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381 results on '"Alter, H. J."'

20. The natural history of acute hepatitis C: clinical presentation, laboratory findings, and treatment outcomes

Author

Loomba, R., Rivera, M. M., McBurney, R., Park, Y., Haynes-Williams, V., Rehermann, B., Alter, H. J., Herrine, S. K., Liang, T. J., Hoofnagle, J. H., and Heller, T.

Subjects
Adult, Male, Time Factors, Interferon-alpha, Interferon alpha-2, Middle Aged, Antiviral Agents, Hepatitis C, Severity of Illness Index, Article, Recombinant Proteins, Young Adult, Treatment Outcome, Acute Disease, Ribavirin, Disease Progression, Humans, Drug Therapy, Combination, Female, Aged
Abstract

Acute hepatitis C has variable modes of presentation and frequently results in chronic infection. Its optimal management has yet to be defined.To establish natural history and complications of treatment of acute hepatitis C.Data from all patients presenting with acute hepatitis C to the National Institutes of Health between 1994 and 2007 were reviewed.Twenty-five patients were identified. Symptoms were reported by 80% and jaundice by 40%. Aminotransferase levels and hepatitis C virus (HCV) RNA levels fluctuated greatly; 18% of patients were intermittently negative for HCV RNA. Five patients recovered spontaneously whereas 20 developed chronicity or received interferon-based therapy during the acute phase. Among 15 patients treated during the acute phase with peginterferon with or without ribavirin for 24 weeks, all became HCV RNA negative within 4-8 weeks, and all except two (HIV-positive) achieved a sustained virological response. Side effects (particularly psychiatric) were common and limited treatment in 30%.Among 25 patients with acute HCV infection, fluctuating illness was common and spontaneous recovery occurred in only 20%. Anti-viral treatment with a 24-week course of peginterferon and ribavirin was highly effective, but marked by frequent and severe side effects.

Published
2010

24. Type B Hepatitis after Needle-Stick Exposure: Prevention with Hepatitis B Immune Globulin: Final Report of the Veterans Administration Cooperative Study

Author

SEEFF, L. B., WRIGHT, E. C., ZIMMERMAN, H. J., ALTER, H. J., DIETZ, A. A., FELSHER, B. F., FINKELSTEIN, J. D., GARCIA-PONT, P., GERIN, J. L., GREENLEE, H. B., HAMILTON, J., HOLLAND, P. V., KAPLAN, P. M., KIERNAN, T., KOFF, R. S., LEEVY, C. M., McAULIFFE, V. J., NATH, N., PURCELL, R. H., SCHIFF, E. R., SCHWARTZ, C. C., TAMBURRO, C. H., VLAHCEVIC, Z., ZEMEL, R., and ZIMMON, D. S.

Published
1978
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31. Hepatitis C in asymptomatic blood donors

Author

Alter, H J, primary, Conry-Cantilena, C, additional, Melpolder, J, additional, Tan, D, additional, Van Raden, Mark, additional, Herion, D, additional, Lau, D, additional, and Hoofnagle, J H, additional

Published
1997
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32. Humoral immune response to the E2 protein of hepatitis G virus is associated with long-term recovery from infection and reveals a high frequency of hepatitis G virus exposure among healthy blood donors

Author

Tacke, M, primary, Schmolke, S, additional, Schlueter, V, additional, Sauleda, S, additional, Esteban, J I, additional, Tanaka, E, additional, Kiyosawa, K, additional, Alter, H J, additional, Schmitt, U, additional, Hess, G, additional, Ofenloch-Haehnle, B, additional, and Engel, A M, additional

Published
1997
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49. Stability of HCV-RNA level and its lack of correlation with disease severity in asymptomatic chronic hepatitis C virus carriers.

Author

Harvey J. Alter, Dr, Yeo, A. E. T., Ghany, M., Conry-Cantilena, C., Melpolder, J. C., Kleiner, D. E., Shih, J. W. K., Hoofnagle, J. H., and Alter, H. J.

