Economic burden made celiac disease an expensive and challenging condition for Iranian patients

Aim: The aim of this study was to estimate the economic burden of celiac disease [CD] in Iran

Background: The assessment of burden of CD has become an important primary or secondary outcome measure in clinical and epidemiologic studies

Methods: Information regarding medical costs and gluten free diet [GFD] costs were gathered using questionnaire and checklists offered to the selected patients with CD. The data included the direct medical cost [including Doctor Visit, hospitalization, clinical test examinations, endoscopies, etc.], GFD cost and loss productivity cost [as the indirect cost] for CD patient were estimated. The factors used for cost estimation included frequency of health resource utilization and gluten free diet basket. Purchasing Power Parity Dollar [PPP dollars] was used in order to make inter-country comparisons

Results: Total of 213 celiac patients entered to this study. The mean [standard deviation] of total cost per patient per year was 3377 [1853] PPP dollars. This total cost including direct medical cost, GFD costs and loss productivity cost per patients per year. Also the mean and standard deviation of medical cost and GFD cost were 195 [128] PPP dollars and 932 [734] PPP dollars respectively. The total costs of CD were significantly higher for male. Also GFD cost and total cost were higher for unmarried patients

Conclusion: In conclusion, our estimation of CD economic burden is indicating that CD patients face substantial expense that might not be affordable for a good number of these patients. The estimated economic burden may put these patients at high risk for dietary neglect resulting in increasing the risk of long term complications

Celiac disease and hepatitis C relationships in transcriptional regulatory networks

Aim: we mainly aimed to elucidate potential comorbidities between celiac disease and hepatitis c by means of data and network analysis approaches

Background: understanding the association among the disorders evidently has important impact on the diagnosis and therapeutic approaches. Celiac disease is the most challenging, common types of autoimmune disorders. On the other hand, hepatitis c virus genome products like some proteins are supposed to be resemble to gliadin types that in turn activates gluten intolerance in people with inclined to gluten susceptibilities. Moreover, a firm support of association between chronic hepatitis and celiac disease remains largely unclear. Henceforth exploring cross-talk among these diseases will apparently lead to the promising discoveries concerning important genes and regulators

Methods: 321 and 1032 genes associated with celiac disease and hepatitis c retrieved from DisGeNET were subjected to build a gene regulatory network. Afterward a network-driven integrative analysis was performed to exploring prognosticates genes and related pathways

Results: 105 common genes between these diseases included 11 transcription factors were identified as hallmark molecules where by further screening enriched in biological GO terms and pathways chiefly in immune systems and signaling pathways such as chemokines, cytokines and interleukins

Conclusion: in silico data analysis approaches indicated that the identified selected combinations of genes covered a wide range of known functions triggering the inflammation implicated in these diseases

Occult Hepatitis B as a Cause of Cryptogenic Cirrhosis

Background: occult hepatitis B virus [HBV] infection is characterized by presence of HBV infection with undetectable hepatitis B surface antigen [HBsAg]. Diagnosis of occult HBV infection requires sensitive HBV-DNA PCR assay. Recently it has been shown that occult hepatitis B may be a cause of cryptogenic liver disease. The aim of this study is the investigation of occult HBV infection among patients with cryptogenic liver disease

Methods: 65 consecutive paraffin-embedded liver tissues from cases referred to RCGLD [Research Center for Gastroenterology and Liver Diseases] and THC [Tehran Hepatitis Center] during the years 2001 and 2002 for liver biopsy because - of elevation of alanine aminotransferase [ALT] levels for more than six months were studied. Among these, 12 patients with cryptogenic liver disease were found. Human tissue DNA could be extracted in 7 of 12 patients. In these patients liver biopsies were reviewed and HBV-DNA and HBsAg and HBcAg were assayed in liver tissue by polymerase chain reaction [PCR] and immunohistochemistry [IHC], respectively

Results: histologically, chronic hepatitis, cirrhosis and nonspecific changes were reported. HBVDNA was detectable in 4 patients but IHC was negative in all. The frequency of occult HBV infection was more than 50%

Conclusions: occult HBV infection is common among patients with cryptogenic liver disease. In these patients, HBV-DNA may be detected more frequently among patients with more advanced liver pathology [cirrhosis] and more aggressive clinical course [decompensated cirrhosis]