Drugs and Lactation Database (LactMed)

Posted by on 13 Jul 2018 | Tagged as: Hepatitis B Alternative Medicine, Others

Related Articles Drugs and Lactation Database (LactMed) Book. 2006 Authors: Abstract Published experience with tenofovir during breastfeeding in HIV-positive mothers and HIV-negative mothers treated for HIV prophylaxis or hepatitis B infection indicates that the exposure of the infant to the drug is trivial. A few infants have been breastfed during maternal tenofovir therapy and no adverse effects have been seen up to 2 years of age. Expert reviews of available data concluded that there is currently no justification for contraindicating the use of tenofovir for hepatitis B during breastfeeding.[1][2] Professional organization guidelines generally allow breastfeeding during tenofovir therapy, although one guideline cautions against it because of a lack of long-term safety data.[3][4][5] The lack of long-term safety data with long-term, low-level infant exposure should be discussed with the mother.[3] No differences exist in infection rates between breastfed and formula-fed infants born to hepatitis B-infected women, as long as the infant receives hepatitis B immune globulin and hepatitis B vaccine at birth. Mothers with hepatitis B are encouraged to breastfeed their infants after their infants receive these preventative measures.[6][7] Maternal use of prophylactic vaginal tenofovir (investigational in the U.S.) does not appear to present a great risk to the breastfed infant.[8] In the United States and other developed countries, HIV-infected mothers should generally not breastfeed their infants. In countries in which no acceptable, feasible, sustainable and safe replacement feeding is available, World Health Organization guidelines recommend that all women with an HIV infection who are pregnant or breastfeeding should be maintained on antiretroviral therapy for at least the duration of risk for mother-to-child transmission. Mothers should exclusively breastfeed their infants for the first 6 months of life; breastfeeding with complementary feeding should continue through at least 12 months of life up to 24 months of life.[9] The first choice regimen for nursing mothers is tenofovir, efavirenz and either lamivudine or emtricitabine. If these drugs are unavailable, alternative regimens include: 1) zidovudine, lamivudine and efavirenz; 2) zidovudine, lamivudine and nevirapine; or 3) tenofovir, nevirapine and either lamivudine or emtricitabine. Exclusively breastfed infants should also receive 6 weeks of prophylaxis with nevirapine.[10][11] Use of tenofovir as an agent for pre-exposure prophylaxis (PrEP) in HIV-uninfected nursing mothers appears to pose little risk to their breastfed infants and might prevent vertical HIV transmission by preventing maternal infection.[12] Treatment of mothers of HIV+ mothers with efavirenz as part of Option B+ therapy does not appear to affect growth of their HIV-negative breastfed infants. PMID: 30000609

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Drugs and Lactation Database (LactMed)

Cerebral Malaria in a Patient with HIV, Hepatitis B, and Hepatitis C.

Posted by on 06 Jul 2018 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Cerebral Malaria in a Patient with HIV, Hepatitis B, and Hepatitis C. Cureus. 2018 May 02;10(5):e2569 Authors: Uddin SMM, Haq A, Haq Z, Yaqoob U, Shah H, Kazmi SFA Abstract Cerebral malaria is one of the most common causes of non-traumatic encephalopathy. A 25-year-old man who is a known intravenous and oral drug abuser presented to our clinic with fever and sore throat for two days prior and an altered level of consciousness for one day. On examination, the patient was icteric, and his Glasgow coma scale score on arrival was 10/15; he had dilated pupils reactive to light and a positive corneal reflex. All cranial nerves were intact; however, signs of meningeal irritation were positive. Motor examination showed an increased tone and rigidity in all limbs, patellar reflex was 3+, plantars were down-going, and clonus was negative. A fundoscopic examination was unremarkable. Additional investigations revealed he was positive for Plasmodium falciparum, HIV, hepatitis B, and hepatitis C. In addition, a test of his cerebrospinal fluid revealed evidence of cerebral malaria. We initiated artemether 120 mg, intravenous ceftriaxone 2 g, and 5% dextrose saline for the intermittent hypoglycemia. The patient’s condition eventually improved drastically. This case outlines the possible exacerbating effect of HIV on malaria, and it calls for HIV screening and staging alongside suspected malaria. This case also underlines the need for further evaluation of a potential protective role of hepatitis B and C to find an alternative therapeutic cure for malaria. PMID: 29974024 [PubMed]

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Cerebral Malaria in a Patient with HIV, Hepatitis B, and Hepatitis C.

