Differences In Liver Function Tests Research Articles

A single-center review of outcomes between COVID-19 vaccinated and unvaccinated liver transplant recipients.

With the availability of vaccines against SARS-COV-2, recommendations for vaccination of transplant candidates are widespread. At our institution, patients may receive liver transplant (LTx) regardless of vaccine status. The purpose of this study is to compare post-LTx outcomes between vaccinated (VAX) and unvaccinated (UNVAX) LTx recipients. This is a retrospective, single-center study of LTx from January 1, 2021-March 30, 2022. The primary outcome is incidence of post-LTx COVID-19. Secondary outcomes include graft function, mortality, graft loss, and COVID-19 treatment. One hundred and seventy-seven LTx recipients were included, 57% [101/177] VAX and 43% [76/177] UNVAX. Baseline characteristics were similar between groups. Overall, 28 (36.8%) UNVAX and 34 (33.7%) VAX tested COVID-19 positive during the study period (p = .193) at a mean of 312.6 [255.4-369.8] days for UNVAX versus 254.6 [215.2-293.9] days for VAX (p = .084). COVID-19 treatment was administered in 15 (53.6%) of the UNVAX compared to 22 (64.7%) in the VAX (p = .374), although eight (28.6%) of UNVAX required hospital admission for treatment compared with two (5.9%) of VAX (p = .016). There were no statistically significant differences in death, and no COVID-19 related death or graft loss. There were no statistically significant differences in liver function tests at 3- and 12-months post LTx. In a series with a large percentage of UNVAX patients, LTx appears to be safe, with no difference in the rate of COVID-19 or transplant-related outcomes compared to VAX. While we encourage vaccination to prevent severe COVID, based on our results, vaccine status should not be reason to deny lifesaving transplant.

Statin liver safety in non-alcoholic fatty liver disease: A systematic review and metanalysis.

AimsStatin liver safety in non‐alcoholic fatty liver disease (NAFLD) patients is not well defined. We analysed differences in liver function tests, including alanine transaminase aminotransferase (ALT), aspartate transaminase (AST) and gamma‐glutamyl transpeptidase (GGT) in NAFLD patients treated or not treated with statins.MethodsWe performed a systematic review of MEDLINE via PubMed and EMBASE databases and metanalysis of clinical studies investigating levels of ALT, AST and GGT in NAFLD according to statin treatment. Mean difference (MD) and percentage MD were calculated between the two groups.ResultsWe included 22 studies with 2345 NAFLD patients. Overall, 16 were before‐after interventional, five were cross‐sectional and one was combined cross‐sectional/interventional study. In all interventional studies, except one, patients had raised ALT, AST and GGT at baseline. Interventional studies showed reduced ALT values with an MD reduction of −27.2 U/L (95% CI −35.25/−19.15) and a percentage MD reduction of −35.41% (95% CI −44.78/−26.04). Also, AST values were reduced after statin treatment in interventional studies with an MD of −18.82 U/L (95% CI −25.63/−12.02) (percentage −31.78%, 95% CI −41.45/−22.11). Similarly, GGT levels were reduced after statin treatment with an MD of −19.93 U/L (95% CI −27.10/−12.77) (percentage −25.57%, 95% CI −35.18/−15.97). Cross‐sectional studies showed no difference in AST and GGT values between patients treated with and without statins.ConclusionIn interventional studies, ALT, AST and GGT were reduced after statin treatment with a percentage mean difference of −35.41%, −31.78% and −25.57%, respectively, while observational studies showed a null effect, suggesting liver safety of statins in NAFLD patients.

Genome-wide association study on liver function tests in Chinese.

Liver function tests (LFTs) measure a series of complex traits that are affected by genetic and environmental factors. Previous studies demonstrated that there exist significant differences in LFTs across individuals, which may be the results of the unique genetic profile of each individual. Therefore, we performed a genome-wide association study (GWAS) to evaluate the influence of single nucleotide polymorphisms (SNPs) in LFTs and identify the significant association between genotypes and phenotypes using 1653 Chinese subjects from the UK Biobank database. We successfully identified 229 SNPs significantly associated with total bilirubin (TB) levels, 27 SNPs significantly associated with alkaline phosphatase (ALP), and 36 SNPs significantly associated with γ-glutamyl transpeptidase (GGT) in serum. In addition, one SNP significantly associated with aspartate transaminase (AST) in serum was also found. Among the most significant ones, the topmost 11 SNPs were found to be associated with LFTs for the first time. Through functional genomic analysis, the clinical significance of these SNPs could be associated with diseases (e.g. Gilbert's syndrome) and the respective candidate genes (UGT1A, ABO, GGT1). This study provides a preliminary rationale for research to understand the associations of individual genetic differences and clinical liver functions in the Chinese population.

