Front View of Liver

The liver is a large, meaty organ that sits on the right side of the belly. Weighing about 3 pounds, the liver is reddish-brown in color and feels rubbery to the touch. Normally you can't feel the liver, because it's protected by the rib cage.

The liver has two large sections, called the right and the left lobes. The gallbladder sits under the liver, along with parts of the pancreas and intestines. The liver and these organs work together to digest, absorb, and process food.

The liver's main job is to filter the blood coming from the digestive tract, before passing it to the rest of the body.

The liver also detoxifies chemicals and metabolizes drugs. As it does so, the liver secretes bile that ends up back in the intestines. The liver also makes proteins important for blood clotting and other functions.

the liver,hepatitis B,C,The liver's main,

The liver also detoxifies chemicals,The liver is a large,Front View of Liver,hepatitis a,b,c

treatment for chronic hepatitis

Specific treatment for chronic hepatitis will be determined by your physicians based on:

• your overall health and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Treatment of chronic hepatitis depends on the underlying cause of the disease. The goal of treatment is to stop damage to the liver and alleviate symptoms.

Treatment may include one/more of the following:

Antiviral Agent - When caused by hepatitis B or C, inflammation of the liver may be stopped with the antiviral agent interferon-alpha.

Corticosteroids - Corticosteroids may be used to treat chronic liver disease caused by an autoimmune disorder. Inflammation is suppressed, but scarring of the liver may continue.

Discontinuation of certain drugs - When chronic hepatitis is caused by certain drugs, discontinuing those drugs usually clears up any symptoms.

Preventing the spread of viral hepatitis:

Proper hygiene is the key to preventing the spread of many diseases, including hepatitis. Other preventive measures include:

• vaccinations - A hepatitis B vaccine is routinely given to toddlers as part of their immunization schedule. A hepatitis A vaccine is available for people at risk for contracting the disease while traveling. (There are no vaccines for hepatitis C, D, or E at this time.)
• blood transfusion - Blood transfusions are routinely screened for Hepatitis B and C to reduce the risk of infection.
• antibody preparation - If a person has been exposed to hepatitis, an antibody preparation can be administered to help protect them from contracting the disease.treatment

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Pegasys interferon therapy II

Sustained Response in HBeAg Negative Chronic Hepatitis B Patients 3 Years After Treatment with Pegasys

Investigators with the international Peginterferon alfa-2a in HBeAg-negative Chronic Hepatitis B Study Group randomly assigned more than 500 HBeAg negative chronic hepatitis B patients to received 180 mcg/week pegylated interferon monotherapy, 100 mg/day lamivudine (Epivir) monotherapy, or the same doses of both drugs used in combination, all for 48 weeks.

The researchers previously reported that HBeAg negative patients treated with pegylated interferon, with or without lamivudine, achieved significantly higher rates of sustained response 6 months after completing therapy than individuals treated with lamivudine alone.

In the present analysis, the authors looked at long-term durability though 3 years after treatment completion. A total of 315 patients (59% of the original patient population) participated in the post-treatment observational study.

Results

	3 years after treatment, 28% of patients treated with pegylated interferon (with or without lamivudine) had HBV DNA levels <10,000 copies/mL, compared to 15% of patients treated with lamivudine monotherapy (P = 0.039).
	Similarly, more patients treated with pegylated interferon had normal alanine aminotransferase (ALT) at the end of follow-up compared to those treated with lamivudine monotherapy (31% vs 18%; P = 0.032).
	Use of pegylated interferon and high baseline ALT were independent predictors of long-term virological response (P = 0.040 and 0.01, respectively).
	Among participants treated with pegylated interferon (again, with or without lamivudine), 8.7% overall -- or 44% of those with undetectable HBV at the end of follow-up -- cleared hepatitis B surface antigen (HBsAg), versus none treated with lamivudine monotherapy.

Based on these findings, the study authors concluded, "Biochemical and virologic responses were sustained for <3 years in approximately 25% of patients given a 48-week course of peginterferon alpha-2a, with or without lamivudine."

In their discussion, they added, "The ability to induce HBsAg clearance -- an outcome that is associated with long-term complication-free survival -- supports the use of peginterferon alfa-2a as a first-line treatment of HBeAg negative disease, avoiding the need for long-term therapy and the associated risks of developing drug resistance in those patients who achieve and maintain their response."

Drug resistance is a known risk with lamivudine and other nucleoside/nucleotide analogs that directly target HBV. Interferon is less likely to be limited by resistance since it promotes immune response against HBV rather than interfering directly with the viral life-cycle.

