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Biomedical subjects

A Hatzakis

Publications and source records attributed to A Hatzakis.

At least 91 records · Page 5Linked to original sources
PubMed1993

Recombinant human interferon alfa-2b treatment for acute non-A, non-B hepatitis.

To assess the safety and possible efficacy of recombinant human interferon alfa-2b in preventing the development of chronic hepatitis, 24 adults (eight men, 16 women) with acute non-A, non-B (NANB) hepatitis were recruited to a pilot study. Half of the cases were parenterally transmitted and half were community acquired. Twelve patients received 3 million units (MU) interferon three times weekly subcutaneously for six weeks and the remaining 12 patients received no treatment. Anti-hepatitis C virus (HCV) was detected in 14 (58.3%) of the 24 patients. The alanine aminotransferase activity returned to normal in nine of 12 interferon alfa-2b treated patients and six of 12 controls by week 52. Interferon alfa-2b was well tolerated, even in jaundiced patients, who only complained of mild flu like syndrome during the first week of treatment. These data are consistent with the hypothesis that interferon alfa-2b may help prevent progression to chronic hepatitis (interferon alfa-2b 25% v controls 50%), particularly in anti-HCV negative cases (interferon alfa-2b none of six v controls two of four). A randomised, double blind placebo-controlled trial is required, however, to substantiate these results further.

Acute Disease↗
PubMed1993

Hepatitis C virus infection among Greek renal transplant patients.

In this study, the prevalence of hepatitis C virus (HCV) infection among renal transplant recipients was high, directly proportional to the haemodialysis time before transplant and inversely proportional to the time after this. There was evidence of previous infection with hepatitis B virus (HBV), and a high prevalence of abnormal liver function tests. Virus induced chronic hepatitis lesions were rare, probably as a result of immunosuppression.

Female↗
PubMed1992

Association between hepatitis C virus and hepatocellular carcinoma using assays based on structural and nonstructural hepatitis C virus peptides.

Stored sera from 181 Greek patients with hepatocellular carcinoma (HCC), 35 patients with metastatic liver cancer, and 416 hospital controls with diagnoses other than malignant neoplasm or liver disease were examined with first and second generation hepatitis C virus (HCV) enzyme immunoassays as well as with five HCV supplemental assays based on structural and nonstructural HCV peptides. Second generation HCV enzyme immunoassays were more sensitive than first generation assays. However, both assays had suboptimal specificity using the standard reactivity criterion (absorbance of sample to cutoff greater than or equal to 1.0). Specificity was improved by centrifugation and by using a sample's optical density to cutoff ratio greater than or equal to 3.0 or supplemental assays; in this instance the prevalence of antibodies to HCV was 13.3% (24 of 181), 0 (0 of 35), and 1.4% (6 of 416) in HCC, metastatic liver cancer, and hospital controls, respectively. A similar estimation of prevalence of antibody to HCV in HCC (12.5% or 4 of 32) was obtained when the recombinant immunoblot assay, second generation, was used to screen a random sample of HCC patients. The relative risk linking HCV to HCC was estimated as 10.4 (95% confidence interval, 4.2-26.0; P less than 0.0001). These data suggest that the prevalence of antibodies to HCV in HCC using stored sera has been previously overestimated even though the evidence of a causal association of HCV with HCC persists.

Carcinoma, Hepatocellular↗
PubMed1992

Incidence of lymphomas and other cancers in HIV-infected and HIV-uninfected patients with hemophilia.