Clinical considerations on posaconazole administration and therapeutic drug monitoring in allogeneic hematopoietic cell transplant recipients.

There is a paucity of data on posaconazole (PCZ) dosing and therapeutic-drug-monitoring (TDM) in allogeneic hematopoietic cell transplant recipients (allogeneic-HCTr). This was a 3-year retrospective multicenter study (January 1, 2016 to December 31, 2018) in adult allogeneic-HCTr who received PCZ (intravenously, IV and/or as delayed-release tablet, DRT) as prophylaxis or treatment for≥7 consecutive days (D) with at least 1-PCZ-level available using data of the Swiss Transplant Cohort Study. The primary objective was to describe the distribution of PCZ-level and identify predictors of therapeutic PCZ-level and associations between PCZ-dosing and PCZ-level. A total of 288 patients were included: 194 (67.4%) and 94 (32.6%) received PCZ as prophylaxis and treatment, respectively, for a median of 90 days (interquartile range, IQR: 42-188.5). There were 1944 PCZ-level measurements performed, with a median PCZ level of 1.3mg/L (IQR: 0.8-1.96). PCZ-level was<0.7mg/L in 383/1944 (19.7%) and<1.0mg/L in 656/1944 (33.7%) samples. PCZ-level was<0.7mg/L in 260/1317 (19.7%) and<1.0mg/L in 197/627 (31.4%) in patients who received PCZ-prophylaxis versus treatment, respectively. There were no significant differences in liver function tests between baseline and end-of-treatment. There were nine (3.1%) breakthrough invasive fungal infections (bIFI), with no difference in PCZ levels between patients with or without bIFI. Despite a very intensive PCZ-TDM, PCZ-levels remain below target levels in up to one-third of allogeneic-HCTr. Considering the low incidence of bIFI observed among patients with PCZ levels in the targeted range, our data challenge the clinical utility of routine universal PCZ-TDM.

Influence of different intravenous lipid emulsions on fatty acid status and laboratory and clinical outcomes in adult patients receiving home parenteral nutrition: A systematic review

Patients who have chronic intestinal failure require home parenteral nutrition (HPN) support. Intravenous lipid emulsions (IVLEs) are a vital part of HPN. The conventional IVLE is based on pure soybean oil, which contains a high concentration of omega-6 fatty acids. Alternative IVLEs are commercially available. These contain various oil blends and have different fatty acid compositions from soybean oil that could provide benefit to patients on HPN. The aim of this systematic review is to assess the effects of different IVLEs in adult patients requiring HPN. A systematic literature search was conducted up to October 2019 using relevant search terms in the Medline, EMBASE and CINAHL databases. Only randomised controlled trials (RCTs) in adults on HPN that compared two or more IVLEs were included. Data were extracted and the Cochrane Collaboration's tool for assessing risk of bias was used. Six articles were identified for inclusion in this systematic review. Studies differed according to sample size, duration and the IVLEs compared. Four studies found no increased risk of adverse effects related to the different IVLEs, whilst one study found a higher frequency of serious adverse events with soybean oil. One study found higher serum α-tocopherol with the blend of soybean oil, medium chain triglycerides, olive oil and fish oil. Inflammatory markers were not affected by different IVLEs in three studies. Differences in liver function tests were minimal, but one study found slight abnormalities in patients receiving soybean oil. IVLEs containing olive oil or fish oil modified the blood fatty acid profile. No studies reported essential fatty acid deficiency. There may be benefits of using alternative IVLEs to soybean oil-based emulsions in adults requiring HPN, although there is currently insufficient evidence to determine superiority of one formulation over another. More and larger RCTs are required in this area.

DIFFERENCES OF LIVER FUNCTION TESTS IN TYPE 2 DIABETES MELLITUS PATIENTS WITH AND WITHOUT CORONARY ARTERY DISEASE

One of the macroangiopathic complications of Diabetes Mellitus (DM) is Coronary Arterial Disease (CAD). Several studies showed that the liver was one of the organs involved in the pathological development of diabetes.The aim of this study was to find the differences of liver function in type 2 DM patients with CAD and without CAD. This was an analytical observational study with cross-sectional design. Forty-four type 2 DM patients with and without CAD at the Adam Malik Hospital Medan who came during June - August 2016 were studied for liver function (total bilirubin, direct bilirubin, AST and ALT). In this study, the average values of total bilirubin and direct bilirubin level in patients with CAD were found to be lower than without CAD. Statistically a significant difference revealed a total bilirubin (p &lt; 0.001) and direct bilirubin (p = 0.001) in type 2 DM patients with and without CAD. There was a significant difference in liver function tests in DM type 2 patients with, and without coronary arterial disease, these data suggested that total billirubin and direct billirubin levels in type 2 DM patients with CAD were found lower than those without CAD.