Pegasys interferon therapy,Pegasys interferon therapy,Similarly,sylimarin,atients treated with pegylated interferon,peginterferon alfa-2a as a first-line treatment of HBeAg negative disease

Research

Antibody to hepatitis C virus and liver disease in volunteer blood donors

Hepatitis C virus (HCV) is the major cause of transfusion-associated hepatitis that is neither hepatitis A nor hepatitis B, and one screening test for the antibody to the virus (anti-HCV) is called the ELISA (enzyme-linked immunosorbent assay). However, this test can give false-positive results, suggesting the presence of disease when, in fact, it does not exist. A more specific test is the recombinant immunoblotting assay or RIBA, which determines whether antiviral antibodies present are specifically directed against HCV. To learn more about the specificity of anti-HCV antibodies among blood donors, a study was carried out of a group of 50 donors found to be positive for HCV using ELISA. The subjects' blood was analyzed using the RIBA test. Results showed that 13 of the donors (26 percent) tested positive on RIBA analyses and 6 had indeterminate results with elevated levels of a liver enzyme that indicates disease. Twenty patients had negative RIBA results and normal results on tests of liver enzymes. The 19 patients with positive or indeterminate results underwent liver biopsies to determine whether liver disease was present. The 6 patients whose RIBA patterns were indeterminate had no signs of active hepatitis on biopsy. Of the 13 with positive RIBA tests, 8 were found to have chronic active hepatitis; in 2 cases, signs of cirrhosis (a condition in which fibrous tissue replaces liver tissue) were noted. Blood donors who test HCV-positive with ELISA and then with RIBA should be referred for further medical follow-up, as they could have active liver disease. No statement can be made about those who are positive for HCV on ELISA and then negative on RIBA, as none of them underwent liver biopsy. The anti-HCV RIBA is a useful aid for identifying blood donors with underlying chronic liver disease.

author: Alberti, Alfredo, Tagger, Alessandro, Ruol, Arturo, Chemello, Liliana, Cavalletto, Daniela, Dal Canton, Alessandro, Bizzaro, Nicola, Tagariello, Giuseppe

Publisher:American College of Physicians
Publication Name:Annals of Internal Medicine
Subject:Health
ISSN:0003-4819
Year:1991

Hepatitis C virus (HCV), hepatitis C virus and liver ,,The anti-HCV,,Tunderlying chronic liver disease.the liver virus,hepatitis B and C, Enzyme-linked immunosorbent assay, Blood donors, Blood dmunoblotting

Hepatitis B virus

Hepatitis B virus is 100 times more contagious than human immunodeficiency virus (HIV), which causes AIDS.

It is spread through sexual activity and by contact with blood and other body fluids.

The effects range from flu-like illness, nausea, and vomiting to cirrhosis and liver cancer. Statistics from the U.S.

Centers for Disease Control and Prevention indicate that 14 Americans die every day from hepatitis B and more than one-third of the 300,000 people infected are college-aged young adults.

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The symptoms of cirrhosis II

• The most common symptoms of cirrhosis are as follows:
  • Tiredness (fatigue) or even exhaustion
  • Weakness
  • Nausea
  • Loss of appetite leading to weight loss
  • Loss of sex drive

• Symptoms may not appear until complications of cirrhosis set in. Many people do not know they have cirrhosis until they have a complication.

• Jaundice - Yellowing of the skin and eyes from deposition of bilirubin in these tissues. Bilirubin is a product of the breakdown of old blood cells in the liver.
• Fever
• Vomiting
• Diarrhea
• Itching - From deposition in the skin of products of the breakdown of bile
• Abdominal pain - From enlargement of the liver or formation of gallstones
• Abdominal swelling or bloating - From fluid retention
• Weight gain - From fluid retention
• Swelling in ankles and legs (edema) - From fluid retention
• Difficulty breathing - From fluid retention
• Sensitivity to medications - Due to impairment of the liver's ability to filter medications from blood
• Confusion, delirium, personality changes, or hallucinations (encephalopathy) - From buildup of drugs or toxins in the blood, which then affect the brain
• Extreme sleepiness, difficulty awakening, or coma - Other symptoms of encephalopathy
• Bleeding from gums or nose - Due to impaired production of clotting factors
• Easy bruising - Due to impaired production of clotting factors
• Blood in vomit or feces - Due to bleeding of varicose veins caused by liver congestion
• Hemorrhoids - Varicose veins in rectum due to liver congestion
• Loss of muscle mass (wasting)
• In women, abnormal menstrual periods - Due to impairment in hormoneproduction and metabolism
• In men, enlargement of the breasts (gynecomastia), scrotal swelling, or small testes - Due to impairment in hormone production and metabolism
• The symptoms of cirrhosis II

The symptoms of cirrhosis ,The symptoms of cirrhosis ,Symptoms may not appear until complications of cirrhosis set in. Many people,liver,hepatitis B,C,virus HBV,virus HCV

Cirrhosis

The liver is the largest organ in the body, weighing up to 2.5 percent of total lean body mass. Located in the upper right quadrant of the abdomen, the liver varies in size and shape, depending on each person’s anatomy. Its main function is to metabolize substances in the blood in preparation for excretion, although it has many other important functions, including synthesis of most essential proteins, production of bile, and regulation of nutrients such as glucose, cholesterol, and amino acids.

