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Biomedical subjects

K J Lo

Publications and source records attributed to K J Lo.

At least 91 records · Page 5Linked to original sources

Hepatitis D virus (delta agent) superinfection in an endemic area of hepatitis B infection: immunopathologic and serologic findings.

In 86 Chinese patients with histologically proven hepatitis B surface antigen (HBsAg) positive chronic hepatitis and serum alanine aminotransferase levels exceeding 200 U/l, antibody to hepatitis D antigen (HDAg) was detected more frequently in sera from hepatitis B e antigen (HBeAg) negative patients (11/35, 31.4%) than in HBeAg positive (4/51, 7.8%) patients (p less than 0.02). 10 liver biopsy specimens (76.9%) from 13 chronic hepatitis B patients with superimposed hepatitis D virus (HDV) infection, showed positive staining for HDAg in their hepatocytes. Neither HBsAg nor hepatitis B core antigen (HBcAg) was found in the liver in 12/13 patients with superimposed HDV infection. However, in liver biopsy specimens from 42 patients without HDV superinfection, HBsAg was stained positively in 41 patients (97.6%), and HBcAg in 24 patients (47.1%). Using dot blot hybridization technique, serum hepatitis B virus (HBV) DNA was detected in 62.1% (41/66) of patients without HDV superinfection, while it was detected only in 10.0% (1/10) of patients who had HDV superinfection. It is concluded that HDV superinfection plays a significant role in Taiwan in HBeAg negative chronic hepatitis B patients with clinical "exacerbation". The data show clear evidence of HDV interfering with the replication of HBV.

Adult↗

Hepatitis B and D virus infection among drug abusers in Taiwan.

Approximately 15 to 20% of the general population in Taiwan are chronic hepatitis B surface antigen (HBsAg) carriers. However, the incidence of hepatitis D virus (HDV) infection is low (5-8%) in patients with HBsAg-positive chronic liver diseases in this area. To evaluate the prevalence of hepatitis B virus (HBV) and HDV infection among drug abusers in Taiwan, serum samples were collected from 152 drug abusers at the Taipei Municipal Anti-Narcotic Institute and test for HBV and HDV markers. Of these, 24 (15.8%) were HBsAg positive, and only 15 (9.9%) were seronegative for all HBV markers. Of the 115 intravenous drug abusers, serum antibody to hepatitis D antigen (anti-HD) was positive in 78.9% of 19 persons who were HBsAg positive, and in 7.5% of 80 persons who were positive for antibody to HBsAg (anti-HBs). Anti-HD was not detected in the sera from all 37 nonintravenous drug abusers regardless of the status of their HBV markers. Also, none of 63 asymptomatic HBsAg carrier pregnant women or 23 patients with acute type B viral hepatitis had measurable anti-HD in their sera. Thus, the high frequency of HDV detected among Chinese HBsAg carrier intravenous drug abusers in Taiwan is similar to that reported in Western countries.

Adolescent↗

Hemodynamic effect of propranolol on portal hypertension in patients with HBsAg-positive cirrhosis.

Wedged hepatic venous pressure, free hepatic venous pressure, and cardiac index were measured before and one hour after intravenous and one month after chronic oral administration of propranolol in nine patients with HBsAg-positive cirrhosis. The gradient between wedged hepatic venous pressure and free hepatic venous pressure was decreased 22.7% at one hour after intravenous administration of 5 mg propranolol, and a sustained decrease in hepatic venous pressure gradient was also demonstrated in five patients after one month of continuous oral administration of propranolol. Thus, we conclude that chronic oral administration of propranolol can reduce the hepatic venous pressure gradient in patients with compensated HBsAg-positive cirrhosis.

Adult↗

Effects of H2-receptor antagonists on the rat liver after partial hepatectomy or carbon tetrachloride-induced hepatic injury.

A total of 512 male rats were used to investigate the effects of H2-receptor antagonists on the liver after two-thirds hepatectomy or after carbon tetrachloride (CCl4)-induced hepatic injury. The serum aminotransferase levels in hepatectomy rats were significantly elevated as compared with those of rats with the sham operation 1 and 2 days after the operation. However, there were no differences in the serum aminotransferase levels and liver regeneration rates among the groups of hepatectomy rats who were treated with saline, cimetidine, or ranitidine. The injections of cimetidine or ranitidine did not induce a significant increase in serum amino-transferase levels or increase the severity of liver cell necrosis in CCl4-treated rats, as compared with the CCl4-treated rats who received saline injection. Thus, our data indicate that H2-receptor antagonists do not inhibit liver regeneration in rats after two-thirds hepatectomy or exert a detrimental effect on the liver cell necrosis in rats after CCl4-induced hepatic injury.

