Value of PCR in the detection of occult hepatitis B virus infection in chronic end stage liver disease

Persistence of Hepatitis B virus [HBV] DNA in HBV surface antigen [HBsAg] negative individuals is termed occult HBV infection. Occult HBV infection has frequently been identified in patients with chronic HCV infection. This study aimed to evaluate the prevalence of occult HBV infection among late stage liver diseased patients and apparently healthy household contacts who may be used as potential donors for their liver transplantation. Also, prevalence of occult l-TBV infection in HCV-Ab and HBcAb seropositive subjects was evaluated. The study included 500 individuals distributed as 100 patients from National Liver Institute, 300 household contacts, and 100 apparently healthy subjects as a control group. All studied individuals were subjected to: full history taking, complete clinical examination, abdominal ultrasonography, liver biopsy if possible and laboratory investigations including: liver function tests, anti- HCV and HBV serological markers, as well as HBV- DNA detection using nested PCR. HBV-DNA was detected in 54% of patients, 18% of household contacts and 6% of control group. The prevalence of occult HBV infection in HBcAb seropositive subjects was; 75% in patients, 31.6% in household contacts, 46.2% in control group. The prevalence of occult HBV infection in HCV-Ab seropositive subjects was 55.8% in patients, 8.2% in contacts and 10% in control group. In conclusion, there is a high prevalence of occult HBV infection in patients with end stage liver disease, particularly those who are HCV-Ab and or HBcAb seropositive. The results of the current study indicate the need for a sensitive investigation for potentially infected relatives among family members of HBsAg carriers. On the other hand, apparently recovered people, are considered to be at risk for disease complications or for transmission of the infection till proved HBV-DNA negative

Antioxidants in children with protein energy malnutrition

The activity of erythrocytes antioxidant enzymes superoxide dismutase [SOD], glutathione peroxidase [GPX], blood glutathione [GSH] and the concentrations of non enzymatic antioxidants [plasma ceruloplasmin, vitamin E and C, serum Beta carotene, albumin, uric acid and TIBC] were measured in 15 children with kwashiorkor. These data were compared with those of 15 children with marasmus and 10 children who were normally nourished as control. SOD was similar in all groups. GSH and plasma ceruloplasmin were significantly lower in kwashiorkor than in the other two groups. GPX, plasma vitamin E, and serum albumin and uric acid were significantly lower in children with kwashiorkor than those with marasmus and both were lower than in controls. Serum TIBC, Beta carotene and plasma vitamin C were significantly lower in children with kwashiorkor and marasmus than in the control group. Concentration of serum malondialdehyde [MDA], a maker of lipid peroxidation was significantly elevated in children with kwashiorkor and marasmus than in the control group [P<0.05]. The elevated MDA in malnourished group of children who had decreased concentrations of antioxidants suggested that there were increased oxidative damage and lipid peroxidation in those children. A therapy directed to the restoration of antioxidant capacity might be beneficial for children with malnutrition, especially kwashiorkor