Acute flare or exacerbation of hepatitis B: Intermittent elevations in hepatic aminotransferases that can occur in chronic hepatitis B, usually more than twice the baseline value and as high as 10 times the upper limit of normal. Anti-hepatitis B core antibody (anti-HBc), total: The antibody directed against hepatitis B core antigen - see below under Core antibody for details. Anti-hepatitis B surface antibody (anti-HBs): The antibody directed against hepatitis B surface antigen.
Bridging fibrosis: An indicator of advanced disease characterized by fibrosis that extends to form bridges between portal-vascular structures. Child-Turcotte-Pugh Classification System: Widely used and published scoring system for liver disease severity. Cirrhosis: Describes a condition of the liver characterized by prominent and irreversible scarring.
Compensated versus decompensated cirrhosis: Patients with cirrhosis can be categorized as having compensated or decompensated cirrhosis. Core promoter mutations: These mutations in the hepatitis B DNA core region can emerge spontaneously or under drug pressure resulting nucleotide substitutions in the core promoter region that effectively decrease the production of HBeAg. Direct-acting antiviral agents (DAAs): DAAs refer to the array of small-molecule compounds that have been designed and are currently being studied to target specific HCV enzymes. Encephalopathy: Describes a syndrome of global brain dysfunction characterized by confusion and cognitive impairment. FibroScan: An office-based instrument that uses an ultrasound-based technique called transient elastrography to measure the speed through which elastic shock waves pass through the liver. Genotype, HBV: There are 8 genotypes for HBV worldwide, labeled A through H, all of which have been found in the United States. Hepatitis B c Antigen (HBcAg): HBcAg is an intracellular antigen synthesized within infected hepatocytes. Hepatitis B e antigen (HBeAg) seroconversion: Loss of HBeAg and development of anti-HBe antibody. Hepatitis B surface antigen (HBsAg): HBsAg exists as the major component of the surface (envelope) of the intact hepatitis B virion and as excess viral envelope in the form of subviral lipoprotein particles (spheres and filaments). Hepatitis E antigen (HBeAg): A precore protein secreted into the circulation by hepatitis B virus (HBV)-infected hepatocytes and generally considered a marker of HBV replication and infectivity. Histologic response: A decline in histologic activity by at least two points on a scoring scale and no worsening fibrosis on liver biopsy compared to pre-treatment biopsy, an outcome typically measured in clinical trial rather than actual practice settings. IL28B genotype: The IL28 gene encodes interleukin 28, also known as interferon lambda, a cytokine (chemical messenger) with antiviral activity. Interferon Ineligible: The American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA) have established criteria for considering patients interferon ineligible. Lead-in phase: Refers to the initial (typically 4-week) period of HCV treatment where pegylated interferon and ribavirin are started before the addition of the third agent. Model for End-Stage Liver Disease (MELD): Used to estimate the survival probability of a patient with end-stage liver disease. Necroinflammatory activity: Reflects the degree of inflammation and necrosis seen on liver biopsy in a patient with chronic viral hepatitis – the severity of this activity is characterized by a scoring system (Ishak, Knodell, Metavir are examples). Precore mutation: These mutations occur in the precore region of the hepatitis B DNA and can emerge spontaneously or under drug pressure. Reactivation of hepatitis B: Reappearance of active necroinflammatory disease in the liver in an individual who was known to have resolved hepatitis B or inactive carrier state. Response-guided therapy (RGT): Response-guided therapy is a strategy of following early HCV viral kinetics and adjusting the treatment duration based on the early virologic response. Ribavirin: Ribavirin is an antiviral medication used in combination with other agents to treat HCV infection. Sustained virologic response at week 12 (SVR12): Maintaining an undetectable HCV RNA level 12 weeks after completion of therapy. Sustained virologic response at week 24 (SVR24): Maintaining an undetectable HCV RNA level 24 weeks after completion of therapy. Undetectable viral level, HCV: HCV RNA level that is below the lower limit of detection of a sensitive molecular assay.
