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Biomedical subjects

O Weiland

Publications and source records attributed to O Weiland.

At least 109 records · Page 6Linked to original sources
PubMed1991

Interferon alpha-2b treatment of chronic posttransfusion non-A, non-B/C hepatitis: long-term outcome and effect of increased interferon doses in non-responders.

The biochemical and histological long-term outcome of interferon alpha-2b treatment for chronic posttransfusion non-A, non-B/C hepatitis was evaluated in a randomized study. 4/19 treated patients had a sustained response with normal serum alanine aminotransferases (s-ALAT) levels during follow-up, at present for 18-20 months after the end of interferon treatment. None of 11 responders with biochemical relapse normalized their s-ALAT levels during 1 year follow-up after treatment. Histological changes were assessed by a scoring system. The scores for portal inflammation, piecemeal necrosis and fibrosis were essentially unchanged in all treated patients between biopsies taken at the end of treatment and 1 year later. Six non-responders to 3 million units (MU) alpha-2b interferon thrice weekly (t.i.w.) were given 6 MU t.i.w. for at least 8 weeks. None normalized the s-ALAT levels during treatment with the higher dose, instead the side effects were much more pronounced, an obstacle to the usefulness of higher interferon doses. The biochemical non-responders had higher pretreatment histologic inflammation scores indicating a more severe infection. They also had a higher body weight and seemed to have prominent macrovesicular steatosis more often than responders, a finding that could contribute to raised aminotransferases, thereby in some of the non-responders, masking a positive biochemical effect of interferon treatment.

Adult↗
PubMed1991

Sandfly fever among Swedish tourists.

All clinical and serologically confirmed cases of sandfly fever among Swedish tourists during 1986-1989 were investigated. A total of 37 cases of Sicilian virus sandfly fever and 1 case of Naples virus sandfly fever were recorded from Cyprus. One case of Toscana virus infection was documented from Spain. The clinical and laboratory findings did not differ from those in previous reports, except for elevated aminotransferase levels. A questionnaire, that offered a possibility to estimate the number of cases that had not been reported, was sent to 713 tourists who had visited different hotels in Cyprus and Mallorca in September 1987. Serum samples from 95 of these tourists were tested for sandfly fever virus antibodies. These tests indicated that only some 20% of the real number of sandfly fever infections had been diagnosed. Both clinical cases and cases found by the questionnaire showed a focal distribution with an overrepresentation of certain hotels in Cyprus. The results were reported to the local health officers and possibly due to the measures undertaken hereafter the number of sandfly fever cases diagnosed have decreased.

Adult↗
PubMed1991

Successful treatment of fulminant hepatitis B and fulminant hepatitis B and D coinfection explained by inhibitory effect on the immune response?

Foscarnet has been shown to inhibit the proliferation of human T and B lymphocytes in vitro. The production of lymphokines was more strongly affected than the DNA synthesis. Monocyte function was only partly inhibited by the highest foscarnet concentration tried. The influence of foscarnet on the immune system could explain the beneficial effect observed in patients with HBV-related fulminant hepatitis treated with foscarnet.

Antiviral Agents↗
PubMed1990

Heterosexual contact as a major route for transmission of acute hepatitis B among adults.

Possible routes for transmission of acute hepatitis B were studied retrospectively in 78 consecutive adult patients seen at the Department of Infectious Diseases, Roslagstull Hospital in Stockholm. Sexual transmission was found to be a major route of transmission, being more common than intravenous drug abuse. A single possible route of transmission was found in 66/78 (84%) patients. Eleven of the 78 patients (14%) had two possible routes, sexual contact being one. Overall sexual contact possibly accounted for 53% of all cases of hepatitis B, homosexual contact being responsible for only 10%. Cases reported earlier as being of unknown origin or associated with a recent visit abroad or to be 'social contact cases' are probably most often due to heterosexual transmission. Seven patients (9%) were heterosexually infected by persons who had been recently receiving medical care for hepatitis B. Seven sexually transmitted cases of acute clinical hepatitis B secondary to the patients studied were seen also. These findings show that sexual transmission, mainly heterosexual, is a major route for transmission of hepatitis B in a western society. They also emphasise the importance of taking an adequate sexual history as a prerequisite for providing effective prophylaxis for sexual partners of patients with acute hepatitis B.

