ABSTRACT
Aim: To evaluate the association between biochemical, virologic and histologic features in patients with HBeAg-negative chronic hepatitis B [CHB]
Background: Hepatitis-B e-antigen [HBeAg]-negative is common in Iran, is progressive with poor prognosis. Therefore, it seems necessary to perform a comprehensive evaluation of different spectrum of laboratory measurements accompanying histological findings
Methods: HBeAg- negative CHB patients referring to two university hospitals during two years were enrolled. Alcohol consumption, liver mass, fatty liver and positive results of Anti HDV, Anti HCV or Anti HIV were excluded. The relationship between viral loads, liver enzymes [old and new cutoffs] and histopathological features was analyzed using descriptive and analytic statistical methods
Results: A total of 150 HBeAg-negative CHB [males=110, mean age=38.44 +/- 11.34 years] were assessed. ALT had a significant relation with the logarithm of serum HBV-DNA [P<0.0001], grade and stage on liver biopsy [P<0.001, P=0.034, respectively]. Serum viral load, AST and ALT were independent predictors of histological grade, age was the only independent predictor of the stage of liver fibrosis. There was a significant relationship between serum ALT and stage of liver fibrosis [P<0.0001] when new cutoff values for ALT were considered. We found that age had a significant relation with histological grade but it showed a reverse relation with ALT levels [P=0.009]
Conclusion: In HBeAg-negative CHB, AST had a better prediction for liver necrosis and inflammation. Age could be an independent predictor for liver fibrosis. New cutoff values for ALT had superiority over conventional values to identify higher risk of liver fibrosis
ABSTRACT
Introduction: It is long known that vitamin D deficiency was common in patients with liver disease, but little is known on the therapeutic effects of vitamin D, especially in patients with chronic liver disease. In this study, we aimed to systematically review the literatures and study the evidences in which the effects of vitamin D supplementation had been investigated on the severity of chronic liver disease or liver cirrhosis
Methods: A systematic literature search was performed by using the following key terms "vitamin D supplementation" and "chronic liver disease" in the PubMed, Scopus and Google scholar to find relevant articles. After collecting the eligible documents, data were extracted and described based on the purpose of this review
Result: Of total 196 articles found, only 7 relevant documents with 518 studied patients were included. The results of this study showed that the levels of 25[OH] D were considerably lower in patients with chronic liver disease. Findings showed that vitamin D supplementation can rise up the mean serum level of 25[OH] D in patients with severe vitamin D deficiency, especially patients with liver cirrhosis
Conclusion: The results of this review showed that vitamin D deficiency is associated with the severity of liver disease and may have prognostic value in the assessment of liver disease. Also, it was shown that vitamin D supplementation may be helpful for the treatment of liver disease at least in certain groups of patients
ABSTRACT
Pancreatitis is the most common and important complication of endoscopic retrograde cholangiopancreatography [ERCP]. Several risk factors play a role in the formation and progression of pancreatitis. These risk factors may be related to the patient, procedure or operator. All of these risk factors should be considered and should be lowered as far as possible with attention to pathogenesis of the development of post-ERCP pancreatitis. The pathogenesis include sphincter spasm, infection, contrast toxicity and pancreatic secretion that induce the activation of proteolytic enzymes and inflammatory processes. Some methods and pharmacologic agents assessed for the prevention of pathway in the pathogenesis to decrease post-ERCP pancreatitis