Latest & greatest articles for hepatitis

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Top results for hepatitis

1621. Hepatitis B vaccine in medical staff of hemodialysis units: efficacy and subtype cross-protection. (PubMed)

Hepatitis B vaccine in medical staff of hemodialysis units: efficacy and subtype cross-protection. We evaluated the efficacy of hepatitis B vaccine (Heptavax-B) containing only the ad subtype in a randomized, placebo-controlled, double-blind trial among 865 staff members of 43 hemodialysis units in the United States. Surface antibody developed in 92.6 per cent of the subjects after two doses of vaccine and in 96 per cent after the six-month booster. The incidence of infections with hepatitis B (...) virus (with or without hepatitis) was 9.9 per cent in placebo recipients and 2.2 per cent in vaccine recipients (P less than 0.01). The two cases of hepatitis B among vaccine recipients did not occur in subjects in whom antibody had developed. In 81 per cent of the hepatitis events, the virus was of the ay subtype. The indicence of ay virus was 8.2 per cent among placebo recipients and 1.2 per cent among vaccine recipients (P less than 0.005). We conclude that these data confirm the efficacy

1982 NEJM Controlled trial quality: uncertain

1622. Passive-active immunisation against hepatitis B: immunogenicity studies in adult Americans. (PubMed)

Passive-active immunisation against hepatitis B: immunogenicity studies in adult Americans. Three sex and age matched groups of medical personnel, 20-40 individuals in each, received a course of hepatitis B vaccine: in one group the first dose of vaccine was given a month after injection of hepatitis B immune globulin; in the second, vaccine and immune globulin were given simultaneously; and, in the third, vaccine was given alone. The passively acquired antibody did not interfere with an active (...) immune response to the vaccine. Both the timing of antibody appearance and the antibody titres were similar in the three groups, and the actively acquired antibody persisted for the 8 months of follow-up. Administration of the vaccine together with hepatitis B immune globulin will provide immediate protection, whereas people who receive vaccine alone may lack antibody for several months. This opens new possibilities for post-exposure prophylaxis.

1981 Lancet Controlled trial quality: uncertain

1623. Randomised placebo-controlled trial of hepatitis B surface antigen vaccine in french haemodialysis units: II, Haemodialysis patients. (PubMed)

Randomised placebo-controlled trial of hepatitis B surface antigen vaccine in french haemodialysis units: II, Haemodialysis patients. A vaccine against hepatitis B surface antigen (Institut Pasteur Production) was assessed in 138 haemodialysis patients in a placebo-controlled randomised double-blind trial. In an interim analysis, hepatitis B infections were observed in 21% of the vaccine group and 45% of the placebo group (p less than 0.02). 2 of the infections in the vaccine group and 12

1981 Lancet Controlled trial quality: predicted high

1624. Efficacy of hepatitis B vaccine in prevention of early HBsAg carrier state in children. Controlled trial in an endemic area (Senegal). (PubMed)

Efficacy of hepatitis B vaccine in prevention of early HBsAg carrier state in children. Controlled trial in an endemic area (Senegal). Three doses of inactivated hepatitis B vaccine were given at one-month intervals to Senegalese children aged less than two years. A control group received diphtheria/tetanus/polio vaccine. Of those HB vaccine recipients who were seronegative before immunisation, 94.5% had a specific anti-HBs response. Anti-HBs of maternal origin did not interfere with the active (...) immunisation. HB vaccine was without ill-effects, irrespective of hepatitis B marker status before immunisation. After twelve months' follow-up, the incidence of the HBsAg carrier state was reduced by 85% in susceptible children (p less than 0.0001).

1981 Lancet Controlled trial quality: uncertain

1625. Deleterious effect of prednisolone in HBsAg-positive chronic active hepatitis. (PubMed)

Deleterious effect of prednisolone in HBsAg-positive chronic active hepatitis. To study the efficacy of corticosteroids in chronic active hepatitis (CAH) positive for hepatitis B surface antigen (HBsAg), we pair-randomized 51 patients to receive either 15 to 20 mg of prednisolone per day or a placebo. After initial remission, the maintenance dosage of prednisolone was 10 mg per day, and the patients were prospectively followed for up to 3 1/2 years. Prednisolone decreased serum bilirubin (P

1981 NEJM Controlled trial quality: uncertain

1626. Randomised placebo-controlled trial of hepatitis B surface antigen vaccine in French haemodialysis units: I, Medical staff. (PubMed)

