Different Types Of Hepatitis Research Articles

Article Review: The Hepatic Physiology and Pathophysiology of Different Types of Hepatitis

Globally, viral hepatitis is a frequent cause of liver disease with high morbidity and fatality rates. Since the liver produces a large number of hematopoietic factors and carries out numerous essential tasks that influence metabolism throughout the body. The purpose of this study is to identify hematological complications in patients with acute viral hepatitis. This information will be useful for treating and monitoring these patients. Also, everyone should be aware of the symptoms of hepatitis. Due of this, this article.

Understanding the knowledge, awareness, and attitudes of the public towards liver diseases in Malaysia.

Viral hepatitis B and C (HBV, HCV) and non-alcoholic fatty liver disease (NAFLD) are the commonest etiologies of liver-related deaths in Malaysia. Herein, this study aims to explore and understand the knowledge and attitudes of the public toward liver-related health and diseases in Malaysia. A cross-sectional, self-reported, web-based questionnaire was conducted among 500 adults between February and March 2020. Questionnaire items pertained to the knowledge and attitudes toward liver-related health and diseases. Half of the respondents were aged ≥35 years and 52.0% were males. Gaps in knowledge included the lack of awareness of different types of hepatitis, including the potential transmission risks and complications of HBV and HCV. About half acknowledged liver fibrosis and cirrhosis as key determinants of liver-related disease progression. A higher proportion rightly recognized the diagnostic test for HCV (40.8%) than HBV (30.0%) despite more being aware of HBV than HCV. Less than one-third were aware of the risk factors, screening tests, and complications of NAFLD. Despite the majority (92.8%) agreeing that regular screening was important for liver health, only 67.0% attended recent health screening and one-fifth were unlikely to seek medical consultation upon exposure to viral hepatitis risk factors. Reasons for this low urgency included the perception of being healthy, cost-related concerns, and societal discrimination. Robust education efforts are needed to raise awareness and empower the community with knowledge of liver-related diseases, particularly viral hepatitis and NAFLD in Malaysia.

Comparative prevalence of different types of viral hepatitis in the district Dera Ismail Khan, Khyber Pakhtunkhwa, Pakistan

BackgroundViral hepatitis causes both liver inflammation and damage and is a serious health problem.MethodsThe indoor data of different types of hepatitis were collected from the official records of the administration of District Head Quarter Hospital Dera Ismail Khan for 2 years (2020–2021).ResultsA total of 1193 cases of viral hepatitis during the study period were found including viral hepatitis C accounted for 547 (45.9%) cases, followed by the co-infection of viral hepatitis A and E 367 (30.8%) cases, and viral hepatitis B 279 (23.4%) cases. March showed the highest prevalence of hepatitis (33.2%), followed by February (10.2%). The co-infection of hepatitis A and E showed a relatively higher prevalence in 6 months from May to November except September including a peak in June (76.5%) during the study period. While viral hepatitis B demonstrated a comparatively higher percentage prevalence in both February and September with a peak in February (68%), and viral hepatitis C is dominant in January, March, and December with a peak in March (83.8%).ConclusionAll types of viral hepatitis showed variation in prevalence over months and monthly variation concerning peak prevalence exists among different types of hepatitis. Both viral hepatitis A and E demonstrated similar trend in relative prevalence in both 2020 and 2021. Nevertheless, viral hepatitis A and B showed monthly and seasonal variation in relatively prevalence in both years. The study help in adopting strategies for the prevention of viral hepatitis in the study area.

