An analysis of acute changes in interleukin-6 levels after treatment of hepatitis C with consensus interferon.

Cytokine production has been implicated in the antiviral response to interferon-alpha (IFN-alpha) in hepatitis C and in the development of IFN-alpha-related side effects. We characterized acute changes in serum cytokine levels following administration of a single dose of consensus IFN (IFN-con1) and during continuous treatment of chronic hepatitis C patients. Serum samples were collected at baseline, at multiple times early after IFN administration, and weekly thereafter.

Patients' values for health states associated with hepatitis C and physicians' estimates of those values.

Objectives: Hepatitis C is the leading cause of chronic hepatitis in the United States. Little information is available regarding how persons with hepatitis C view health with their disease. We studied patients' perceptions about the value of hepatitis C health states and evaluated whether physicians understand their patients' perspectives about this disease.

Daily interferon therapy for hepatitis C virus infection in liver transplant recipients.

Background: Hepatitis C virus infection persists after liver transplantation and causes recurrent liver injury in the majority of patients. Standard dose interferon therapy has been largely unsuccessful for hepatitis C in transplant recipients.

Methods: Twelve patients, at least 7 months posttransplant, with detectable hepatitis C virus RNA in serum and features of hepatitis C on liver biopsy were randomized to interferon-alpha2a, 3 mU daily for 12 months (n=8) or no treatment (n=4).

Chronic hepatitis C virus patients with breakthroughs during interferon treatment can successfully be retreated with consensus interferon. The Consensus Interferon Study Group.

Patients with chronic hepatitis C who have not had a sustained hepatitis C virus (HCV)-RNA response or serum alanine transaminase (ALT) response to a 6-month course of interferon (IFN) may respond to higher dose retreatment with consensus interferon (CIFN). Some nonresponders to initial IFN treatment have a transient response defined as undetectable HCV RNA or normalization of ALT during treatment, but subsequently have a "breakthrough" while still on treatment. The aim of this study was to determine if nonresponders who had breakthroughs responded differently to CIFN retreatment than nonresponders without breakthroughs using data from a large, multicenter trial.

Transjugular intrahepatic portosystemic shunt (TIPS) for Budd-Chiari syndrome or portal vein thrombosis: review of indications and problems.

Objective: The aim of this study was to evaluate the role of transjugular intrahepatic portosystemic shunt (TIPS) in patients who present with portal vein thrombosis (PVT) or Budd-Chiari Syndrome (BCS).

Methods: Nine patients with recent PVT and four patients with BCS underwent TIPS. The diagnosis was confirmed by color Doppler ultrasound and by angiogram in most patients.

Relationship between biochemical and virological responses to interferon therapy in chronic hepatitis C infection. Consensus Interferon Study Group.

We have investigated the relationship between serum alanine aminotransferase (ALT) and hepatitis C virus (HCV) RNA in the assessment of responses to interferon (IFN) therapy in chronic HCV infection. Data from 704 patients with HCV infection who were randomized to receive consensus IFN-alpha (CIFN) 3 micrograms (n = 232 patients) or 9 micrograms (n = 232 patients), or IFN-alpha 2b 3 million units (MU) (n = 240 patients), were used for these analyses. All patients were treated three times weekly.

Transjugular intrahepatic portosystemic shunt in nonliver transplant candidates: is it indicated?

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is an effective treatment of severe portal hypertension complications. Liver transplantation (LT) candidacy has not been a prerequisite to TIPS placement in some medical centers.

Objectives: To investigate the outcome and survival of non-LT candidates after TIPS.

Large focal defect on liver/spleen scan caused by fatty liver and masquerading as neoplasm.

Focal fatty infiltration of the liver may be mistaken for metastatic disease, primary tumor or other space-occupying lesions on CT or ultrasound. Usually, a 99mTc-sulfur colloid scan is sensitive in documenting the presence of Kupffer's cell in such a process. We present a case that was suggestive of focal fatty infiltrate on a CT scan, nondiagnostic on ultrasound, and seen as a large focal defect on the 99mTc-sulfur colloid liver/spleen scan.

Trichosporon cholangitis associated with hyperbilirubinemia, and findings suggesting primary sclerosing cholangitis on endoscopic retrograde cholangiopancreatography.

Usually, ascending cholangitis is a bacterial process. However, in the debilitated or immunocompromised patient, mycotic cholangitis must be placed in the differential diagnosis. We report a patient with cryptogenic cirrhosis whose presenting problem in his terminal hospitalization was spontaneous bacterial peritonitis, for which he was treated with broad-spectrum antibiotics.

Hepatitis in marmosets: induction of disease with coded specimens from a human volunteer study.

Marmosets inoculated with plasma from three early acute hepatitis patients developed hepatitis 30 to 40 days later. Other groups of marmosets receiving preinfection plasmas from the same patients showed no evidence of hepatitis in this experiment. It is, therefore, most probable that hepatitis in marmosets represented transmission of human disease rather than activation of latent "marmoset hepatitis.