Prevalence of parenterally transmitted viral hepatitis infections in chronic hemodialysis patients

Background: Patients on maintenance hemodialysis represent a high risk group of parenterally transmitted viral hepatitis infections, such as hepatitis B, D, C and G due to impairment of immune response, blood transfusion and nosocomial transmission in hemodialysis units

Aim: The objectives of this study are to determine the prevalence of parenterally transmitted viral hepatitis in chronic hemodialysis patients and find out any possible association between those viruses and possible risk factors in those patients

Subjects and Methods: The study was conducted on 91 individuals, 71 hemodialysis patients and 20 normal healthy individuals as a control group. The individuals of the control group were selected to be with normal liver and kidney functions and with no history of blood transfusion, operations or dental visits in the previous six months. Serum samples were taken from all the individuals included in the study and these sera had been tested for liver and kidney functions, for HBsAg and Anti-HCV by ELISA technique and also tested for HGVRNA by RT-PCR

Results: Hepatitis virus infection was detected in 32 of the hemodialysis patients [45 %] and in 3 individuals of the control group [15 %]. The studied cases showed high prevalence of HCV infection 30 cases [42.2 %], 4 cases with HBV [5.6 %] and 12 cases [16.6 %] with HGV. Co-infection of HGV with HCV was detected in 9 cases [12.7 %], whereas co-infection of HGV, HBV and HCV was detected in one case only [1.4 %]. Meanwhile, in the control group there was only one positive case for HBV [5 %] and 2 positive cases for HCV [10 %]

Conclusions: In spite of that AST and ALP enzymes reported significant difference between the positive hepatitis cases and the control group; yet no significant statistical difference in ALT, AST and ALP was reported between hemodialysis patients with single HCV infection and those with combined HCV and HGV infection. There is a significant association between HCV and HGV infection raising the possibility that HCV infection may be a high risk factor for HGV infection. Similarly; blood transfusion and duration of dialysis were risk factors significantly associated with increased risk of HGV infection

Serodiagnosis of chronic hepatitis C in Egypt by second generation recombinant immuno-blot assay

Aim of study; It is to evaluate the traditional method of third generation enzyme linked immunosorbent assay compared to recombinant immuno-blot assay used as a confirmatory test for the diagnosis of Hepatitis C virus infection in 35 subjects seropositive for hepatitis C virus Results; This study confirmed the presence of hepatitis C virus antibodies in 26 out of 35 hepatitis C virus seropositive specimens [74.3%], 8 [22.9%] were undetermined and one [2.9%] was negative. Highly significant positive correlation was observed between recombinant immuno-blot assay results and hepatitis C virus antibody titre by third generation enzyme linked immuno-sorbent assay. No correlation could be found between elevation of alanine transaminase and the presence of hepatitis C virus antibodies or its titre. Conclusion; Enzyme linked immuno-sorbent assay test has high sensitivity and specificity allowing it to be used in screening of hepatitis C virus infection in mass work as for blood banks as it is easily performed, more rapid and less expensive

Role of E- selectin in coronary artery disease

Our present study was designed to evaluate the role of circulating E-selectin as a marker of endothelial dysfunction in coronary artery disease [CAD] and to answer the question [Is E-selectin considered one of the acute phase reactants in acute coronary syndrome or not?]. Fifty-six patients with CAD [thirteen cases had stable angina pectoris [SAP]; twenty-two cases had unstable angina [UA] and twenty one cases had acute myocardial infarction [AMI] were included in this study compared with ten healthy normal persons as control groups [NC]. All patients and control group were subjected to the following: [full medical history, clinical examination; resting [ECG]; two dimensional echo-cardiographic Doppler examination and coronary angiography [where CAD was considered when one or more of epicardial coronary vessels was stenosed >/= 50% E-selectin was evaluated once for all patients except for those of AMI the evaluation of E-selectin was done twice [at admission and after 24 hours of admission]. Total serum cholesterol [TC], serum triglyceride [TG], LDL-cholesterol, HDL-cholesterol, and random blood sugar [RBS] were evaluated for all patients. A highly significant levels of E-selectin were obtained when E-selectin level in AMI group was compared to NC group [P<0.01]. UA group showed a significant comparative results with NC group [P<0.05]; while no significant results when E-selectin in SAP group was compared to NC group. E-selectin show significant statistical difference when comparison was done between AMI group and UA [P<0.05], and between AMI and SAP [P<0.01] and between UA and SAP [P<0.05]. E-selectin did not show a statistical difference when comparison was made in AMI group at admission and 24 hs later.No direct relation between E-selectine and other risk factors TC, TG, HDL-C, LDL-C, RBS, but there is parallel relation between E-selectin and TC, TG, HDL-C. E-selectin is significantly elevated in AMI and UA [compared to SAP group and NC group]; so it is suggested to be used in the future as a useful marker for the diagnosis of AMI and UA but not for SAP [i.e. as acute phase reactant in acute coronary syndrome]. E-selectin may be used as a diagnostic tool to differentiate between UA and SAP