Effect of Ethinyl Estradiol on Chronic Active Hepatitis

Guattery, Joseph M.; Faloon, William W.; Biery, Daniel L.

doi:10.7326/0003-4819-126-1-199701010-00019

Cited by 7 publications

(4 citation statements)

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“…Hormone replacement therapy has been used safely in PBC and chronic active hepatitis and may be protective against fibrosis in hepatitis C and risk of HCC in viral hepatitis . The presence of compensated cirrhosis is not a contraindication to HRT, but the same precautions and contraindications considered in the general population apply to patients with cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

Review article: the management of cirrhosis in women

Allen

Hay

2014

Aliment Pharmacol Ther

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Summary Background There are differences in the predisposition, natural history of liver disease, complications and treatment response between men and women. Aim To review clinical differences in cirrhosis between men and women and to address unique management issues of fertility, pregnancy and contraception in this patient population. Methods PubMed and MEDLINE were searched using the terms ‘cirrhosis’ and ‘chronic liver disease’, each cross‐referenced with specific liver diseases, as well as terms such as ‘cancer’, ‘hepatocellular carcinoma’, ‘smoking’, ‘liver transplantation’, ‘metabolic bone disease’, ‘fertility’,’ pregnancy’ and ‘contraception’. Results Pre‐menopausal status is protective in viral hepatitis C and non‐alcoholic steatohepatitis. However, smoking, especially in combination with alcohol, is a stronger risk factor for cirrhosis and malignancies in women with chronic liver disease compared to men, although they are less likely than men to develop hepatocellular carcinoma. Women with cirrhosis have more osteopenic bone disease than men and require active management. Successful pregnancy is possible in well‐compensated cirrhosis or with mild portal hypertension, although the maternal and foetal mortality and morbidity are higher than in the general population. The maternal risk correlates with liver disease severity and derives mostly from variceal bleeding. The choices for contraception in compensated cirrhosis are generally the same as for the general population. Women with cirrhosis are disadvantaged by the current MELD system of organ allocation, at least in part due to body size. Conclusion The management of women with chronic liver disease is unique in regards to counselling, screening for complications, fertility and pregnancy.

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Section: Discussionmentioning

confidence: 99%

Review article: the management of cirrhosis in women

Allen

Hay

2014

Aliment Pharmacol Ther

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“…8 In general, both serum aminotransferase levels in females tend to be lower than those in males. 7,[25][26][27][28][29][30] Puoti et al speculated that different hormonal factors, such as estrogens, could act as modulators of some mechanisms and may explain the differences between genders, 25 based on the decreased ALT levels in pregnant and estrogen-treated females with chronic hepatitis C. 31,32 Indeed, in the present study, the aminotransferase levels in HCV positive females were independent of age; although these levels, especially ALT, were elevated in males aged less than 65 years. The current results may be supported by these reports.…”

Section: Discussionmentioning

confidence: 99%

The associated markers and their limitations for the primary screening of HCV carriers in public health examination

Miyazaki

Honda

Ikegami

et al. 2009

Hepatology Research

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“…Guattery et al studied a heterogeneous group of 6women with average age of 60 years with hepatic inflammatory diseases (viral hepatitis B or C, self-immune and cryptogenic hepatitis). The authors reported normalization of the transaminase level (ALT) after the use of ethinylestradiol, elevation and drop of the hepatic enzymes after later suspension and hormone reintroduction [28].…”

Section: Oral Contraceptives Pregnancy Menopause and Chronic Hepatimentioning

confidence: 99%

Chronic hepatitis C and fibrosis: evidences for possible estrogen benefits

2007

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The main injury caused by hepatitis C virus is the hepatic fibrosis, as a result of a chronic inflammatory process in the liver characterized by the deposit of components from the extracellular matrix. The fibrosis development leads to the modification of the hepatic architecture, of the hepatocellular function and to irregularities in the microcirculation. The tissue remodeling process observed in fibrosis has stellate cells, located at the space of Disse, as main acting agents. These cells, in response to a harmful stimulus, undergo phenotypic changes from nonproliferating cells to proliferating cells that express a-smooth-muscle actin (α α α α α-SMA), a process called as transdifferentiation. There are evidences that the oxidative stress is involved in the chronic liver disease and serves as bond between the injury and the hepatic fibrosis. A number of studies suggest that the estrogen, at physiological levels, presents an antifibrogenic action probably through an antioxidant effect, decreasing the levels of lipid peroxidation products in the liver and blood, thus inhibiting the myofibroblastic transformation of stellate cells and contributing for gender-associated differences in relation to the fibrosis development. The aim of this paper was to describe data from literature concerning the interaction between chronic hepatitis C and estrogens, pregnancy, use of oral contraceptives, menopause and hormone reposition therapy.

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Effect of Ethinyl Estradiol on Chronic Active Hepatitis

Cited by 7 publications

References 0 publications

Review article: the management of cirrhosis in women

Review article: the management of cirrhosis in women

The associated markers and their limitations for the primary screening of HCV carriers in public health examination

Chronic hepatitis C and fibrosis: evidences for possible estrogen benefits

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