Randomised placebo-controlled trial of hepatitis B surface antigen vaccine in French haemodialysis units: I, Medical staff. A vaccine against hepatitis B surface antigen (Institut Pasteur Production) was assessed in staff members from forty-eight French haemodialysis units where the risk of hepatitis B was high. Of 318 subjects who completed the protocol, 164 received three monthly injections of vaccine and 154 received corresponding injections of placebo. Hepatitis B infection was observed

1981 Lancet Controlled trial quality: uncertain

1627. Serum levels of hepatitis B surface and core antigens during immunosuppressive treatment of HBsAg-positive chronic active hepatitis. (PubMed)

Serum levels of hepatitis B surface and core antigens during immunosuppressive treatment of HBsAg-positive chronic active hepatitis. One of the following treatments was randomly assigned to 101 consecutive patients with biopsy-proven chronic active hepatitis: prednisone 20 mg daily, azathioprine 100 mg daily, prednisone 20 mg and azathioprine 50 mg daily, or B vitamins 2 tablets daily (control group). Patients were observed at the beginning of the study, then at 2, 6, and 12 months after (...) of the study, this antigen became persistently detectable in 40% of the 42 patients who were treated, and was transiently present in 2 (12%) out of the 17 untreated patients (p < 0.05). Our data indicate that long-term prednisone and/or azathioprine treatments favour the replication of hepatitis-B virus in patients with HBsAg-positive chronic active hepatitis.

1980 Lancet Controlled trial quality: uncertain

1628. Hepatitis B vaccine: demonstration of efficacy in a controlled clinical trial in a high-risk population in the United States. (PubMed)

Hepatitis B vaccine: demonstration of efficacy in a controlled clinical trial in a high-risk population in the United States. We assessed the efficacy of an inactivated hepatitis B vaccine in a placebo-controlled, randomized, double-blind trial in 1083 homosexual men known to be at high risk for hepatitis B virus infection. The vaccine was found to be safe and the incidence of side effects was low. Within two months, 77% of the vaccinated persons had high levels of antibody against (...) the hepatitis B surface antigen. This rate increased to 96% after the booster dose and remained essentially unchanged for the duration of the trial. For the first 18 months of follow-up, hepatitis B or subclinical infection developed in only 1.4 to 3.4% of the vaccine recipients as compared with 18 to 27% of placebo recipients (P < 0.0001). The reduction of incidence in the vaccinees was as high as 92.3%; none of the vaccinees with a detectable immune response to the vaccine had clinical hepatitis B

1980 NEJM Controlled trial quality: predicted high

1629. Hepatitis B vaccine: immune responses in haemodialysis patients. (PubMed)

Hepatitis B vaccine: immune responses in haemodialysis patients. Antibody to hepatitis B surface antigen (anti-HBs) developed within six months in 80% of haemodialysis patients given either two or three 40 micrograms doses of hepatitis B vaccine. A total of 89% had anti-HBs after a booster dose given six months later. Anti-HBs titres were higher in patients who received three initial doses than in those who received only two doses, but the proportion of anti-HBs-positive patients was the same

1980 Lancet Controlled trial quality: uncertain

1630. Aminoacid therapy of alcoholic hepatitis. (PubMed)

Aminoacid therapy of alcoholic hepatitis. 35 consecutive patients with alcoholic hepatitis were randomly allocated to control (18 patients) and study (17 patients) groups. All patients were offered a 3000 kcal 100 g protein diet and were studied for 28 days. The study group received 70-85 g of intravenous aminoacids daily in the form of 'Aminosyn' or 'Travasol'. Both groups had similar clinical and biochemical features at the time of randomisation. Ascites and encephalopathy tended to improve (...) more in the study group. Serum concentrations of bilirubin (p < 0.01) and albumin (p < 0.025) improved in the study but not in the control group. 4 patients died in the control group, but none died in the study group. Intravenous therapy with aminoacid for 4 weeks seemed to be associated with lower mortality rate (p < 0.02) and improved serum bilirubin and albumin concentrations in patients with alcoholic hepatitis.

