Chronic Hepatitis C: Acute Exacerbation and Alanine Aminotransferase Flare

Matsumoto, Naoki; Ishii, Tomotaka; Arima, Shuhei; Shibuya, Shinji; Honda, Masaaki; Sasaki, Reina; Masuzaki, Ryota; Kanezawa, Shini; Nishizawa, Tsutomu; Gon, Yasuhiro; Ogawa, Masahiro; Kogure, Hirofumi

doi:10.3390/v15010183

Cited by 5 publications

(4 citation statements)

References 125 publications

(209 reference statements)

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“…The evidence that, generally, HCV infection rarely causes ACLF has been supported by numerous previous studies [35][36][37][38][39][40], but a reactivation of HCV infection is recognized to be one of the precipitating factors in ACLF induction [9], considering the possibility that an acute HCV infection can result in acute fulminant liver failure [3,[41][42][43].…”

Section: Etiological Factors Of Aclfmentioning

confidence: 89%

Challenges in Diagnosis and Therapeutic Approach of Acute on Chronic Liver Failure—A Review of Current Evidence

et al. 2023

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Acute-on-chronic liver failure (ACLF) is a syndrome characterized by acute and severe decompensation of chronic liver disease (CLD) correlated with multiple organ failure, poor prognosis, and increased mortality. In 40–50% of ACLF cases, the trigger is not recognized; for many of these patients, bacterial translocation associated with systemic inflammation is thought to be the determining factor; in the other 50% of patients, sepsis, alcohol consumption, and reactivation of chronic viral hepatitis are the most frequently described trigger factors. Other conditions considered precipitating factors are less common, including acute alcoholic hepatitis, major surgery, TIPS insertion, or inadequate paracentesis without albumin substitution. Host response is likely the primary factor predicting ACLF severity and prognosis, the host immune response having a particular significance in this syndrome, together with the inflammatory cascade. The management of ACLF includes both the prevention of the precipitating factors that lead to acute liver decompensation and the support of vital functions, the prevention and management of complications, the estimation of prognosis, and the opportunity for liver transplantation.

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Section: Etiological Factors Of Aclfmentioning

confidence: 89%

Challenges in Diagnosis and Therapeutic Approach of Acute on Chronic Liver Failure—A Review of Current Evidence

et al. 2023

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“…39 However, the JFH1, a cell-culture-grown HCV genotype (GT) 2a virus, has been found in a Japanese patient with fulminant hepatitis C virus infection. [40][41][42] During the acute phase of HCV infection, serum HCV RNA and ALT levels may have significant fluctuations. About 80% of people with acute HCV infection will develop chronic infection, generally defined as the persistence of viremia for more than six months.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Fulminant hepatitis and acute liver failure rarely occur in people with acute HCV infection [ 39 ]. However, the JFH1, a cell-culture-grown HCV genotype (GT) 2a virus, has been found in a Japanese patient with fulminant HCV infection [ 40 - 42 ].…”

Section: Clinical Presentationmentioning

confidence: 99%

Acute hepatitis C virus infection: clinical update and remaining challenges

Liu¹,

Kao²

2023

Clin Mol Hepatol

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Acute hepatitis C virus (HCV) infection is a global health concern with substantial geographical variation in the incidence rate. People who have received unsafe medical procedures, used injection drugs, and lived with human immunodeficiency virus are reported to be most susceptible to acute HCV infection. The diagnosis of acute HCV infection is particularly challenging in immunocompromised, reinfected, and superinfected patients due to difficulty in detecting anti-HCV antibody seroconversion and HCV ribonucleic acid (RNA) from a previously negative antibody response. With an excellent treatment effect on chronic HCV infection, recently, clinical trials investigating the benefit of direct-acting antivirals (DAAs) treatment for acute HCV infection have been conducted. Based on the results of costeffectiveness analysis, DAAs should be initiated early in acute HCV infection prior to spontaneous viral clearance. Compared to the standard 8-12 week-course of DAAs for chronic HCV infection, DAAs treatment duration may be shortened to 6-8 weeks in acute HCV infection without compromising the efficacy. Standard DAA regimens provide comparable efficacy in treating HCV-reinfected patients and DAA-naïve ones. For cases contracting acute HCV infection from HCV-viremic liver transplant, a 12-week course of pangenotypic DAAs is suggested. While for cases contracting acute HCV infection from HCV-viremic non-liver solid organ transplants, a short course of prophylactic or pre-emptive DAAs is suggested. Currently, prophylactic HCV vaccines are unavailable. In addition to treatment scale-up for acute HCV infection, practice of universal precaution, harm reduction, safe sex, and vigilant surveillance after viral clearance remain critical in reducing HCV transmission.

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“…An acute attack refers to the sudden onset of symptoms such as coughing, wheezing, shortness of breath, and chest tightness, or a significant worsening of preexisting symptoms. Chronic persistence asthma, on the other hand, describes the occurrence of these symptoms at varying frequencies and intensities over the past three months [3]. Acute asthma symptoms develop rapidly, leading to severe conditions like dyspnea, and chest tightness.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of the combination of terbutaline and budesonide inhalation in treating acute bronchial asthma during pregnancy

Zhang,

Zhou,

Guo

et al. 2023

Trop. J. Pharm Res

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Purpose: To investigate the therapeutic benefits of terbutaline sulfate aerosol inhalation combined with budesonide, and its influence on pulmonary function in pregnant women suffering from acute bronchial asthma attacks. Methods: A total of 100 pregnant patients diagnosed with acute bronchial asthma in PLA Strategic Support Force Characteristic Medical Center, Beijing, China were divided into control and study groups (n = 50 each). Control group received aerosol inhalation of normal saline along with standard treatments, viz, oxygen inhalation, sputum aspiration, anti-infection measures, and maintenance of water- electrolyte balance. Study group received combined terbutaline sulfate and budesonide aerosol inhalation in addition to standard treatment. Both groups underwent a 7-day treatment course, with inhalation therapy twice daily. Results: Study group showed significantly shorter relief times for cough, wheezing, and chest tightness compared to control group (p < 0.05). After treatment, 92.0 % of patients in study group exhibited improvement or relief from their symptoms, compared to 80.0 % in control group (p < 0.05). Pulmonary function indices, including first vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), and FEV1/FVC, improved in both groups after treatment. Study group exhibited significantly lower laboratory indices, including immunoglobulin E (IgE), C-reactive protein (CRP), and eosinophils (EOS) compared to control group (p < 0.05). Conclusion: The combination of inhalation therapy of terbutaline sulfate with budesonide in pregnant women experiencing acute bronchial asthma demonstrates significant enhancements in clinical effectiveness, pulmonary function, and laboratory parameters. Clinical trials of this combined therapy should be carried out in other locations to ascertain the effect of population variation on treatment efficacy.

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Chronic Hepatitis C: Acute Exacerbation and Alanine Aminotransferase Flare

Cited by 5 publications

References 125 publications

Challenges in Diagnosis and Therapeutic Approach of Acute on Chronic Liver Failure—A Review of Current Evidence

Challenges in Diagnosis and Therapeutic Approach of Acute on Chronic Liver Failure—A Review of Current Evidence

Acute hepatitis C virus infection: clinical update and remaining challenges

Effectiveness of the combination of terbutaline and budesonide inhalation in treating acute bronchial asthma during pregnancy

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