Knowledge and Practices in Viral Hepatitis Management and its Challenges: A Survey Among Ayurveda Physicians of Kerala

Ayurveda physicians provide treatment for viral hepatitis patients in Kerala. A survey was conducted to assess the knowledge and practices in viral hepatitis management among Ayurveda physicians (APs) of Kerala.
 Materials & Methods: An in depth telephonic interview and a questionnaire were administered among APs in Kerala for assessing knowledge about viral hepatitis and its treatment.
 Results: All the 150 participants were aware about different types of viral hepatitis. Around 90% Aps know about complications of viral hepatitis and mode of transmission. Only 20% screen their patients before performing Panchakarma therapy and para-surgical procedures in their clinic. All physicians depends liver function test for diagnosing and assessing different types of Hepatitis; only 6.6% physicians additionally prescribe Ultrasonogram of abdomen and viral load. Majority physicians reported chronicity for HBV and HCV infections and good outcome/ curable for hepatitis A. Only a few physicians were documenting the cases in their clinics. The lack of structured case proforma for documentation and guidelines for management, research, patient education and time constraints was reported as challenges in the treatment of viral hepatitis by the majority of AP in the current survey. 
 Conclusion: The majority of doctors had a good knowledge of the different types of viral hepatitis and they depended on laboratory examinations for diagnosis and evaluation. The treatment strategies were based on the treatment principles of Kamala and Panduroga in Ayurveda.

A Voting Ensemble Approach for Hepatitis Disease Detection

The inflammation of the liver is termed as Hepatitis. Several different types of hepatitis are from A to G. For example, Hepatitis A is caused by the hepatitis A virus. Similarly, other type of Hepatitis virus is formed by the name, say Hepatitis G. Some types of virus will not create any serious problems. Long-lasting (chronic) and cause scarring of the liver (cirrhosis), loss of liver function and in some cases, liver cancer are also caused by this disease. An automated tool is suggested in this paper that recognizes patients with hepatitis syndromes. This paper proceeds by implementing an automated tool by implementing multi-phase classification approach. During the first phase, numerous classifiers such as Support Vector Machine, Multi-layer Perceptron, naive Bayes, k-Nearest neighbor, Decision tree are implemented. AdaBoost, Gradient Boost, and Random Forest are implemented as phase-2 classifiers. These implemented classifiers are evaluated as well as compared in terms of prediction performance. Voting ensemble based approach is proposed in this paper as final phase classification that accepts top two classifier models obtained from first and second phase classification respectively. The reason of using the proposed classifier is to enhance the prediction performance so that patients with hepatitis disease are identified correctly.

Ethnopharmacological survey of herbal remedies used in the treatment of hepatitis

