ABSTRACT
It is important to differentiate whether isolated anti-HBc is due to false positive results or the prior exposure to hepatitis B virus, because individuals with false-positive anti-HBc can benefit from vaccination and their blood can be safely transfused. To distinguish between these two conditions, we evaluated the serologic response to hepatitis B vaccine. Ninety subjects with isolated anti-HBc [cases] and 100 subjects with totally negative hepatitis B serologic markers [controls]] were recruited to receive three doses of hepatitis-B [HB] vaccine. Thirty days after the first dose of the vaccine, anti-HBs titers were checked and individuals with anti-HBs titer >50 mlU/mL did not receive additional doses of the vaccine. However, others completed the vaccination course, and another blood sample was collected 30 days after the third dose to measure anti-HBs level. Nineteen [21.1%] cases and three [3%] controls had no sero-conversion [anti-HBs titers <10 mlU/mL] 30 days after the third dose [p<0.000l]. Primary response, defined as the development of anti-HBs antibody titers >10 mlU/mL 30 days after the third dose, was observed in 43 [47.8%] cases and 92 [92%] controls [p<0.000l]. Also, 31.1% of cases developed anti-HBs titers > 50 mlU/mL 30 days after the first dose of vaccine, but the rate was significantly lower [5%] in the control group [P<0.0001]. Furthermore, half of the individuals with positive isolated anti-HBc developed protective levels of anti-HBs after three doses of HB vaccination. More than 75% of individuals with positive isolated anti-HBc can benefit from vaccination and can be included in donor pool. Also, one fifth seemed to have occult HBV infection. So HB vaccination may be used as a diagnostic tool for clarifying the situation of the subjects with isolated anti-HBc
ABSTRACT
Hepatitis delta virus [HDV] infection results in more severe and even fulminant form of hepatitis B in co-infected cases. This study was designed to estimate the prevalence of anti-HDV positivity and the associated risk factors in patients with chronic hepatitis B virus infection in Zahedan [Iran]. In this cross sectional study a total of 440 consecutive patients with chronic hepatitis B virus [HBV] infection attending the Zahedan Gastroenterology and Hepatology clinics from 2008 to 2011 were included. We performed test for HDV serum marker, using commercially available enzyme-linked immunosorbent assay kit. Patients were split into two groups according to their HDV antibody status as HDV positive or negative. The collected data were coded, and the statistical analyses were conducted. Four hundred and forty patients with various forms of chronic HBV-related liver diseases enrolled in the study. 200 [45.5%] patients were carrier for HBV. 196 [44.5%] patients had chronic active hepatitis and 44 [10%] patients suffered from cirrhosis. Anti-HDV was demonstrated in 75 patients [17%]. The prevalence of HDV was 7%, 16.3% and 65.9% in carriers, patients with chronic active hepatitis and cirrhosis, respectively. HDV infection is still an important public health problem in Zahedan and appears a major cause of progression of liver disease induced by HBV
ABSTRACT
Coeliac disease [CD] may be associated with several liver disorders including primary biliary cirrhosis, primary sclerosing cholangitis and autoimmune hepatitis. Furthermore preliminary data suggest a causative role of CD in steatosis and steatohepatitis. The aim of present study was to determine the prevalence of CD in a series of patients with non-alcoholic fatty liver disease [NAFLD]. In a cross sectional study [2008-2010], 403 consecutive NAFLD patients [127 female and 276 male] referred to GI clinics of the Zahedan University of Medical Sciences were included. IgA anti-tissue transglutaminase [Anti-tTG] was used for screening of coeliac disease. In the patients with a positive serologic test, duodenal biopsies were taken to confirm the diagnosis. The mean +/- SD of the age and BMI of patients were 37.4 +/- 12.4 years and 28.3 +/- 4.15 kg/m[2] respectively. BMIs lower than 25 kg/m2 were found in 58 subjects [14.5%]. Furthermore diabetes mellitus and hyperlipidaemia were diagnosed in 48 [11.9%] and 84 [20.8%] individuals respectively. Positive Anti-tTGs were found in 14/403 [3.4%] and 13/403 [3.2%, 95% CI 1.5-4.9] had coeliac disease according to the modified Marsh classification; 8 had type I, 3 type II, 1 type IIIA and 1 type IIIB lesions. According to our data, prevalence of CD in the subjects with NAFLD is higher than the rates reported in the general population. Therefore screening for CD in selected cases of NAFLD may be appropriate