Association of aspirin and nonaspirin NSAIDs therapy with the incidence risk of hepatocellular carcinoma: a systematic review and meta-analysis on cohort studies.

According to the current research evidence, the therapy of nonsteroidal anti-inflammatory drugs (NSAIDs) might effectively decrease the risk of hepatocellular carcinoma (HCC) incidence. Investigations have been conducted on the relationship between NSAIDs (aspirin and nonaspirin NSAIDs) and the risk of HCC incidence. We searched the PubMed, Web of Science, Embase and Cochrane Library databases for cohort studies published prior to 15 March 2020 and screened eligible studies. There were a total of 12 eligible studies (published between 2012 and 2020). We observed a lower risk of HCC among aspirin users [hazard ratio 0.53; 95% confidence interval (CI), 0.43-0.65]. However, there were no statistically significant associations discovered between nonaspirin NSAID use and the risk of HCC incidence (hazard ratio 0.95; 95% CI, 0.79-1.15). Furthermore, aspirin use has also been found to reduce the risk of HCC in patients with cirrhosis or viral hepatitis compared to that in the general population (hazard ratio 0.15; 95% CI, 0.10-0.23; hazard ratio 0.65; 95% CI, 0.56-0.76, respectively). Moreover, no statistical associations were found between aspirin use and a higher risk of bleeding risk, with a hazard ratio value of 0.76 (95% CI, 0.51-1.13). In summary, the conducted meta-analysis reveals that aspirin, rather than nonaspirin NSAIDs, can significantly decrease the risk of HCC, particularly in patients with cirrhosis or viral hepatitis.

Hepatitis Viruses in Kidney Transplantation.

Hepatitis viruses are named for their primary clinical illness, inflammation of the liver. Currently, six types of viruses are designated hepatitis viruses (A, B, C, D, E, and G), although only five of these cause hepatitis. Hepatitis viruses are composed of RNA and DNA viruses from different families and with different virologic properties, some of which typically cause acute hepatitis while others cause acute and chronic hepatitis. In addition to their role in liver disease, members of this group of viruses may cause a variety of pathologic changes in the kidney and other organs, and chronic infection may lead to cirrhosis in addition to raising a variety of important issues in the management of kidney transplant recipients. In this brief report, we review the virologic and clinical properties of each of the hepatitis viruses, and highlight the role of each virus in renal disease and kidney transplantation.

Adenovirus hepatitis presenting as tumoral lesions in an immunocompromised patient.

A 59-year-old man with T-cell prolymphocytic leukemia on alemtuzumab presented with neutropenic fever, intermittent nausea, and multiple ill-defined low attenuation foci in the liver on abdominal computed tomography scan which were suspicious for metastatic disease. Histological examination revealed the diagnosis of adenovirus hepatitis. Patient responded well to cidofovir. Adenovirus hepatitis is a rare but important entity to be considered by the clinicians, radiologists, and pathologists. Timely diagnosis and appropriate management are essential to improve the prognosis of adenovirus hepatitis in immunocompromised patients.

Hepatotoxicity of agents used in the management of inflammatory bowel disease.

Patients with inflammatory bowel disease (IBD) are at risk for hepatobiliary disease and toxicity, and the diagnosis of drug-induced liver disease in patients being treated for IBD can represent a clinical challenge. There are a number of disease states associated with IBD, which are primary sclerosing cholangitis, cholangiocarcinoma and autoimmune hepatitis. There is a wide spectrum of hepatic injury that can occur from the agents used to treat IBD, such as acute or chronic hepatic injury directly attributable to the drugs used to treat IBD (e.g. sulfasalazine, mesalamine, thiopurines, methotrexate, TNF antagonists, quinolone antibiotics); liver toxicity from drugs used to treat complications of immunomodulators and TNF antagonists (e.g. isoniazid for treatment of reactivation tuberculosis), and exacerbation of underlying chronic viral hepatitis with infliximab and other TNF antagonists. Thiopurines are also associated with the development of hepatic vascular lesions, such as nodular regenerative hyperplasia and peliosis hepatic. In addition, biologics can be associated with the reactivation of underlying chronic viral hepatitis, mandating universal screening prior to initiation of TNF-alpha antagonist therapy.

Fatal adenoviral hepatitis after rituximab therapy.

