• Title/Summary/Keyword: 만성 B형 간염

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Acute Exacerbation with Severe Jaundice in Chronic Hepatitis B Patient (만성 B형 간질환 환자에서 심한 황달을 동반한 급성 악화)

  • Lee, Heon-Ju
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.483-496
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    • 1997
  • 만성 B형 간염의 경과중 흔히 볼 수 있는 간기능의 이상은 대부분 심한 황달의 동반없이 혈청 AST와 ALT의 증가만 보이면서 악화되는 것이다. 저자는 심한 황달을 동반한 16명의 만성 B형 간염 악화 환자(연구군)와 심한 황달없이 AST와 ALT치만 증가된 13명의 환자(비교군)를 비교관찰하였다. PMC 제재를 복용했던 환자는 연구군에서 11명(68.8%), 대조군에서 1명(7.7.%)으로 나타났으며 PMC를 포함하여 각종 약제 및 알콜 섭취가 저명했던 환자가 연구군에서 15명(93.8%), 대조군에서는 2명(15.4%)이었다. 혈청 HBeAg 양성율은 급성 악화전에는 연구군에서 14명 중 7명(50.0%), 비교군에서는 13명 모두 (100%)에서 양성이었으며, 급성 악화 경과후에는 연구군에서는 변함없었고 비교군에서는 13명중 3명(23.1%)에만 양성이었다. 연구군 중 anti-HBe 양성화는 한 사람도 생기지 않았고 6명이 사망하였으며 대조군에서는 8명의 환자에서 anti-HBe 양성화가 생겼고 아무도 간기능 부전으로 사망하지 않았다. 만성 B형 간질환에서 심한 황달을 동반한 급성 악화와 관련있는 요인은 진행된 만성 활동성 간염, 간경변 등 근본적으로 진행된 간기능 저하와 동반된 부적절한 약제나 알콜 복용이 확실히 관계있을 것으로 사료되며 간기능 부전도 그리 드물지 않다. 반면에 간경변으로 진행되기 전 상대적으로 진행이 덜 된 비교군의 만성 B형 간염 환자에서는 황달의 저명한 증가없이 간기능이 갑자기 악화될 때는 자연적인 혈청 anti-HBe 양성전환의 동반이 흔한 것으로 나타났다.

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Acute Exacerbation with Severe Jaundice in Chronic Hepatitis B Patients (만성 B형 간질환 환자에서 심한 황달을 동반한 급성 악화)

  • Lee, Heon-Ju
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.329-336
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    • 1997
  • 만성 B형 간염의 경과중 흔히 볼 수 있는 간기능의 이상은 대부분 심한 황달의 동반없이 혈청 AST와 ALT의 증가만 보이면서 악화되는 것이다. 저자는 심한 황달을 동반한 16명의 만성 B형 간염 악화 환자(연구군)와 심한 황달없이 AST와 ALT치만 증가된 13명의 환자(비교군)를 비교관찰하였다. PMC 제재를 복용했던 환자는 연구군에서 11명(68.8%), 대조군에서 1명(7.7%)으로 나타났으며 PMC를 포함하여 각종 약제 및 알콜 섭취가 저명했던 환자가 연구군에서 15명(93.8%), 대조군에서는 2명(15.4%)이었다. 혈청 HBeAg 양성율은 급성 악화전에는 연구군에서 14명 중 7명(50.0%), 비교군에서는 13명 모두(100%)에서 양성이었으며, 급성 악화 경과후에는 연구군에서는 변함없었고 비교군에서는 13명 중 3명(23.1%)에서만 양성이었다. 연구군 중 anti-HBe 양성화는 한 사람도 생기지 않았고 6명이 사망하였으며 대조군에서는 8명의 환자에서 anti-HBe 양성화가 생겼고 아무도 간기능 부전으로 사망하지 않았다. 만성 B형 간질환에서 심한 황달을 동반한 급성 악화와 관련있는 요인은 진행된 만성 활동성 간염, 간경변 등 근본적으로 진행된 간기능 저하와 동반된 부적절한 약제나 알콜 복용이 확실히 관계있을 것으로 사료되면 간기능 부전도 그리 드물지 않다. 반면에 간경변으로 진행되기 전 상대적으로 진행이 덜 된 비교군의 만성 B형 간염 환자에서는 황달의 저명한 증가없이 간기능이 갑자기 악화될 때는 자연적인 혈청 anti-HBe 양성 전환의 동반이 흔한 것으로 나타났다.