OBJECTIVE: To determine the types and rates of cancers occurring in excess in the presence of infection with the human immunodeficiency virus type 1 (HIV-1). DESIGN: Cohort analytic study of HIV-infected and HIV-uninfected subjects followed for up to 12 years. SETTING: Fifteen hemophilia treatment centers. PATIENTS: A total of 1701 patients with hemophilia, of whom 1065 (63%) were HIV-1 seropositive. MAIN OUTCOME MEASURES: Morphologic classification and incidence rates of cancers. MAIN RESULTS: The incidence of non-Hodgkin's lymphoma after HIV seroconversion averaged 0.15 case per 100 person-years (95% confidence interval [CI], 0.08 to 0.25) and rose exponentially with increasing duration of HIV infection. Although the greatest absolute risk of lymphoma was in the oldest age group, the relative increase compared with general population rates was 38-fold in subjects 10 to 39 years old and 12-fold in older subjects (P less than .05). The CD4+ T-lymphocyte levels for lymphoma cases were similar to HIV-positive subjects without the acquired immunodeficiency syndrome (AIDS) who had been infected for the same length of time. The incidence of Kaposi's sarcoma was increased 200-fold (95% CI, 20 to 700). The incidence of cancers other than non-Hodgkin's lymphoma and Kaposi's sarcoma were not increased in the HIV-positive subjects (ratio of observed to expected cases, 0.9 [95% CI, 0.4 to 1.9]). The HIV-negative subjects had no significant increase in cancer incidence. CONCLUSIONS: HIV infection has restricted effects on cancer incidence that are only partly explained by immunosuppression. Paradoxically, improvements in therapy of HIV infection that prolong survival may lead to further increases in HIV-associated lymphoma.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Antibodies against hepatitis C virus among renal transplant patients in Greece.

To evaluate the prevalence of hepatitis C virus (HCV) infection in Greek renal transplant (RT) patients and its association with abnormal liver function tests (LFTs), serum anti-HCV was determined (Ortho-ELISA test system) in 206 RT and 245 haemodialysis patients (HD) as controls. The prevalence (10.2%) of anti-HCV in RT patients was significantly higher (P < 0.0001) than in the Greek general population (0.7%) and lower (P < 0.0001) than in the HD patients (23.8%), and was not related to the patients' age, post-transplant time or pre-transplant HD time. None of the anti-HCV RT patients was HBsAg+, whereas 13 (62%) and 12 (57%) of them were anti-HBsAg+ and anti-HBc+, respectively. The incidence of abnormal LFTs in anti-HCV+ HBsAg- and anti-HCV- HBsAg+ RT patients was similar. Our findings indicate that: (a) the prevalence of serum anti-HCV in the Greek RT population is high, although considerably lower than in HD pts; (b) anti-HCV+ RT patients have a high incidence of abnormal LFTs, comparable to that seen in HBsAg+ RT patients; and (c) in a substantial proportion of anti-HCV+ RT patients there is evidence of previous HBV infection.

Adolescent↗
PubMed1992

Role of hepatitis C virus in acute non-A, non-B hepatitis in Greece: a 5-year prospective study.

The prevalence of hepatitis C virus (HCV) infection in 182 prospectively followed adult patients (110 males, 72 females) with acute non-A, non-B hepatitis and its correlation with progression to chronic hepatitis were studied. These patients were followed for a mean of 24.7 +/- 13.1 (range, 6-57) months. By using a specific enzyme immunoassay for the detection of antibodies against C100-3 polypeptide of HCV, 96 (52.7%) were found antibody positive. HCV was implicated in 64/89 (71.9%) of the cases with classical parenteral exposure but only in 18/64 (28.1%) of the community-acquired cases. Progression to chronic hepatitis was observed more frequently in antibody-positive than in antibody-negative cases (60/96 or 62.5% vs. 27/86 or 31.4%, P = 0.00002). Progression was also observed more often in males than in females (66/112 or 58.9% vs. 21/70 or 30.0% P = 0.0001), both in the antibody positive (48/68 or 70.6% vs. 12/28 or 42.9%, P = 0.01) and in the antibody negative (18/44 or 40.9% vs. 9/42 or 21.4%, P = 0.043) cases. These data indicate that (a) acute hepatitis due to HCV is characterized by a high rate of chronicity, especially in males, and (b) a non-A, non-B, non-C agent or a different strain of HCV may be responsible for the majority of the community-acquired cases of non-A, non-B hepatitis in Greece.

Acute Disease↗
PubMed1992

Antibody responses to hepatitis C virus by second-generation immunoassays in a cohort of patients with bleeding disorders.