Background: Hepatitis is a serious illness and can be fatal, which has caused a dangerous ratio round the globe especially in the developed and under-developing countries. About 1.4 million deaths are reported each year from the different types of hepatitis especially hepatitis B virus (HBV) and hepatitis C virus (HCV) which cause 90% mortality and the other 10% deaths are caused due to all other hepatitis types. Methods: By using different online database such as Google scholar, Science Direct Navigator, ISI Web of Knowledge, Elsevier, springer link, Test databases, research gate and PubMed, date were retrieved by giving different keywords. Various keywords were used on plants used traditionally to treat hepatitis.Results: A total of 128 medicinal plant species were identified, belonging to 108 genera and 61 botanical families by reviewing 220 research articles. From the study, it showed that the medicinal plants are used from the very ancient time to cure hepatitis worldwide. These medicinal plants are used in different parts of the world as a traditional herbal medicine for the control of hepatitis.Conclusion: Our literature review will help the scientific communities to identify anti-hepatitis plant in order to isolate novel anti-hepatitis natural products.Keywords: Hepatitis, medicinal plants, treatment, ethnopharmacological, survey خلاصہ:پس منظر: ہیپاٹائٹس ایک سنگین بیماری ہے اور یہ مہلک بھی ہوسکتا ہے ، جس کی وجہ سے خاص طور پر ترقی یافتہ اور ترقی پذیر ممالک میں دنیا بھر میں ایک خطرناک تناسب پیدا ہوا ہے۔ ہیپاٹائٹس بی وائرس (HBV) اور ہیپاٹائٹس سی وائرس (HCV) کی مختلف اقسام سے ہر سال تقریبا 1.4 ملین اموات کی اطلاع دی جاتی ہے جو %90 اموات کا سبب بنتی ہے اور دیگر %10اموات ہیپاٹائٹس کی دوسری تمام اقسام کی وجہ سے ہوتی ہیں۔ اس کے علاوہ ، دواؤں کے پودوں کے فوائد کی وضاحت کرنے کے لئے جو ہیپاٹائٹس کے علاج کے لئے استعمال ہوتے ہیں۔طریقے:گوگل اسکالر ، سائنس ڈائرکٹ نیویگیٹر ، آئی ایس آئی ویب آف نالج ، ایلسیویئر ، اسپرنگر لنک ، ٹیسٹ ڈیٹا بیس ، ریسرچ گیٹ اور پب میڈ کے جیسے مختلف آن لائن ڈیٹا بیس کا استعمال کرکے ، تاریخ کو مختلف اہم الفاظ دے کر تلاش کیا گیا۔ دنیا کے کچھ حصوں میں پودوں اور ان کی نسلی دواسازی کی تعلیم کے بارے میں تفصیلی معلومات حاصل کرنے کے لئے تلاش کے عمل کے دوران مختلف اہم الفاظ استعمال کیے گئے۔نتائج:کل 128 دواؤں کے پودوں کی انواع کی نشاندہی کی گئی ، جن کا تعلق 108 نسلوں اور 61 نباتاتی خاندانوں سے ہے۔ مطالعے سے ، یہ ظاہر ہوا ہے کہ دواؤں کے پودوں کو دنیا بھر میں ہیپاٹائٹس کے علاج کے لئے بہت قدیم زمانے سے ہی استعمال کیا جاتا ہے۔ یہ دواؤں کے پودوں کو ہیپاٹائٹس کے کنٹرول کے لئے روایتی جڑی بوٹیوں کی دوائی کے طور پر دنیا کے مختلف حصوں میں استعمال کیا جاتا ہے۔نتیجہ اخذ کرنا: ہمارے لٹریچر کا جائزہ سائنسی برادریوں کو اینٹی ہیپاٹائٹس پلانٹ کی شناخت کرنے میں مدد دے گا تاکہ ناول اینٹی ہیپاٹائٹس قدرتی مصنوعات کو الگ تھلگ کیا جاسکے۔اہم الفاظ: ہیپاٹائٹس ، دواؤں کے پودوں ، علاج ، ایتھنوفرماکولوجیکل ، سروے ۔

Immune response to different types of hepatitis B vaccine booster doses 2–32 years after the primary immunization schedule and its influencing factors

ObjectiveTo assess the immune effect of different types of hepatitis B vaccine (HepB) booster doses 2–32 years after primary immunization, explore the influencing factors, and offer guidance regarding the necessity and timing of boosters. MethodsIn total, 1163 participants who were born from 1986 to 2015, received the HepB full-course primary vaccination, were hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (anti-HBc) negative, and had hepatitis B surface antibody (anti-HBs) <10 mIU/mL were enrolled. Individuals were randomly divided into two groups and received a booster dose of HepB. Venous blood samples were collected 30 days later and tested for anti-HBs. ResultsIn total, 595 and 568 individuals received a single dose of HepB (CHO) and HepB (SC), respectively. Venous blood samples were obtained from 1079 vaccinees (CHO: 554, SC: 525). The seroconversion rates were 93.68% (519/554) and 86.67% (455/525) (p < 0.05), with geometric mean concentrations (GMCs) of 426.58 mIU/ml and 223.8 mIU/ml, respectively. This result indicated that BMI, smoking status, vaccine types of booster and prebooster anti-HBs concentration significantly influenced anti-HBs levels. Only BMI, prebooster anti-HBs concentrations and booster types were different between the anti-HBs positive and negative groups. ConclusionsParticipants boostered with HepB (CHO) had a relatively higher seroconversion rate than those boostered with HepB (SC). The high seroconversion rates in the two groups suggested that the subjects remained protected despite low circulating antibodies, so there is currently no urgent need for booster immunization. Factors including BMI ≥ 25 and prebooster anti-HBs concentration <2.5 mIU/mL, which contributed to lower responses to a booster dose, might indicate a greater risk of breakthrough infection.