Occult Hepatitis C Virus Infection: A Review.

Posted by on 29 Jun 2018 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Occult Hepatitis C Virus Infection: A Review. J Clin Transl Hepatol. 2018 Jun 28;6(2):155-160 Authors: Austria A, Wu GY Abstract Occult hepatitis C virus (HCV) infection (OCI), first described in 2004, is defined as the presence of HCV RNA in hepatocytes or peripheral blood mononuclear cells without detectable HCV RNA in the serum. Here, we aimed to review the epidemiology, diagnostic methods, clinical implications and potential management recommendations currently described in the literature, as well as the future directions for investigation of this entity. PubMed and Cochrane databases were searched with combination of the following keywords: “occult”, “hepatitis C virus”, and “occult HCV infection”. There are data to support OCI as a potential culprit in cryptogenic liver disease. There are also consistent data demonstrating the existence of OCI in specific populations, such as dialysis, human immunodeficiency virus-infected and hepatitis B virus-infected patients, and also in the general population. While the gold standard for diagnosis is liver biopsy, examination of peripheral blood mononuclear cells may be a reliable, safer alternative method of diagnosis. Occult HCV infection is likely associated with liver fibrosis and progression of liver disease. Additional studies are required to determine the infectivity of OCI patients, as well as clarify the natural course and specific clinical implications of OCI. Lastly, studies are needed to determine whether treatment of OCI leads to decreased morbidity and/or mortality. PMID: 29951360 [PubMed]

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Occult Hepatitis C Virus Infection: A Review.

A Case of Recurrent Hepatocellular Carcinoma Acquiring Complete Remission of Target Lesion With Treatment With Traditional Chinese Medicine.

Posted by on 21 Jun 2018 | Tagged as: Hepatitis B Alternative Medicine

Related Articles A Case of Recurrent Hepatocellular Carcinoma Acquiring Complete Remission of Target Lesion With Treatment With Traditional Chinese Medicine. Integr Cancer Ther. 2017 Dec;16(4):597-604 Authors: Jianxin C, Qingxia X, Junhui W, Qinhong Z Abstract Hepatocellular carcinoma (HCC) is one of the most prevalent malignancies worldwide. Although surgery is known as the most promising radical treatment, a high recurrent or metastatic rate after surgery has limited its clinical efficacy. Sorafenib, a target agent, has seemed to be the only option for metastatic HCC patients to date, but none of clinical trials showed it could prolong the overall survival (OS) of advanced HCC to 1 year. How to prolong the OS and improve cure rate of HCC patients is still beset with difficulties. This report presents a rare case of recurrent HCC patient with complete regression of target lesion with 2 years of Chinese herbal treatment. A 64-year-old Chinese man with hepatitis B virus-associated chronic hepatitis presented HCC has been clinically diagnosed tumor relapse and omentum metastasis with computed tomography and α-fetoprotein blood test 4 months after surgery. It was decided the patient would receive traditional Chinese medicine treatment because of poor prognosis. After approximately 2 years of treatment, recurrent hepatic tumor and omentum metastasis have been found in complete regression. The patient remains alive over 31 months after relapse. PMID: 27444311 [PubMed – indexed for MEDLINE]

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A Case of Recurrent Hepatocellular Carcinoma Acquiring Complete Remission of Target Lesion With Treatment With Traditional Chinese Medicine.

Hepatitis B virus pathogenesis: Fresh insights into hepatitis B virus RNA.