Virologic Breakthrough, HCV: Reappearance of HCV RNA during treatment, occurring after patient has achieved complete virologic suppression (undetectable HCV RNA level). Virologic Response, HBV: A decrease in serum HBV DNA to undetectable levels by PCR assays, and loss of HBeAg in patients who were initially HBeAg-positive. Here’s a question we get a lot at The Healthy Gurus – Should I use the Body Mass Index (BMI) to truly understand where I am in my level of fitness? The Body Mass Index is a measure of relative weight based on the mass and height of an individual. In the UK, there have been increasing concerns about how people are getting heavier and the resulting problems of public health. A number of serious health problems are known to be associated with a high Body Mass Index (BMI). In October 2007 a major report from the World Cancer Research Fund (WCRF) identified keeping a healthy body weight (BMI of 20-25) as one of the most important things that can be done to prevent cancer.


Knowing your weight in kilograms and height in metres makes it simple to calculate your Body Mass Index.
The Body Mass Index was developed by the World Health Organisation and allows people to quickly and easily establish whether they are under weight, normal weight, overweight or obese. First, make sure you know your weight in kilograms (kg) – if you don't know your weight in kg, there is advice here – and your height in metres, which you can calculate here. Try working that out if you start with your weight at the equivalent 14 stone 2 pounds 6 ounces. If you work in kilograms you can very easily work out your percentage gain or loss in weight. Calculadora Del Indice De Masa Corporal (imc) Para Que Los PapA?s Puedan Chequear El Peso Saludable De Sus Hijos. Calculates Bmi, Waist-to-height Ratio, Percent Body Fat, Lean Body Mass And Gives Personal Suggestions For Protein Intake. The concept of BMI - a simple ratio of weight in relation to height, was the work of a Belgian statistician, Adolphe Quetelet who published his "Quetelet Index" in 1832.
It was Quetelet's interest in applying probability calculus to human physical characteristics which led him to develop an index of relative weight.
After World War II, following reports of increased mortality and morbidity of overweight and obese life insurance policy holders, the validity of the Quetelet Index was confirmed as a practical index of relative body weight. Body Mass Index (BMI) has proved an invaluable tool for identifying and tracking population trends in weight. Although BMI is a useful measurement across populations, it is increasingly apparent that BMI has significant limitations in the assessment of the individual as it does not take into account the distribution of body fat.
The above CT scans show cross sections through the abdomens of two men who have exactly the same weight and BMI. The scan at the top of the slide demonstrates that this man has stored most of his excess fat under the skin (larger black area).
Note: BMI calculator provided by Gluxus is not intended for use for pregnant or lactating women, and, children (under 20). To clarify risk for each individual, other factors such as lifestyle habits, fitness level, and presence or absence of other health risk conditions also need to be considered.
This threshold is relevant for both treatment and biopsy decisions when managing this infection.
Total anti-HBc refers to presence of either IgG or IgM and test result does not discriminate between the subclasses.
The BMI chart shows four ranges of weight: underweight, healthy weight, overweight, and obese.
Physical examination or ultrasound findings may suggest a diagnosis of cirrhosis, and some non-invasive tests provide moderately accurate assessment of whether cirrhosis is present. From a clinical standpoint, patients with compensated cirrhosis have no clinical manifestations of portal hypertension. These antibodies (anti-HBc) can be detected throughout the course of HBV infection and are a marker of natural exposure to HBV; anti-HBc is absent in those who have been vaccinated. Patients who have these mutations can have active liver disease with high HBV DNA levels after HBeAg seroconversion.
This speed correlates directly with liver stiffness; fibrotic livers generate higher FibroScan readings.
Genotypes A and B are more responsive to interferon-based therapy compared with genotypes C or D, but initial responses to oral antiviral agents appear to be similar across genotypes. Genotype 1 (subtypes 1a and 1b) is the most commonly isolated genotype in the United States, followed by 2 and 3.
In setting of decreased HBV DNA levels and normal ALT, this is usually associated with disease remission. Investigators discovered that genetic variations of this gene are strongly associated both with spontaneous clearance and sustained virologic response to treatment of hepatitis C. The model uses the most recent laboratory tests for serum bilirubin, international normalized ratio (INR), and serum creatinine to generate a "MELD score".
Necroinflammatory activity is one of the main predictors of liver disease outcome in hepatitis B; patients with a high activity score are at greater risk of rapid progression of fibrosis and cirrhosis. Response-guided therapyhas been utilized with triple-therapy regimens that include an NS34A protease inhibitor.