RISK FACTORS FOR HEPATITIS;

Background: Infections with Hepatitis B Virus (HBV) and Hepatitis C virus (HCV) are worldwide public health problem. Thisis related to the continued occurrence of new infections and the presence of a large reservoir of chronically infected persons. Objective:To determine the frequency of risk factors (causes of transmission) for HBV and HCV infections in hospitalized patients of CMH, Lahoreand Sheikh Zayed hospital, Lahore. Design: Descriptive (cross sectional). Setting: The study was carried out in CMH, Lahore and SheikhZayed hospital, Lahore from January, 2012 to July, 2012. Methods: The patients were selected by consecutive (non-probability)sampling technique. The data was collected through questionnaire. Informed written consent was obtained SPSS version 16.0 was usedto calculate the descriptive statistics. Results: Out of total of 100 subjects, 50 were cases and 50 were controls. Out of 50 cases, 26%were HBV positive and 74% were HCV positive with female preponderance. The history of injections was very high in both the groups,making a total of 64% (14% HBV; 16% HCV) the important contributors for different types of hepatitis were blood transfusion (HBV =10%; HCV = 28%; controls = 14%). Surgical procedures (4% HBV, 28% HCV; 8% controls). History of piercing in the last six months(HBV = 6%; HCV = 22% and control = 8%). History of dental procedures in the last six months was higher in HCV patients (18% HCV and4% HBV). History of HBV or HCV positive patients or relatives at home. (HBV 18%; HCV 36%; control 30%). Conclusions: In Pakistan thereis an urgent need to raise the public awareness about importance of properly screened blood transfusion, use of disposable needles andusing new blades for shaving and haircuts especially at barber shops. In our study, the important contributors for different types ofhepatitis were blood transfusion, surgical procedures and history piercing in the last 6months.

Identification of a Shared Cytochrome p4502E1 Epitope Found in Anesthetic Drug-Induced and Viral Hepatitis.

Cytochrome p4502E1 (CYP2E1) autoantibodies are biomarkers for drug-induced hepatitis and chronic hepatitis C. However, major histocompatibility-restricted CYP2E1 epitopes associated with these diseases have not been identified. We hypothesized that CYP2E1 epitopes associated with different types of hepatitis may be shared and may impact immune responses and metabolism. SYFPEITHI epitope prediction identified CYP2E1 candidate epitopes that would be recognized by MHC II haplotypes. Candidate epitopes were tested for induction of hepatitis and CYP2E1 autoantibodies in mice and recognition by sera from patients with anesthetic drug-induced and viral hepatitis. Human liver cells treated with epitope hybridoma serum were analyzed for mitochondrial stress. CYP2E1 activity was measured in human microsomes similarly treated. Epitope antibodies in viral hepatitis sera were analyzed using linear regression to uncover associations with liver pathology. A P value of <0.05 was considered significant. One epitope (Gly113-Leu135) induced hepatitis and CYP2E1 autoantibodies in mice after modification of Lys123 (P < 0.05). Gly113-Leu135 antiserum recognized mitochondria and endoplasmic reticula (P < 0.05), upregulated HSP27 (P < 0.01) and mitochondrial oxidative stress via complex 1 inhibition (P < 0.001), and inhibited CYP2E1 activity. Gly113-Leu135 IgG4 detected in viral hepatitis sera was associated with severe hepatic fibrosis (P = 0.0142). We found a novel CYP2E1 epitope that was detected in anesthetic and viral hepatitis and that triggered hepatitis in mice. Our findings may improve understanding of hepatic immune responses triggered by metabolism or viruses.IMPORTANCE Drug-induced hepatitis is the leading reason that an approved drug is removed from the commercial market. Halogenated anesthetics can induce hepatitis in susceptible persons, and cytochrome p4502E1 (CYP2E1) enzymes responsible for their metabolism induce antibodies in addition to hepatitis. CYP2E1 antibodies detected in anesthetic hepatitis patients have been detected in patients with viral hepatitis, suggesting that these different forms of hepatitis could develop immune reactions to a common segment or epitope of CYP2E1. We have found a common MHC-restricted CYP2E1 epitope in anesthetic and viral hepatitis that is a dominant epitope in anesthetic hepatitis and is significantly associated with fibrosis in patients with viral hepatitis. Along with conformational epitopes, our identification of MHC-restricted CYP2E1 epitopes can be used to develop specific diagnostic tests for drug-induced or viral hepatitis or associated fibrosis or to predict individuals at risk for developing these diseases or their sequelae.