The antibody responses and the prevalence patterns of antibodies to hepatitis C virus (anti-HCV) in a cohort of patients (n = 210) with bleeding disorders were studied using a first-generation and a second-generation enzyme immunoassays (EIA-1, EIA-2) as well as a second-generation recombinant immunoblot assay (RIBA-2). The anti-HCV prevalence as determined by EIA-1 and EIA-2 was 183/210 (87.1%) and 197/210 (93.8%), respectively (p = 0.0026). None of the 17 EIA-2(+)/EIA-1(-) samples was scored nonreactive by RIBA-2. At follow-up, samples of 123 patients were tested. Twenty-nine out of 111 patients reactive by EIA-1 seroreverted according to EIA-1 while the seroreversion rate with EIA-2 was 0 out of the 121 (p < 10(-8)). The anti-HCV prevalence by EIA-2 was 150/154 (97.4%) in anti-HIV-1-positive individuals and 47/56 (83.9%) in the anti-HIV-1-negative ones (p = 0.001). However, high assay signals (OD 492 nm > 2.0) were observed in 94/150 (62.7%) and 45/47 (95.7%) of the anti-HIV-1-positive and -negative patients, respectively (p = 10(-5)). The decreasing anti-HCV reactivity among anti-HIV-1-positive individuals was mainly due to diminishing c33c reactivity. Seroconversion to anti-HCV was observed in 3/7 (42.9%) cases with acute icteric non-A, non-B hepatitis by both EIA-1 and EIA-2, while the remaining 4 cases had detectable levels of anti-HCV 1-18 months before the acute episode.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Heterosexual co-transmission of hepatitis C virus (HCV) and human immunodeficiency virus (HIV).

OBJECTIVES: To determine the prevalence of antibodies to hepatitis C virus (HCV) in female sexual partners of multitransfused men with hemophilia and to compare the frequency of transmission of HCV and human immunodeficiency virus (HIV). STUDY DESIGN: Cross-sectional measurement of HCV and HIV antibodies. SETTING: Ten hemophilia treatment centers. PATIENTS: A total of 234 female sexual partners of 231 multitransfused men with hemophilia. MEASUREMENTS AND MAIN RESULTS: The prevalence of antibodies to HCV (anti-HCV) among female sexual partners of HCV-positive men was 5 of 194 (2.6%). Anti-HIV prevalence among female sexual partners of HIV-positive men was 25 of 196 (12.8%). Five (3%) of the 164 female sexual partners of HIV-positive/HCV-positive men were infected with HCV compared with none of the 30 female sexual partners of HIV-negative/HCV-positive men. Twenty-one (13%) of the 164 female sexual partners of HIV-positive/HCV-positive men were infected with HIV compared with 4 (13%) of 32 female sexual partners of HIV-positive/HCV-indeterminate men. The co-infected men were five times more likely to transmit both viruses than would be expected by chance (P = 0.01). When a single virus was transmitted to a female sexual partner, it was more often HIV than HCV (18 of 164 compared with 2 of 164, P = 0.001; odds ratio, 8.5; 95% Cl, 2.2 to 33.1). CONCLUSIONS: The higher prevalence of HCV in female sexual partners of men with hemophilia than in blood donor and other low-risk groups suggests that there is a low level of sexual transmission. Male to female sexual transmission of HCV is less efficient than that of HIV. The frequency of HCV transmission to sexual partners is five times higher when HIV is also transmitted, suggesting that HIV may be a cofactor for the sexual transmission of HCV.

Adult↗
PubMed1991

Hepatitis B and C viruses and their interaction in the origin of hepatocellular carcinoma.

Serum taken from patients in a case-control study in Athens, Greece, was used to examine the interactive roles of hepatitis B virus (HBV) and hepatitis C virus (HCV) in the origin of hepatocellular carcinoma (HCC). An enzyme immunoassay for anti-HCV was used to test serum taken from 185 cases with HCC, 35 cases with metastatic liver cancer (MLC), and 432 hospital controls. Weakly positive anti-HCV results were more strongly related to MLC than to HCC, implying that these anti-HCV results are false positive. By contrast, strongly positive anti-HCV results were significantly related to HCC (relative risk [RR], 6.3), whereas no significant association was evident for MLC (RR, 0.6). The association of anti-HCV with HCC was substantially higher among subjects whose radioimmunoassay was positive for hepatitis B surface antigen (RR, 20.0) than among those whose radioimmunoassay was negative for this marker (RR, 4.8). These findings indicate that HCV infection has an interactive role in the origin of HCC.

Aged↗
PubMed1991

Cost-effectiveness of hepatitis-B vaccine in Greece. A country of intermediate HBV endemicity.