Subjects
HEPATITIS C virus, INFECTIOUS disease transmission, LIVER diseases
Abstract

This study examines the relationship between HCV-RNA levels and disease severity in 60 individuals with chronic hepatitis C virus infection. HCV-RNA levels were quantified by the branched DNA (bDNA) assay in 445 samples (median: eight samples per patient) obtained over a median of 40.4 months (95% confidence interval (CI): 37.0–42.5). The median log HCV-RNA level was 6.77 (95% CI: 6.62–6.92) molecular equivalents/mL (MEQ/mL). The median log range of HCV-RNA levels in individual patients over the course of the study was 0.89 (95% CI: 0.69–1.16). HCV-RNA level varied over time by less than one log in 62% of patients, by 1–1.5 logs in 22% and by greater than 1.5 logs in only 17%. Univariate analysis, revealed an inverse association between HCV-RNA levels and ALT levels (P=0.037). Univariate and logistic regression analysis showed no significant association between HCV-RNA levels and either the degree of inflammation or fibrosis. In contrast, there was a significant positive association between alanine aminotransferase (ALT) levels and histological activity especially in individuals with ALTs> 100 IU/L. Hence, HCV-RNA levels: (i) almost always fell within the dynamic range of the bDNA assay; (ii) were stable in asymptomatic chronically infected patients, with only a small proportion of patients exceeding a range of 1.5 logs; (iii) did not correlate with either the extent of inflammation or degree of fibrosis. In contrast, there was a strong association between ALT level and the histological severity of liver disease. [ABSTRACT FROM AUTHOR]

Published
2001
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50. The relationship of acute transfusion-associated hepatitis to the development of cirrhosis in the presence of alcohol abuse.

Author

Harris, D. Robert, Gonin, Rene, Alter, Harvey J., Wright, Elizabeth C, Buskell, Zelma J., Hollinger, F. Blaine, Seeff, Leonard B., Harris, D R, Gonin, R, Alter, H J, Wright, E C, Buskell, Z J, Hollinger, F B, Seeff, L B, and National Heart, Lung, and Blood Institute Study Group

Subjects
HEPATITIS C, CIRRHOSIS of the liver, ALCOHOLISM, COMPLICATIONS of alcoholism, ALCOHOLIC liver diseases, BLOOD transfusion reaction, COMPARATIVE studies, LONGITUDINAL method, RESEARCH methodology, MEDICAL cooperation, RESEARCH, LOGISTIC regression analysis, EVALUATION research, RETROSPECTIVE studies, CASE-control method, DISEASE progression, DISEASE complications
Abstract

Background: Although concomitant alcoholism is widely believed to enhance liver disease progression in persons with hepatitis C virus (HCV) infection, this relationship has not been well quantified.Objective: To quantify the relationship of transfusion-associated HCV infection and history of heavy alcohol abuse to development of cirrhosis.Design: Retrospective cohort study.Setting: Liver clinics in university and government hospitals.Patients: Extended follow-up of 1030 patients in prospective investigations of transfusion-associated viral hepatitis conducted in the United States between 1968 and 1980.Measurements: Development of cirrhosis and history of heavy alcohol abuse were determined from review of interviews with patients or their proxies, medical records, death certificates, and autopsy and biopsy reports. Logistic regression was used to estimate the risk for cirrhosis associated with transfusion-associated HCV infection and history of heavy alcohol abuse.Results: The absolute risk for cirrhosis was 17% among patients with transfusion-associated HCV; 3.2% among patients with transfusion-associated non-A, non-B, non-C hepatitis; and 2.8% among controls. Patients with transfusion-associated HCV were more likely than controls to develop cirrhosis (odds ratio, 7.8 [95% CI, 4.0 to 15.1]). A history of heavy alcohol abuse was associated with a fourfold increased risk for cirrhosis. Hepatitis C virus infection plus a history of heavy alcohol abuse led to a substantial increase in risk for cirrhosis (odds ratio, 31.1 [CI, 11.4 to 84.5]) compared with controls without such a history.Conclusions: Heavy alcohol abuse greatly exacerbates the risk for cirrhosis among patients with HCV infection. This finding emphasizes the need to counsel such patients about their drinking habits. [ABSTRACT FROM AUTHOR]

Published
2001

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