A prospective single-institute study of the impact of Daikenchuto on the early postoperative outcome after living donor liver transplantation

The aim of this study was to investigate the impact of Daikenchuto (DKT) on early postoperative outcomes after living donor liver transplantation (LDLT), focusing on the prevention of abdominal distension and bacterial translocation. Adult LDLT recipients were prospectively divided into 2 groups, who were administered DKT (n=20, group A) or not (n=20, group B). The area of bowel gas defined as gas volume score (GVS) 7 days after LDLT was calculated. Postoperative liver function tests, the development of bacterial, viral, and fungal infections, and GVS after LDLT were reviewed. There were no significant differences in liver function tests and ammonia level after LDLT. Also, the rates of infection and the result of culture study were not different between groups. The median GVS 7 days after LDLT was not significantly different between groups A (0.26 (range, 0.12-0.58)) and B (0.23 (range, 0.15-0.42)). No positive impact was observed for 14-day DKT administration after LDLT, in terms of preventing infection or abdominal distension.

Evaluation of Ledipasvir plus Sofosbuvir for Treatment of Compensated and Decompensated HCV Cirrhotic Patients

Background:unlike human immunodeficiency virus (HIV) and hepatitis B virus (HBV), hepatitis C virus (HCV) infection is a curable disease. Current direct acting antiviral agent (DAA) targets are focused on HCV NS3/4A protein (protease), NS5B protein (polymerase) and NS5A protein. The first generation of DAAs includes boceprevir and telaprevir, which are protease inhibitors and were approved for clinical use in 2011. The cure rate for genotype 1 patients increased from 45% to 70% when boceprevir or telaprevir was added to standard PEG-IFN/ribavirin. More effective and less toxic second generation DAAs supplanted these drugs by 2013. The second generation of DAAs includes sofosbuvir, simeprevir and fixed combination medicines containing ledipasvir plus sofosbuvir and Viekira Pak. These drugs increase cure rates to over 90% without the need for interferon and effectively treat all HCV genotypes. With these drugs the “cure HCV” goal has become a reality. The aim of this study was to assess of ledipasvir plus sofosbuvir as treatment of HCV infection in patients with advanced liver disease including cirrhotic patients with child B and C. Patients and methods:in this prospective study, seventy five HCV PCR positive patients were classified into three groups according to child score. Each group included twenty five patients. All patients received ledipasvir plus sofosbuvir for six months. For all patients thorough medical history, clinical examination, kidney function tests, liver function tests, complete blood count, pelvi-abdominal ultrasound, HCVantibodies, hepatitis C viral RNA, quantitative, HbsAg, alpha fetoprotein as baseline screening. HCV PCR done for all patients at end of treatment and three months later to detect sustained virological response (SVR12). Patients with combined HCV and HBV infection, hepatic or extrahepatic malignancies and late child C were excluded. Results: showed that no statistical significant difference were detected in patients of group A as regard liver function tests before and after treatment and SVR12 achieved by 96%. Patients of group B showed significant statistical difference as regard liver function tests before and after treatment with SVR12 achieved by 88%. In patients of group C there were significant statistical difference in liver function tests with SVR12 achieved by 80%. Also there were clinical improvement in patients of group B and C after end of treatment. Conclusion:it could be concluded that there will be a dramatic improvement in HCV therapy followed the introduction of oral medicines that directly inhibiting the replication cycle of HCV. The combination pill contains a fixed-dose of ledipasvir 90 mg and sofosbuvir 400 mg, two direct-acting antiviral agents against HCV. Ledipasvir is an inhibitor of the NS5A protein, which is required for HCV replication. Sofosbuvir inhibits the HCV NS5B RNA-dependent RNA polymerase, which is also required for viral replication. Sofosbuvir is a nucleotide prodrug that undergoes intracellular metabolism to form a pharmacologically active triphosphate that can incorporate into the HCV RNA. Ledipasvir plus sofosbuvir can be used safely in treatment of compensated and decompensated post hepatitis C liver cirrhosis. SVR12 can be achieved by 96% in patients with early cirrhosis (child A), 88% in patients with child B cirrhosis and 80% in patients with child C with subsequent improvement in liver functions.