Posted by on 09 Jun 2018 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Hepatitis B virus pathogenesis: Fresh insights into hepatitis B virus RNA. World J Gastroenterol. 2018 Jun 07;24(21):2261-2268 Authors: Sekiba K, Otsuka M, Ohno M, Yamagami M, Kishikawa T, Suzuki T, Ishibashi R, Seimiya T, Tanaka E, Koike K Abstract Hepatitis B virus (HBV) is still a worldwide health concern. While divergent factors are involved in its pathogenesis, it is now clear that HBV RNAs, principally templates for viral proteins and viral DNAs, have diverse biological functions involved in HBV pathogenesis. These functions include viral replication, hepatic fibrosis and hepatocarcinogenesis. Depending on the sequence similarities, HBV RNAs may act as sponges for host miRNAs and may deregulate miRNA functions, possibly leading to pathological consequences. Some parts of the HBV RNA molecule may function as viral-derived miRNA, which regulates viral replication. HBV DNA can integrate into the host genomic DNA and produce novel viral-host fusion RNA, which may have pathological functions. To date, elimination of HBV-derived covalently closed circular DNA has not been achieved. However, RNA transcription silencing may be an alternative practical approach to treat HBV-induced pathogenesis. A full understanding of HBV RNA transcription and the biological functions of HBV RNA may open a new avenue for the development of novel HBV therapeutics. PMID: 29881235 [PubMed – in process]

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Hepatitis B virus pathogenesis: Fresh insights into hepatitis B virus RNA.

Alternative splicing of hepatitis B virus: A novel virus/host interaction altering liver immunity.

Posted by on 06 Jun 2018 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Alternative splicing of hepatitis B virus: A novel virus/host interaction altering liver immunity. J Hepatol. 2017 Oct;67(4):687-699 Authors: Duriez M, Mandouri Y, Lekbaby B, Wang H, Schnuriger A, Redelsperger F, Guerrera CI, Lefevre M, Fauveau V, Ahodantin J, Quetier I, Chhuon C, Gourari S, Boissonnas A, Gill U, Kennedy P, Debzi N, Sitterlin D, Maini MK, Kremsdorf D, Soussan P Abstract BACKGROUND & AIMS: Hepatitis B virus (HBV) RNA can undergo alternative splicing, but the relevance of this post-transcriptional regulation remains elusive. The mechanism of HBV alternative splicing regulation and its impact on liver pathogenesis were investigated. METHODS: HBV RNA-interacting proteins were identified by RNA pull-down, combined with mass spectrometry analysis. HBV splicing regulation was investigated in chemically and surgically induced liver damage, in whole HBV genome transgenic mice and in hepatoma cells. Viral and endogenous gene expression were quantified by quantitative reverse transcription polymerase chain reaction, Western blot and enzyme-linked immunosorbent assay. Resident liver immune cells were studied by fluorescence-activated cell sorting. RESULTS: HBV pregenomic RNA-interacting proteins were identified and 15% were directly related to the splicing machinery. Expression of these splicing factors was modulated in HBV transgenic mice with liver injuries and contributed to an increase of the HBV spliced RNA encoding for HBV splicing-generated protein (HBSP). HBSP transgenic mice with chemically induced liver fibrosis exhibited attenuated hepatic damage. The protective effect of HBSP resulted from a decrease of inflammatory monocyte/macrophage recruitment through downregulation of C-C motif chemokine ligand 2 (CCL2) expression in hepatocytes. In human hepatoma cells, the ability of HBSP to control CCL2 expression was confirmed and maintained in a whole HBV context. Finally, viral spliced RNA detection related to a decrease of CCL2 expression in the livers of HBV chronic carriers underscored this mechanism. CONCLUSION: The microenvironment, modified by liver injury, increased HBSP RNA expression through splicing factor regulation, which in turn controlled hepatocyte chemokine synthesis. This feedback mechanism provides a novel insight into liver immunopathogenesis during HBV infection. Lay summary: Hepatitis B virus persists for decades in the liver of chronically infected patients. Immune escape is one of the main mechanisms developed by this virus to survive. Our study highlights how the crosstalk between virus and liver infected cells may contribute to this immune escape. PMID: 28600137 [PubMed – indexed for MEDLINE]

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Alternative splicing of hepatitis B virus: A novel virus/host interaction altering liver immunity.

Polymeric Nanocapsules for Vaccine Delivery: Influence of the Polymeric Shell on the Interaction With the Immune System.

