HCV RNA in peripheral blood mononuclear cells [PBMCs] as a predictor of the response to antiviral therapy in chronic hepatitis C

Hepatitis C virus [HCV] has been found to infect peripheral blood mononuclear cells [PBMCs], using them as a reservoir, which might contribute to the development of resistance to treatment. To study hepatitis virus C [HCV] RNA in peripheral blood mononuclear cells [PBMC5] of patients with chronic HCV infection, and explore the relationship between the HCV RNA in the PBMCs and response to interferon [IFN] therapy. Twenty-five patients with chronic viral hepatitis C were included. The HCV RNA in PBMCs and serum was detected after 12 weeks of initializing interferon treatment, at the end of treatment, and 24 week and 1 year follow up after the end of the treatment. At the end of the treatment course, patients who were found to have positive PCR test for HCV RNA in PBMCs were subdivided into two groups, one group continues to receive IFN therapy while the other group stops. The HCV RNA in PBMCs and serum was detected by RT-PCR using the Amplicor HCV 2.0 assay. All patients had negative serum PCR test for HCV RNA at the end of treatment, nevertheless HCV RNA was detected in PBMCs of approximately 32% of these patients. Patients who tested positively for HCV RNA in PBMCs at the end of treatment had an overall significantly

Serum complements C3 and C4 in chronic HCV infection and their correlation with response to pegylated interferon and ribavirin treatment

To search for an immunological parameter that may correlate with the response to interferon [IFN] treatment is very crucial. The objective of this study was to correlate the levels of C3 and C4 complement components with the response to IFN treatment in patients with chronic hepatitis C virus [HCV] infection. Patients and This study was conducted on 100 patients and control subjects classified into three groups. Group [I] consisted of 50 patients with chronic hepatitis C who were receiving IFN treatment and showed various responses; group [II] included 25 patients with chronic hepatitis C naive to IFN treatment; and group [III] included 25 healthy subjects matched for age and sex who served as controls. Measurement of the level of complement C3 and C4 was done by a quantitative turbidimetric test. Measurement of complement levels in group [I] was done at the end of treatment at the 48th week. Serum levels of C3 and C4 were found to be significantly reduced in all patients with chronic HCV infection in both groups [I and II] compared to the healthy control group [III] [p < 0.05]. Moreover, chronic HCV patients treated with IFN and ribavirin had significantly lower levels of C3 and C4 compared with patients naive to IFN and ribavirin treatment. At the end of treatment, both C3 and C4 had significantly increased in responders to IFN when compared to non-responders [p = 0.025 and 0.05, respectively]. There was a significant negative correlation between C3 and C4 levels and the concentration of serum alanine aminotransferase [ALT] measured simultaneously. Higher C3 and C4 serum concentrations were found to be positively correlated to the end-of-treatment response in patients with chronic HCV infection treated with IFN and ribavirin

Urinary beta-2 microglobulin level in urinary tract infections in infancy and childhood

Upper urinary tract infection is a serious bacterial illness among febrile infants and young children. Significant renal scarring may occur after a single episode especially with delayed diagnosis and treatment. In this study, we evaluated the value of measurement of urinary beta 2 microglobulin [B2-MG] in the differentiation between upper and lower urinary tract infections. Fifty children with urinary tract infections [UTIs] aged between 1-12 years were studied: 15 children with acute pyelonephritis documented by positive DMSA scan, 15 children with acute cystitis documented by negative DMSA scan and 20 normal children as control. In all children, total Ieukocytic count [TLC], erythrocyte sedimentation rate [ESR], serum C reactive protein [CRP], blood urea and serum creatinine were measured. Also, B2-MG in 24 hours collected urine was measured using ELISA technique. It was found that TLC, ESR and CRP were significantly higher in cases of acute pyelonephritis compared with those of cystitis. However, there was no statistically difference between the three studied groups as regards blood urea and serum creatinine. Urinary B2-MG was significantly higher in children with acute pyelonephritis compared with the other two groups [P= 0.01]. The sensitivity, specificity, and positive predictive value of urinary B2-MG in the diagnosis of acute pyelonephritis were 94.3%, 100% and 91.6% respectively

Conclusion: This study showed the importance of measuring of urinary B2-MG in children with urinary tract infection and the possibility of using this non invasive test in the differentiation between upper and lower UTIs

Value of first-day bilirubin in predicting the development of significant hyperbilirubinemia in healthy term newborns in Alexandria

The recognition, follow-up, and early treatment of neonataljaundice has become more difficult, since the earlier discharge of newborns from hospitals has become common practice. This prospective study was undertaken to identify the newborns at risk for developing significant hyperbilirubinemia later during the first days of life by measuring the serum bilirubin levels of the first 5 days of life to determine the critical predictive serum bilirubin value on the first day of life. A total of 498 healthy term newborns were followed with daily serum total bilirubin measurements for the first 5 days of life, and cases with serum bilirubin levels of >/= 17 mg/dL after 24 hours of life were defined to have significant hyperbilirubinemia. The results showed that no newborns had a serum total bilirubin level of >/= 17 mg/dL in the first 72 hours of life. Sixty of 498 cases [12.05%] had significant hyperbilirubinemia after 72 hours of life, and these cases had significantly higher bilirubin levels than those who did not develop significant hyperbilirubinemia on each of the first 5 days' measurements. Of the 206 newborns who had a serum bilirubin level of >/= 6 mg/dL in the first 24 hours, 54 [26.21%] developed significant hyperbilirubinemia, whereas only 6 of the 292 newborns [2.05%] who had a serum bilirubin level of <6 mg/dL on the first day developed significant hyperbilirubinemia. A mean serum bilirubin level of >/= 6mg/dL on the first day had the highestsensitivity [90%]. At this critical serum bilirubin value, the negative predictive value was very high [97.9%] and the positive predictive value was fairly low [26.2%]. Furthermore, because no cases with a serum bilirubin level of <6 mg/dL in the first 24 hours of life required a subsequent phototherapy treatment and because all of those infants requiring a phototherapy treatment with serum bilirubin levels of >/= 20 mg/dL were just among the cases whose first-day bilirubin levels were >/= 6 mg/dL, the critical bilirubin level of 6 mg/dL on the first day made it possible, with the highest [100%] sensitivity and negative predictive value, to definitely predict all of the infants who would have a bilirubin level of >20 mg/dL, requiring a phototherapy treatment later during the first days of life

Conclusion: A serum bilirubin measurement and the use of the critical bilirubin level of 6 mg/dL in the first 24 hours of life will predict nearly all of the term newborns who will have significant hyperbilirubinemia and will determine all those who will require a phototherapy treatment later during the first days of life