Rituximab is an anti-CD20 monoclonal antibody used in the treatment of B-cell proliferative disorders. Although it is very effective in many cases, a number of case reports in the literature have described fatal viral reactivations associated with rituximab therapy. We report what is to our knowledge the first case of fatal adenoviral hepatitis in a patient with Waldenstrom macroglobulinemia treated with rituximab. This case is a new example of an emerging pattern of association between rituximab therapy and fatal viral reactivations, and it urges increased vigilance when using rituximab-based treatment regimens.

Synergistic effect of hepatitis virus infection and occupational exposures to vinyl chloride monomer and ethylene dichloride on serum aminotransferase activity.

AIMS: To study the synergistic effect of occupational chemical exposure and hepatitis virus infection on serum aminotransferase activity. METHODS: A total of 568 male workers who were employed in five polyvinyl chloride (PVC) or four vinyl chloride monomer (VCM) manufacturing factories were studied. Information relating to current job title, alcohol consumption, and cigarette smoking was obtained. Exposure level of chemical mixtures was classified by hygienic effect (a summation of personal time weighted average/reference permissible exposure level of each chemical) into high, moderate, and low exposure groups. Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT), hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and anti-hepatitis C antibody were assayed. RESULTS: Hepatitis virus infection and increased body mass index were associated with abnormal serum aminotransferase activity. In workers with hepatitis virus infection, those with high exposure had a higher prevalence of abnormal AST and ALT compared to low exposure; among those without hepatitis virus infection, the differences of prevalence of abnormal AST and ALT were not significant between different chemical exposure groups. There was a significant trend of increasing risks of increased AST and ALT in moderate and high exposure groups with hepatitis virus infection. Such a synergistic effect was more prominent among HBeAg-positive workers. CONCLUSIONS: Mixed exposures to 1,2-ethylene dichloride and VCM have a positive synergistic effect with hepatitis virus infection on liver damage. Assessment of fitness for work should be considered in workers with hepatitis B and C infection, when they have potential exposure to hepatotoxins in the workplace.

Side effects and combination anti-HIV drugs.

AIDS: Anti-HIV drugs can have some serious side effects. The AIDS Treatment Data Network has developed fact sheets on each available anti-HIV drug free on request. There is limited information on some drug combinations, particularly since triple combination therapy has only been used for a short time. Drugs and the related symptoms that can be responsible for hepatitis, diabetes, buffalo hump/lipomas, pancreatorenal syndrome, and hemolytic anemia are described. The standard dosage and side effects of nucleoside reverse transcriptase inhibitors (NRTIs) and protease inhibitors are provided.^ieng

[Effects of green tea extract on galactosamine-induced hepatic injury in rats].

The present study examined the preventive effects of green tea extract on D-galactosamine (GalN)-induced hepatic injury in rats, an animal model of viral hepatitis. A single i.p.-injection of GalN (700 mg/kg) to male Wistar rats caused fulminant hepatitis by 48 hr as assessed by marked increases in the serum aspartate aminotransferase (GOT), alanine aminotransferase (GPT) and alkaline phosphatase (ALP) activities; decreases in the serum protein and cholesterol levels and the amount of liver microsome P-450; and marked changes in organ weights. The lecithin: cholesterol acyltransferase (LCAT) activity markedly increased at 8 hr and markedly decreased at 24 hr after the GalN injection. In the experiment, animals were orally administered green tea extract at doses of 50, 100 or 200 mg/kg five times each before and after the GalN injection. Treatment with green tea extract significantly prevented the increases in the GOT, GPT and ALP activities in a dose-related manner. It also significantly prevented the decreases in serum albumin and total cholesterol, although not in a dose-related manner. A tendency to prevent the increase in LCAT activity and the decrease in liver microsome P-450 was also noted. Little effect was found on the other abnormal changes in the serum lipids and proteins and the organ weights. These results suggest that green tea may have an ameliorating effect on hepatic dysfunction.

[Types of hepatitis in parenteral opiate addicts (author's transl)]. / Verlaufsformen der Hepatitis bei Drogensüchtigen mit parenteralem Opiat-Abusus.

Fifty drug addicts with parenteral heroin abuse and tentative diagnosis of acute hepatitis were examined by means of biochemical and serological tests and by liver biopsy. Diagnosis of acute hepatitis was confirmed in 23 patients. 12 patients were examined by liver biopsy a second time 2 months to 18 months later, 3 patients underwent liver biopsy three times. In 80% of the patients markers of hepatitis B (HBsAg, anti-HBs and anti-HBc) were found in the sera. There is some evidence of not only hepatitis B, but also hepatitis non-A, non-B in parenteral drug addicts leading to protracted forms of acute hepatitis and chronic hepatitis.