GALAD score and a proposal for GALADUS model for detecting hepatocellular carcinoma in Vietnamese patients with chronic liver disease.

OBJECTIVE: The GALAD score, a serum biomarker-based model, predicts the likelihood of hepatocellular carcinoma (HCC) in patients with chronic liver disease. We evaluated the performance of the GALAD score compared to that of liver ultrasound in detecting HCC. PATIENTS AND METHODS: This study recruited a group of 136 patients with HCC and a control group of 436 patients with cirrhosis or chronic hepatitis B or hepatitis C. The performance of the GALAD score and ultrasound in detecting HCC in these patients was analyzed using the area under the receiver operating characteristic curve (AUC). The sensitivity and specificity of the optimal GALAD score were compared to those of ultrasound. RESULTS: The AUC of the GALAD score for detecting HCC was 0.940 [95% confidence interval (CI) 0.92-0.96], higher than that of ultrasound [0.939 (0.91-0.96), p < 0.001]. At a threshold of 1.24, the GALAD score had a sensitivity of 91.2% and a specificity of 81.9% for detecting HCC. The AUC of the GALAD score for early HCC detection was 0.75 (95% CI 0.71-0.80, p < 0.001; threshold 1.13, sensitivity 87.5%, specificity 67.8%, p < 0.001). The combination of GALAD and ultrasound (GALADUS score) showed further improvement, achieving an AUC of 0.97 (95% CI 0.96-0.99; cut-off point 1.37, sensitivity 95.6%, specificity 89.2%, p < 0.001). CONCLUSIONS: In our study, the GALADUS score showed improved performance compared to the GALAD score. Therefore, we suggest that the performance of the GALAD score should be reconsidered and that it should be evaluated in combination with ultrasound for HCC detection.

Return to post-test counselling by out-of-treatment injecting drug users participating in a cross-sectional survey in north Vietnam.

Return to post-test counselling is essential for optimal individual and public health impact of voluntary counselling and testing (VCT) services. Our study assessed factors associated with return to post-test counselling among 309 out-of-treatment injecting drug users who underwent VCT as part of a cross-sectional survey in Bac Ninh, Vietnam during August and September 2003. The overall return rate to post-test counselling was 54% (n=167). While participants in the rural study district were significantly less likely (chi2=5.8; p<0.05) to return compared with participants in the town centre (42.7 versus 58.1%), return rates did not significantly vary by age, perception of personal HIV risk, HIV serostatus diagnosed by the study, counsellor, history of HIV testing or prior knowledge of HIV status. In a multivariate analysis, higher return rate was associated with residence in Bac Ninh town centre (adjusted OR=1.9; CI=1.1-3.1). Of HIV-positive participants (n=131), 45% (n=59) did not return to collect test results. In view of the findings it is crucial to address risk perception and benefits of collecting test results during pre-test counselling sessions in order to maximize the desired impact of community-based VCT services targeting IDUs in Vietnam.

[Isolation of an avirulent strain of the chicken herpes virus type B]. / Izolirane ne avirulenten shtam kokoshi kherpesvirus tip B.

Experiments were carried out to isolate type 'B' of the chicken Herpes virus on a farm for stock layers with a low level of losses due to Marek's disease. Seven virus isolates were obtained from 3-4-month-old White Leghorn poults via direct kidney cell cultures. One of them, named strain C-80, was studied in chick embryo fibroblast cultures, and egg cultures (Büllow's test) as well as biochemically, serologically, and through the electron microscope. Results made it reasonable to identify it as a chicken Herpes virus type 'B'. In vivo experiments with strain C-80 inoculated in day-old chicks at the rate of 15 x 10(3) PFU showed that it did not cause gross and microlesions in the nervous system and the parenchymal organs in the course of 18 weeks of observation. The immunogenic properties of strain C-80 were studied in 2250 day-old White Plymouth Rock chicks inoculated at the rate of 1360 PFU, kept in an infected environment together with as many as 4500 control birds immunized three times with a vaccine (obtained from a turkey Herpes virus) at 1500 PFU. Twenty-four weeks later the losses due to Marek's disease were 3.4 per cent in the test group, and 7.2 per cent in the control one. It is believed that strain C-80 is appropriate for the production of a vaccine against Marek's diseases--Rispens type. Further studies are being performed on the antigenic composition and the immunogenic properties as well as series of in vivo passages with regard to reversibility.