Relationship between liver injury and serum cytokeratin 18 levels in asymptomatic hepatitis B virus carriers and in patients with chronic hepatitis B infection

Background and study aims: Apoptosis represents a well-known mechanism of cell death involved in most chronic liver injuries. Our aim was to investigate the serum fragment level of cytokeratin 18 [CK18], M30, in asymptomatic hepatitis B virus [HBV] carriers and patients with chronic hepatitis B [CHB] and to evaluate the relationship between serum M30 levels and the severity of hepatic injury

Patients and methods: Asymptomatic HBV carriers [n = 169], patients with CHB [n = 100], and healthy control subjects [n = 43] were enrolled in the study. Serum CK18 [M30] levels were analysed in all subjects. Liver biopsy for histopathological assessment was performed in asymptomatic HBV carriers and in patients with CHB infection

Results: Serum CK18 [M30] levels were significantly higher in asymptomatic HBV carriers [198.77 +/- 77.62 U/L] than in healthy control subjects [146.92 +/- 40.18 U/L]. Patients with CHB [283.02 +/- 147.45 U/L] had significantly higher CK18 [M30] levels than asymptomatic HBV carriers [p = 0.001]. The diagnostic efficacy of CK18 [M30] levels in distinguishing patients with HBeAg-negative CHB from asymptomatic HBV carriers was found to be moderate [c-statistics: 0.695], and the diagnostic cut-off value of CK18 [M30] was 262 U/L [specificity: 85%, sensitivity: 48%, positive likelihood ratio: 3.35, and negative likelihood ratio: 0.60]. There was a positive correlation between serum CK18 [M30] levels and histological activity index scores in asymptomatic HBV carriers and patients with CHB

Conclusions: Serum CK18 [M30] levels may be a valuable indicator in distinguishing asymptomatic HBV carriers from patients with HBeAg-negative CHB when considered together with ALT and HBV-DNA levels

Predictive Role of Acute Phase Reactants in the Response to Therapy in Patients with Chronic Hepatitis C Virus Infection

BACKGROUND/AIMS: Biochemical parameters and acute-phase proteins (APPs) may provide complementary data in patients with chronic hepatitis C (CHC). We aimed to evaluate the predictive role of APPs in the response to antiviral therapy. METHODS: Forty-five patients underwent antiviral therapy. Serum ferritin, C-reactive protein (CRP), transferrin, albumin, alpha-1 acid glycoprotein (A1AG), and alpha-2 macroglobulin (A2MG) levels were examined at the initial evaluation and at the 4th, 12th, and 48th weeks. HCV RNA levels were examined at the initial evaluation and at the 12th and 48th weeks. RESULTS: Ferritin, transferrin, A1AG, and A2MG levels were significantly higher in the patient group (p<0.05). CRP, ferritin, A1AG, and A2MG levels were significantly increased from baseline to the 4th week (p<0.05). The responders and nonresponders to antiviral therapy had insignificantly but remarkably different levels of CRP, ferritin, transferrin, A1AG, A2MG, and alanine aminotransferase (ALT) both at the initial evaluation and at the 12th week. CONCLUSIONS: Variations in ferritin, A1AG, A2MG, albumin, CRP, and transferrin levels are not alternatives to virological and biochemical parameters for predicting an early response to therapy in patients with CHC. However, the investigation of ALT levels and hepatitis C virus RNA in combination with acute-phase reactants may provide supplementary data for evaluating responses to antiviral therapy.

Demographic and clinicopathological characteristics of nonalcoholic fatty Liver disease in the East-Southeastern Anatolia regions in Turkey

To identify the demographic and Clinicopathological characteristics of patients diagnosed with nonalcoholic fatty liver disease [NAFLD] and the risk factors for fibrosis based on histopathological findings in East-Southeastern Anatolia regions in Turkey. The study included a total of 93 patients diagnosed with NAFLD from 5 different centers. Histopathological findings were evaluated by dividing them into four categories using Matteoni classifications. Cases with fibrosis were further evaluated using Brunt classifications. The patients with a nonalcoholic fatty liver were in the 3rd and 4th decade age groups. The mean age was 38 years, 76% of the patients were male, 85% were overweight, 37% were obese, 18% had type 2 diabetes mellitus, and 80.6% had hyperlipidemia. A multiple regression analysis showed that age, type 2 diabetes mellitus, and aspartate aminotransferase [AST] levels were linked with the severity of the disease. Of the 93 patients, 55 [59.1%] had fibrosis, of which 10.8% were classified as severe. The severity of fibrosis was significantly higher in obese patients. The risk factors for severity of NAFLD included advanced age, type 2 diabetes mellitus and serum AST level, while the risk factor for the severity of fibrosis was obesity

High prevalence of transfusion-transmitted virus infection in patients with chronic liver diseases in an endemic area of hepatitis B and C virus

To determine the prevalence and clinical impact of transfusion-transmitted virus [TTV] DNA in patients with chronic liver diseases in the Southeast Anatolia region of Turkey where hepatitis B and C viral infections are endemic. Subjects and Patients diagnosed with chronic liver disease by clinical, biochemical and histologic means were enrolled in the study. Serum samples of 60 patients [19 males, 41 females] with chronic liver diseases, and of 45 healthy volunteer blood donors as a control group were collected. The chronic liver disease group consisted of 11 patients with hepatitis B, 44 with hepatitis C and 5 with chronic liver disease of unknown etiology. Presence of TTV DNA was investigated by the polymerase chain reaction. Using a scoring system histological grading of inflammation and staging of fibrosis were performed only in the chronic hepatitis C group. TTV DNA was detected in 47 [78%] patients with chronic liver disease and 5 [11%] volunteers in the control group. The difference was statistically significant [p < 0.001]. Ten of the 11 [91%] patients with hepatitis B, 32 of 44 [73%] of those with hepatitis C-related chronic liver disease, and 5 of 5 [100%] of the patients with cryptogenic liver disease were positive for TTV DNA. TTV is highly prevalent in patients with chronic liver diseases in Southeast Anatolia, Turkey but no pathogenic effect attributable to TTV infection was detected