Alanine Transaminase↗

Immunoprophylaxis of infection with hepatitis B virus in infants born to hepatitis B surface antigen-positive carrier mothers.

Infants born to carrier mothers positive for hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) received 5 micrograms of hepatitis B virus (HBV) vaccine on four occasions. Group 1 received vaccine only, group 2 received vaccine plus hepatitis B immune globulin (HBIG) at birth, and group 3 received vaccine plus HBIG at birth and at one month. Infants born to HBeAg-positive mothers (group 4) received a reduced dose of vaccine (2.5 micrograms) on three occasions as well as HBIG at birth. As compared with 78.4% of the control group (infants whose parents refused vaccination) who became chronic HBV carriers at the age of 14 months, the protective efficacy rate of vaccination was 75.3% in group 1,85.5% in group 2,89.7% in group 3, and 87.2% in group 4. HBV vaccine (5 micrograms) was also given to infants born to HBsAg-positive, HBeAg-negative mothers on four on four occasions. The antibody response to HBsAg in vaccine recipients was 12% after the first dose, 44% after the second dose, and 75% and 100% at six months and 1.5 years of age, respectively.

Adult↗

Combined passive and active immunization for interruption of perinatal transmission of hepatitis B virus in Taiwan.

We attempted a clinical trial to interrupt transmission of hepatitis B virus (HBV) infection from hepatitis B surface antigen (HBsAg) positive and hepatitis Be antigen (HBsAg) positive mothers to their infants in Taiwan. Screening of 5,595 pregnant women revealed that 856 (15.3%) were HBsAg positive. Three hundred and sixty-one (42.2%) of the HBsAg positive pregnant women were HBeAg positive. Infants born to HBsAg and HBeAg positive mothers were randomized into 3 groups to receive the HBV vaccine alone or combined with hepatitis B immune globulin (HBIG). HGV vaccine was given at 2, 6, and 10 weeks after birth. Group I received HBV vaccine alone while Group II received HBV vaccine in combination with HBIG at birth and group III received HBV vaccine plus HBIG at birth and again at one month old. Group IV constituted the control group when their parents refused vaccination. At 6 months of age, the HBV carrier rate was 23.7% (9/38) in Group I, 11.1% (4/36) in Group II, and 5.3% (2/38) in Group III infants. Compared with 90% of infants who became HBV carriers in the control group (Group IV), the efficacy of HBV vaccination in preventing HBV infection among these high risk infants at the 6th month was 73.7% in Group I, 87.7% in Group II, and 94.1% in Group III. The antibody to HBsAg (anti-HBs) positivity rate in sera of Group I, II, III infants at 6 months of age was 79.0%, 88.9% and 94.7%, respectively. These initial results indicate that combined passive and active immunization is efficacious in interrupting perinatal transmission of HBV infection.

Adult↗

Des-gamma-carboxy (abnormal) prothrombin as a serum marker of primary hepatocellular carcinoma.

We detected des-gamma-carboxy prothrombin, an abnormal prothrombin, in the serum of 69 of 76 patients (91 per cent) with biopsy-confirmed hepatocellular carcinoma (the mean level of the abnormal prothrombin was 900 ng per milliliter). In contrast, levels of the abnormal prothrombin were low in patients with chronic active hepatitis (mean, 10 ng per milliliter) or metastatic carcinoma involving the liver (mean, 42 ng per milliliter), and undetectable in normal subjects. In five patients treated with vitamin K there was no reduction in abnormal prothrombin, indicating that its presence was not due to vitamin K deficiency. Surgical resection of tumors in two patients and chemotherapy in one patient markedly reduced abnormal-prothrombin concentrations, which later increased with recurrence of disease. Serum alpha-fetoprotein levels correlated poorly with abnormal-prothrombin levels. Together, the assay for abnormal prothrombin and the alpha-fetoprotein assay identified 64 of 76 patients with hepatoma (84 per cent). Abnormal prothrombin may be useful in the laboratory diagnosis of primary hepatocellular carcinoma.

Aged↗

Prevalence of delta agent among Chinese in Taiwan and Los Angeles.

