Hepatitis Patients Research Articles

Perceived Social Support and Anxiety among Chronic Hepatitis-C Patients.

To study the relationship of perceived social support (PSS) and anxiety among patients of Chronic Hepatitis C (CHC). It is a cross sectional survey conducted from March 2021 to December 2021 in different hospitals of Islamabad and Rawalpindi. Sampling was done through purposive and snowball technique. Self-administered and standardized questionnaires were used. To analyze perceived social support and anxiety, perceived social support "scale" and Beck anxiety inventory were used in patients of Hepatitis C. Patients Polymerase Chain Reaction (PCR) positive HCV patients between the ages 31 to 50 years were included. Patients with comorbid conditions and other than 31 to 50 years of age were excluded from the study. Out of 250, males were 185(74%) and females 65(26%). Ages were between 31 to 50 years. PSS in both males and females was 49.8 and 49 (p=0.63%) with anxiety level 44.63 and 56.18 (p=0.00) respectively. There was no significant gender differences on PSS but women had significantly higher on anxiety (M = 56.18, SD = 11.36) with moderate effect size (>.05). PSS had significant negative correlation with anxiety (r = -.31, p < .05). Anxiety is more common in females and perceived social support has negative correlation with anxiety in patients of Chronic Hepatitis C.

The Liver Function Score – “ALBI” Sets Apart Melioidosis, Scrub Typhus from Viral Hepatitis, Tuberculosis, Enteric Fever in a III-II Grade Score: Useful in Machine Learning and AI

ALBI (Albumin-Bilirubin) score is routinely used in grading liver function of hepatocarcinoma and hepatitis patients. In this purposive review, the published values of serum albumin, bilirubin in Viral hepatitis, Tuberculosis, Scrub typhus, Enteric fever has been compared with that of melioidosis. Since PubMed yielded zero searches with key words “albumin, bilirubin, melioidosis”, it was searched in Google Scholar, a better retrievable search engine. This yielded 46 relevant articles with 53 ALBI scores for Melioidosis. An equivalent search to retrieve 53 ALBI scores was made in Google Scholar for other confounding diseases of Melioidosis with search words “albumin, bilirubin, hepatitis” “albumin, bilirubin, tuberculosis”, “albumin, bilirubin, scrub typhus”, “albumin, bilirubin, enteric fever”. This raw data was deposited in Harvard dataverse (https://doi.org/10.7910/DVN/QEW20J) and subsequent analysis done is documented in this article. This placed Melioidosis patients and Scrub typhus patients to be on an average grade III ALBI and the patients of Viral hepatitis, Tuberculosis, and Enteric fever in grade II ALBI.&#x0D; GRAPHICAL ABSTRACT&#x0D;

The comparative study of skin staples and polypropylene sutures for securing the mesh in Lichtenstein's tension-free inguinal hernia repair in HIV and hepatitis (B and C)-positive patients: a randomized controlled trial.

The mesh fixation in the Lichtenstein's hernioplasty was traditionally performed with polypropylene sutures. A modification of this technique uses skin staples for securing the mesh. Using polypropylene sutures may increase the needle prick injuries (NPIs) in HIV and hepatitis-positive patients. This is the first study in India to compare the efficacy of anchoring the mesh with skin staplers and polypropylene sutures in hepatitis and HIV-positive patients. Fifty-two seropositive patients undergoing sixty repairs were randomized into two groups. In the control group polypropylene mesh was secured with polypropylene sutures and the skin was closed with ethilon. In the study group polypropylene mesh was secured with skin staples and the skin was closed with staples from the same stapler. Duration of surgery, postoperative complications, NPIs, recurrences and costs were compared. The operation was significantly shorter when staples were used (median 46 vs. 57 min, P<0.00001). There was no significant difference in the incidence of postoperative complications. The NPIs was statistically significant in the suture group as compared to the stapler group (P<0.05). Using skin staples to secure the mesh in Lichtenstein inguinal hernioplasty significantly reduced the duration of surgery. It was as effective as conventional mesh fixation with polypropylene with added advantages to reduce the operating time, duration of exposure to infected blood, and the NPIs significantly in HIV, hepatitis B virus and hepatitis C virus-positive patients.

Epidemic within pandemic: Alcohol-associated hepatitis and COVID-19.

