role of anti-tissue transglutaminase IgA for the diagnosis of celiac disease

To evaluate and compare the sensitivity and specificity of the serological marker human antitissue transglutarninase antibodies [IgA anti-tTG] with those of antiendomysium [EMA] and antigliadin antibodies [IgA and lgG AGA] for the diagnosis of celiac disease [CD]. The level of IgA antibodies to tTG in serum was determined by an enzyme-linked immunosorbent assay [ELISA] test using recombinant human tTG as the antigen; EMA, by indirect immunofluorescence; and IgA and IgG AGA, by ELISA. Twenty serum samples with untreated CD were studied and compared with serum samples from 58 children examined for failure to thrive, short stature and various digestive diseases as control group. Nineteen of 20 patients with CD had IgA anti-tTG, 20 of 20 patients had EMA, 16 of 20 had IgA AGA and 19 of 20 had lgG AGA. In control group without CD, 2 Of 58 had IgA AGA and 12 of 58 had lgG AGA, but none had IgA anti-tTG or EMA. The positive predictive value of IgA anti-tTG was 100% and the negative predictive value 98.3%. In comparison, results for EMA were 100% and 100%, IgA AGA 88.9% and93.3%and IgG AGA 61.3% and 97.9% respectively. The presence of human anti-tTG is a reliable indicator for the diagnosis of CD

Detection and quantification of hepatitis B virus DNA by three different methods in HBsAg positive patients

The detection and quantification of hepatitis B virus genomes appear to be the most reliable methods for monitoring HBV infection and assessing response to antiviral treatment. The aim of this study assess the performance of three HBV DNA detection and quantification assays currently used for the management of HBV infected patients. In our study. 44 HBsAg +ve samples were assayed to HBV DNA detection and quantification by three different methods [In House HBV PCR. Amplicor HBV Monitor and HBV branched DNA DNA "bDNA"]. Twenty three samples [52.27%] were HBV DNA positive by one or more of the three methods and 21 samples [47.73 3/4] were HBV DNA negative by the three methods. Twenty one samples [47.73 3/4] were HBV DNA positive by Amplicor HBV Monitor and their cops number ranged from 440 - 40x106 copies/ml. Ten samples [22.73%] were HBV DNA positive by in House HBV PCR with copy number ranged from 6400 - 40 x 106 copies/ml. Eight samples [18.18%] were HBV DNA positive by NBV branched DNA [bDNA] and their copy number ranged from I.2x106 40x106 copies/ml. Branched DNA [bDNA] versus Amplicor HBV Monitor showed that: [i] bDNA and Arnplicor HBV Monitor gave concordant results for 27 [61.63%] of 44 the samples. The assays were both positive in six samples [13.64%]. The assays were both negative in 21 samples [47.73%]. [ii] bDNA and Amplicor HBV Monitor gave discordant results in 17 cases [38.64%]: bDNA was positive and Amplicor HBV Monitor negative in two cases [4.55%]. While bDNA was negative and Amplicor HBV Monitor positive in 15 cases [34.1%], HBV-DNA load in the Monitor assay was higher in 14] NA positive samples [mean = 9.7 x 106 copies/ml] than bDNA negative samples [mean 4.1 x 104 copies ml]. In House positive [mean = 9.7 x 106 copies/ml] than bDNA negative samples [mean 4.1 x 104 copies/ml]. In House PCR and Amplicor HBV Monitor showed that [i] In House PCR and Amplicor HBV Monitor gave concordant results with 33 of the 44 samples [75.0%]. The assays were both positive with to samples [22.73%]. The assays were both negative in 23 cases [52.27%] [ii] In House PCR and Amplicor HBV Monitor gave discordant results in 11 cases [25.0%] In House PCR was negative and Amplicor HBV Monitor gave discordant results in 11 casses [26.0%] in House PCR was negative and Amplicor HBV Monitor gave discordant resutlds in 11 cases [25.0%]. In House PCR was negative and Amplicor HBV Montor positive in these ii cases. HBV-DNA load in the Monitor assay was higher in In House PCR positive samples [mean 5.88 x 106 copies/ml] than In House PCR negative samples [mean 21 x 102 copies mb. In House PCR versus bDNA showed that: [i] in House PCR and bDNA gave concordant results with 38 of the 44 samples [86.36%]. The assays were both positive in six cases [13.64%]. The assays were both negative in 32 caes [72.73%]. [ii] In House PCR and bDNA gave discordant results in six cases [13.64%] In House PCR was positive and bDNA negative with four samples [0.09%]. In House PCR was negative and bDNA positive with two samples [4.55%]. HBV-DNA load in the Monitor assay was higher in bDNA positive samples [mean x 10 copies mb than In House PCR positive samples [mean 5.88 x 102 copies mb. The monitor assasy was more sensitive than both the In House PCR and bDNA. This better sensitivity appeared to be clinically relevant [even their respective performance, these three assays should be used in complementary fashion in the management of HBV infected patients

value of PCR in the diagnosis of HCV infection in chronic liver disease patients

Hepatitis C virus is a single stranded RNA virus. HCV strains could be grouped into at least 12 genotypes. Diagnosis of HCV infection was made in chronic liver disease patients and the presence of HCV-RNA in the circulation was correlated with the severity of the liver disease in anti- HCV positive chronic liver diseased patients using the polymerase chain reaction [PCR] technique in 159 cases and 50 controls. The prevalence of anti-HCV among the chronic liver disease patients was 83.6% and 38% in the control group. The PCR results were 72.3% in the patient group and 26% in the control group. The percentage of RNA positive cases in the RIBA positive samples was 87.4%. HCV-RNA was present in 89.7% of the cirrhotic patients. ALT level correlated with anti-HCV positivity and there was a significant difference between the patient and control regarding ALT level, 51.6% of the cases in the patient group had elevated ALT and 84.1% of the cases who had elevated ALT were HCV-RNA positive. We concluded that there was a high prevalence of HCV infection among chronic liver disease patients and HCV-RNA was found to correlate with the liver pathology, symptom free HCV infected patients exist and some have normal liver function tests, despite the presence of liver affection which might be severe