We evaluated the cost-effectiveness of (a) a vaccination program for the prevention of hepatitis B; and (b) the two commercially available vaccines (Merck Sharp and Dohme; Pasteur Institute) in Greece, a country of intermediate endemicity. We examined cases of hepatitis-B infection prevented and the expected medical costs among the high-risk groups of medical and nursing students, hospital personnel, and the general population. Employing a vaccination program reduces considerably the risk of infection, especially in the high-risk groups, while it increases the total cost. The vaccines are very comparable in terms of both health and economic outcomes. Sensitivity analysis indicated that vaccine cost, incidence of hepatitis B, and compliance were the key factors for the choice of (a) whether to undertake an extensive program to prevent hepatitis-B infection and its chronic sequelae; and (b) which vaccine to administer.

Adult↗
PubMed1991

Neuropsychological assessment of HIV-seropositive haemophiliacs.

Neuropsychological findings from investigation of 46 HIV-seropositive asymptomatic and 14 HIV-seropositive symptomatic haemophiliacs without AIDS-related complex (ARC) or AIDS, with known duration of HIV seropositivity were compared with 29 seronegative controls. Subjects were assessed blindly using a battery of sensitive computerized neuropsychological tests. They underwent a thorough neurological examination, were assessed for mood and screened for psychopathology. Symptomatic HIV-positive haemophiliacs without ARC or AIDS showed statistically significant decreased performances compared with HIV-negatives in choice reaction, visuomotor coordination and global attentional performance (P = 0.018, 0.039 and 0.044, respectively). HIV-positive asymptomatic subjects gave lower performances than HIV-negative subjects in all tests, although these differences were not statistically significant. However, there was a statistically significant trend for these findings between seronegative, asymptomatic and symptomatic groups. Impairment was not associated with mood factors. Duration of seropositivity was found to be a more important factor than Centers for Disease Control stage in the choice reaction test (P less than 0.01). These findings indicate that mild cognitive impairment observed during the natural history of HIV infection in haemophiliacs without ARC or AIDS may be a progressive phenomenon not necessarily associated with the clinical expression of HIV infection.

Anxiety Disorders↗
PubMed1990

The effect of involuntary smoking on the occurrence of chronic obstructive pulmonary disease.

One hundred and three ever-married women with newly diagnosed Chronic Obstructive Pulmonary Disease (COPD), who have never smoked, and 179 ever-married women who were visiting friends or relatives at the same hospital during the same period and have never smoked, were interviewed regarding the smoking habits of their husbands. There was statistically marginally significant difference between the COPD cases and the controls with respect to their husband's smoking habits. The association was irregular with respect to daily number of cigarettes smoked but there was a smooth dose response curve with respect to life long total number of cigarettes smoked, with women whose husband smoked more than 300 thousand cigarettes having a relative risk of 1.8 (90% confidence interval of 0.9-3.6) compared to women whose husband has never smoked. These findings, and converging related evidence, indicate that exposure to environmental tobacco smoke may be a risk factor for the development of COPD.

Adult↗
PubMed1990

Endemic Kaposi's sarcoma in human immunodeficiency virus type 1-seronegative persons: demonstration of retrovirus-like particles in cutaneous lesions.

In 1984, Greek physicians reported on the clustering of cases of Kaposi's sarcoma (KS) on the Peloponnesus peninsula. To gain more insight into its pathogenesis, we studied the seroepidemiologic and clinicopathologic characteristics of 12 Greek KS patients (eight male/four female) five of whom were residents of an endemic area on the Peloponnesus. These patients were in good general health with ages ranging from 48 to 80 years, had no clinical signs of immunodeficiency, and combined the features of both classic and epidemic KS in that they displayed not only involvement of acral areas but also widespread mucocutaneous lesions. Routine laboratory data were within normal limits; no patient had HTLV-1 and HIV-1/2 antibodies, but all patients had antibodies to several herpesviruses. The histopathology was characteristic of KS with the peculiar feature of a dense infiltrate composed predominantly of CD4+ T lymphocytes. Immunoenzymatic/morphologic studies of the KS cells were consistent with their origin from lymphatic endothelium. Outstanding ultrastructural findings were tubuloreticular structures and cylindrical confronting cisternae, structures that are indicative of an ongoing viral infection. Indeed, extensive electronmicroscopic studies resulted in the detection of retrovirus-like particles in close association to KS cells in five of 12 patients. This in situ observation opens the possibility that this retro-virus contributes to KS development.