1980 Lancet Controlled trial quality: uncertain

1631. Double-blind study of leucocyte interferon administration in chronic HBsAg-positive hepatitis. (PubMed)

Double-blind study of leucocyte interferon administration in chronic HBsAg-positive hepatitis. In a double-blind study human leucocyte interferon was given for six weeks to 8 of 16 patients with chronic HBsAg-positive hepatitis. In the first week 12 x 10(6) reference units were administered daily, and thereafter the dose was halved every week. During the first two weeks leucopenia was observed in 6 of the 8 interferon-treated patients. Apart from a drop in DNA-polymerase activity in the first (...) week, no effect was found on indices of hepatitis-B-virus infection.

1980 Lancet Controlled trial quality: uncertain

1632. Type B hepatitis after transfusion with blood containing antibody to hepatitis B core antigen. (PubMed)

Type B hepatitis after transfusion with blood containing antibody to hepatitis B core antigen. We tested the hypothesis that donor blood containing antibody to hepatitis B core antigen (anti-HBc) but lacking detectable hepatitis B surface antigen (HBsAg) and antibody (anti-HBs)might transmit Type B hepatitis by examining donor and recipient serums from a Veterans Administration study of post-transfusion hepatitis. Donor blood was available from three patients with Type B hepatitis and from one (...) patient with hepatitis B virus infection (development of anti-HBs and anti-HBc) without symptomatic disease. All four had received 1 unit of blood with high titer of anti-HBc but lacking HBsAg and anti-HBs. In contrast, no such units had been transfused into nine patients with "immunization-like" response (development of anti-HBs without anti-HBc) or into 26 control patients. These data stress the importance of anti-HBc as an indicator of hepatitis B virus infection and support the hypothesis

1978 NEJM Controlled trial quality: uncertain

1633. H2-receptor antagonists and antacids in the prevention of acute gastrointestinal haemorrhage in fulminant hepatic failure. Two controlled trials. (PubMed)

H2-receptor antagonists and antacids in the prevention of acute gastrointestinal haemorrhage in fulminant hepatic failure. Two controlled trials. In two controlled trials, involving 75 patients, on the prevention of bleeding from gastric erosions in fulminant hepatic failure, antacids given four-hourly had no significant effect. Only 35% of intragastric pH recordings taken at two-hourly intervals in the treated group were maintained above 5 with the doses used, whereas this could

1977 Lancet Controlled trial quality: uncertain

1634. Treatment of acute viral hepatitis with (+)-cyanidanol-3. (PubMed)

Treatment of acute viral hepatitis with (+)-cyanidanol-3. A double-blind trial of (+)-cyanidanol-3 (2 g/day) versus placebo tablets was carried out in 100 patients with acute viral hepatitis. 51 received the drug and 49 placebo. (+)-Cyanidanol-3 accelerated the disappearance of HBsAg from the blood, lowered serum-bilirubin, and relieved symptoms such as anorexia, nausea, and pruritus. The drug was well tolerated. None of the patients had a relapse of acute hepatitis. Chronic active hepatitis (...) developed in 1 of the placebo-treated patients. Thus, (+)-cyanidanol-3 seems to be of benefit in acute viral hepatitis.

1977 Lancet

1635. Steroid therapy in severe viral hepatitis. A double-blind, randomized trial of methyl-prednisolone versus placebo. (PubMed)

Steroid therapy in severe viral hepatitis. A double-blind, randomized trial of methyl-prednisolone versus placebo. The efficacy of corticosteroid therapy in severe viral hepatitis has never been demonstrated in a controlled clinical trial. For this reason, patients with severe viral hepatitis were randomly assigned to methyl-prednisolone or placebo treatment groups. The two groups were comparable in clinical findings, laboratory results and the presence of bridging necrosis on liver biopsy (...) . Seven of the 14 patients assigned to methyl-prednisolone and two of the 15 assigned to placebo died during the 16-week study period. Although the apparent excess mortality in the steroid-treated patients is not quite statistically significant (P = 0.08), the trend persists when only patients positive for hepatitis B surface antigen (P = 0.04) are analyzed separately. Methyl-prednisolone does not enhance survival in patients with severe viral hepatitis, and it may be detrimental.

