ABSTRACT
BACKGROUND: Timely diagnosis of liver cirrhosis is vital for preventing further liver damage and giving the patient the chance of transplantation. Although biopsy of the liver is the gold standard for cirrhosis assessment, it has some risks and limitations and this has led to the development of new noninvasive methods to determine the stage and prognosis of the patients. We aimed to design an artificial neural network (ANN) model to diagnose cirrhosis patients with non-alcoholic fatty liver disease (NAFLD) using routine laboratory data. METHODS: Data were collected from 392 patients with NAFLD by the Middle East Research Center in Tehran. Demographic variables, history of diabetes, INR, complete blood count, albumin, ALT, AST and other routine laboratory tests, examinations and medical history were gathered. Relevant variables were selected by means of feature extraction algorithm (Knime software) and were accredited by the experts. A neural network was developed using the MATLAB software. RESULTS: The best obtained model was developed with two layers, eight neurons and TANSIG and PURLIN functions for layer one and output layer, respectively. The sensitivity and specificity of the model were 86.6% and 92.7%, respectively. CONCLUSION: The results of this study revealed that the neural network modeling may be able to provide a simple, noninvasive and accurate method for diagnosing cirrhosis only based on routine laboratory data.
Subject(s)
Hepacivirus/isolation & purification , Hepatitis C Antibodies/blood , Renal Dialysis/methods , Female , Humans , MaleABSTRACT
BACKGROUND: Human immunodeficiency virus (HIV) infected patients are also frequently exposed to the hepatitis B virus (HBV), due to the common routes of transmission, therefore, prevention of hepatitis B results in decreased complications of the disease. OBJECTIVES: Since the immune response of HIV patients to hepatitis B vaccination is less robust than that found in healthy individuals, this study aimed to evaluate the effect of a levamisole adjuvant on increasing the immune response. PATIENTS AND METHODS: In this study, 89 HIV infected patients, without a history of HBV infection or vaccination, were randomly allocated into experimental (44 patients) and control (45 patients) groups. HBV vaccination was performed using the Hepavax-Gene TF vaccine, 40 µg three times at intervals of; zero, one, and three months. Levamisole 50 mg twice a day or a placebo, was administered to the experimental and control groups, respectively, for a period of six days before to six days after the vaccination. Immune response was evaluated by measuring hepatitis B surface antibodies (HBsAb) concurrently with the second and third vaccine administration, and at one and three months at the conclusion of the vaccination program. RESULTS: The immune response following the threevaccinations was higher in those who were receiving levamisole compared with the controls (90% vs. 65.38%) (P = 0.05). Furthermore, the immune response and the mean antibody titer following the repeated vaccination in the experimental group showed a higher increase than in the control group. The immune response and the mean titer of antibody were not associated with; age, sex, body mass index, history of smoking and/or intravenous drug use in either of the groups. However, regarding CD4+ cells more than 200 cell/mm3, mean antibody production significantly increased in both groups. CONCLUSIONS: Using levamisole with the hepatitis B vaccination can increase the immune response and antibody titer mean in HIV infected patients. Since these patients have a more complete response with CD4+ cells more than 200 cell/mm3, vaccination and effective adjuvants seem to be most beneficial when CD4+ cells are greater than 200 cell/mm3, in HIV infected patients.
ABSTRACT
This study sought to determine the seroprevalence of the hepatitis D virus (HDV), the risk factors and its association with the severity of liver disease. Continuous patients at Tabriz and Tehran Hepatitis Clinics were enrolled during 2007-2008 in a cross-sectional study. Demographic data and possible risk factors for infection were recorded for all hepatitis B surface antigen positive patients. The blood samples of 847 patients infected with the hepatitis B virus were evaluated. The seroprevalence of HDV was 9.3%. This rate was significantly higher after reaching 40 years of age. The rate was 12.7% in patients with chronic hepatitis B and 4.7% in patients with in-active hepatitis B; the difference was statistically significant. A history of dental interventions and several trips abroad were good predictors of HDV infection in logistic regression. No significant difference in liver function tests was found. The seroprevalence of HDV was higher than in some other studies from Iran but a decrease was noted in younger age.
