DNA was found in 2/4 HBeAg positive/anti-HBe negative patients and in 1/8 patients negative for both markers. The present data indicate that a high proportion of Danish patients with fulminant hepatitis B have hepatitis B and delta agent coinfection. Further, the findings suggest that hepatitis B and delta coinfection may be associated with an increased risk of development of fulminant hepatitis as compared to that of hepatitis B alone.

Adolescent↗

Temporal relation of antigenaemia and loss of antibodies to core antigens to development of clinical disease in HIV infection.

A total of 276 sequential serum samples from 34 men with antibodies to the human immunodeficiency virus (HIV) followed up for two to seven years were analysed for HIV antigen and antibodies to the viral core and envelope proteins. Results were correlated with clinical outcome and CD4 T lymphocyte count. Both antigenaemia and the disappearance of antibodies to the core protein were associated with development of the acquired immune deficiency syndrome (AIDS) or AIDS related complex and depletion of CD4 cells. Thus AIDS or AIDS related complex developed in eight out of 16 patients with antigenaemia compared with one out of 18 patients without antigenaemia. Low counts of CD4 cells (less than 0.5 X 10(9)/l) were found in 14 of the 16 patients with antigenaemia and five of the 18 without antigenaemia. Nine patients seroconverted to HIV during the study; two of these developed antigenaemia 14 and 16 months after the estimated time of seroconversion. These results show that the late stages of HIV infection are characterised by increased production of antigen and a decrease in antibodies directed against the core protein. Antigenaemia indicates a poor prognosis; and as the antigen test is simple to do and interpret, it may therefore be useful for selecting patients for antiviral treatment.

AIDS-Related Complex↗

Variables predicting elevated portal pressure in alcoholic liver disease. Results of a multivariate analysis.

In 46 alcoholic patients the association of wedged-to-free hepatic-vein pressure with other variables (clinical, histologic, hemodynamic, and liver function data) was studied by means of multiple regression analysis, taking the wedged-to-free hepatic-vein pressure as the dependent variable. Four variables showed significant independent association with the wedged-to-free hepatic-vein pressure: indocyanine green clearance (p = 0.031), degree of necrosis (p = 0.023), degree of hepatic architectural destruction (graded as: preserved architecture, nodules alternating with preserved architecture, totally destroyed architecture) (p = 2.3 X 10(-6) and sex (p = 0.0024), male sex being associated with higher wedged-to-free hepatic-vein pressure. The multiple coefficient of determination (R2) was 0.63; thus, 63% of the variation in the wedged-to-free hepatic-vein pressure was 'explained' by variation in these four variables.

Adult↗

A prevalence study of HIV antibodies in rural Kenya.

In order to describe the prevalence of HIV antibodies and AIDS in West Kenya, serological tests, including ELISA, and in some cases immunoblotting, were performed on whole blood collected on filter paper from 603 Kenyans. Serum samples from 55 of these persons underwent the same examinations, and 45 were further examined by immunofluorescence and a commercial ELISA. The majority of the Kenyans examined were residents of a province in West Kenya, while the others were students from other parts of Kenya, predominantly rural areas. Male/female ratio was 62/38. Median age was 18 years (range 0-70). Five Danes with previously demonstrated HIV antibodies, and 10 Danish controls were examined for HIV antibodies in filter paper whole blood, and in serum by ELISA and immunoblotting. The tests carried out on the filter paper blood were found to be reliable. Only one of the examined Kenyans had antibodies to HIV by both ELISA and immunoblotting, representing a prevalence of 0.17% (95% confidence limits: 0.00-0.93%). This low prevalence is not in accord with results previously presented from rural districts in Kenya.

Acquired Immunodeficiency Syndrome↗

Antibody to HIV in patients with acute hepatitis B in the period 1975-1984.

In order to elucidate the time when HIV was introduced into a population of patients with acute hepatitis B, serum samples collected in the period 1975-1984 from 331 patients with hepatitis B were analysed for the presence of antibody to HIV (anti-HIV). Anti-HIV was not detected in any of the serum samples from 97 females. 5/234 serum samples from males (2%) were repeatedly positive. Anti-HIV was first demonstrated in 1978, 3 years before the first patients with AIDS were recognized in Denmark. None of the 4 Danish patients with anti-HIV developed AIDS during a follow-up period of 1-7 years. However, at the time of follow-up in 1985 3 had decreased cell mediated immunity. The hepatitis B infection had an uncomplicated course in 4/5 patients with anti-HIV. One patient had a protracted delta hepatitis and was a HBsAg carrier before as well as after the acute hepatitis. Thus, the HIV infection did not cause any complicated course in this study.