An increase in alcoholic beverage sales was observed during the peak of the COVID pandemic in the US. Little is known about the impact of SARS-CoV-2 infection among hospitalized alcohol-associated hepatitis (AH) patients. In this study we analyzed the available National Inpatient Data (NIS) data from 2020 to determine mortality and healthcare utilization among hospitalized AH patients with and without COVID-19 in the United States. We observed an ~15.6% increase in cases of hospitalized AH patients from 136,620 in 2019 to 157,885 in 2020, a significant increase from an average of 5.5% per annum despite an 8.7% decline in US hospital admissions over the same time span. Men younger than 40 was the fastest growing AH group, representing a 23% increase in 2020. Approximately 1.8% of hospitalized AH patients had a SARS-CoV-2 infection. An infection with SARS-CoV-2 significantly worsened the mortality among patients with AH (11.4% vs. 4.1%, p<0.0001), especially among older AH patients with concomitant comorbidities such as clinically apparent cirrhosis, acute renal failure, upper gastrointestinal bleeding, and sepsis. AH patients with COVID-19 also had a longer length of stay (8.6 vs. 6.1 days, p <0.0001) and higher hospital charges during the stay ($93,670 vs. $66,283, p <0.0001). Our study highlighted the rise in AH cases during the COVID-19 pandemic. Screening and appropriate management of excessive alcohol use and the preventive measure such as the recommendation of COVID-19 vaccination should be considered to prevent the morbidity and mortality among patients with ALD.

Estimation of some immunological markers for patients with Hepatitis C and B viruses with β -thalassemia major in Babylon province

Hepatitis C, B is a severe public health problem worldwide. Thalassemia patients depend on blood transfusions throughout and are at high risk of viral infections. This study aimed to estimate the prevalence of hepatitis C infection and different clinical parameters of (HLA) in the multiplex thalassemia population. In this study, 66 patients with infectious complications beta-thalassemia were enrolled, and samples collected from the Genetic Hematology Center at Babel Women and Children Hospital in Babylon Governorate / Iraq infected with HCV, serum ferritin, PCV and splenectomy were analyzed. The overall prevalence of hepatitis B virus and HCV was 3% and 55%, respectively; 100% of patients over 10-20 years of age had hepatitis C infection, and some episodes were presented by different HLA molecules, by molecule HLA from HLA class II (HLA-DR) and HLA class I (HLAG), In this study, we review the role of the molecule and several parameters along the HLA-G and HLA-DR gene in viral hepatitis, studies of hepatitis suggest that even Human leukocyte antigen contributes to the pathogenesis of the disease. HLA classification combined with the study of the regulatory elements of genes may help understand the influence of genetic background on susceptibility to disease. Keywords: Detection of some immunological markers (HLA) for hepatitis patients and those with a previous infection with thalassemia

Significant gut microbiota related to patterns of drinking and alcohol relapse in patients with alcoholic hepatitis undergoing stool transplant or corticosteroid therapy.

Alcohol-induced gut microbiota (GM) alterations are linked to alcohol use disorder (AUD) pathogenesis. Healthy donor stool transplant (fecal microbiota transplant [FMT]) reduced alcohol desire and improved clinical outcomes in small animal and human studies. Baseline and post-therapy-related GM changes in a real-world cohort with severe alcohol-related liver disease and AUD, patterns of drinking, and relapse have not been studied. We prospectively analyzed retrospective clinical data and stored samples to examine GM alterations in a cohort of severe alcohol-associated hepatitis (SAH) patients who underwent FMT or corticosteroid treatment followed for at least 12 months. The GM changes at baseline in the context of a pattern of drinking (binge vs. every day) and baseline and post-treatment alcohol relapse status (relapser vs. non-relapser). We identified 28 patients on FMT and 25 on corticosteroids who survived 1 year post-treatment. After necessary exclusions, the final cohort for various grouped GM analysis included 16 patients in the FMT arm and 14 on corticosteroids. Pedobacter and Streptophyta species at the commencement of treatment predicted alcohol relapse in steroid-ineligible patients receiving FMT and steroid-treated patients, respectively. At 6-12 months post-FMT, non-relapsers had elevated short-chain fatty acid-producing bacterial taxa linked with lower alcohol cravings. Alcohol relapse was significantly more in those on steroid therapy and was associated with the upregulation of the nucleotide metabolism pathway related to ethanol metabolism. We demonstrate pertinent baseline and post-treatment intestinal bacterial alterations that impact patterns of AUD patterns and relapse in SAH patients in the context of the therapy offered.