Antibodies, Viral↗
PubMed1990

Air pollution and cause specific mortality in Athens.

STUDY OBJECTIVE: The aim was to investigate the reported association between air pollution and cause specific mortality in the city of Athens. DESIGN: Cause specific mortality was contrasted between 199 d with high values of air pollution and 2*199 comparison days with low pollution, matched in a 1:2 ratio on the basis of various confounding factors. Statistical analysis was done, taking matching into account, using analysis of variance for randomised blocks. SETTING: The study was confined to the city of Athens, using data obtained between 1975 and 1982. PARTICIPANTS: Cause of death was assessed in all 25 138 persons dying in the 3*199 d studied. MEASUREMENTS AND MAIN RESULTS: Causes of death were evaluated blindly by two medically qualified investigators on the basis of information in the death certificates. Mortality was generally higher during the high pollution days but the difference was more pronounced and more significant for respiratory conditions, even though the number of deaths in this category was smaller than the corresponding numbers in the other two categories examined (cardiac and "other" deaths). CONCLUSION: The results show that the short term association between air pollution and overall mortality in Athens is likely to be causal, since it is particularly evident with respect to respiratory conditions, for which a biological air pollution link is more plausible.

Air Pollution↗
PubMed1990

The validity of gynecological ultrasonography.

The present study was undertaken to examine the reliability of the sonographic diagnosis in 705 gynecological patients. The determination of the lesions was defined according to the operative diagnosis. The sensitivity, specificity and positive predictive value of the ultrasound technique were evaluated using the surgical findings as 'gold standard'. In 631 patients (89.5%) the ultrasound examination established a correct diagnosis. The sensitivity and specificity of the ultrasound examination varied between 75-95.3% and 93.3-100%, respectively. The positive predictive value was found between 89.7 and 100%, while the false sonographic results were 10.4%, which included those of ectopic pregnancies. It is thus concluded that ultrasonography as compared to the surgical findings has proved to be of great value in establishing a gynecological diagnosis.

Adnexal Diseases↗
PubMed1989

Exposure to lead and cadmium of children living near a lead smelter at Lavrion, Greece.

Exposure of children of the Greek town of Lavrion to lead and cadmium has been evaluated by determination of the levels of lead (PbB) and cadmium (CdB) in the blood of 514 children living in the town. The Lavrion area is heavily polluted by lead owing to the presence of a large lead-zinc mining and smelting industrial complex. The industrial PbB level (geometric mean) was 21.7 micrograms dl-1 (range 7.4-79.8 micrograms dl-1). The CdB levels were, on average, 0.36 micrograms l-1 (range 0.1-3.1 micrograms l-1). The results were evaluated with respect to a number of constitutional, social and environmental variables, such as age, gender, distance of the school from the lead-zinc mining and smelting complex, and occupation and education of the father.

Age Factors↗
PubMed1988

Antibody responses in early human immunodeficiency virus type 1 infection in hemophiliacs.

Sera from hemophiliacs were analyzed for antibodies to human immunodeficiency virus type 1 (HIV-1) by using radioimmunoprecipitation (RIP), western blotting (WB) with nonreducing buffer (NR), and WB with reducing buffer (R). We analyzed envelope gp160, gp120, and gp41; pol gene proteins p64, p53, and p34; and gag gene protein p24. Of 215 samples positive for reactivity to gp160 and gp120(RIP), antibodies to p24 were undetectable in 2 (0.9%), to gp41 in 9 (4.2%), to the pol antigens in 5 (2.3%), to gp120(NR) in 3 (1.4%), and to gp120(R) in 55 (25.6%). By sequential analysis of samples, antibodies to gp120(NR), gp120(R), p24, gp41, p64/53, and p34 were observed later in the course of infection than were antibodies to gp120(RIP) or gp160. This result suggests caution against reliance on WB as the "gold standard." A significantly higher rate of progression to AIDS-related complex was found for individuals lacking antibodies to gp120(R). It is possible that antigenic domains represented by gp120(R) may play a role in the pathogenesis of HIV-1 infection.

AIDS-Related Complex↗