ABSTRACT
Hepatitis B and C infections have remained major global health burdens during the most recent century. The viral agents responsible for these diseases share common modes of transmission with human immunodeficiency virus [HIV] such as needle-sharing in IV drug abusers. Coinfection of hepatitis B or C with HIV increases the rate of progression of chronic liver disease. Given the lack of data in Iran, in particular Khorasan Razavi Province, with regards to this coinfection, the present study evaluates the frequency distribution of hepatitis B and C coinfection with HIV infection and their modes of transmission. This was a retrospective study based on available data at the Gastrointestinal and Liver Diseases Center, Emam Reza Hospital, Mashhad, Iran. We used questionnaires to collect demographic data from 749 patients infected with hepatitis B or C who refered to this clinic between 2005 and 2008. The available sera of these patients were tested for the coexistence of HIV infection with hepatitis B or C infections. The results were analyzed with SPSS version 16 software. From 749 patients infected with hepatitis B or C viruses, 650 were infected with hepatitis B [64.9% male and 35.1% female]. There was no HIV antibody detected in any of the patients' sera who had hepatitis B infection. Among the 106 patients with hepatitis C infection [84% male and 16% female], only one [0.9%] who was an IV drug abuser tested positive for HIV infection. Hepatitis B/hepatitis C coinfection was found in 7 [0.9%] patients. With regards to the risk factors of viral transmission among those with hepatitis B infection, the most common was a positive family history of hepatitis B [37.2%]. Other risk factors in order of decreasing frequency included a history of venesection and tattooing [13.8%], transfusions [7.1%], IV drug abuse [2.6%], needle stick accidents [2.3%], and high-risk sexual activity [0.6%]. In those with hepatitis C infection, a history of IV drug abuse was the most common risk factor [40.6%], followed by a history of transfusions [28.3%], venesection or tattooing [16%], surgery [13.2%], needle stick accidents [4.7%], hepatitis C infection in a family member [2.8%], and unsafe sexual contact [0.9%]. There was a significant difference in the transmission risk factor ratio between hepatitis B and C patients [p=0.001, chi[2]=261/590] The most common risk factor for transmission of hepatitis B and C infections in patients who presented to Emam Reza Hospital, a referral center in Mashhad, was a positive family history of hepatitis B infection and IV drug abuse, respectively. The prevalence of HIV coinfection amongst patients with hepatitis B or C infections was low. However, further studies with larger populations are required
ABSTRACT
BACKGROUND: This study aimed to explore demographic characteristics and clinical presentations of celiac disease [CD] in Northeastern Iran
METHODS: This was a cross-sectional retrospective study of 193 adults with CD who presented to Mashhad University Gastroenterology Clinic between 2008 and 2013. Patient data that included mode of presentation and the presence of any concomitant illnesses were collected. Intestinal biopsy and serum anti-tissue transglutaminase [anti-tTG] were used for diagnosis. Mucosal lesions were classified according to modified Marsh classification
RESULTS: Overall, 132 females and 61 males, with a mean age at diagnosis of 32.6 +/- 13.2 years were included
The patient's chief complaints in order of decreasing frequency were dyspepsia [24.6%], diarrhea [20%], anemia [12.8%], and flatulence [7.2%]
Bone disease was seen [osteopenia, osteoporosis] in 30% of patients
A positive family history of CD was found in 17.9% of cases
There were 64% who had serum anti-tTG >200 units/ml and 78% had a Marsh classification grade 3 on duodenal biopsy
The histology grade [Marsh] did not show any correlation with anti-tTG serum levels, age, body mass index [BMI] or hemoglobin levels
CONCLUSION: In Northeastern Iran, CD was seen more commonly in females and with non-diarrheal presentations. Abdominal discomfort, anemia and bone disease were most common primary presentations in this area. Histology grade showed no significant correlation with level of anti-tTG, BMI or hemoglobin levels
We suggest screening for CD in unexplained abdominal discomfort, bone disease and anemia