Combining the age-male-albumin-bilirubin-platelets score and shear wave elastography stratifies carcinogenic risk in hepatitis C patients after viral clearance.

The treatment of hepatitis C with direct-acting antiviral agents (DAAs) produces a high rate of sustained virological response (SVR) with fewer adverse events than interferon (IFN) therapy with a similar effect in inhibiting carcinogenesis as IFN therapy. The age-male-albumin-bilirubin-platelets (aMAP) score is useful for stratifying the risk of hepatocellular carcinoma in chronic hepatitis patients, and the velocity of shear waves (Vs) measured by shear wave elastography has also been shown to be useful for diagnosing the level of fibrotic progression in hepatitis C and predicting carcinogenic risk. Combining these two may improve the prediction of carcinogenic risk. To determine whether combining the aMAP score with Vs improves carcinogenic risk stratification in medium-to-high-risk hepatitis C patients. This retrospective, observational study involved hepatitis C patients treated with DAAs who achieved SVR. Vs was measured before treatment (baseline), at the end of treatment (EOT), and 12 wk (follow-up 12) and 24 wk (follow-up 24) after treatment. The patients were followed for at least six months after EOT to determine whether cancer developed. Multiple regression analysis was used to identify factors contributing to hepatic carcinogenesis. The diagnostic performances of clinical parameters for predicting the presence of hepatocellular carcinoma were evaluated using receiver-operating characteristic (ROC) curve analyses. A total of 279 patients (mean age 65.9 years, 118 males, 161 females) were included in the analysis. Multiple regression analysis was performed with carcinogenesis as the target variable and alanine aminotransferase, platelets, α-fetoprotein, Vs, and the Fib-4 index as explanatory variables; only Vs was found to be significant (P = 0.0296). The cut-off value for Vs for liver carcinogenesis calculated using the ROC curve was 1.53 m/s. Carcinoma developed in 2.0% (3/151) of those with Vs < 1.53 m/s and in 10.5% (9/86) of those with Vs ≥ 1.53 m/s. In hepatitis C patients after SVR, combining the aMAP score and Vs to stratify the risk of carcinogenesis is more efficient than uniform surveillance of all patients.

Novel Microbial Signatures in the Faecal Microbiome Associated with Severe Alcoholic Hepatitis: Bacteroides Finegoldii and Veillonella Dispar

Background: Alcoholic hepatitis is associated with dysbiosis, resulting in compositional changes in the gut microbiome, endotoxin transfer to the portal vein, and activation of inflammatory signalling pathways in the liver. However, the microbiome signature of severe alcoholic hepatitis (AH) patients of Indian origin is unknown. Aim: To investigate the microbiome diversity of Indian AH patients in comparison to non-alcoholic healthy controls (HC). Methods: 16S rRNA amplicon-based metagenomics analysis of faecal samples at the time of AH diagnosis (n=12) was compared with HC (n=6), and correlation with survival status, co-occurrence networking, Linear Discriminant Analysis Effect Size (LEfSe), and the relationship between diet – microbiome were performed. Results: 16S rDNA data showed a significant abundance of the Enterobacteriaceae family belonging to the phylum Proteobacteria and a depletion of the phylum Firmicutes in AH. A species-level classification identified Klebsiella pneumonia, Klebsiella variicola, and Parabacteroides distasonis as having the highest predictive performance value with reference to mortality at 60 days. Apart from this, a unique finding was the abundance of Bacteroides finegoldii and Veillonella dispar in AH patients. Moreover, the co-occurrence networking analysis revealed a higher level of connectivity and complexity within the microbial community of AH patients compared to HC. Thus, indicating the significant positive association (Spearman r &gt; 0.7, p &lt; 0.01) among members of the Firmicutes, Bacteroidetes, and Proteobacteria phyla in AH. Wilcoxon-Rank Sum test (p &lt; 0.01) identified Firmicutes phyla occurrence associated with high carbohydrate intake and Actinobacteria phyla with low protein intake. Conclusion: The findings provide the baseline occurrence profile of the gut microbiome signature of liver damage and the diet-microbiome relationship in patients with severe AH. The study demonstrated an abundance of Proteobacteria phyla, indicating their role in inflammatory conditions, and further identified Bacteroides finegoldii and Veillonella dispar in severe AH patients. Additionally, Klebsiella pneumonia, Klebsiella variicola, and Parabacteroides distasonis were identified as mortality-predictive risk biomarkers.