The Prevalence of Hepatitis B Surface Antigen and Hepatitis D Virus Antibody Positivity Among Hemodialysis Patients and Patients With Beta-Thalassemia Major

Background: Patients, who receive hemodialysis and patients with beta-thalassemia major are at great risk for blood-borne viral infections, chiefly different types of hepatitis. Objectives: This study aimed at assessing the prevalence of hepatitis B and D among hemodialysis patients and patients with beta-thalassemia major in Kashan, Iran. Methods: This cross-sectional study was conducted in 2016 on 108 patients on hemodialysis and 34 patients with beta-thalassemia major in Kashan, Iran. After explaining the aim of the study to the participants and securing their informed consents, data on their demographic and health-related characteristics were collected through a questionnaire. Then, a five-milliliter venous blood sample was obtained from each participant and tested using enzyme-linked immunosorbent assay technique for hepatitis B surface antigen and hepatitis D virus antibody. The data were entered in the SPSS program (v. 16.0) and analyzed using the Chi-square and the independent-sample t tests. Results: The prevalence of hepatitis B surface antigen positivity among patients on hemodialysis and patients with beta-thalassemia major was 3.7% and 8.8%, respectively. Moreover, the prevalence of hepatitis D virus antibody positivity among these patients was 2.9% and 1.9%, respectively. The prevalence of hepatitis B surface antigen positivity among patients on hemodialysis had a significant relationship with history of addiction and history of unprotected sex. Conclusions: The prevalence of hepatitis B and D was respectively 3.7% and 8.8% among hemodialysis patients and 2.9% and 1.9% among patients with beta-thalassemia major. Effective strategies should be employed to minimize the risks of hepatitis B and D transmission among hemodialysis patients and patients with beta-thalassemia major. Moreover, regular screening programs are needed for early diagnosis and treatment of viral hepatitis among these patients.

HBV polymerase overexpression due to large core gene deletion enhances hepatoma cell growth by binding inhibition of microRNA-100.

Different types of hepatitis B virus (HBV) core gene deletion mutants were identified in chronic hepatitis B patients. However, their clinical roles in different stages of natural chronic HBV infection remained unclear. To address this issue, HBV core genes were sequenced in three gender- and age-matched patient groups diagnosed as chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC), respectively. Functional analysis of the identified mutants was performed. A novel type of large-fragment core gene deletion (LFCD) was identified exclusively in HCC patients and significantly associated with unfavorable postoperative survival. The presence of LFCDs resulted in generation of precore-polymerase fusion protein or brought the polymerase reading frame under direct control of HBV precore/core promoter, leading to its over-expression. Enhanced cell proliferation and increased tumorigenicity in nude mice were found in hepatoma cells expressing LFCDs. Because of the epsilon-binding ability of HBV polymerase, we hypothesized that the over-expressed polymerase carrying aberrant amino-terminal sequence could bind to cellular microRNAs. Screening of a panel of microRNAs revealed physical association of a precore-polymerase fusion protein with microRNA-100. A binding inhibition effect on microRNA-100 by the precore-polymerase fusion protein with up-regulation of its target, polo-like kinase 1 (PLK1), was discovered. The binding inhibition and growth promoting effects could be reversed by overexpressing microRNA-100. Together, HCC patients carrying hepatitis B large-fragment core gene deletion mutants had an unfavorable postoperative prognosis. The growth promoting effect was partly due to polymerase overexpression, leading to binding inhibition of microRNA-100 and up-regulation of PLK1.

