A fertozések megelozésének lehetoségei krónikus hepatitis és cirrhosis esetén

Translated title of the contribution: Prevention of infections in chronic hepatitis and cirrhosis

A. Pár, Elemér Nemesánszky

Research output: Contribution to journalArticle

Abstract

Patients with chronic liver disease, mostly the elderly, due to their impaired immune response, frequently suffer from infections worsening the clinical course. This is sometimes overlooked in the everyday praxis. In patients with alcoholic liver disease both hepatitis A virus (HAV) and acute hepatitis B virus (HBV) infections can lead to fulminant hepatic failure, therefore their immunization with HAV and HBV vaccines is highly recommended, similarly, vaccination against flu and pneumococcus also may be indicated for alcoholics. In chronic viral hepatitis, alcohol abuse can result in rapid progression to cirrhosis and reduces the efficacy of antiviral treatment. Patients with chronic hepatitis C should also be vaccinated against superinfections by HAV and HCV Co-infections by hepatotropic viruses and human immundeficiency virus (HIV) are frequent due to the shared routes of transmission. In HIV-positive patients the efficacy of the vaccination against HAV and HBV depends on the CD4 cell count, which also determined the timing of anti-HBV or anti-HCV treatment. Concerning the bacterial infections, spontaneous bacterial peritonitis (SBP) is the most severe complication of cirrhosis. The prevention of SBP is orally administered, moderately absorbed quinolon (norfloxacin) as long-term selective intestinal decontamination against Gram-negative pathogens. Alcoholic patients are also susceptible for tuberculosis. Bacterial infections play a role even in portal hypertension and variceal rupture, furthermore, both gastrointestinal haemorrhage and invasive endoscopic procedures increase the risk of infection, therefore in such situations a short-term (5-8 day) antibiotic profilaxis is necessary with norfloxacin or ciprofloxacin. Taking into consideration these points of view, it may be of privotal significance for the management of patients with liver disease.

Original languageHungarian
Pages (from-to)799-805
Number of pages7
JournalLege Artis Medicinae
Volume15
Issue number11
Publication statusPublished - Nov 2005

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Chronic Hepatitis
Hepatitis A virus
Fibrosis
Hepatitis B virus
Infection
Norfloxacin
Alcoholics
Viruses
Peritonitis
Bacterial Infections
Liver Diseases
Vaccination
Alcoholic Liver Diseases
Superinfection
Hepatitis B Vaccines
Gastrointestinal Hemorrhage
Decontamination
Acute Liver Failure
Portal Hypertension
Chronic Hepatitis C

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A fertozések megelozésének lehetoségei krónikus hepatitis és cirrhosis esetén. / Pár, A.; Nemesánszky, Elemér.

In: Lege Artis Medicinae, Vol. 15, No. 11, 11.2005, p. 799-805.

Research output: Contribution to journalArticle

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