Circulating Plasma miR-122 and miR-583 Levels Are Involved in Chronic Hepatitis B Virus Pathogenesis and Serve As Novel Diagnostic Biomarkers.

Background: MicroRNAs regulate many biological processes and are involved in the pathogenesis of many diseases including chronic hepatitis B (CHB). Moreover, besides investigation of their roles in hepatitis B virus (HBV) infection, a noninvasive, sensitive, and specific biomarker is essential in the diagnosis of liver diseases. This study was designed to evaluate the role of miR-122, miR-583, and miR-24 in the pathogenesis of CHB both in active chronic hepatitis (ACH) patients and in inactive carriers (IC). Materials and Methods: Plasma samples and all relevant clinical features were collected from 43 patients with CHB (28 ACH and 15 IC) and 43 healthy controls. Quantitative real-time PCR was performed to detect the plasma levels of miR-122, miR-583, and miR-24. Results: Results show miR-122 (p = 0.0001) and miR-583 (p = 0.006) but not miR-24 (p = 0.65) were upregulated in patients with CHB versus the control group. Interestingly, there was a significant increase in the plasma expression of miR-583 in IC versus ACH. Moreover, receiver operating characteristic curve analysis determined plasma levels of miR-122 (area under the ROC curve [AUC] = 0.89, p < 0.0001, sensitivity: 100%, specificity: 62.5%) and miR-583 (AUC = 0.71, p = 0.0007, sensitivity: 90%, specificity: 47.62%) as sensitive biomarkers to discriminate CHB patients from controls. Conclusion: Our data showed an increase in the plasma levels of miR-583 in IC versus ACH patients. Moreover, we demonstrated that miR-122 and miR-583 may serve as potential biomarkers for CHB diagnosis and activity.

Usefulness of aMAP Risk Score for Predicting Recurrence after Curative Treatment for Hepatocellular Carcinoma within Milan Criteria

Introduction: The aMAP score is a prediction model for hepatocellular carcinoma (HCC) risk in chronic hepatitis patients. This study was conducted to elucidate the utility of this model for predicting initial recurrence of HCC in patients within the Milan criteria after undergoing curative treatment. Methods: Patients with naïve HCC within the Milan criteria (n = 1,020) and treated from January 2000 to August 2022 were enrolled. The cohort was divided into two groups according to the aMAP score (high ≥60, low <60) and then compared for recurrence-free survival (RFS) and overall survival (OS). Results: Comparisons between the high and low groups showed that etiology (HBV:HCV:HBV+HCV:NBNC = 41:79:2:37 vs. 65:589:11:196, p < 0.001), AST (36 vs. 46 IU/L, p < 0.001), and multiple HCC occurrence (15% vs. 22%, p = 0.026) were significantly different. Additionally, median RFS (59.8 vs. 30.9 months; p < 0.001) and median OS (154.1 vs. 83.4 months, p < 0.01) were greater in the low group. As for patients with HCC due to chronic viral hepatitis, there was a significant difference in median RFS between the groups (59.8 vs. 30.6 months, p < 0.001), especially for HCV-positive patients (53.1 vs. 27.2 months, p = 0.002). In patients with HCC due to a nonviral cause, the difference in median RFS between the low (70.9 months) and high (32.0 months) groups was not significant. Discussion: Findings of this retrospective study indicate a significant association of elevated aMAP with worse RFS in patients with HCC caused by chronic viral hepatitis, especially those with HCV. The aMAP score is considered useful to predict not only HCC-carcinogenesis risk but also risk of recurrence following curative treatment.

Diabetic MAFLD is associated with increased risk of hepatocellular carcinoma and mortality in chronic viral hepatitis patients.