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간염 virus(1)

  • 서진혜;박병채
    • Journal of Life Science
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    • v.2 no.3
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    • pp.163-173
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    • 1992
  • 간염바이러스들은 이들의 virology 및 임상적 특징들에 따라 A형, B형, C형, D형 및 E형으로 분류되며, A형 및 E형은 미개발국가들의 약년층에서 흔히 발생하는 급성간염의 원인으로 알려져 왔으나 만성간염 또는 간세포 암의 원인은 되지 않음으로 B형 및 C형에 비해 임상적인 의의는 적다. B형 바이러스는 급성간염 및 간세포 암의 가장 중요한 원인이며 전세계 인구 중에서 3억가량이 HBV에 감염되어 있고 이들의 75%가 아시아인인 것으로 밝혀져 있다. C형 바이러스는 최근에 비A형, 비B형 간염바이러스에 의한 간염의 중요한 원인으로 밝혀졌으며 구미 및 일본에서는 만성간염 및 간세포암의 가장 중요한 원인으로도 간주되고 있다. D형 간염바이러스는 지중해 연안국가, 북아프리카 및 중동국가들에서 HBV에 의해 이미 감염되어 있는 환자들을 침범함으로써 HBV에 의한 급성 및 만성간염을 악화시키나 HDV 단독으로는 간염의 원인이 될 수는 없다고 알려져 있다. 본지에서는 한국인에게서 임상적인 의의를 갖는 HBV에 대해 구체적으로 기술한다.

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The Psychosocial Aspects of the Patients with Chronic Hepatitis B (만성 B형 간질환 환자의 정신사회적 측면)

  • Kim, Jin-Sung
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.1
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    • pp.3-10
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    • 2000
  • Objectives : The author wanted to summarize the psychiatric and social aspects of the patients with hepatitis B virus infection. Methods : The author reviewed all pertinent citations in the Medline database from 1966 to 1999. Results : Psychiatric problems in this population include delirium, psychotic disorder due to general medical condition(especially mania), anxiety, depression, adjustment disorder, alcohol abuse/dependence, and drug abuse/dependence. Social aspects of the patients with hepatitis B viral infection relate to the stigma of being a carrier, guilty feeling about infection, guilty feeling about increased family burden, impacts of having hepatitis on interpersonal relations, sexual difficulties, and job loss with increased financial burden, and health care worker's refusal. Conclusions : Appropriate early educational counseling interventions regarding the expected course and psychosocial intervention should be tailored to the sociocultural needs of special populations. Those interventions will increase compliance of treatment and prevent progression to hepatocellalar carcinoma from hepatitis.

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Hepatitis B Virus Reactivation after Partial Hepatic Irradiation Alone: A Case Report (부분 간조사만을 시행받은 환자에서의 B형 간염바이러스의 재활성화: 증례보고)

  • Kim, Bo-Kyong
    • Radiation Oncology Journal
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    • v.28 no.2
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    • pp.106-110
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    • 2010
  • Reactivation of the hepatitis B virus (HBV) is a well-recognized complication in patients with chronic HBV infection who receive cytotoxic or other immunosuppressive therapy. In cases of patients treated by radiotherapy however, only a few of such reports exist and most of these include the patients previously treated by chemotherapy or transarterial chemoembolization. The results of this study point to a case of a patient with reactivation of HBV after radiotherapy alone. This study shows the possibility of HBV reactivation by partial hepatic irradiation alone hence, special attention should be paid to patients with HBV disease.

Consumer's Needs for Development of Smartphone Application for Self Care Performance of Patients with Chronic Hepatitis B (만성 B형간염 환자의 자가간호 수행을 위한 스마트폰 애플리케이션 개발 소비자요구도 조사)

  • Jeon, Jae-Hee;Kim, Kyunghee
    • The Journal of the Korea Contents Association
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    • v.16 no.4
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    • pp.729-740
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    • 2016
  • This study was conducted to assess the needs of smartphone application development for self care performance of 374 patients with chronic hepatitis B. The mean age of the subjects was 46.2 years. The patients obtained information about chronic hepatitis B from the internet (41.3%), nurses or doctors (23.8%), television (15.6%), and smartphones (6.2%). The reason that the information about hepatitis B didn't come from a smartphone were 'Lack of useful applications' (75.9%), 'Could not believe the information' (15.0). If the application is developed, subjects replied 'Frequently use' (59.9%), 'When needed' (33.2%). The desired contents were 'Knowledge of disease' (27.1%), 'Drug calender' (16.8%), 'Reference of information' (15.5%), 'Record of lab data' (14.6%). Ability to use the smartphone, depended on age and level of education, however the needs for the development of the smartphone application, there were not differences. Also, there were different desired contents of application, depended on age and level of education. Therefore, when developing smartphone applications for self care performance of chronic hepatitis B patients considering educational level and age, it could be widely utilized as a tool which can help to the self care performance of chronic hepatitis B patients.

