Bacterial nosocomial infections in chronic liver diseases

This study aimed to survey nosocomial infection in 90 patients with different stages of chronic liver disease in addition to 20 patients without liver diseases as a control group. 37.8% of the patients developed nosocomial infections during the course of their hospitalization compared with 20% of control subjects. A spontaneous bacterial peritonitis accounted for 44.1%, infection of respiratory tract accounted for 35.3%, followed by urinary tract infections [14.7%] and bacteremia [11.8%], intravenous cannula site infection [11.8%] and cellulitis [2.9%]. In conclusion, patients with liver cirrhosis are at an increased risk of developing nosocomial bacterial infections which add to poor prognosis and are associated with significantly high morbidity and mortality

Ribavirin induces immunomodulation in chronic hepatitis C therapy

To investigate the effects of ribavirin on hepatitis C virus [HCV] specific T-helper cell responses and the expression of interleukin-12 receptor-beta-1 and beta-2 chains on CD4+ T cells, peripheral blood mononuclear cells from 56 patients with proven chronic hepatitis C were incubated with or without ribavirin [0.1 mug/ml]. The results suggested that ribavirin induces up-regulation and differentiation of CD4+ T cells through the up-regulation of interleukin-12 receptor beta-2 chain

Analysis of markers of cytotoxicitty and apoptosis in HCV

To determine the role of CD8+ T-cell responses and apoptosis in mediating liver injury in chronic hepatitis C, an analysis of cytotoxic CD8+ T-cell and apoptosis markers was performed in 70 patients with proven chronic hepatitis C and 30 controls. CD8+ T-cell responses to a panel of HCV proteins and peptides were performed in an Elispot assay. Apoptosis was detected by peripheral expression of Fas, Fas ligand and perforin as well as apoptosis of hepatocytes was also detected using transferase-mediated immunohistochemical d-UTP biotin nick labeling [TUNEL] and flowcytometry. Cytotoxic HLA A2 restricted responses were detected in 54 patients. The expression of Fas antigen, Fas ligand and perforin was significantly increased in patients compared with the control subjects. Immunohistochemical intracytoplasmic Fas expression and the apoptosis index of hepatocytes directly correlated to the necroinflammatory activity in the liver. A direct significant correlation was detected between the CD8+ T-cell responses and the apoptosis index. These results indicated that HCV- specific CD8+ T-cell responses and apoptosis can be detected in the majority of patients with chronic HCV and liver injury in chronic HCV is mediated through these responses