Metabolic dysfunction-associated fatty liver disease (MAFLD) can coexist with chronic viral hepatitis. MAFLD is a heterogeneous disease because the diagnostic criteria include various metabolic traits. We aimed to identify patients at high risk of poor long-term outcomes based on MAFLD subgroups in chronic viral hepatitis patients. We evaluated 63 273 chronic hepatitis B and C patients. Patient with a fatty liver index ≥30 was defined to have hepatic steatosis. MAFLD was defined as the presence of hepatic steatosis with any one of the following three conditions, overweight/obesity, type 2 diabetes or ≥2 metabolic risk factors. The prevalence of MAFLD was 38.4% (n = 24 290). During a median 8.8-year follow-up, 1839 HCCs and 2258 deaths were documented in MAFLD patients. Among MAFLD patients, diabetes could identify patients at high risk of HCC and mortality, whereas overweight/obesity and metabolic risk factors did not. Compared with non-MAFLD patients, risk of HCC and mortality was significantly higher in diabetic MAFLD patients (adjusted hazard ratio [aHR] = 1.34, 95% confidence interval [CI] = 1.26-1.43 for HCC; aHR = 1.15, 95% CI = 1.08-1.22 for mortality). Risk of HCC and mortality was significantly higher in diabetic MAFLD patients (aHR = 1.40, 95% CI = 1.26-1.55 for HCC; aHR = 1.77, 95% CI = 1.63-1.93 for mortality) compared with non-diabetic MAFLD patients. Diabetic MAFLD is associated with increased risk of HCC and mortality among chronic viral hepatitis patients. Our findings highlight the need for close surveillance and effective treatment for these high-risk patients to reduce HCC and mortality in patients with chronic viral hepatitis.

Clinical Distribution Characteristics and Identification for Significant Liver Inflammation of Patients in Chronic Hepatitis B with Indeterminate Phase.

In clinical practice, a considerable proportion of patients with chronic hepatitis B (CHB) who do not conform to any immune status are considered to be in the "indeterminate phase". In this study, we aim to study the clinical distribution characteristics and identification of significant liver inflammation in patients in indeterminate phase. This study retrospectively analyze clinical data of 1226 patients with CHB at two medical centers in Zhejiang province. According to American Association for the Study of Liver Diseases (AASLD) 2018 hepatitis B guidance, CHB can be divided into four phases: immune-tolerant phase, HBeAg-positive immune active phase, inactive phase, and HBeAg-negative immune active phase. Liver inflammation grade was evaluated using the Scheuer scoring system, and significant liver inflammation was defined as G ≥ 2. The distribution of different immune status was as follows: 259 (21.1%) patients in immune-tolerant phase, 365 (29.8%) patients in HBeAg-positive immune active phase, 128 (10.4%) patients in inactive phase, and 33 (2.7%) patients in HBeAg-negative immune active phase. However, 441 (36.0%) patients did not meet any of the above immune phases, which were defined as indeterminate phase. Significant liver inflammation (54.1%) was common in CHB patients with indeterminate phase. Prothrombin time (PT), platelet count (PLT), alanine aminotransferase (ALT), and hepatitis B virus (HBV)-DNA were associated with significant inflammation. The results of this study showed that about 36.0% of patients were divided into indeterminate phase. The proportion of patients with significant inflammation in indeterminate phase and liver inflammation becomes more severe with aggravation of fibrosis stage. PT, PLT, ALT, and HBV-DNA may have a significant correlation with severe inflammation and prognosis of CHB.

Percutaneous Antegrade Transvenous Variceal Obliteration for Portal Vesiculopathy-Related Gross Hematuria

AbstractVesical varices secondary to portal hypertension are extremely rare cause of hematuria with only a few cases reported to date. We report a case of portal vesiculopathy in a patient of hepatitis B virus-related chronic liver disease presenting with gross hematuria, successfully treated with percutaneous antegrade transvenous obliteration using n-butyl cyanoacrylate glue and Amplatzer vascular plug.

The Elk-3 target Abhd10 ameliorates hepatotoxic injury and fibrosis in alcoholic liver disease

Alcoholic liver disease (ALD) and other forms of chronic hepatotoxic injury can lead to transforming growth factor β1 (TGFβ1)-induced hepatic fibrosis and compromised liver function, underscoring the need to develop novel treatments for these conditions. Herein, our analyses of liver tissue samples from severe alcoholic hepatitis (SAH) patients and two murine models of ALD reveals that the ALD phenotype was associated with upregulation of the transcription factor ETS domain-containing protein (ELK-3) and ELK-3 signaling activity coupled with downregulation of α/β hydrolase domain containing 10 (ABHD10) and upregulation of deactivating S-palmitoylation of the antioxidant protein Peroxiredoxin 5 (PRDX5). In vitro, we further demonstrate that ELK-3 can directly bind to the ABHD10 promoter to inhibit its transactivation. TGFβ1 and epidermal growth factor (EGF) signaling induce ABHD10 downregulation and PRDX5 S-palmitoylation via ELK-3. This ELK-3-mediated ABHD10 downregulation drives oxidative stress and disrupts mature hepatocyte function via enhancing S-palmitoylation of PRDX5’s Cys100 residue. In vivo, ectopic Abhd10 overexpression ameliorates liver damage in ALD model mice. Overall, these data suggest that the therapeutic targeting of the ABHD10-PRDX5 axis may represent a viable approach to treating ALD and other forms of hepatotoxicity.