Adjuvant interferon for early or late recurrence of hepatocellular carcinoma and mortality from hepatocellular carcinoma following curative treatment: A meta-analysis with comparison of different types of hepatitis.

Adjuvant interferon (IFN) therapy following curative treatment for hepatocellular carcinoma (HCC) has been extensively investigated; however, the clinical benefits with different hepatitis backgrounds remain unclear. Medline, Embase, PubMed and the Cochrane Library databases were searched to identify randomized trials and cohort studies that enrolled HCC patients who received curative surgery or ablation therapy followed by IFN and control subjects; the studies were required to include data on early or late recurrence and mortality rates of HCC. Hepatitis B virus (HBV) associated with HCC (HBV-HCC) and hepatitis C virus (HCV) associated with HCC (HCV-HCC) were separately analyzed and recurrence, mortality and clinicopathological factors were compared. A total of 14 studies (9 randomized trials and 5 cohort studies, including 1,385 patients in total) were eligible for meta-analysis. IFN was found to decrease mortality and early recurrence rates, but exerted no effect on late recurrence rate. The effect of IFN differed between HBV-HCC and HCV-HCC cases. In HCV-HCC, IFN significantly reduced mortality as well as recurrence rates. However, in HBV-HCC patients, IFN reduced mortality rather than recurrence rates, although it also reduced the recurrence rate in certain subgroups. In conclusion, the effect of adjuvant IFN on postoperative recurrence differed between HBV-HCC and HCV-HCC cases; therefore, different strategies with adjuvant IFN should be used to treat HCC with different hepatitis backgrounds.

Lessons learned from exploratory research about viral hepatitis.

The Centers for Disease Control and Prevention conducted exploratory research as part of planning a national education campaign to raise awareness about viral hepatitis in the United States. The purpose of this qualitative research was to assess the baseline knowledge, attitudes, and screening behaviors of four population groups. Sixteen focus groups were conducted during a 6-week period in the fall of 2009, with a total of 119 adults aged 35 to 60 years in Boston, Massachusetts; Chicago, Illinois; and Houston, Texas. The groups were stratified by Asian Americans, African Americans, gay or bisexual men, and general population. Group size ranged from three to nine participants, and each session was approximately 90 minutes in length. Both awareness and knowledge of viral hepatitis were low among all participants, including those at increased risk for the disease. Little was known about the different types of hepatitis, risk factors, or how the viruses are transmitted. Regarding the last, many indicated that the disease was airborne. In addition, participants incorrectly assumed that if they had viral hepatitis, they would have symptoms and know they were infected. Many participants also believed that they had been tested for the disease since their health care providers routinely "test their blood." The findings indicate that significant and concerted educational efforts are needed to improve basic knowledge of viral hepatitis, as well as knowledge about transmission, risk factors, screening, and treatment. As a result, a general awareness and education campaign must precede and support efforts to encourage screening.

The epidemiological pattern of acute viral hepatitis in Tehran and Zahedan: a comparison study.

Aim : The aim of this study was to identify and compare the pattern of acute viral hepatitis in two regions of Iran. Background : The epidemiological pattern of acute hepatitis varies across the Globe depending on geographic region, health status, socioeconomic conditions and differences in exposure to etiological factors. Patients and methods : A cross-sectional study was carried out among 357 cases of acute viral hepatitis referring to the hepatitis centers in Tehran (n = 109) and Zahedan (n = 248) during 2003-2004. All patients were tested against Anti-HAV IgM, HBsAg, HCV and HDV antibody by enzyme linked immunosorbent assay (ELISA). Specific viral cause of hepatitis and demographic characteristics of patients were compared between the two populations. Results : Study participants in Zahedan were significantly younger than those in Tehran (11.4±9.63 years vs. 31.0±10.76; P Conclusion : The present study showed a discrepancy in morbidity pattern of acute hepatitis between the two regions of Iran. This variability may be due to differences in socioeconomic status and environmental risk factors for the acquisition of the different types of hepatitis. Therefore, regional information about viral hepatitis is needed in order to direct and evaluate prevention and control activities.