Adolescent↗
PubMed1990

Therapy of chronic post-transfusion non-A, non-B hepatitis with interferon alfa-2b: Swedish experience.

Thirty-three Swedish patients with chronic post-transfusion non-A, non-B hepatitis entered a randomized trial of interferon alfa-2b treatment (INTRON A, Schering-Plough Corporation) (3 million units, three times weekly, subcutaneously for 36 weeks). Twenty-two patients (67%) were reactive for antibodies against hepatitis C virus. Nineteen patients completed the course of therapy; 11 (58%) had a complete response with normalization of serum alanine aminotransferase levels, compared to none of the 12 controls (p less than 0.001). Four treated patients with chronic active hepatitis were non-responders. Non-responders had a significantly higher mean body weight than responders (p less than 0.05) and tended to have a longer duration of prior disease. During the 10-month follow-up period post treatment, 4/11 (36%) complete responders had a sustained response and three (75%) of these four were reactive for antibodies against hepatitis C virus, whereas 7/11 (64%) relapsed, of whom four (57%) were reactive for antibodies against hepatitis C virus. All patients who were treated again responded but relapsed once more after retreatment was stopped. We conclude that the majority of patients with chronic post-transfusion non-A, non-B hepatitis will respond to 9 months' interferon alfa-2b treatment, but that only one of three responders will have a sustained response 10 months post treatment. Reactivity for antibodies against hepatitis C virus is not predictive of the outcome of therapy.

Adult↗
PubMed1990

Application of a numerical scoring system for assessment of histological outcome in patients with chronic posttransfusion non-A, non-B hepatitis with or without antibodies to hepatitis C.

A numerical scoring system was applied and compared to the conventional histological classification to assess the histological status of liver specimens from 37 patients with chronic posttransfusion non-A, non-B hepatitis followed for 7 to 105 months (mean 35 months). Four histological categories of alterations were assessed and scored: piecemeal necrosis (PMN), fibrosis and cirrhosis, lobular necrosis and portal inflammation. Sequential liver biopsies were obtained from 19 patients. PMN was generally mild but still predictive of progressing fibrosis. Thus, in none of the biopsies from four patients with initial PMN score 0 was there any increase in the fibrosis score in the follow-up biopsy, while in 10/15 (67%) patients with an initial PMN score of greater than or equal to 1 the fibrosis score increased with time (p = 0.033). Lobular necrosis and portal inflammation were not predictive of progressing fibrosis. Judging from the scoring method, 22% of all the 37 patients displayed cirrhosis and 27% bridging fibrosis in the latest liver biopsy performed. Patients with antibodies to hepatitis C did not differ in histological status or outcome from those without antibodies to hepatitis C. It is concluded that the scoring system can be used to monitor the histological long-term follow-up in patients with chronic posttransfusion non-A, non-B hepatitis, and offers a means of predicting the histological outcome.

Biopsy↗
PubMed1990

Autoimmune chronic active hepatitis: changing reactivity for antibodies to hepatitis C virus after immunosuppressive treatment.

Thirty-three patients fulfilling stringent criteria for autoimmune chronic active hepatitis (CAH) were tested for antibodies against hepatitis C virus (anti-HCV) with an enzyme immunoassay. Eleven of the 33 (33%) patients were anti-HCV-reactive in a serum drawn before initiation of immunosuppressive therapy. Anti-HCV-reactive patients had significantly higher median s-IgG level (32.3 g/l) than nonreactive patients (23.5 g/l) (p less than 0.01). When in remission with normalized s-IgG levels as a result of the immunosuppressive therapy, only 1 of the 11 initially reactive patients was still reactive. Sera from patients with acute autoimmune CAH and high s-IgG levels may be nonspecifically reactive for anti-HCV.

