Browsing by Subject "Hepatitis"

Now showing 1 - 3 of 3
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    Chronic hepatitis at Groote Schuur Hospital: 1978-1996 : a literature review of the syndrome, its clinical spectrum and management at Groote Schuur Hospital
    (1999) Hairwadzi, Henry N; Hall, Pauline de la Motte
    Chronic hepatitis has multiple aetiologies which include viral hepatitis (hepatitis B, B+D and C), autoimmune hepatitis and drugs. In sub-Saharan Africa the major aetiological factor is chronic hepatitis B virus infection. In this region 10-15% of the population is chronically infected with the virus and 76% have serological evidence of past exposure to the hepatitis B virus. HDV infection has not been documented in Southern Africa but studies from Northern Africa show antibody positivity for HDV of 21-31 % in patients with chronic HBV infection. Drug-induced hepatitis is also increasingly being recognised as a significant entity. This study arose from the observation that there are a significant number of patients with autoimmune hepatitis on follow-up at the Groote Schuur Hospital liver clinic. This group includes patients who test negative for the standard autoimmune markers done at Groote Schuur Hospital but have liver histology that is typical of classical autoimmune hepatitis. They also show a clinical and biochemical response to steroid and azathioprine therapy that is indistinguishable from that seen in classical autoimmune hepatitis cases on similar treatment. This study is retrospective and covers the period 1978 - 1996. The patients studied are those with chronic hepatitis as defined by the International Working Party in 1995, i.e. patients with necro-inflammatory disease of the liver lasting at least 6 months. This includes hepatitis B, B + D, C, autoimmune hepatitis and drug-induced liver disease. Several other liver diseases that may present with clinical and histological features of chronic hepatitis are specifically excluded. These include Wilson's disease, Primary biliary cirrhosis, Primary sclerosing cholangitis, alpha-1-antitrypsin deficiency, alcohol abuse and iron over load states.
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    N-acetylcysteine for non-paracetamol drug-induced liver injury: a systematic review protocol
    (BioMed Central Ltd, 2015) Chughlay, Mohamed; Kramer, Nicole; Werfalli, Mahmoud; Spearman, Wendy; Engel, Mark E; Cohen, Karen
    BACKGROUND: Drug-induced liver injury (DILI) refers to acute or chronic liver injury that may occur as a consequence of using drugs and herbal or dietary supplements. Specific therapies for DILI are limited. There is considerable evidence for efficacy and safety of N-acetylcysteine (NAC) in management of paracetamol-induced liver injury. More recently, research has explored the use of NAC in non-paracetamol drug-induced liver injury. It is important to summarise the evidence of NAC for non-paracetamol DILI to determine if NAC may be considered a therapeutic option in this condition.METHODS/DESIGN:We will conduct a systematic review of the benefit and harm of NAC in non-paracetamol drug-induced liver injury. Primary and secondary outcomes of interest are pre-specified. Primary outcomes include all-cause mortality, mortality due to DILI, time to normalisation of liver biochemistry (e.g. return of alanine transaminase to <100 U/l and/or international normalized ratio (INR) <1.5) and adverse events. Secondary outcomes include transplantation rate, time to transplantation, transplant-free survival and duration of hospitalisation. We will include randomized controlled trials (RCTs) and prospective cohort studies. RCTs will contribute to the evaluation of safety and efficacy of NAC, whereas, the cohort studies will contribute exclusively to the evaluation of safety. We will search several bibliographic databases (including PubMed, Scopus, CINAHL, CENTRAL), grey literature sources, conference proceedings and ongoing trials. Following data extraction and assessment of the risk of bias, we will conduct a meta-analysis if feasible, as well as subgroup analyses. We will assess and explore clinical and statistical heterogeneity.DISCUSSION:The aim of this review is to provide evidence on the effectiveness and safety of NAC in non-paracetamol DILI. We anticipate that the results could aid health care practitioners, researchers and policymakers in the decision-making regarding the use of NAC in patients with non-paracetamol DILI.SYSTEMATIC REVIEW REGISTRATION:PROSPERO CRD42014008771
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    Prevalence of hepatitis B and C infection in persons living with HIV enrolled in care in Rwanda
    (2017) Umutesi, Justine; Simmons, Bryony; Makuza, Jean D; Dushimiyimana, Donatha; Mbituyumuremyi, Aimable; Uwimana, Jean Marie; Ford, Nathan; Mills, Edward J; Nsanzimana, Sabin
    BACKGROUND: Hepatitis B (HBV) and C (HCV) are important causes of morbidity and mortality in people living with human immunodeficiency virus (HIV). The burden of these co-infections in sub-Saharan Africa is still unclear. We estimated the prevalence of the hepatitis B surface antigen (HBsAg) and hepatitis C antibody (HCVAb) among HIV-infected individuals in Rwanda and identified factors associated with infection. METHODS: Between January 2016 and June 2016, we performed systematic screening for HBsAg and HCVAb among HIV-positive individuals enrolled at public and private HIV facilities across Rwanda. Results were analyzed to determine marker prevalence and variability by demographic factors. RESULTS: Overall, among 117,258 individuals tested, the prevalence of HBsAg and HCVAb was 4.3% (95% confidence interval [CI] (4.2-4.4) and 4.6% (95% CI 4.5-4.7) respectively; 182 (0.2%) HIV+ individuals were co-infected with HBsAg and HCVAb. Prevalence was higher in males (HBsAg, 5.4% [5.1-5.6] vs. 3.7% [3.5-3.8]; HCVAb, 5.0% [4.8-5.2] vs. 4.4% [4.3-4.6]) and increased with age; HCVAb prevalence was significantly higher in people aged ≥65 years (17.8% [16.4-19.2]). Prevalence varied geographically. CONCLUSION: HBV and HCV co-infections are common among HIV-infected individuals in Rwanda. It is important that viral hepatitis prevention and treatment activities are scaled-up to control further transmission and reduce the burden in this population. Particular efforts should be made to conduct targeted screening of males and the older population. Further assessment is required to determine rates of HBV and HCV chronicity among HIV-infected individuals and identify effective strategies to link individuals to care and treatment.