Is physical activity possible and beneficial for patients with hepatitis C receiving pegylated interferon and ribavarin therapy?

The great majority of patients with chronic viral hepatitis C are treated with pegylated interferon-ribavirin therapy. The aim of this study was to demonstrate that these patients were able to have some form of physical exercise, and that this activity can lead to an improvement in their quality-of-life. Twelve volunteer patients with hepatitis C, who were either sedentary or had become sedentary and who had been treated by combination therapy for the past few weeks, were recruited at hepatology clinics in the Midi-Pyrénées region of France early in 2006. All patients attended a sports medicine consultation for an initial evaluation: maximal aerobic power and maximal oxygen consumption tests, maximum heart rate (MHR), search for contraindications for participation in the proposed program of physical exercise. The patients were given a heart rate monitor so they could measure their heart rate during physical exercise and check that they exercised under safe conditions and remained within the so-called "endurance" zone. The patients came to a sports facility daily for 5 days for the exercise program. The activities were divided into four sessions each day: an individual physical exercise selected by the patient, team physical exercise, recreational physical exercise, lectures on the different types of hepatitis and their treatment, on nutrition and on sports medicine assessments. Data on hepatitis, results of the cardiorespiratory examination and personal history and record of past physical activity were collected for each patient. Quality-of-life (SF36) was assessed at enrollment in the study and one month after the training sessions. At the initial sports medicine consultation, all patients reached their MHR and were found capable of participating in the proposed physical exercise program. One enrolled patient was excluded from the analysis because of the presence of sinusitis on arrival. Seven men and four women, mean age of 46 years completed the full course of the study protocol. All participated in the three types of proposed physical activity with no problem. The score of the general perception item of the SF36 questionnaire increased from 63 on day 0 to 71 at one month (p=0.07). In conclusion, patients with hepatitis C receiving pegylated interferon plus ribavirin may safely participate in a program of suitably supervised physical exercise. Taking part in physical exercise leads to clear changes in the way patients perceive their bodies and its capacities. Participating in sports activities could improve self-confidence and lead to far-reaching changes in the way patients perceive their disease and the constraints of treatment.

Self-reported Hepatitis and Non-Hodgkin Lymphoma: An Analysis According to the Time Since Hepatitis Diagnosis

Using data from the Selected Cancers Study, the authors tested whether the association between hepatitis infection and non-Hodgkin lymphoma (NHL) varied according to the time since the diagnosis of hepatitis. Cases were 1177 men ages 32-60 diagnosed with NHL between 1984 and 1988. Controls were men with no history of NHL who were frequency-matched to lymphoma cases by age and cancer registry (n = 1852). Interviews were conducted to collect data on risk factors including history of hepatitis. No information on types of hepatitis was obtained. Logistic regression analyses indicated that history of hepatitis diagnosed 3 or more years prior to the reference date was not a significant risk factor for NHL (OR [odds ratio] = 0.92, 95% CI: 0.63-1.35). In contrast, men with a history of hepatitis diagnosed within 3 years prior to the diagnosis date had more than a five-fold increased risk of NHL (OR = 5.77, 95% CI: 1.99-16.74). Although the study was limited by lack of information on different types of hepatitis, the increased OR for hepatitis diagnosed more closely to the NHL diagnosis suggests that the reported association between hepatitis and NHL might partly result from increased detection of NHL in patients with recently reported hepatitis virus infection.