Posted by on 07 May 2018 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Polymeric Nanocapsules for Vaccine Delivery: Influence of the Polymeric Shell on the Interaction With the Immune System. Front Immunol. 2018;9:791 Authors: Peleteiro M, Presas E, González-Aramundiz JV, Sánchez-Correa B, Simón-Vázquez R, Csaba N, Alonso MJ, González-Fernández Á Abstract The use of biomaterials and nanosystems in antigen delivery has played a major role in the development of novel vaccine formulations in the last few decades. In an effort to gain a deeper understanding of the interactions between these systems and immunocompetent cells, we describe here a systematic in vitro and in vivo study on three types of polymeric nanocapsules (NCs). These carriers, which contained protamine (PR), polyarginine (PARG), or chitosan (CS) in the external shell, and their corresponding nanoemulsion were prepared, and their main physicochemical properties were characterized. The particles had a mean particle size in the range 250-450 nm and a positive zeta potential (~30-40 mV). The interaction of the nanosystems with different components of the immune system were investigated by measuring cellular uptake, reactive oxygen species production, activation of the complement cascade, cytokine secretion profile, and MAP kinases/nuclear factor κB activation. The results of these in vitro cell experiments showed that the NC formulations that included the arginine-rich polymers (PR and PARG) showed a superior ability to trigger different immune processes. Considering this finding, protamine and polyarginine nanocapsules (PR and PARG NCs) were selected to assess the association of the recombinant hepatitis B surface antigen (rHBsAg) as a model antigen to evaluate their ability to produce a protective immune response in mice. In this case, the results showed that PR NCs elicited higher IgG levels than PARG NCs and that this IgG response was a combination of anti-rHBsAg IgG1/IgG2a. This work highlights the potential of PR NCs for antigen delivery as an alternative to other positively charged nanocarriers. PMID: 29725329 [PubMed]

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Polymeric Nanocapsules for Vaccine Delivery: Influence of the Polymeric Shell on the Interaction With the Immune System.

Anoectochilus roxburghii: A review of its phytochemistry, pharmacology, and clinical applications.

Posted by on 04 May 2018 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Anoectochilus roxburghii: A review of its phytochemistry, pharmacology, and clinical applications. J Ethnopharmacol. 2017 Sep 14;209:184-202 Authors: Ye S, Shao Q, Zhang A Abstract ETHNOPHARMACOLOGICAL RELEVANCE: Anoectochilus roxburghii (Orchidaceae), also known as Jinxianlian (Simplified Chinese: ) and Jinxianlan (Simplified Chinese: ), is valued in many Asian countries, where this plant species is used for medicinal, culinary, and ornamental purposes. As a food, A. roxburghii is widely used as a treatment booster and medicine because of its various beneficial properties; these include, most notably, the curative effects of heat dissipation and cooling of blood, elimination of dampness, detoxification, and immunity enhancement. AIM OF THIS REVIEW: This review aims to provide up-to-date information on the phytochemistry, pharmacology, and clinical applications of A. roxburghii. MATERIALS AND METHODS: Relevant information on A. roxburghii was obtained by an online search of worldwide-accepted scientific databases (Web of Science, ScienceDirect, Elsevier, Springer, NCBI, ACS Publications, CNKI, and Wanfang data). RESULTS: Phytochemical investigations have revealed that the major chemical constituents of A. roxburghii are polysaccharides, flavonoids, glycosides, organic acids, volatile compounds, steroids, triterpenes, alkaloids, and nucleosides. These compounds have been proven to be the main bioactive substances responsible for pharmacological activities such as antidiabetic, antilipemic, anti-inflammatory, antiviral, liver protective, renal protective, immunomodulatory, abirritant, sedative, and antineoplastic effects. CONCLUSIONS: A variety of dosage forms of A. roxburghii are currently being applied to patients suffering from hyperuricemia, type 2 diabetes mellitus, chronic hepatitis B, Helicobacter pylori infection, cough-variant asthma, and other conditions. Nevertheless, further research is needed to clarify A. roxburghii absorption, distribution, metabolic, and excretion pathways. Moreover, the toxicology in A. roxburghii and A. formosanus are also in urgent need of research, especially long-term in vivo chronic toxicity tests need to be carried out. PMID: 28755972 [PubMed – indexed for MEDLINE]

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Anoectochilus roxburghii: A review of its phytochemistry, pharmacology, and clinical applications.

Novel treatment strategy with radiofrequency ablation and surgery for pregnant patients with hepatocellular carcinoma: a case report.