Clinical Usefulness of Machine Learning Approaches as a Non-Invasive Technology in Reducing Hepatitis Disease Mortality

Hepatitis is a viral infection that causes inflammation of the liver. However, other factors can cause the disease, including secondary effects from drugs, toxins, alcohol, and autoimmune hepatitis. The autoimmune form of the disease occurs when the body produces antibodies against the liver tissue, and many people worldwide are affected by it. Various clinical factors and parameters are examined in diagnosing hepatitis disease, which is analyzed by performing various tests of these factors and parameters. As a result of the vastness of the parameters under examination, it is challenging and complicated for the experts in this field to perform the analysis process on these parameters on a large scale. Healthcare experts can now identify the factors influencing the death rate of patients with high speed and accuracy thanks to emerging technologies such as machine learning, which is a subset of artificial intelligence. In this study, KNN and SVM machine learning techniques were used to analyze the positive effect of clinical parameters such as LIVER BIG, LIVER FIRM, SPLEEN PALPABLE, and ANOREXIA on patients' survival or death rates. This study investigates and analyzes the results of the implementation in two parts. The first part deals with determining the positive impact of these clinical parameters on the death and survival rate of patients, and the second part examines the performance of machine learning techniques based on the evaluation criteria of accuracy (ACC), error rate (ERR), specificity (SPE), and negative prediction value (NPV).Based on the implementation finding of machine learning techniques on data related to hepatitis patients, it has been determined that patients with positive LIVER BIG, LIVER FIRM, SPLEEN PALPABLE, and ANOREXIA clinical parameters can have a high chance of survival. On the other side, The SVM technique outperformed the KNN technique by ACC 94.05%, ERR 16.02%, SPE 93.07%, and NPV 85.7% in an analysis of the performance of machine learning techniques.

FREQUENCY OF HEPATITIS C SEROCONVERSION IN CHRONIC KIDNEY DISEASE PATIENTS ON HEMODIALYSIS

Background: Haemodialysis increases Hepatitis-C seroconversion risk adversely affecting Chronic Kidney Disease (CKD) prognosis. This study aimed to determine the frequency of Hepatitis C seroconversion in chronic kidney disease patients on haemodialysis. Method: This cross-sectional study was conducted at Dialysis Unit of Ayub Teaching Hospital, Abbottabad from March 2016 to January 2019. A pre-designed proforma was used for data collection. A sample of 121 patients of dialysis dependent CKD was enrolled for the study through non-probability consecutive sampling. The Glomerular Filtration Rate (GFR) was re-estimated from serum creatinine to confirm the diagnosis using Modification of Diet in Renal Disease (MDRD) study equation. Patients who were Hepatitis C virus (HCV) negative at the start of dialysis, and became positive 3 months post-dialysis were considered having undergone seroconversion. Data were analysed using SPSS-16. Results: Out of 121 participants, 80 (66.1%) were male and 41 (33.8%) were female. The mean age of the patients was 51.0±6.22 years with range from 41 to 61 years. Hepatitis C seropositivity was recorded in 40 (33.06%) of the study participants during the study period. Statistically significant (p&lt;0.05) associations were observed between HCV seropositivity and age and gender of the patients. Conclusion: Hepatitis C infection is a common complication of haemodialysis. Rigorous screening of patients for Hepatitis C and separate machines for Hepatitis C patients can lead to a decrease in the burden of this disease. Pak J Physiol 2023;19(2):32–5

FIB 4 Score (Liver Fibrosis) and Attending Level of Vitamin D in Chronic Hepatitis C Patients

