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Infectious Disorders - Drug Targets

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ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

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Research Article

Hemodynamic Changes of Hepatic & Renal Vessels in Systemic Bacterial Infection with Fever in HCV Related Cirrhosis

Author(s): Eman Mohammed Helal, Mohamed Sharaf-Eldin, Abdel Raouf Abou El Azm, Nagwa Mansour Badr Eldin, Mohammed Mahmoud Dawoud , Sherief Abd-Elsalam* and Dina Hazem Ziada

Volume 20, Issue 4, 2020

Page: [511 - 516] Pages: 6

DOI: 10.2174/1871526519666190506102703

Price: $65

Abstract

Objectives: To study the hemodynamic changes of hepatic & renal vessels in systemic bacterial infection with fever in HCV related cirrhosis with possible complications.

Methods: Three groups of patients with systemic bacterial infection with fever were included in the study; group І included 15 patients with decompensated cirrhosis, group ІІ included 15 patients with compensated cirrhosis and group ІІІ included 10 patients without liver affection. Laboratory parameters and Doppler US of hepatic and renal vessels were evaluated during and after subsidence of fever in all patients.

Results: Forty patients were enrolled in this prospective study. There were 22 male and 18 female patients. We found that the direction of blood flow in the portal and splenic veins was hepatopetal and the veins were non pulsatile in all cases with no change during and after subsidence of infection. There was no significant difference in portal or splenic vein diameters during and after subsidence of infection in the three studied groups. However, the mean values of portal and splenic veins peak velocities were significantly lower during infection in cirrhotic groups. The mean value of hepatic artery resistive index during fever was significantly higher than after fever in cirrhotic groups. Renal resistive and pulsatility indices were significantly higher during fever in cirrhotic groups.

Conclusion: Systemic bacterial infection with fever can affect hepatic haemodynamics leading to aggravation of portal hypertension and increasing the risk of complications as variceal bleeding and hepatic encephalopathy and can also affect renal haemodynamics with increased risk of renal impairment.

Keywords: Hepatitis C virus, cirrhosis, encephalopathy, portal hypertension, hepatorenal syndrome, renal haemodynamics.

