Comparing anti-hepatitis B antibody level in Iranian obese or overweight with non-obese cases

Background: There is a controversy about the relation between anti-hepatitis B [anti-HBs] antibody level and obesity. We designed this study to compare the vaccine efficacy in obese/overweight and non-obese cases

Methods: In this cross-sectional study, 242 obese/overweight and 85 non-obese individuals were participated. Cases were selected from a referral clinic for obesity and a referral hepatology clinic, both in Tehran, Iran

Results: Obese cases had lower percentage of liver diseases [66.9% vs. 100%, P<0.001] but higher hepatitis B vaccination history [74.9% vs. 51.2%, P<0.001]. Median+/-inter-quartile range of anti-HBs titer in obese cases was significantly lower than controls [48.5+/-194.5 vs. 100+/-557.6, P=0.012]

Conclusion: The level of anti-HBs surface antigen antibody's titer in obese cases without liver disease is lower than control group. Therefore, a suitable strategy is needed to overcome this problem, which can be the use of longer needles for vaccination

Letter to the Editor: Should We Really Take Anti-Viral Therapy into Account in Chronic Hepatitis B Patients with Normal Liver Function?

No abstract available.

Occult Hepatitis B infection [OBI] in vaccinated groups, a metanalysis

Nowadays, the presence of HBV DNA in the absence of HBsAg; occult hepatitis B infection; [OBI], is a known clinical entity along with the rapid influx of research being conducted on its clinical relevance. Biologists and clinicians alike have a recent-standing interest in this regards. OBI has been described in several clinical settings. However, the data on its prevalence among immunized and non-immunized healthy general population, in particular, among health care workers [HCWs] is ambigous. This review attemps to explore the significance of OBI in vaccinated groups as a special subject. The prevalence of OBI among general population, vaccinated children/general population and health care workers were: 157 [5.2%], 222 [6.7%] and 33 [1.8%], respectively. The prevalence of anti-HBc among OBI-positive subjects were: 64 [40.7%], 133 [82.7%] and 27 [81.8%], respectively. OBI is partly prevalent in general population and in vaccinated individuals, especially in those who born to HBsAg positive mothers. HBV serological surveys are not enough adequate and sensitive to rule out the presence of HBV DNA. For high-risk groups [subjects born to HBsAg mothers, health care workers, isolated anti-HBc, etc] sensitive molecular tests based on real time PCR should be applied for a proper diagnosis

Can We Accurately Assess Liver Fibrosis with Fibroscan(R) Using Fewer Valid Measurements?

No abstract available.

Oral conditions associated with hepatitis C virus infection

Hepatitis C virus [HCV] infection in more than 170 million chronically infected patients with no developed preventive vaccine is a globally important issue. In addition to expected hepatic manifestations, a number of extrahepatic manifestations, such as mixed cryoglobulinemia, glomerulonephritis, polyarteritis nodosa, rashes, renal disease, neuropathy, and lymphoma, have been reported following HCV infection, which are believed to be influenced by the virus or the host immune response. HCV combination therapy with pegylated interferon and ribavirin might be associated with side effects as well. The association of HCV with special oral conditions has also been reported recurrently; the mechanism of most of which remains unclear. This article reviews the association of HCV infection with some of the oral conditions such as oral health, Sjogren's syndrome, lichen planus and oral cancer.

Statistical count models for prognosis the risk factors of hepatitis C

The aim of this study was to compare alternatives methods for analysis of zero inflated count data and compare them with simple count models that are used by researchers frequently for such zero inflated data. Analysis of viral load and risk factors could predict likelihood of achieving sustain virological response [SVR]. This information is useful to protect a person from acquiring Hepatitis C virus [HCV] infection. The distribution of viral load contains a large proportion of excess zeros [HCV-RNA under 100], that can lead to over-dispersion. This data belonged to a longitudinal study conducted between 2005 and 2010. The response variable was the viral load of each HCV patient 6 months after the end of treatment. Poisson regression [PR], negative binomial regression [NB], zero inflated Poisson regression [ZIP] and zero inflated negative binomial regression [ZINB] models were carried out to the data respectively. Log likelihood, Akaike Information Criterion [AIC] and Bayesian Information Criterion [BIC] were used to compare performance of the models. According to all criterions, ZINB was the best model for analyzing this data. Age, having risk factors genotype 3 and protocol of treatment were being significant. Zero inflated negative binomial regression models fit the viral load data better than the Poisson, negative binomial and zero inflated Poisson models

Elevated alanine aminotransferase activity is not associated with dyslipidemias, but related to insulin resistance and higher disease grades in non-diabetic non-alcoholic fatty liver disease