Adolescent↗
PubMed1990

Serum levels of the aminoterminal propeptide of type III procollagen and hyaluronan during resolving and nonresolving posttransfusion non-A, non-B hepatitis.

Serum levels of the aminoterminal propeptide of type III procollagen (PIIINP) and hyaluronan were analysed before and during the acute, recovery and chronic phases of non-A, non-B (NANB) posttransfusion hepatitis (PTH) in 13 patients. All patients were discovered during a prospective study on NANB PTH in patients undergoing open-heart surgery. 7/13 (54%) patients resolved their hepatitis within 6 months after onset, whereas 6/13 (46%) went on to chronic hepatitis. In 5 of these 6 patients a liver biopsy during the chronic phase of the hepatitis showed chronic active hepatitis in 2 and chronic persistent hepatitis in 3. During the acute NANB PTH phase the mean serum PIINP level rose significantly as compared to prehepatitis levels and to levels in a reference group not developing hepatitis. Neither PIIINP levels nor hyaluronan levels, however, could differentiate patients with resolving from patients with nonresolving hepatitis. These markers should, however, be further evaluated as potential markers for development of fibrosis/cirrhosis during chronic hepatitis.

Aged↗
PubMed1990

Prevalence of hepatitis B virus markers in Icelandic outpatients and hospital personnel in 1979 and in 1987.

The prevalence of hepatitis B virus (HBV) infections in Iceland was investigated in 619 outpatients and 72 hospital personnel in 1979 and in 445 outpatients and 284 hospital personnel in 1987 by anti-HBc testing. The overall prevalence of anti-HBc among outpatients remained almost unchanged and was 5.7% in 1979 and 5.4% in 1987. In 1987 the prevalence rate in outpatients increased significantly from 0% in persons less than 20 years to 9.8% in persons greater than 60 years (p = 0.008). Among hospital personnel tested in 1987 the prevalence rate also increased significantly with age from 4% in those 20-29 years of age to 26% in those greater than 60 years (p = 0.024). A significant increase of the prevalence rate with years of employment was, however, not found. Laboratory technicians with frequent blood contacts had a significantly higher prevalence rate than other health care workers and outpatients tested in 1987 (p less than 0.001). Laboratory technicians had an annual attack rate of HBV infection of 1.4% from 1979 to 1987. The results indicate that the prevalence of HBV infection in 1979 and 1987 has remained unchanged in the general population and that hospital personnel exposed to blood are at increased risk of getting HBV infection.

Age Factors↗
PubMed1989

Immunoglobulin isotypes of anti-HBc and anti-HBe and hepatitis B virus (HBV) DNA elimination in acute hepatitis B.

Antibodies to hepatitis B core antigen (anti-HBc) and e antigen (anti-HBe) were assayed in 46 sera from ten patients with acute hepatitis B utilizing immunoglobulin class- and subclass-specific enzyme immunoassays (EIAs). The sera were sampled 1 to 512 days after onset of hepatic symptoms. Four patients cleared HBsAg rapidly, within 24 days, and six patients cleared HBsAg slowly, within 27-74 days after the onset of symptoms. In three of the patients with rapid clearance of HBsAg, hepatitis B virus (HBV) DNA was not detected in sera tested during the first week after onset. The fourth patient was not tested until 12 days after onset and was then found to be negative for HBV DNA. In four of the patients with slow clearance of HBsAg, HBV DNA was present during the first week of illness. In the other two patients, HBV DNA was not detected in the first serum, 11 and 17 days after the onset of illness. Anti-HBc IgM and IgA1 were detected in all patients, with maximum titers shortly after onset. Anti-HBc IgG1 was present in all sera tested. Anti-HBc IgG2 was not detected in any of the sera. Anti-HBc IgG3 and IgG4 were detected in all patient sera, with IgG3 paralleling IgG1, and IgG4 mainly in sera long after onset. Anti-HBe IgG1, IgG3, and IgG4 were detected in three, two, and two patients, respectively. Anti-HBe IgG2, IgM, IgA1, or IgA2 was not found in any patient. The time required for maximum titer of anti-HBc IgG1 was shorter in the patients with rapid clearance of HBsAg.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Chronic non-A, non-B hepatitis developed after transfusions, illicit self-injections or sporadically. Outcome during long-term follow-up--a comparison.