1976 NEJM Controlled trial quality: uncertain

1636. Efficacy of prophylactic gamma-globulin in preventing non-A, non-B post-transfusion hepatitis. (PubMed)

Efficacy of prophylactic gamma-globulin in preventing non-A, non-B post-transfusion hepatitis. Of 279 cardiac-surgery patients receiving a mean of twelve transfusions, 47 had significantly increased transaminase concentrations 14 to 180 days postoperatively and 10 were icteric. Preoperatively, each patient randomly received high-titre HbsAb gamma-globulin, normal gamma-globulin, or placebo and was followed at intervals for 9 months. Only 3 patients had serological evidence of hepatitis-B (...) infection. 3 additional patients had serological evidence of cytomegalovirus infection, while none had evidence of hepatitis-A or Epstein-Barr infection. Less icteric hepatitis occurred in patients receiving the gamma-globulin preparations (P = 0-003), and the overall frequency of hepatitis was significantly reduced when compared with recipients of placebo. The protective effects of the two gamma-globulin preparations were not significantly different. Most post-transfusion hepatitis tody is neither

1976 Lancet

1637. Hepatitis B "immune" globulin: effectiveness in prevention of dialysis-associated hepatitis. (PubMed)

Hepatitis B "immune" globulin: effectiveness in prevention of dialysis-associated hepatitis. A randomized, double-blind, multicenter study of hepatitis prevention by immune serum globulin with high anti-HBs titer ("hepatitis B immune globulin") was carried out among 318 new patients and 296 staff members of renal dialysis units. Three milliliters of high titer globulin, repeated at four months, was compared with equal doses of intermediate or normal titer globulin. Among staff members (...) , the cumulative percentages developing hepatitis or HBs Ag, or both, within eight months were 6.9, 11.7, and 11.1 in the high, intermediate, and normal titer groups respectively. The lower incidence associated with high titer globulin was not significant (P greater than 0.05). However, among the patients the respective percentages were 7.9, 21.3, and 23.1 and the lower incidence in the high titer globulin group was significant.

1975 NEJM Controlled trial quality: uncertain

1638. Hepatitis B immune globulin--prevention of hepatitis from accidental exposure among medical personnel. (PubMed)

Hepatitis B immune globulin--prevention of hepatitis from accidental exposure among medical personnel. The role of anti-HBs antibody in reducing the probability of hepatitis after accidental exposure to serum from patients with hepatitis or carriers of HBs Ag was studied prospectively among 712 medical workers. One fourth of the workers were anti-HBs positive and less than one per cent of them developed hepatitis, in contrast to 11 per cent among those who were anti-HBs negative. Three coded (...) immune-serum globulin preparations of varying anti-HBs titer were randomly assigned. Among 251 persons passively immunized with globulin having a conventionally low anti-HBs titer, hepatitis developed in 17 (seven per cent) within six months. Comparative rates among those receiving intermediately high titer and high titer globulin, respectively, were five per cent (11 of 208) and two per cent (5 of 253). The significantly lower incidence among the latter (P less than 0.05) was offset by six

1975 NEJM Controlled trial quality: uncertain

1639. Efficacy of hepatitis B immune serum globulin after accidental exposure. Preliminary report of the Veterans Administration Cooperative Study. (PubMed)

Efficacy of hepatitis B immune serum globulin after accidental exposure. Preliminary report of the Veterans Administration Cooperative Study. A randomised, double-blind, controlled trial has been undertaken to compare the efficacy of hepatitis B immune globulin (H.B.I.G.) with that of immune serum globulin (I.S.G.) for the prophylaxis of viral hepatitis. Participants in the trial were individuals exposed accidentally to material infectious for hepatitis (primarily viral B hepatitis (...) ). Preliminary evaluation of the first 302 of the 561 individuals entered into the study indicates that H.B.I.G. significantly reduced the frequencies of both clinical and subclinical hepatitis during the first 3--4 months after the injection. Less than 10% of H.B.I.G. recipients had detectable anti-HBs at the sixth month after the injection, suggesting that H.B.I.G. might need to be given every 3--4 months to continually exposed individuals. Further long-term evaluation is required in order to define more

1975 Lancet

1640. Hepatitis-B immunoglobulin in prevention of HBs antigenaemia in haemodialysis patients. (PubMed)

Hepatitis-B immunoglobulin in prevention of HBs antigenaemia in haemodialysis patients. In a double-blind study, hepatitis-B immunoglobulin significantly protected patients in a haemodialysis unit against the development of HBs antigenaemia, compared to control patients receiving normal human immunoglobulin (p less than 0-01). Injections were given at the beginning and after 6 months, and observations extended over 16 months. Analysis of antiHBc and anti-HBs antibodies suggested

1975 Lancet