<p><b>OBJECTIVE</b>To explore demographic and metabolic factors associated with increased alanine aminotransferase (ALT) activity in non-diabetic non-alcoholic fatty liver disease (NAFLD) patients.</p><p><b>METHODS</b>Overall 372 patients who consecutively attended to Gastroenterology Clinic of Baqiyatallah University of Medical Sciences, Tehran, Iran awere diagnosed as NAFLD entered into analysis. Exclusion criteria were having diabetes mellitus and fasting blood glucose over 126 mg/dL, active hepatitis B virus infection, having hepatitis C virus positive serology, and to be under corticosteroid therapy. ALT levels were considered pathologically high when it was over 30 IU/L for men and over 19 IU/L for women.</p><p><b>RESULTS</b>Bivariate analyses using t test and chi-square test showed that patients with pathologically augmented ALT levels had significantly higher NAFLD grades in their ultrasonographic evaluations (P=0.003). Moreover, these patients represented significantly higher homeostatic model assessment levels (P=0.003), levels of serum insulin (P=0.002), fasting blood glucose (P<0.001), and uric acid (P=0.02). The prevalence of insulin resistance was also higher in patients with increased serum ALT concentrations. Multifactorial logistic regression models showed that ultrasonographic grading of NAFLD (P=0.027) and insulin resistance (P=0.013) were the only variables significantly associated with abnormal ALT levels.</p><p><b>CONCLUSIONS</b>This study shows that the associations of increased ALT serum levels in NAFLD patients are different from what are supposed before. By excluding diabetic patients from our population, we find that increased ALT levels are not associated with dyslipidemias but are independently associated with insulin resistance and NAFLD grading on ultrasonographic evaluations. Further studies are needed to confirm our results.</p>

Letter to the Editor: The Increasing Hepatitis A Incidence in Korea: Is It Possible Within a Limited Time? / 예방의학회지

No abstract available.

Seroprevalence of Hepatitis B Virus infection and its risk factors in the west of Iran: a population-based study

Hepatitis B virus [HBV] infection is a serious global public health problem affecting billions of people globally. The lack of information of its seroprevalence among the general population is an obstacle for formulating effective policies to reduce the burden viral hepatitis. Therefore, this population based serological survey was conducted in Kurdistan province, where no epidemiological data was available to determine the prevalence and risk factors of HBV infection. 1613 healthy subjects were selected from all districts of Kurdistan province [in the western of Iran] using random cluster sampling. The subjects' age ranged from 6 to 65 years old. Serum samples were tested for HBcAb, HBsAg and anti HDV antibody. Screening tests were carried out by the third generation of ELISA. Various risk factors were recorded and multivariate analysis was performed. The prevalence of HBsAg and HBcAb in Kurdistan was before 0.80% [95% CI 0.44; 1.34] and 5.02% [95% CI 4.03; 6.17], respectively. None of HBsAg carriers had positive anti HDV antibody. Predictors of HBsAg or HBcAb in multivariate analysis were: older age and marriage. We did not find any significant differences between males and females. Our population based study suggests that intrafamilial HBV transmission plays a major role in HBV transmission in Kurdistan province. Furthermore, approximately 5% of general population in this province has prior exposure to HBV and less than 1% is HBsAg carriers. However, we could not find any case of HDV infection among them

prevalence of hepatitis B virus surface antigen [HBsAg] variations and correlation with the clinical and serologic pictures in chronic carriers from Khorasan Province, North-East of Iran

This study was designed to determine the correlation of hepatitis B virus surface Ag [HBsAg] variations with the clinical/serological pictures among chronic HBsAg positive patients. The surface gene [S-gene] was amplified and directly sequenced in twenty-five patients. Eight samples [group I] contained at least one mutation at the amino acid level. Five showed alanine aminotransferase [ALT] levels above the normal range of which only one sample was anti-HBe positive. Group II [17 samples] did not contain any mutation, 4 were anti-HBe positive and 9 had increased ALT levels. In both groups, from a total of 18 mutations, 5 [27.5%] and 13 [72.5%] occurred in anti-HBe and HBeAg positive groups respectively. The small number of amino acid mutations might belong to either the initial phase of chronicity in our patients; or that even in anti-HBe positive phase in Iranian genotype D-infected patients, a somehow tolerant pattern due to the host genetic factors may be responsible

Lipid Profiles and Hepatitis C Viral Markers in HCV-Infected Thalassemic Patients

BACKGROUND/AIMS: The distribution of blood lipids, glucose and their determinants in thalassemic patients with chronic hepatitis C virus (HCV) infection has rarely been investigated. Thus, we aimed to investigate the relationship between both liver histologic findings and viral markers and serum lipids in thalassemic patients chronically infected with HCV. METHODS: We enrolled 280 polytransfused thalassemic patients with chronic hepatitis C. HCV viral load was determined using the Amplicor test. Genotyping was performed using genotype specific primers. Fasting serum lipid, glucose, ferritin and liver function enzyme concentrations were measured. A modified Knodell scoring system was used to stage liver fibrosis and to grade necroinflammatory activity. Perls' staining was used to assess hepatic siderosis. RESULTS: Just one subject had total cholesterol >200 mg/dL, and 7% had triglycerides >150 mg/dL. The mean high-density lipoprotein cholesterol (HDL-C) and glucose levels were 37 and 104 (97-111) mg/dL, respectively. Viral markers, liver histological findings and aminotransferase activity were not associated with serum lipid levels. Serum triglycerides, total cholesterol and ferritin were independent risk factors for impaired glucose tolerance or diabetes in these patients. CONCLUSIONS: The majority of the patients had blood lipid levels (with the exception of HDL) within the defined normal range; viral and liver histological factors do not appear to play a significant role in changing the levels of serum lipids or glucose in these patients.

Hepatitis A in Developed Country, the Result Should Interpret Carefully

No abstract available.