Acquired Immunodeficiency Syndrome↗

Hepatitis B virus DNA in hepatitis B surface antigen-positive blood donors: relation to the hepatitis B e system and outcome in recipients.

The presence of hepatitis B virus (HBV) DNA was investigated in 26 hepatitis B surface antigen-positive blood donors. Three donors (12%) were concordantly positive for HBV DNA and hepatitis B e antigen (HBeAg) and had IgM antibody to hepatitis B core antigen (anti-HBc). Two donors (8%) had HBV DNA without HBeAg; both were positive for antibody to HBeAg and lacked IgM anti-HBc. Twenty-one HBV DNA-negative donors had antibody to HBeAg, and all were negative for HBeAg and IgM anti-HBc. Blood units from 16 donors were transfused. A sufficient serological and clinical follow-up was available for 10 HBV-susceptible recipients. Three recipients of HBV DNA-positive blood units were infected irrespective of HBeAg status or presence of IgM anti-HBc. Six (86%) of seven recipients of HBV DNA-negative blood units developed HBV infection. Thus all hepatitis B surface antigen-positive blood donors should still be considered infectious irrespective of status with regard to HBeAg, HBV DNA, and IgM anti-HBc.

Adolescent↗

Frequencies of hepatitis B, delta and HTLV-III virus markers in Saudi Arabia.

Serum samples from 608 residents of Saudi Arabia were examined for the presence of hepatitis B, delta and HTLV-III virus markers. The HBsAg carrier rate was 17% and the prevalence of all hepatitis B virus markers was 55%. Males between 16 and 25 years had a significantly higher prevalence of all HBV markers (69%; 95% confidence limits: 49%-82%) compared to females in the same age group (34%; 95% confidence limits: 25%-45%). The prevalence of HBsAg was significantly higher among males aged 25-35 years (24%; 95% confidence limits: 19%-40%) compared to females in the same age group (9%; 95% confidence limits: 4%-18%). In addition, the HBsAg carrier rate for all males (23%) was significantly higher compared to females (11%) (p less than 0.001). HBeAg was found in 12% of 89 HBsAg-positive individuals, 48% were anti-HBe positive and 40% were negative for both markers. Hepatitis B virus DNA was found in 11 of 41 individuals tested. Five of these were HBeAg positive and four were anti-HBe positive. Anti-delta was found in three of 36 HBsAg positive serum samples (8%). Of 485 individuals tested for anti-HTLV-III, none were positive.

Adolescent↗

Correlation between liver morphology and haemodynamics in alcoholic liver disease.

In 32 alcoholic patients the degree of hepatic architectural destruction was graded (preserved architecture, nodules alternating with preserved architecture, totally destroyed architecture) and related to portal pressure. A significant positive correlation was found between degree of architectural destruction and wedged-to-free hepatic vein pressure (W-FHVP) (p less than 0.001). The degree of necrosis, fatty change and inflammation showed no correlation with portal pressure, whereas a significant positive correlation was found between the occurrence of Mallory bodies and W-FHVP (p less than 0.01) and between degree of fibrosis and W-FHVP (p less than 0.001). In 22 of the patients, hepatic blood flow (HBF) was measured and in these patients hepatic resistance was calculated (W-FHVP/HBF). A significant positive correlation was found between fibrosis and hepatic resistance (p less than 0.01). Further, hepatic architectural destruction (p less than 0.01) was positively correlated to hepatic resistance. Necrosis, fatty change, occurrence of Mallory bodies or inflammation showed no significant correlation with hepatic resistance. Mean hepatocyte volume was calculated in 29 patients, but no correlation was found with haemodynamic variables. The present data substantiate the concept that established portal hypertension in alcoholic liver disease is mainly accomplished by a derangement in hepatic architecture, whereas parenchymal changes, including hepatocyte size, are of less importance.

Adult↗

Veno-occlusive disease and peliosis of the liver after thorotrast administration.

A case of veno-occlusive disease and peliosis of the liver without coexisting liver malignancy 35 years after thorotrast administration is presented. In the liver four main widely distributed lesions were found: Veno-occlusive disease (VOD), peliosis, fibrosis and thorotrast deposits. Whether the VOD and the peliotic lesions are pathogenetically related or totally independent cannot be determined in the present case. However, the VOD and the peliosis are possibly related to the protracted alpha-emitting effect of thorotrast deposited in the liver parenchyma.

Alpha Particles↗