The ribavirin mechanism of action involves one or more of the following: (1) enhanced immune clearance of HCV via shifting from Th2 to Th1, (2) inhibition of the cellular enzyme Inosine Monophosphate Dehydrogenase (IMPDH), leading to depletion of cellular levels of GTP, which is a necessary substrate for HCV replication, (3)inhibition of the HCV NS5B RNA polymerase enzyme (RdRp), (4) generation of RNA mutagenesis, which results in the creation of defective HCV particles. Generally, this is a simple method to compare the level of health for someone compared to what the norm should be.
However, practitioners have come to rely on its apparent numerical value for medical diagnosis, but that was never the BMI’s purpose. The best measurement used to understanding where you are health wise, would be determined through you Body Fat Percentage. However, there are a lot of areas you must fit into first for the number to be accurate in determining your healthy weight.


The International Obesity Taskforce reports that this is particularly a problem in England where obesity has risen threefold between 1980 and 2001. In Western countries it is estimated that 90% of type 2 diabetes cases are caused by excessive weight. Make a note of your height in metres and weight in kg, so that you can easily monitor your BMI in future. To get to a healthier weight you would probably choose to increase your exercise and improve what you eat.
It is important to emphasise that Quetelet had no interest in studying obesity when he developed this index. He used this index to study the growth of normal man, having established that during normal growth, weight tends to increase in relation to height in meters squared1.
Renamed the Body Mass Index, it was adopted by the World Health Organization in 1995 as a tool to quickly and easily determine level of obesity. BMI data continues to provide extremely important information regarding the rate of acceleration of the obesity epidemic over the last thirty years. The black area within the white body outline circumference represents fat stored under the skin, whereas the white central area represents storage of high risk internal body fat.
The scan below this demonstrates that this individual stores much more of this body fat as internal, high risk intra-abdominal or visceral fat (larger white area). Access to the materials on this web site for the sole purpose of personal educational use only. BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems.
One meta-analysis found that an APRI threshold of 1.0 was 76% sensitive and 72% specific for detecting hepatitis C-associated cirrhosis. Measurement of BMI may not be accurate in all persons, particuarly persons with large muscle mass (such as athletes), persons who have lean muscle mass (such as seniors), or persons shorter than 5 feet tall. When bridging fibrosis is seen diffusely in a liver specimen, it is classified as cirrhosis.
However, ultimately the diagnosis of cirrhosis is based on liver histology and the presence the bridging fibrosis (see above). Core antibody is generally in the form of IgM during acute infection or flares of HBV and predominantly in the form of IgG during chronic or resolved infection. This test has been validated across multiple patient populations including viral hepatitis but is not currently available in the U.S. Genotypes 4, 5 and 6 are increasingly observed in the US, especially among foreign-born patients from Asia and Africa (see Map). In patients who go on to resolve their infection, HBsAg usually becomes undetectable after 4 to 6 months. The lead-in provides the advantage of assessing interferon responsiveness and likelihood of subsequent treatment response in treatment-naive individuals. The MELD scores range from 6 (less ill) to 40 (gravely ill) and are often used to prioritize patients waiting for a liver transplant.
BMI does not distinguish between these two very different patterns of body fat partitioning. Waist circumference, waist-to-hip ratio and body mass index as predictors of adipose tissue compartments in men. Downloads of patients monitoring sheets may be freely copied and where appropriate a single print out of a reasonable proportion of these materials may be made for personal education, research and private study. It is advised to check your BMI index regularly and discuss irregularities or significant changes with your family doctors.
For example, if you weigh 69 kg and are 173 cm tall, you have a BMI of approximately 23, which is in Normal Weight. Genotypes 1 and 4 HCV are associated with lower response rates to pegylated interferon and ribavirin compared with genotypes 2 and 3. In acute infection that resolves, the HBeAg is promptly cleared with subsequent development of anti-HBe antibody.
You will be able to calculate total weight in fat and total free fat mass or lean muscle mass. BMI remains a simple, accurate indication of the health of body weight for the overwhelming majority of people. Materials should not be further copied, photocopied or reproduced, or distributed in electronic form. Clearance of this antigen with subsequent development of surface antibody (anti-HBs) is a major benchmark but occurs rarely (0.5% or less per year) in patients with chronic infection.
Any other unauthorised use or distribution of the materials may constitute an infringement of Cut the Waist Limited's copyright and may lead to legal action.



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