The prevalence of delta agent among 120 Chinese patients with HBsAg-positive chronic active and hepatocellular carcinoma from Taiwan and Los Angeles were studied by serological assay for antibody to delta antigen and immunoperoxidase staining for delta antigen in the liver biopsies. Of 120 patients, only four with chronic active hepatitis and one with hepatocellular carcinoma from Taiwan had antibody to delta antigen in their sera, while none was detected in the patients from Los Angeles. Indirect immunoperoxidase staining for delta antigen in the liver tissue from three of the patients with circulating anti-delta was positive. Thus, the overall prevalence of delta infection was 5.8% among the 86 patients from Taiwan, and 0% in the 34 Chinese patients from Los Angeles.

Adult↗

Prevention of hepatitis B virus infection in children born to HBsAg positive/HBeAg positive mothers. Preliminary results of active and passive-active immunization.

In Taiwan the Hepatitis B virus (HBV) carrier rate is 15% to 20%. Mother infant transmission plays the most important role in the endemy resulting in 20% of the children being HBsAg carrier at 4 years of age. A large proportion of HBV carriers will develop a chronic hepatitis leading to cirrhosis and ultimately to primary hepatocellular carcinoma. Children born to HBsAg +/HBeAg + mothers (7% of neonates) have an estimated risk of 90% to become HBsAg chronic carriers. A plan for control of Hepatitis B in Taiwan will aim to solve the problem of these children, as a priority. A Hepatitis B vaccine trial has been undertaken in Taiwan since October 1981 in a selected population of children born to HBsAg +/HBeAg + mothers. The purpose of the study was to determine the efficacy of Hepatitis B vaccine alone or in combination with Hepatitis B immunoglobulin in preventing maternal infant transmission of HBV infection. A three way prophylactic regimen comparison was carried out. Subjects consisted of children born to HBsAg +/HBeAg + mothers. Only mature and apparently healthy neonates were included with the parents' formal consent based on real knowledge and understanding. Babies were randomly included in four different groups of study.

Female↗

The natural course of hepatitis B surface antigen-positive chronic active hepatitis in Taiwan.

A prospective study on the natural course of hepatitis B surface antigen (HBsAg)-positive chronic active hepatitis (CAH) in 84 patients was conducted at the Taiwan Veterans General Hospital in Taipei. On presentation, 36% of the patients had jaundice and 94% had elevated serum transaminase activity in addition to clinical symptoms. Of the 84 patients with HBsAg-positive CAH, 76 were followed for an average of 46 months, and at the time of the last visit 46% either had evidence of progressive liver disease or had died. Of the 15 deaths, nine were due to complications of liver disease and six were due to primary hepatocellular carcinoma (PHC), alpha-Fetoprotein levels of greater than 400 ng/ml were found only in patients in whom PHC was detected. The course of HBsAg-positive CAH in this predominantly male Asian population was progressive, and deaths occurred either by liver failure, by bleeding esophageal varices, or by progression to PHC.

Adult↗

Hepatitis B viral markers in patients with primary hepatocellular carcinoma in Taiwan.

The presence of hepatitis B viral markers in patients with primary hepatocellular carcinoma (PHC) was studied retrospectively at the Taiwan Veterans General Hospital in Taipei, Taiwan. Serum samples from 102 PHC patients and from 100 control individuals were tested for hepatitis B surface antigen (HBsAg), antibody to HBsAg (anti-HBs), antibody to hepatitis B core antigen (anti-HBc), hepatitis Be antigen (HBeAg), and antibody to HBeAg (anti-HBe). Of the 102 PHC patients, 72 (71%) were positive for HBsAg. Nine (9%) additional patients were positive for anti-HBc alone in high titer, 19 (19%) had both anti-HBc and anti-HBs, and 9 (9%) had HBsAg, anti-HBc, and anti-HBs. In the 100 controls, 12 (12%) were HBsAg-positive, whereas 22 (22%) had anti-HBc alone and 50 (50%) had both anti-HBc and anti-HBs. Only 4 (4%) controls and no PHC patients had anti-HBs alone. Of the HBsAg-positive patients with PHC, 17 (29%) had HBeAg and 36 (61%) had anti-HBe. The alpha-fetoprotein (AFP) levels above 400 ng/ml were found in 44% of the PHC patients. Values of AFP above 1 x 10(5) ng/ml were more frequently detected in PHC patients who were HBsAg-positive. Categorization of the geographic origins of the families whose members had PHC revealed that most families had originated from southern China. This study confirms that hepatitis B viral markers are frequently present in Chinese patients with PHC.

Adult↗