Gender Differences in Liver Function Tests in Coastal Karnataka

Gender Differences in Liver Function Tests in Coastal Karnataka

Impact of intravenous lipid emulsions on liver function tests: Contribution of parenteral fish oil

ObjectiveLipids in parenteral nutrition (PN) have been linked to liver damage. The aim of this study is to 1) determine whether the incidence of alterations in liver function tests (LFTs) changes over time among hospitalized adult patients receiving PN; 2) evaluate whether the alteration in LFTs varies with the pattern of lipid administration; and 3) study the relationship between LFT alterations and fish oil (FO) emulsions. MethodsPatients treated with PN over 4 y were included. Demographic, clinical, nutritional, and analytical variables were collected. LFTs (γ-glutamyl transferase [GGT], alkaline phosphatase [AP], alanine aminotransferase [ALT], and total bilirubin [BIL]) were collected during PN treatment. Differences in LFTs were studied with t tests for paired samples. To match the type of lipid with each of the LFTs studied, four multivariate statistical models were performed. Significance was reported with the 95% confidence interval (CI) at p < 0.05 (two-tailed). ResultsWe studied 1555 patients. LFT alterations at baseline were high and increased during PN treatment except ALT. GGT and AP showed significant increases from baseline values. In the multivariate study, daily dose of FO (g·kg−1·d−1) was associated with a significant decrease in GGT (B = −11.189; 95% CI, −19.799 to −2.578) and in AP (B = −5.250; 95% CI, −10.263 to −0.237). Daily dose of vegetal oil (g/kg) had a tendency for a significant increase in GGT (B = 0.441; 95% CI, −0.107 to 1.039) and AP (B = 0.312; 95% CI, −0.023 to 0.648). ConclusionsGGT and AP increased throughout the clinical course of PN administration. These alterations had a multifactorial component. The administration of FO was associated with a significant decrease in the levels of GGT and AP.

P1243 : Birth cohort distribution and screening of viremic HCV infections in luxembourg

Background and Aims: Non-alcoholic fatty liver disease (NAFLD) is now the most common cause of liver disease in children, with an estimated prevalence of 5–10%. The majority of published data has involved Caucasians. Data is lacking regarding the phenotypic differences of NAFLD in children of Asian origin. Methods: We performed a retrospective review of children consecutively diagnosed with NAFLD at a tertiary referral hepatology service in the UK, between 2003 and 2014. Patients had been referred from either primary care physicians or general paediatricians with incidental asymptomatic abnormal liver function tests (LFTs) and/or fatty liver on ultrasound scan (USS). Patients with inadequate data or with secondary fatty liver disease were excluded. Patients were divided by ethnicity into Asian and Caucasian. All values are (±SD), unless stated. Results: 100 patients with primary NAFLD were identified. 59/100 were Caucasian and 41/100 were of Asian origin, of whom, 73% (30/41) were Pakistani. There was male predominance in both groups, 73% (43/59) in Caucasian and 78% (32/41) in Asians. Mean ages at presentation were 12.6±2.5 and 11.7±2.8 years in Caucasian and Asian groups, respectively. Asian patients had a significantly lower body mass index (BMI) centile than Caucasian (91.2±9.5 vs. 96.1±5.1, p < 0.05). There were no differences in LFTs between Asian and Caucasian patients, ALT (87.8±60.9 vs. 94.3±84.5 IU/L) and bilirubin (9.4±7.6 vs. 9±6.5mmol/L). 61% (25/41) Asian patients had an elevated gamma glutamyl transferase, compared to 60% (35/59) Caucasian patients. Markers of the metabolic syndrome were similar in both groups: total cholesterol 4.4±1 vs. 4.4±1mg/L, triglycerides 2.0±1.4 vs. 2.2±1.4mg/L, and HbA1c 38.6 vs. 39.1±7.4mmol/mol. 20 patients had undergone biopsy. 33% (2/6) demonstrated moderate-severe fibrosis in Asian patients, compared to 21% (3/14) Caucasian patients (p =0.61). Conclusions: Asian children with NAFLD have similar disease severity as their Caucasian counterparts, despite a significantly lower BMI centile at presentation. Referring clinicians and risk stratification scores require a greater awareness of ethnic differences in adiposity in paediatric NAFLD. EU Public health

