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Hepatitis C
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Rebecca Pierce-Williams, Neil Silverman, Raja Dhanekula, Jonathan M. Fenkel, Danielle Tholey
Any woman who tests positive for anti-HCV antibody should have HCV RNA quantitative evaluation (via PCR) performed. An HCV genotype is also recommended, as treatment is tailored to the genotype and subtype. She should be screened for co-infection with HIV (HIV antibody) and hepatitis A and B (hepatitis B surface antigen), as well as other STIs. Patients with chronic HCV infection are at high risk of liver failure if they are infected with other forms of viral hepatitis. Screening for immunity to hepatitis A (hepatitis A total antibody) and hepatitis B (hepatitis B surface antibody), and vaccinating if non-immune, is also recommended. Blood tests to measure liver function include aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin, platelet count and international normalized ratio (INR). Imaging of the liver to evaluate for cirrhosis can be completed with ultrasound during pregnancy, or liver elastography preconception or postpartum. Patients with cirrhosis should receive the pneumococcal vaccination [5]. A hepatology referral is recommended for assessment of disease severity, counseling on risk reduction behaviors, and treatment.
Liver Function Tests and Physiological Features of Liver Failure
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
Aminotransferases (transaminases) are enzymes present in the hepatocytes which leak out into the circulation with liver cell damage. The two enzymes measured are: Aspartate aminotransferase (AST) is a mitochondrial (80%) enzyme. As high blood levels are seen in hepatic necrosis, myocardial infarction, congestive heart failure and muscle injury, it is not specific for liver disease.Alanine aminotransferase (ALT) is a cytosol enzyme which is more specific to the liver. A rise in ALT occurs only in liver disease.
Liver Function Tests in the Differential Diagnosis of Hepatotoxicity
Published in Robert G. Meeks, Steadman D. Harrison, Richard J. Bull, Hepatotoxicology, 2020
Alanine aminotransferase (ALT) activities in normal mice have been reported to be X ± SD (IU/1) 13.1 ± 4.8 (Mitruka and Rawnsley, 1977) and 40 ± 21 (Harrison et al., 1978). ALT values in albino mice range 2.1–23.8 IU/1 (Bonilla, 1972; Nomura et al., 1975). Serum aspartate aminotransferase (AST) values normally vary in the range 23–48 IU/1 but the enzyme is present in many tissues and not liver specific.
Outcomes of wasp and bee stings in Taiwan
Published in Clinical Toxicology, 2023
Thi Ngat Nguyen, Mei-Jy Jeng, Nai-Yu Chen, Chen-Chang Yang
The patients with wasp or bee stings might manifest local effects, organ injury following toxic reactions, and anaphylactic reactions. Local effects included swelling, redness, necrosis, blister and itching. Organ injuries caused by a bee or wasp venom could be acute kidney injury (AKI), rhabdomyolysis, aminotransferase elevation, and coagulation abnormality such as prolongation of activated partial thromboplastin time (aPTT) [12,15]. Acute kidney injury was classified into stage I, stage II, and stage III based on Acute Kidney Injury Network (AKIN) [16]. A diagnosis of rhabdomyolysis was based on a creatine kinase (CK) concentration greater than 1000 U/L [17]. Aminotransferase elevation was defined as an aspartate aminotransferase (AST) or alanine aminotransferase (ALT) concentration greater than three times the upper limit of normal (ULN) [18]. The aPTT levels were categorized as less than 90 seconds or greater than or equal to 90 seconds [19].
Evaluation of hepatotoxicity and nephrotoxicity induced by fenpyroximate in subchronic-orally exposed Wistar rats
Published in Biomarkers, 2022
Imen Ayed-Boussema, Karima Rjiba, Hiba Hamdi, Asma M’nassri, Awatef Azzebi, Moncef Mokni, Salwa Abid
Alanine aminotransferase (ALT) catalyses the transfer of an amino group from alanine to alpha-ketoglutarate in the alanine cycle to form pyruvate and glutamate. Aspartate aminotransferase (AST) is a transaminase enzyme that catalyses the conversion of aspartate and alpha-ketoglutarate to oxaloacetate and glutamate. ALT and AST activities were measured using the NADH oxidation method (reactions (1) and (2)). In this detection method, the measurement of the absorbance change of NADH concentration at 340 nm is used based on the pyruvate reaction with lactate dehydrogenase (LDH) (ALT activity), or the oxaloacetate reaction with malate dehydrogenase (MDH)(AST activity) (Knight and Hunter 1968; Huang et al. 2006). The activity was expressed in International Unit/Liter (IU/L).
Cumulative effects of manganese nanoparticle and radiofrequency radiation in male Wistar rats
Published in Drug and Chemical Toxicology, 2022
Sonali Pardhiya, Usha Singh Gaharwar, Rohit Gautam, Eepsita Priyadarshini, Jay Prakash Nirala, Paulraj Rajamani
In the present study, intraperitoneal administration of MNPs resulted in alteration in alanine aminotransferase (ALT) level of rats in all the treatment groups as compared to control (Figure 7(A)). ALT levels of MNP and MNP + RFR exposed rats decreased significantly (p < 0.05) as compared to control, whereas in RFR exposed, the level was found to increase significantly (p < 0.05). However, in the case of aspartate aminotransferase(AST), there were no significant alterations within the groups (Figure 7(B)). Figure 7(C) shows significant alterations in the ratio of AST and ALT (AST/ALT) in all the treated groups as compared to control. Similarly, alkaline phosphatases (ALP) enzyme was found to be elevated in the serum of treated rats (Figure 7(D)). The changes in ALP levels were significant (p < 0.05) in MNP and MNP + RFR groups, whereas RFR group showed an insignificant increase. Total protein was observed to reduce significantly in MNP and MNP + RFR treated rats while no considerable decrease in RFR treated rats was observed (Figure 8(A)). Albumin decreased significantly in MNP and MNP + RFR treated groups (Figure 8(B)). The RFR group did not show any decrease in the albumin level. Figure 8(C) shows that the RFR group had significantly less globulin than the control rats. Interestingly in MNP + RFR rats, the globulin level is increased significantly than the MNP and RFR groups. Albumin–globulin ratio (A/G) decreased in MNP and MNP + RFR groups (Figure 8(D)) while the RFR group showed an increased A/G level.