HCV serotypes in Brazilian patients

Objective: To investigate the prevalence of the different types of hepatitis C virus (HCV) in a population of chronic HCV carriers using the Murex HCV serotyping 1–6 assay. Methods: All serum samples from these patients had a positive nested PCR HCV reaction. The sera were submitted to ELISA, modified, for the identification of antibodies against HCV serotypes 1, 2, 3, 4, 5 and 6 (Murex HCV serotyping 1–6 assay). Results: The viral serotype was identified in 166 (75.8%) of the 219 patients, 108 (65.11%) males and 58 (34.9%) females. Patient age ranged from 12 to 73 years, with a mean of 41.1 years. The form of acquisition of the disease most frequently reported was blood transfusion. The results showed a predominance of type 1 (70.0%), followed by type 3 (22.3%) and type 2 (4.2%). Conclusion: Samples presenting low and very close optical density readings may lead to discrepant diagnoses concerning HCV serotypes and should be confirmed by genotyping. The serotyping can be useful in clinical practice and can be of help in establishing the prognosis of the disease, also favoring epidemiologic studies independently of the technology required for genotyping tests.

Antigenic heterogeneity of the hepatitis C virus NS5A protein.

The effect of sequence variability between different types of hepatitis C virus (HCV) on the antigenic properties of the NS5 protein was studied by using recombinant proteins. A strong antigenic region was identified within the HCV NS5A protein at amino acids 2212 to 2313. Forty-five unique sequences encompassing this region were selected from GenBank and were compared to each other. The results of this analysis showed that the primary structure of this strong antigenic region is highly variable. Percent homology between different genotype sequences varied from 40.4 to 72.5%. Thirteen representative sequences from all six HCV genotypes were selected to design synthetic genes coding for this antigenic region. These genes were assembled by PCR from synthetic oligonucleotides and expressed in Escherichia coli as hybrid proteins with glutathione S-transferase. All 13 fusion proteins were purified from bacterial lysates and used to test a panel of anti-HCV positive sera (n = 91) obtained from patients infected with HCV genotypes 1 through 6. All but two proteins immunoreacted with 62 to 93% of HCV anti-NS5-positive serum samples. Although a variable degree of genotype-specific antigenic reactivity was detected, only one protein demonstrated a noticeable preference to immunoreact with antibodies against the homologous HCV genotype. On the other hand, closely related proteins derived from the same subtype or genotype immunoreacted with significantly different efficiency with HCV antibodies. Thus, sequence variability has a profound effect on the antigenic properties of the NS5A immunodominant regions. This observation should be taken into consideration in the development of diagnostic tests for the efficient detection of anti-HCV activity in serum specimens.

Lichen planus occurring after hepatitis B vaccination: A new case

Lichen planus is a pruritic inflammatory dermatosis of unknown origin. An increased prevalence of a wide range of liver disease in lichen planus has been observed by many authors. Most recently, many reports appeared of the occurrence of lichen planus after administration of different types of hepatitis B vaccines. We report one case and briefly review this intriguing observation. (J Am Acad Dermatol 2001;45:614-5.)

Prevalences of hepatitis A, B, C and E viruses in Behçet's disease.

To determine whether Behçet's disease (BD), being a systemic vasculitis of unknown aetiology, is associated with hepatitis viruses (HAV, HBV, HCV and HEV). In addition to 124 patients [male:female (M/F): 73/51], all fulfilling the diagnostic criteria of the International Study Group for BD (1991), 14 patients with systemic necrotizing vasculitis (M/F: 7/7), 47 patients with ankylosing spondylitis (M/F: 36/11) and 51 healthy controls (M/F: 22/29) were also included in this study. Serological markers of four different types of hepatitis (anti-HAV IgM, total anti-HAV, HBsAg, anti-HBs, total anti-HBc, anti-HBc IgM, anti-HCV and anti-HEV) were studied in all cases. There was no difference between the groups with respect to HAV, HCV and HEV serologies. Anti-HBs positivity was observed less frequently in BD compared with healthy controls and systemic vasculitis (P<0.05). Serological evidence of previous HAV, HCV and HEV infections was not significantly different between Behçet's patients and other groups. However, previous HBV infection was found in a significantly lower number of BD patients as compared with healthy controls and systemic vasculitic patients.