[1]
Abd-Elsalam, S.; Sharaf-Eldin, M.; Soliman, S.; Elfert, A.; Badawi, R.; Ahmad, Y.K. Efficacy and safety of sofosbuvir plus ribavirin for treatment of cirrhotic patients with genotype 4 hepatitis C virus in real-life clinical practice. Arch. Virol., 2018, 163(1), 51-56.
[http://dx.doi.org/10.1007/s00705-017-3573-0] [PMID: 28983675]
[2]
Ahmed, O.A.; Kaisar, H.H.; Hawash, N.; Samir, H.; Shabana, S.S.T.; Hassan, A; Fouad, M.; Rizk, F.; Abd-Elsalam, S.; Abd-Elsalam, S. Effica-cy of sofosbuvir plus ribavirin with or without peginterferon-alfa in treatment of a cohort of Egyptian patients with hepatitis C virus infection. Infect. Disord. Drug Targets, 2017, 17(2), 95-100.
[http://dx.doi.org/10.2174/1871526517666170417143216] [PMID: 28413993]
[3]
Ahmed, O.A.; Kaisar, H.H.; Badawi, R.; Hawash, N.; Samir, H.; Shabana, S.S.; Fouad, M.H.A.; Rizk, F.H.; Khodeir, S.A.; Abd-Elsalam, S. Efficacy and safety of sofosbuvir-ledipasvir for treatment of a cohort of Egyptian patients with chronic hepatitis C genotype 4 infection. Infect. Drug Resist., 2018, 11, 295-298.
[http://dx.doi.org/10.2147/IDR.S153060] [PMID: 29535545]
[4]
Ahmed, O.A.; Elsebaey, M.A.; Fouad, M.H.A.; Elashry, H.; Elshafie, A.I.; Elhadidy, A.A.; Esheba, N.E.; Elnaggar, M.H.; Soliman, S.; Abd-Elsalam, S. Outcomes and predictors of treatment response with sofosbuvir plus daclatasvir with or without ribavirin in Egyptian patients with genotype 4 hepatitis C virus infection. Infect. Drug Resist., 2018, 11, 441-445.
[http://dx.doi.org/10.2147/IDR.S160593] [PMID: 29628768]
[5]
Ahmed, O.A.; Safwat, E.; Khalifa, M.O.; Elshafie, A.I.; Fouad, M.H.A.; Salama, M.M.; Naguib, G.G.; Eltabbakh, M.M.; Sherief, A.F.; Abd-Elsalam, S. Sofosbuvir Plus Daclatasvir in Treatment of Chronic Hepatitis C Genotype 4 Infection in a Cohort of Egyptian Patients: An Experiment the Size of Egyptian Village. Int. J. Hepatol., 2018., 20189616234
[http://dx.doi.org/10.1155/2018/9616234] [PMID: 29755792]
[6]
Rajekar, H.; Chawla, Y. Terlipressin in hepatorenal syndrome: Evidence for present indications. J. Gastroenterol. Hepatol., 2011, 26(1)(Suppl. 1), 109-114.
[http://dx.doi.org/10.1111/j.1440-1746.2010.06583.x] [PMID: 21199521]
[7]
Kim, M.Y.; Baik, S.K.; Lee, S.S. Hemodynamic alterations in cirrhosis and portal hypertension. Korean J. Hepatol., 2010, 16(4), 347-352.
[http://dx.doi.org/10.3350/kjhep.2010.16.4.347] [PMID: 21415576]
[8]
Sharaf-Eldin, M.; Bediwy, A.S.; Kobtan, A.; Abd-Elsalam, S.; El-Kalla, F.; Mansour, L.; Elkhalawany, W.; Elhendawy, M.; Soliman, S. Pigtail Catheter: A Less Invasive Option for Pleural Drainage in Egyptian Patients with Recurrent Hepatic Hydrothorax. Gastroenterol. Res. Pract., 2016., 20164013052
[http://dx.doi.org/10.1155/2016/4013052] [PMID: 27340399]
[9]
Elfert, A.; Abo Ali, L.; Soliman, S.; Ibrahim, S.; Abd-Elsalam, S. Randomized-controlled trial of rifaximin versus norfloxacin for secondary prophylaxis of spontaneous bacterial peritonitis. Eur. J. Gastroenterol. Hepatol., 2016, 28(12), 1450-1454.
[http://dx.doi.org/10.1097/MEG.0000000000000724] [PMID: 27512927]
[10]
Abd-Elsalam, S.; Habba, E.; Elkhalawany, W.; Tawfeek, S.; Elbatea, H.; El-Kalla, F.; Soliman, H.; Soliman, S.; Yousef, M.; Kobtan, A.; El Nawasany, S.; Awny, S.; Amer, I.; Mansour, L.; Rizk, F. Correlation of platelets count with endoscopic findings in a cohort of Egyptian patients with liver cirrhosis. Medicine (Baltimore), 2016, 95(23)e3853
[http://dx.doi.org/10.1097/MD.0000000000003853] [PMID: 27281094]
[11]
Thalheimer, U.; Triantos, C.K.; Samonakis, D.N.; Patch, D.; Burroughs, A.K. Infection, coagulation, and variceal bleeding in cirrhosis. Gut, 2005, 54(4), 556-563.
[http://dx.doi.org/10.1136/gut.2004.048181] [PMID: 15753544]
[12]
Bustamante, J.; Rimola, A.; Ventura, P.J.; Navasa, M.; Cirera, I.; Reggiardo, V.; Rodés, J. Prognostic significance of hepatic encephalopathy in patients with cirrhosis. J. Hepatol., 1999, 30(5), 890-895.
[http://dx.doi.org/10.1016/S0168-8278(99)80144-5] [PMID: 10365817]
[13]
Gerritzen-Bruning, M.J.; van den Ingh, T.S.; Rothuizen, J. Diagnostic value of fasting plasma ammonia and bile acid concentrations in the identification of portosystemic shunting in dogs. J. Vet. Intern. Med., 2006, 20(1), 13-19.
[http://dx.doi.org/10.1111/j.1939-1676.2006.tb02818.x] [PMID: 16496918]
[14]
Tarantino, G.; Citro, V.; Esposito, P. Blood ammonia levels in liver cirrhosis: A clue for the presence of portosys-temic collateral veins. BMC Gastroenterol., 2009, 17, 9-21.
[http://dx.doi.org/10.1186/1471-230X-9-21]
[15]
Byl, B.; Roucloux, I.; Crusiaux, A.; Dupont, E.; Devière, J. Tumor necrosis factor alpha and interleukin 6 plasma levels in infected cirrhotic patients. Gastroenterology, 1993, 104(5), 1492-1497.
[http://dx.doi.org/10.1016/0016-5085(93)90361-F] [PMID: 8482461]
[16]
Suliman, M.A.; Khalil, F.M.; Alkindi, S.S.; Pathare, A.V.; Almadhani, A.A.; Soliman, N.A. Tumor necrosis factor-α and interleukin-6 in cirrhotic patients with spontaneous bacterial peritonitis. World J. Gastrointest. Pathophysiol., 2012, 3(5), 92-98.
[http://dx.doi.org/10.4291/wjgp.v3.i5.92] [PMID: 23515243]
[17]
Terra, C.; Guevara, M.; Torre, A.; Gilabert, R.; Fernández, J.; Martín-Llahí, M.; Baccaro, M.E.; Navasa, M.; Bru, C.; Arroyo, V.; Rodés, J.; Ginès, P. Renal failure in patients with cirrhosis and sepsis unrelated to spontaneous bacterial peritonitis: value of MELD score. Gastroenterology, 2005, 129(6), 1944-1953.
[http://dx.doi.org/10.1053/j.gastro.2005.09.024] [PMID: 16344063]
[18]
Kim, J.H.; Lee, J.S.; Lee, S.H.; Bae, W.K.; Kim, N.H.; Kim, K.A.; Moon, Y.S. Renal dysfunction induced by bacterial in-fection other than spontaneous bacterial peritonitis in patients with cirrhosis: incidence and risk factor. Gut Liver, 2009, 3(4), 292-297.
[http://dx.doi.org/10.5009/gnl.2009.3.4.292] [PMID: 20431763]
[19]
Ruiz-del-Arbol, L.; Urman, J.; Fernández, J.; González, M.; Navasa, M.; Monescillo, A.; Albillos, A.; Jiménez, W.; Arroyo, V. Systemic, renal, and hepatic hemodynamic derangement in cirrhotic patients with spontaneous bacterial peritonitis. Hepatology, 2003, 38(5), 1210-1218.
[http://dx.doi.org/10.1053/jhep.2003.50447] [PMID: 14578859]
[20]
Popov, D.; Krasteva, R.; Ivanova, R.; Mateva, L.; Krastev, Z. Doppler parameters of hepatic and renal hemodynamics in patients with liver cirrhosis. Int. J. Nephrol., 2012.2012961654
[http://dx.doi.org/10.1155/2012/961654] [PMID: 22811907]
[21]
Abufaddan, N.; Omar, N. Renal hemodynamic changes as-sessed by color Doppler sonography in children with liver cirrhosis. J. Diagn. Med. Sonogr., 2010, 26(4), 171-177.
[http://dx.doi.org/10.1177/8756479310374363]

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