Posted by on 04 May 2018 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Novel treatment strategy with radiofrequency ablation and surgery for pregnant patients with hepatocellular carcinoma: a case report. Surg Case Rep. 2018 May 02;4(1):43 Authors: Matsuo M, Furukawa K, Shimizu H, Yoshitomi H, Takayashiki T, Kuboki S, Takano S, Suzuki D, Sakai N, Kagawa S, Nojima H, Ohsuka M Abstract BACKGROUND: Hepatocellular carcinoma (HCC) during pregnancy is rare, with a poor prognosis. Recently, however, increasing resection rates have improved survival rate. Currently, various surgeries are safely performed after the second trimester and termination of pregnancy is not always necessary. However, surgery is sometimes limited by gestational age or the patient’s will. When patients with HCC refuse surgery during pregnancy, we face specific problems with respect to curability and fetal life. Meanwhile, previous studies have revealed radiofrequency ablation (RFA) as a possible alternative to surgery for the treatment of early HCC and shown its favorable local control rate for advanced HCC. However, no case of HCC treated with RFA during pregnancy has yet been reported. CASE PRESENTATION: Here, we present the case of a 33-year-old woman, who was a hepatitis B virus carrier. The patient had been followed up because HBV carrier could develop hepatitis or HCC. And she was diagnosed with a 40-mm HCC tumor at 17 weeks of gestation. She refused surgery because she was pregnant and wanted to continue her pregnancy; therefore, we performed RFA for the local control of her HCC at 17 weeks of gestation and radical surgery at postpartum. She delivered a healthy baby and has survived without recurrence for 6 years after the surgery. CONCLUSIONS: Surgery is potentially a curative treatment for HCC whether the patient is pregnant or not. However, various problems unique to pregnancy make it difficult to perform a straightforward surgery. Our case revealed that RFA can be safely performed in pregnant patients during the second trimester, and the combination of RFA and surgery can radically increase the resection rate of HCC during pregnancy. PMID: 29721779 [PubMed]

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Novel treatment strategy with radiofrequency ablation and surgery for pregnant patients with hepatocellular carcinoma: a case report.

Notification and counselling of hepatitis positive blood donors, their immediate emotional response, contact-testing and their follow-up: Study from a…

Posted by on 25 Apr 2018 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Notification and counselling of hepatitis positive blood donors, their immediate emotional response, contact-testing and their follow-up: Study from a tertiary care hospital! Transfus Apher Sci. 2018 Apr 13;: Authors: Tiwari AK, Bhardwaj G, Dara RC, Arora D, Aggarwal G, Bhargava R, Madan K Abstract INTRODUCTION: Post-donation counselling informs donors of unusual test results. Timely notification and counselling regarding their Transfusion Transmitted Infection (TTI) status is necessary for early clinical intervention in the donor and reducing risk of transmission. We share our experience with respect to Hepatitis B (HBV) and Hepatitis C (HCV) positive donors who were counselled and followed-up for clinical outcome. MATERIALS AND METHODS: It was prospective 2-year study in TTI positive blood donors. Confirmed positive HBV/ HCV donors were notified to attend the donor-clinic or to visit local hepatologist for further management. At donor clinic, donor’s immediate emotional response was observed; donors were offered contact-testing, associated risk factors were noted, counselled, referred to hepatologist, treated and followed-up for clinical outcome. RESULTS: Of 481 donors (0.91%) confirmed positives, 351 were contacted telephonically; 280 promised to attend donor clinic and 71 were referred to their local hepatologist. 145 donors attended the donor clinic, eventually. Most common immediate emotional response noted were ‘feeling of fear’ (55.2%) and ‘disbelief’ (35.2%). Most common associated risk factor was history of medical treatment/ injections without knowledge of sterilisation. Five donors availed contact testing and four (spouses in all four cases) came out positive. Of 98 donors contacted post-counselling; 89 went to hepatologist. No medication was advised to seven donors (low viral load), 59 donors completed treatment course and 23 donors were undergoing treatment at time of follow-up. Nine donors opted for alternative treatment or “no treatment”. CONCLUSION: Donor-clinic proved beneficial to substantial number of donors and their families. PMID: 29685393 [PubMed – as supplied by publisher]

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Notification and counselling of hepatitis positive blood donors, their immediate emotional response, contact-testing and their follow-up: Study from a…

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