The main kind of liver cell is called a hepatocyte. These cells comprise about two thirds of the liver’s mass. The liver’s blood supply comes from the hepatic artery, which supplies oxygen-rich blood. The liver also receives blood from the portal vein, which filters blood from the stomach, intestines, pancreas, and spleen.

The most common liver function tests are enzyme, bilirubin, albumin, and prothrombin time tests. The liver contains thousands of enzymes, only a few of which are routinely measured as indicators of liver function. These enzymes include the following:

Alkaline phosphatase. Abnormal levels may indicate bile obstruction, liver injury, or some forms of cancer.

Alanine transaminase. Abnormal levels may indicate hepatitis or other liver cell injury.

Aspartate transaminase. Abnormal levels may indicate injury to liver, heart, muscle, or brain.

Gamma-glutamyl transpeptidase. Abnormal levels may indicate organ damage, drug toxicity, alcohol abuse, or pancreatic disease.

Lactic dehydrogenase. Abnormal levels may indicate damage to liver, heart, or lung, and excessive breakdown of red blood cells.

5'-nucleotidase. Abnormal levels may indicate impaired bile flow.

The other major liver tests include the serum bilirubin test, which measures bile excretion, and the albumin test, which can indicate liver damage. Finally, the prothrombin time test measures the time needed for blood to clot. Because most blood clotting factors are produced in the liver, and they have rapid turnover, this test can help measure the liver’s ability to synthesize cells. Prothrombin may be elevated in hepatitis and cirrhosis as well as in disorders related to vitamin K deficiency.

Taken together, these tests provide physicians with a relatively complete picture of liver function and can help diagnose liver disease.

Cirrhosis Symptoms

Many people with cirrhosis have no symptoms during the early phases of the disease. Symptoms are caused by either of 2 problems:

1.Gradual failure of the liver to carry out its natural functions

2.Distortion of the liver's usual shape and size because of scarring

The symptoms of cirrhosis of the liver can vary greatly from patient to patient.

Cirrhosis,Cirrhosis Symptoms,The symptoms of cirrhosis of the liver,hepatitis B and C,chirosis,The other major liver tests include,hepatitis,virus HCV,HBV,The other major liver tests include

Liver Donations

A recent study found that living donation increased 42% and the number of individuals who presented for donation evaluation increased 74% at centers in New York. The surge in live donation and donor evaluation occurred after additional education was provided to liver transplant candidates. Those candidates exposed to the peer-based intervention (education) reported significantly greater knowledge, greater likelihood to discuss donation and increased self-efficacy compared to those not exposed to the intervention. Details of the study are reported in the January 2010 issue of Liver Transplantation, a journal of the American Association for the Study of Liver Diseases, published by Wiley-Blackwell.

According to the United Network for Organ Sharing (UNOS) as of January 30, 2009 there were 100,539 candidates on the waiting list in the U.S., with over 15,000 individuals in need of a liver transplant. UNOS also reported the number of deceased donors is decreasing from 6,650 donors in 2006 to 6,494 donors in 2007-a concerning fact for liver transplant candidates. Past studies have shown that the median wait time for a liver was 296 and 306 days (2005 and 2006, respectively). In New York State in 2008, there were 133 deaths on the liver waitlist, an increase of 16% over 2007. The critical shortage of deceased liver donors, a lack of broader national sharing, increased wait times and deaths on the wait list, all incentivize transplant programs to look to alternative ways to expand the pool of livers available for transplant.

Hepatitis B

Hepatitis B - This type of hepatitis spreads mainly through contaminated blood and blood products, sexual contact, and contaminated intravenous needles. Hepatitis B can lead to chronic hepatitis, cirrhosis, liver cancer, liver failure, and death.

Acute hepatitis is quite common in the US: 20 to 30 cases reported per 100,000 people each year.

Causes:
Common causes of acute hepatitis may include:

• infection with a virus (viral hepatitis A, B, C, D, or E)
• overdose of drugs (such as acetaminophen)
• chemical exposure (such as dry cleaning chemicals)

Chronic hepatitis:

Some people do not recover fully from acute hepatitis and develop chronic hepatitis, as the liver continues to sustain more damage and inflammation. Hepatitis is considered chronic if symptoms persist longer than six months. Chronic hepatitis can last years.

Different forms of:

alcohol-induced chronic hepatitis - continued damage throughout the liver from heavy alcohol consumption.
chronic active hepatitis - an aggressive inflammation and destroyer of liver cells, which usually leads to cirrhosis.
chronic persistent hepatitis - a milder inflammation of the liver, which usually does not lead to cirrhosis.

It helps in the treatment of liver

Clubmoss plant

The plant contains radium, triterpanes, alkaloids and mineral substances which give it diuretic, anti-alcoholic, anti-tobacco, anti-cirrhotic, and purgative properties.

In hepatitis and tumors of the conjunctive tissue of the liver, clubmosss are indispensable. Hepatic cirrhosis or liver cancer can also be treated with the help of clubmoss tea. Because it contains radium, clubmosss are used for calming muscle cramps. For this purpose, a pillow can be stuffed with this plant.

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