Browsing by Subject "Hepatitis C"
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Item Antigen-Specific Natural Killer Cell Responses in Chronic Hepatitis C Virus Infection(2014-02-04) Bowman, Kathryn; Holz, Lauren; Rehermann, BarbaraChronic hepatitis C virus (HCV) infection results in an inflammatory liver disease leading to fibrosis and cirrhosis. The progression of liver disease is thought to be immune-mediated because HCV itself is non-cytopathic. Given that HCV-specific T cells are diminished in number and functionally exhausted in chronic HCV infection, it remains unclear which cell population drives disease pathogenesis. Here, we investigated the function of natural killer (NK) cells, the major innate immune cell population in the liver. The NK cell population increases further in the setting of chronic hepatitis C infection and have multiple mechanisms of cytotoxicity. We investigated whether NK cells could respond to HCV in an antigen-specific manner. PBMCs from 39 patients with chronic HCV infection (gt 1) not recently on medication (>2 years) were stimulated for 8 hours in a whole blood activation assay with pools of overlapping 18-mer peptides comprising HCV structural (E1, E2) and nonstructural (NS3) proteins. Cytokine production by NK cells and T cells was assessed by multicolor flow cytometry. The frequency of IFN-γ+ NK cells was 5 fold greater than the frequency of IFN-γ+ T cells. A minority of IFN-γ+ NK cells co-produced TNF-α. NK cell responses to HCV peptides varied between subjects, but did not correlate with T cell responses or viremia. This study demonstrates that NK cells are activated in an antigen-specific manner in chronic HCV infection and respond to both structural and nonstructural HCV proteins. Natural killer cell cytokine and cytotoxic responses were larger than corresponding T cell responses. The mechanism of antigen-specific NK cell activation is currently under investigation.Item Chronic hepatitis C: 1996(1996-02-15) Maddrey, Willis C.Item Clinical decision-making in chronic hepatitis C(2002-12-19) Malet, Peter F.Item Hepatitis C update: progress and problems(1993-01-14) Cuthbert, Jennifer A.Item Hepatitis C virus new diagnostic and therapeutic options(2011-12-09) Thiele, Dwain L.Item Hepatitis C: 2001(2001-01-11) Maddrey, Willis C.Item Hepatitis C: a work in progress(1999-10-28) Maddrey, Willis C.Item Hepatitis C: the evolving strategy to test and treat(2014-01-24) Jain, Mamta K.Item Hepatitis C: Transplantation dilemmas(2001-10-04) Brown, GeriItem Integrated Model for Hepatitis C Screening and Linkage to Care in Homeless Population(2019-01-22) Xia, Amy; Balakrishnan, Naveen; Tran, Minh; Pagels, PattiBACKGROUND: Hepatitis C is a major cause of morbidity and mortality as up to 46% of people infected with Hepatitis C develop cirrhosis and up to 20% develop hepatocellular carcinoma. Over the past year, a new initiative through the DFW Hep B Free organization at the University of Texas Southwestern (UTSW) was formed to target Hepatitis C among the homeless population, starting with screening at the Union Gospel Mission's Calvert Place homeless shelter. This underserved population is vulnerable because of inadequate healthcare access and resources, in addition to other risk factors such as former incarceration and injection drug usage. The main barriers to care for a transient, homeless population are 1) their lack of access to regular healthcare and screenings, 2) their inability to receive screening results via phone or mail, and 3) the difficulty of linking patients to affordable, accessible healthcare and treatment. METHODS: Our model integrates a student-run screening program, an on-site clinic at the shelter, and specialized hepatology services at Parkland Health Hospital System (PHHS), a local safety-net provider, to maximize the strengths that each component offers. Using OraQuick Rapid Hepatitis C Virus (HCV) tests, which screen for HCV antibodies and produce results in 20 minutes, we can deliver test results and provide counseling on the screening day. Under an IRB through a faculty hepatologist, patients that test positive are registered into Parkland Hospital's hepatitis surveillance program. The program then provides patient navigation, financial support, and treatment. RESULTS: On average, the HCV antibody positive rate from screenings at Calvert Place is 12.7% (N=126). 100% of positive patients were contacted with their result. For patients who tested positive (n=16), 2 (12.5%) did not need care (resolved HCV). From the 14 of 16 that had active HCV infections, 50% were lost to follow up and 50% were linked to care at Parkland hepatology clinic. CONCLUSION: Through our integrated model, we have created the foundations for a sustainable system to break down barriers to care while ultimately connecting HCV-positive homeless patients to treatment.Item Liver disease and hepatitis C infection: is it the virus or is it the host?(1998-08-27) Thiele, Dwain L.Item Mechanisms of non-AIDS complications of HIV disease: role of hepatitis C co-infection(2015-02-20) Bedimo, RogerItem Mixed essential cryoglobulinemia and hepatitis C: a model of viral induced autoimmunity?(1992-10-08) Geppert, Thomas D.Item Patient Perspectives on Barriers to Hepatitis C Treatment: Qualitative Analysis of Patient Focus Groups(2013-01-17) Devereaux, Robert Logan; North, Carol S.Much of the research to date on barriers to treatment for patients with hepatitis C (HCV) has approached the problem from either the perspective of either the medical provider or healthcare system. To better understand these barriers from the patients' perspectives, exploratory focus groups were conducted with both mono-infected HCV and coinfected HCV/HIV patients. Nine focus groups with a total of 48 patients were conducted in 2008 and 2009. Transcribed focus group passages were categorized using qualitative analysis software. The category with the most passages was treatment knowledge (24%), which contained patients' expressions of their personal understanding as well as requests for additional information. The category with the fewest passages was desire for treatment (6%). The treatment barriers category included frustration with medical provider communication and difficulty with physician-patient relationships as well as social stigma and lack of accurate disease knowledge. These areas of concern expressed by patients in focus groups have highlighted underexplored areas that may warrant future investigation as potential opportunities for development of intervention.Item [Southwestern News](2001-04-04) Baxter, MindyItem [Southwestern News](2000-06-14) Echeverria, IoneItem [Southwestern News](2005-10-26) Rian, RussellItem An update: management and treatment of hepatitis C virus infection(2014-09-05) Brown, GeriItem [UT Southwestern Medical Center News](2009-08-06) Ladson, LaKishaItem [UT Southwestern Medical Center News](2006-12-25) Despres, Cliff