Increased risk of cirrhosis and hepatocellular cancer during long-term follow-up of patients with biopsy-proven NAFLD

Objective. Our aims were to investigate the natural history of biopsy-proven non-alcoholic fatty liver disease (NAFLD) in Sweden, its associated complications, the clinical and biochemical factors associated with more advanced liver disease and the survival rate with a mean follow-up time of 27 years. Material and methods. All subjects participating in the population-based prospective cohort study Malmö Preventive Project (MPP) from 1974 to 1992 who had undergone liver biopsy with the diagnosis of NAFLD were included. The remaining MPP cohort was used as a control group. Subjects with other liver diseases and alcohol overconsumption were excluded. A panel of blood tests was analyzed in the MPP cohort. Follow-up of the NAFLD patients included studies of medical records, pathology records and mortality rates from the Swedish National Board of Health and Welfare’s register until the end of 2011. Results. A total of 36 patients were diagnosed with biopsy-proven NAFLD. Median follow-up time was 27.0 years (6.32–35.3). Nine patients (25%) were diagnosed with cirrhosis and five (14%) with hepatocellular cancer, all with a previous diagnosis of cirrhosis. There were significant differences in liver function tests, insulin resistance (as homeostasis model assessment of insulin resistance) and body mass index (BMI) in patients with NAFLD compared with the control group. Mortality in the NAFLD group was significantly higher, 58.3% compared to 33.8% (p = 0.004). Hepatocellular cancer accounted for 23.8% of all deaths in the NAFLD group, compared to 0.7% (p = 0.000). Conclusions. NAFLD can progress to advanced liver disease, including cirrhosis, with a higher than expected mortality and incidence of hepatocellular cancer.

Transabdominal Ultrasound Finding and Acute Hepatocellular Injury in Different Cohorts of Elderly Adults with and without Common Bile Duct Stones

Transabdominal Ultrasound Finding and Acute Hepatocellular Injury in Different Cohorts of Elderly Adults with and without Common Bile Duct Stones

Pigmented purpura dermatosis and viral hepatitis: a case-control study

Pigmented purpuric dermatosis (PPD) is characterized by petechial and pigmented macules on the lower limbs. The aetiology of PPD remains obscure. Some reports have suggested an association between PPD and hepatitis B or C infection. This prospective case-control study was designed to investigate the association of positive hepatitis B or C serology with PPD. A total of 60 PPD patients and 230 randomly selected controls were enrolled. Sera from all patients and controls were tested for liver function tests (LFT), hepatitis B surface antigen (HBS Ag), and hepatitis C virus antibody (HCV Ab). The prevalence of HBS Ag in patients with PPD and the controls was 3 per cent (5/60) and 4.3 per cent (10/230), respectively. The prevalence of HCV Ab was 1.7 per cent (1/60) and 1.3 per cent (3/230) among patients and controls, respectively. No statistically significant difference was noted in the prevalence of positive hepatitis B or C serology (P-values 0.73 and 0.58, respectively). No statistically significant difference in LFT was observed between the two groups. Therefore, the authors believe it is unlikely that HBV or HCV are directly involved in the pathogenesis of PPD.

Perihepatic lymph node enlargement is a negative predictor of liver cancer development in chronic hepatitis C patients

Perihepatic lymph node enlargement (PLNE) is a common ultrasound finding in chronic hepatitis C patients. Although PLNE is considered to reflect the inflammatory response to hepatitis C virus (HCV), its clinical significance remains unclear. Between December 2004 and June 2005, we enrolled 846 chronic hepatitis C patients in whom adequate ultrasound examinations had been performed. PLNE was defined as a perihepatic lymph node that was at least 1 cm in the longest axis by ultrasonography. We analyzed the clinical features of patients with PLNE and prospectively investigated the association between PLNE and hepatocellular carcinoma (HCC) development. We detected PLNE in 169 (20.0%) patients. Female sex, lower body mass index (BMI), and HCV serotype 1 were independently associated with the presence of PLNE. However, there were no significant differences in liver function tests, liver stiffness, and hepatitis C viral loads between patients with and without PLNE. During the follow-up period (mean 4.8 years), HCC developed in 121 patients. Unexpectedly, patients with PLNE revealed a significantly lower risk of HCC development than those without PLNE (p = 0.019, log rank test). Multivariate analysis revealed that the presence of PLNE was an independent negative predictor of HCC development (hazard ratio 0.551, p = 0.042). In addition, the sustained viral response rate in patients who received interferon (IFN) therapy was significantly lower in patients with PLNE than in patients without PLNE. Patients with PLNE had a lower risk of HCC development than those without PLNE. This study may provide new insights into daily clinical practice and the pathophysiology of HCV-induced hepatitis and hepatocarcinogenesis.