Prospective Study on the Development of Glaucoma after Interferon alfa Therapy for Chronic Hepatitis B (만성 B형 간염 환자에서 인터페론 치료 후 녹내장 발생 여부의 전향적 연구)

  • Kwon, Young-Se;Choe, Yon-Ho;Hong, Sung-Bum
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.2
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    • pp.169-174
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    • 2000
  • Purpose: Previously reported ocular complications of interferon alfa administration are extremely rare. We experienced a 15-year-old boy with chronic hepatitis B who developed glaucoma after interferon alfa therapy. The purpose of this prospective study was to evaluate the possible development of glaucoma after interferon alfa therapy for chronic hepatitis B. Methods: Nine patients with chronic hepatitis B who visited Inha university hospital between February 1998 and July 1999 received interferon alfa therapy. We measured visual acuity, intraocular pressure, C/D ratio, and visual field examination at pre-interferon therapy, three and six months after therapy, respectively. Results: The total number of patients was 9 (4 boys and 5 girls). Mean age was $11.7{\pm}4.1$ years. The duration of therapy was 6 months and mean dosage of interferon was 5 million units. Compared with visual acuity, intraocular pressure, and C/D ratio at pre-therapy, those parameters at 3 months and 6 months after therapy showed no significant differences and none showed visual field defect after therapy. Conclusion: Our prospective study showed no evidence of development of glaucoma after interferon therapy. However, it is necessary to be concerned about the possibility of developing glaucoma or other ophthalmologic diseases after interferon therapy in chronic hepatitis B.

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Therapeutic Efficacy of Prednisolone Withdrawal Followed by Recombinant ${\alpha}$ Interferon in Children with Chronic Hepatitis B (소아 만성 B형 간염 환자에서 스테로이드 이탈 요법 후 인터페론 병용 투여의 치료 효과)

  • Ryu, Na-Eun;Kim, Byung-Ju;Ma, Jae-Sook;Hwang, Tai-Ju
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.2
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    • pp.169-177
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    • 1999
  • Purpose: To evaluate the efficacy of interferon alpha therapy with or without prednisolone in children with chronic hepatitis B. Methods: Twenty-eight children (22 boys, 6 girls, mean age 130 months) had seropositive results for HBsAg, HBeAg and HBV DNA; 11 had chronic persistent hepatitis and 17 had chronic active hepatitis. The patients were divided into two groups depending upon their inflammatory activity on liver biopsy, pretreatment serum ALT levels and HBV DNA levels. Fourteen children (group 1: chronic active hepatitis, ALT ${\geq}$ 100 IU/L and HBV DNA ${\leq}$ 100 pg/$300\;{\mu}L$) received interferon alpha 2a 5 $MU/m^2$ of body surface three times weekly for 6 months. Fourteen children (group 2: chronic persistent hepatitis or chronic active hepatitis with ALT < 100 IU/L or HBV DNA > 100 pg/$300\;{\mu}L$) received prednisolone in decreasing daily doses of 60 mg/$m^2$, 40 mg/$m^2$, and 20 mg/$m^2$, each for 2 weeks, followed after 2 weeks by interferon alpha 2a on the same schedule. At the end of therapy, 3 end points were analyzed: HBeAg seroconversion, serum ALT normalization rate and clearance of serum HBV DNA. Results: At the end of treatment, HBe antigen-to antibody seroconversion was higher but not more significant in group 1 than group 2 (71.4% vs. 50.0%). Only one patient in group 2 who lost HBeAg, also cleared HBsAg. ALT normalization was similar in both groups (64.3% in group 1 vs. 55.6% in group 2). Clearance of serum HBV DNA was observed in 78.6% of patients in group 1 and 64.3% in group 2, but no significant differences. Complete response was similarly achieved in both groups (57.1% in group 1 vs. 50.0% in group 2). Interferon alpha therapy with prednisolone priming was well tolerated and all children finished therapy. Conclusion: The combined therapy with prednisolone followed by interferon alpha may be safe and effective in inducing a serological and biochemical remission of the disease in approximately 50% of children with chronic hepatitis B and with a high level of viral replication and less active disease. However, a controlled study should be performed to confirm these results.

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