Millions of people around the world are affected by chronic hepatitis C (HCV), which is a global health issue. It is a major contributor to chronic liver conditions such as cirrhosis, hepatocellular carcinoma, and liver fibrosis. For optimal therapy and intervention, prompt identification of liver fibrosis is essential. The rate of hepatic fibrosis progression in HCV-infected patients varies substantially. Objective: To evaluate the vitamin D level and liver fibrosis degree by non-invasive Fib 4 score among chronic hepatitis patients. Methods: This Cross-sectional study was conducted at a tertiary care hospital in Karachi, Pakistan, from August 2020 to September 2022. 65 participants were recruited through a non-probability sampling technique. Results: Study findings show that 21.9% of the patients have low risk for advanced fibrosis, whereas 9.2% have an Intermediate risk for advanced fibrosis, and 69.2% have a high risk for advanced fibrosis. Moreover, findings also revealed that among 65 patients, 66.2% have a deficient amount of Vitamin D, whereas 16.9% have an insufficient amount of Vitamin D level and 16.9% have a sufficient amount of vitamin D. Furthermore, the findings also showed significant association based on p-value (0.001) between Age and Fib4 score of the participant. Conclusions: In conclusion, the study revealed that a significant proportion of chronic hepatitis C patients were at high risk for advanced fibrosis, while vitamin D deficiency/ insufficiency were prevalent among the majority of the patients.

Characteristics and Factors Associated with Inflammatory Activity on Liver Biopsy in Autoimmune Hepatitis Patients Aged 50 Years or Older

Introduction: Autoimmune hepatitis is an inflammatory liver disorder histologically characterized by portal lymphoplasmocytic hepatitis with interface activity and lobular inflammation.&#x0D; Aims: To identify clinical characteristics associated with older age and also to pinpoint clinical characteristics associated with significant inflammation in liver histology.&#x0D; Methods: Cross-sectional analytical study that evaluated medical records of adult patients with autoimmune hepatitis seen at the Gastroenterology and Hepatology Outward of a Tertiary University Hospital. Bivariate analysis was performed to identify the characteristics associated with age equal or greater than 50 years and the significant histological inflammatory activity.&#x0D; Results: Forty-seven patients were included, with their mean age of 42.8±16.0 (43.0) years. Furthermore, 80.9% of them were women, 31.9% were 50 years-old or older. Thirty-one patients were submitted to liver biopsy and 29.0% presented significant inflammation. When compared in terms of age, individuals equal or higher 50 years old presented higher medians of GGT (129 vs. 282 U/L; P = 0.034) and a higher proportion of significant inflammation (50 vs. 6.7%; P = 0,024). Patients with significant inflammation on the liver biopsy presented a higher mean age (63.7±14.0 vs. 41.0±14.4; P = 0.001), and a greater proportion of patients equal or above 50 years old (85.7% vs. 66.7%; P=0.024) than individuals with mild inflammation.&#x0D; Conclusions: Individuals equal or higher 50 years old presented higher medians of GGT levels and a greater proportion of significant inflammation on liver histology.

Telomerase Expression Related with Poor Immune Response to HCV Core Antigen in Egyptian HCV Patients’ PBMCs

IntroductionHepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver.AimThis study aimed to assess serum hTERT level and its relation to the progression of liver disease. Also, it aimed to assess the effect of HCV core protein on memory T-cells in HCV patients with or without HCC, and the correlation between memory cells phenotype and the progression of the disease in the same patients.MethodsHTERT level in serum was assessed through relative quantitative RT-PCR. Flow cytometric analysis was used to assess T-cells responsiveness (as IFN-γ secretion) before and after stimulation with HCV core protein, and memory CD8+ cells phenotype using several differentiation markers.ResultsHTERT was found to be increased in a stepwise manner upon comparing its level in controls, chronic hepatitis patients, cirrhotic patients, and HCC patients. T-cells showed a similar manner of stepwise decrease in response (decreased IFN-γ secretion) in HCC patients compared to HCV patients without HCC and controls. Also, late differentiated memory cells (CD8+ CD27- CD28- CD45RA+CCR7-) were depleted in HCC patients compared to HCV patients without HCC.ConclusionThese results suggest a negative correlation between hTERT and IFN-γ secretion by T- cells in HCV patients and that this relationship along with the depletion of late differentiated memory cells could help the progression of liver disease to HCC.

Performance Analysis of Selected Machine Learning Algorithms for Prediction of Mortality and Survival Chances of Viral Hepatitis and Hepatocellular Carcinoma Patients

Performance Analysis of Selected Machine Learning Algorithms for Prediction of Mortality and Survival Chances of Viral Hepatitis and Hepatocellular Carcinoma Patients