Transaminase in rotavirus gastroenteritis

Children infected with rotavirus often show increased levels of transaminase, and symptoms are characterized by white stool, similar to biliary atresia. Rotavirus infections are also sporadically accompanied with convulsions, encephalopathy and Reye syndrome. The aim of the present study was therefore to investigate transaminase and interleukin (IL)-6 levels in rotavirus infection, in order to better understand their clinical significance. Results of liver function tests, mainly the elevation of transaminase and IL-6 in rotavirus gastroenteritis with or without convulsions, were evaluated. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were high in 23 of 26 samples (88.5%), and in three of 26 samples (11.5%), respectively. No significant differences in liver function tests could be found between the groups with or without convulsions. Three patients whose direct bilirubin levels were above the upper normal limit were all classified into the group without convulsions. Spearman's correlation coefficient was 0.89 between increasing AST levels and IL-6 levels. Rotavirus infection is occasionally accompanied with hepatitis, but only in a mild form, and does not correlate with neurological complications. High levels of transaminase might reflect high IL-6.

Ethnicity and Insurance Status Affect Health Disparities in Patients with Gallstone Disease

Complex gallstone disease is associated with greater risk of morbidity, associated with operative complications and longer hospital stays. The purpose of this study is to evaluate whether ethnicity or insurance status is associated with differences in presentation and outcomes in gallstone disease. A retrospective analysis was performed for all patients who underwent cholecystectomy between August 1, 2007 and May 31, 2010 at the only teaching hospital in the region. Analysis of Variance, Chi square (χ(2)) and logistical regression analyses were used to evaluate the impact of ethnicity and insurance status on the complexity of gallstone disease and surgical outcomes. A total of 562 patients had a cholecystectomy during the study period, of whom 255 (45.4%) were Latino. Latino patients were significantly younger than any other ethnic group (P < 0.001) and had a significantly higher rate of being uninsured (40%, P = 0.03). Latino patients were significantly more likely to require ERCP (38.6% versus 28.8% for non-Latino, P = 0.01). Latino patients had a significantly higher white blood cell count (P = 0.017). There were no significant differences in liver function tests, bilirubin levels, albumin levels, hospital lengths of stay, operation types, pathology types, or complication rates between ethnic groups. Uninsured patients were significantly younger (P = 0.003) and were more likely to require an ERCP (39.5% versus 26.8% for privately insured and 31.9% for publicly insured, P = 0.04). Patients with no insurance were significantly more likely to have a higher white blood cell count (P = 0.039) and aspartate aminotransferase (AST) level (P = 0.04). Patients with public insurance and no insurance had a significantly longer median length of hospital stay (4.0 d versus 3.0 d for privately insured, P = 0.045). There were no significant differences in operation types, complication rates, or pathologic diagnosis based on insurance status. In our population, ethnicity and insurance status do play a role in the presentation and care of patients with gallstone disease. Latino and uninsured patients present with a higher complexity of disease and require interventions more frequently.

PP-140 Difference in liver function tests in patients with chronic HCV-infection depend on some predisposing factors

Results: Level of AST was significantly higher in HCV-infected patients with obesity (body mass index less than 25 – 56.8±8.0; BMI 25-30 – 59.3±11.9; BMI more than 30 – 79.4±20.1) and GGT was significantly higher in HCV-infection with duration of disease more than 10 years (less than 5 years – 77.0±25.7; 5-10 years – 88.7±9.7; more than 10 – 159.2±33.6). Ferritinemia was higher in male in comparison with female (326±38.4 vs. 108.2±44.7) and in long history of HCV-infection (up to 5 years – 198.8±45.9; 5-10 years – 251.1±39.1; more than 10 – 546.5±80.8).

The frequency of hepatitis D virus in patients with hepatitis B in Iran: an increasing rate?

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.

Abnormal liver function tests are associated with increased mortality in both cardiothoracic and general intensive care

The objective of this study was to identify differences in liver function tests (LFT) between patients admitted to a general ICU (GICU) and a cardiothoracic ICU (CTICU), and the effect on mortality. Liver dysfunction (LD) in critically ill patients is common and is associated with increased mortality and prolonged ICU stay [1]. Patients undergoing cardiothoracic surgery are anecdotally at increased risk of LD as a consequence of haemodynamic instability.