Ninety-two patients with biopsy-proven chronic non-A, non-B hepatitis after blood transfusions, illicit self-injections or sporadically were followed clinically for an average of nearly 5 years. In the posttransfusion hepatitis group, which comprised 37 patients with a mean age of 54 years (range 18-83 years), 59% developed chronic active hepatitis (CAH) and 46% also showed signs of early cirrhosis (eCi) or manifest cirrhosis (Ci). In the illicit self-injection group, comprising 33 patients with a mean age of 26 years (range 17-63 years), 39% manifested CAH and 18% eCi or Ci. In the sporadic group, which consisted of 22 patients with a mean age of 32 years (range 16-62 years), 41% showed CAH and 23% eCi. Thus, in all, 44/92 (48%) of the patients with chronic non-A, non-B hepatitis developed CAH and 28/92 (30%) signs of early or manifest cirrhosis. Patients greater than or equal to 30 years of age displayed CAH and signs of cirrhosis more often than patients less than 30 years of age (p less than 0.01). Chronic non-A, non-B hepatitis is a slowly progressive disease with a high incidence of cirrhosis, especially in patients greater than or equal to 30 years of age and when caused by blood transfusion.

Adult↗
PubMed1989

A randomized controlled open study of interferon alpha-2b treatment of chronic non-A, non-B posttransfusion hepatitis: no correlation of outcome to presence of hepatitis C virus antibodies.

33 patients with biopsy-proven chronic non-A, non-B posttransfusion hepatitis (NANB PTH) were randomized 2:1 to treatment with interferon alpha-2b (Introna) or to controls. The treatment group received 3 MU interferon 3 times weekly subcutaneously for 36 weeks. 22/33 (67%) patients were reactive for antibodies against hepatitis C virus (anti-HCV). 11/19 (58%) treated patients versus none of the 12 controls had a complete response with normalization of serum alanine aminotransferase levels (p less than 0.001). Another 4/29 (21%) treated patients had a partial response which was also seen in 4/12 (33%) controls; 4 treated patients were nonresponders, all with chronic active hepatitis. Nonresponders had a significantly higher mean weight than responders (p less than 0.05) and tended to have a longer duration of their disease before therapy. During the 6-month follow-up period post treatment 4/11 (36%) complete responders had a sustained response and 7/11 (64%) relapsed. All who were retreated responded again. We conclude that a majority of patients with chronic NANB PTH will respond to 9 months interferon alpha-2b treatment, but that only 1 out of 3 will have a sustained response 6 months post treatment, and that the reactivity for anti-HCV was not correlated to the outcome of therapy.

Adult↗
PubMed1989

Interferon alpha-2b treatment of chronic posttransfusion non-A, non-B hepatitis: interim results of a randomized controlled open study.

32 patients with biopsy-proven chronic non-A, non-B posttransfusion hepatitis and raised aminotransferase levels since more than 1 year were randomized 2:1 to treatment with interferon alpha-2b, Introna, or to controls. The interferon group received 3 MU interferon 3 times weekly subcutaneously. Interim results 12 weeks after randomization showed that 14/21 (67%) patients in the treatment group had normalized their serum alanine aminotransferase levels whereas none of 11 patients in the control group had (p less than 0.001). If interferon alpha-2b is only suppressive during ongoing therapy or curative will be shown later during continued follow-up.

Adult↗