Hepatitis D Virus: An Overview for Dentists

Hepatitis D is considered to be the most severe form of viral hepatitis. This virus requires hepatitis B for its life cycle and it is estimated that at least 5% of hepatitis B virus infected patients are also infected with hepatitis D, counting for 15 million infections worldwide most optimistically. Hepatitis D has a similar transmission pattern to hepatitis B and hepatitis C viruses. However, there is less information about the virus of hepatitis D than aboutthe other agents of viral hepatitis. In particular, there is total lack of information on hepatitis D in the setting of dental diseases and management. To our knowledge, there are only few reports on hepatitis D of dental health care workers (DHCW), the association of hepatitis D with oral conditions and on the role of oral fluid in transmission of hepatitis D. The present report reviews current knowledge of hepatitis D for dentists and dental personnel. Therefore, epidemiology, transmission modes, sign and symptoms, diagnostic methods and treatment options of hepatitis D are discussed under relevant subheadings

Combination of Ledipasvir and Sofosbuvir for Treatment of Hepatitis C Virus Genotype 1 Infection: Systematic Review and Meta-Analysis

ABSTRACT Background and aim. The combination of Sofosbuvir (SOF) and Ledipasvir (LDV) has been lead to considerable enhancement of treatment of hepatitis C virus (HCV) genotype 1 infection. A meta-analysis of the currently available studies was undertaken with the aim to evaluate the antiviral efficacy of SOF/LDV therapy for 12 or 24 weeks with or without Ribavirin (RBV) in patients with HCV genotype 1 infection. Material and methods. In this meta-analysis, we searched databases including PubMed, Scopus, Science Direct and Web of Science using appropriate keywords. All papers which evaluated the efficacy of combination therapy of SOF/LDV with or without RBV for 12 or 24 weeks among patients with HCV genotype 1 infection were included. Results. The 20 published articles were assessed for eligibility and finally 10 articles pooling 2248 participants were included in this meta-analysis. Pooled SVR12 for four SOF/LDV regimens were 95% (95%CI = 93%-97%) for 12 weeks of treatment with SOF/LDV, 97% (95%CI = 95%-98%) for 24 weeks of treatment with SOF/LDV, 96% (95%CI = 94%-97%) for 12 weeks of treatment with SOF/ LDV/RBV and 98% (95%CI = 97%-99%) for 24 weeks of treatment with SOF/LDV/RBV. Only in treatment regimen of SOF/LDV for 12 weeks, cirrhosis had a significant effect on the SVR12 (OR = 0.21, 95%CI = 0.07-0.66). Furthermore, NS5A resistance-associated substitutions at baseline were associated with decrease in the rate of SVR (OR = 0.31, 95%CI = 0.2-0.5). Conclusions. The Interferon-free regimen of SOF/LDV for 12 or 24 weeks with or without RBV is highly effective for treatment of patients with HCV genotype 1 infection.

Hepatitis B vaccination in hemodialysis patients: different points of view for conclusion / A vacinação contra hepatite B em pacientes em hemodiálise: diferentes pontos de vista para a conclusão

The present letter to the editor shows the other aspect of Hepatitis B vaccination in hemodialysis patients.

A presente carta para o editor mostra ou- tro aspecto da vacinação contra Hepatite B em pacientes de hemodiálise.

Hepatitis B core antibody in blood donor in sistan-balutuestan province of Iran.

Background: Safety of blood donor is an important issue for a recipient of blood so all blood donors are to screened for viral such as HBV, HCV, and HIV. Nevertheless, infections sometime occur by blood and its products. Objective: Because we haven't got any awareness about isolated Hbc Ab from a blood donor who presented of occults B hepatitis which can transmit infection to blood recipient, we decided to evaluate HbcAb in a blood donor in this province. Materials and Methods: This is a cross-sectional study on a blood donor in Sistan-Balutuestan province in southeast of Iran in 2010. All individuals referred for blood donation recruited to this. After consent demographic data was recorded from each case, 5 ml blood sample was drawn and centrifuged to separate out the serum and then HbsAb, HbcAb was assayed. Data analyzed by SPSS 16 and frequency, chi- square test, and Fisher exact test was used and if P > 0.05 it was accented as significant association. Result: All individuals were men with age 55 10.5 years. The number of people who had free job was 149 (34.6%) and the number of people whose education level was diploma was 159 (36.9%). About 423 (98.1%) lived in urban areas. The mean weight of men was 76.6 13.7; about 259 (60.1%) men were married. A total of 22 (5.1%) had a positive smoking history. HBc Ab was positive in 87 (20.2%). Nearly all people had HBsAb titer more than 10 IU/L. Conclusion:This study showed that some of the blood donors had isolated HbcAb positive therefore we recommend HbcAb screening for blood donation.

Insulin resistance in chronic hepatitis B and C.

AIM: To determine whether insulin resistance occurs in patients with chronic hepatitis B (CHB) and chronic hepatitis C (CHC) and its relationship with the presence of liver fibrosis and steatosis. METHODS: Untreated patients with CHC (n=60) or CHB (n=40), similar in age, gender, body mass index and waist-hip ratio, were studied. Relationship between anthropometric, biochemical (fasting serum insulin, C-peptide, ferritin, iron, TNF-alpha, cholesterol, triglyceride, bilirubin, hemoglobin and platelet concentrations) and liver biopsy (43 CHC and 20 CHB patients) findings was investigated by insulin resistance determined via the homeostasis model assessment (HOMA-IR). RESULTS: The mean fasting serum insulin was 14.9 (11.9) mU/mL in CHC and 21.4 (17.4) in the CHB group (normal range 0.7-9; p=0.049) and mean HOMA-IR was 3.1 (2.6) in CHC versus 4.7 (4.1) in the CHB group (normal range 0.12-4.61; p=0.036). HOMA-IR was significantly associated with fibrosis stage in the CHC group (p=0.015), but not in the CHB group. CONCLUSION: Hyperinsulinemia occurs in chronic viral hepatitis B and hepatitis C; insulin resistance is associated with stage of fibrosis in hepatitis C.