Presence Of HCV Infection Research Articles

Relationship between Helicobacter pylori and development of hepatocellular carcinoma: A systematic review and meta-analysis.

4091 Background: The relationship between Helicobacter pylori (H.pylori) and hepatocellular carcinoma (HCC) was first proposed in 1994. Since then, several studies have been performed to explore the association. The role of Hepatitis C (HCV) viruses coexisting with H.pylori in causing HCC was also studied. With the emergence of data in this regard, a causal relationship has been postulated, but not confirmed, and hence the relationship remains controversial. Our meta-analysis aims to summarize the research on this topic and investigate if there exists a relationship between H. pylori infection and the development of HCC and if the presence of HCV along with H.pylori plays a role in liver carcinogenesis. Methods: Following PRISMA guidelines, we performed a systematic review of all relevant studies published in the literature using keywords “Helicobacter pylori” and “Hepatocellular carcinoma” on major literature databases, including PubMed, EMBASE, Web of Science, and Cochrane controlled trials register. A total of 656 studies were identified between 1994 to March 2020, out of which 26 studies qualified under our selection criteria. Patients positive for HCC are included as cases and patients that did not have HCC under control group. In both groups, H.pylori positive patients and their HCV status, was identified. Results: Out of the 26 studies included in the final analysis, the prevalence of H. pylori infection was 64.78% (561 of 866) amongst HCC cases and 47.92% (1718 of 3585) in the non-HCC control group. The summary odds ratio for the association of H. pylori infection with the risk for HCC using the random-effects model was determined to be 4.75 (95% CI, 3.06-7.37), I²=63%. Subgroup analysis to determine the odds of developing HCC in the presence of H.pylori and HCV coinfection, was 13.97 (95% CI, 3.94-49.61), I²=81%. Whereas, the odds of developing HCC in the presence of only HCV without H.pylori was found to be 2.21 (0.70-6.94), I²=79. Subgroup analysis by study design showed no significant difference between the study groups (P= 0.5705). Conclusions: Our meta-analysis showed a positive association between H. pylori infection and the development of HCC. It showed a significantly higher risk of developing HCC in the presence of HCV infection along with H.pylori. Further prospective cohort studies are needed to prove the causal relationship, especially in cases of Hepatitis B, C coinfection, and cirrhotic patients.[Table: see text]

Subclinical hepatitis C virus infection in Egyptian patients with rheumatic diseases: a multi-center study

BackgroundHepatitis C virus (HCV) infection is highly prevalent in Egypt. It was found to be 7.0% in a study done in 2015. There are some studies on the prevalence of HCV in rheumatoid arthritis, but to our knowledge, no previous study was done to detect it in other rheumatologic diseases. This study aims at detecting the prevalence of subclinical HCV infection in Egyptian patients with different rheumatic diseases. In the current study, eight hundred and three patients with different rheumatic diseases collected from five—geographically different—Egyptian rheumatology departments were studied. Patients with known current or previous HCV infection were excluded from the study. Screening for the positive anti-HCV antibodies was done for all patients. Screening for the presence of HCV ribonucleic acid (RNA) was done in patients with positive serology by reverse transcriptase-polymerase chain reaction.ResultsIn the studied population, 675 (84.1%) patients were women. The mean age [± SD] was 44.2 [± 12.9] years. Hepatitis C antibody positivity was found in 73 (9.1%) of the patients, while 67 (8.3%) were having positive HCV-RNA quantitative PCR tests. The highest prevalence of seropositive HCV was found in drug-induced vasculitis (DIV) and cryo-vasculitis (100%), while in RA, HCV antibodies and PCR were found to be positive in 9.1% and 8.3% of patients, respectively.ConclusionsDetection of the presence of HCV infection in 9.1 % of the studied middle-aged Egyptian patients with rheumatologic conditions points to the importance of screening for HCV in such population for early detection and intervention especially for those patients that are planned to start biologic therapy.

Correlation of Liver Function Test with Different Age and Sex Group and with Ferritin Level in Thalassemia

Thalassemia is the most common genetic blood disease in the world and varies in different population group in the world. In thalassemic patients liver damage is augmented when age of the patients are increase. These are due to increasing age with advancement of disease progression, repeated blood transfusion, less use/ intolerance of iron chelating agent, decreased activity of hepatocyte to rescue them in such excess billirubin and iron flood. Secondary to hypersplenism. Iron overload due to frequent transfusions in ?-thalassemia results in abnormal organ function tests. Proper and timely screening of these parameters can help in early diagnosis & prevention of iron overload. Iron overload is a main leading cause of elevated liver enzymes, and presence of HCV infection is significantly related to the increased iron overload14. Liver injury whether acute or chronic, eventually results in an increase in serum concentrations of Alanine transaminase (ALT) and Aspartate transaminase (AST). In transfusion dependent thalassemia patients iron overload is often inevitable and exposed to transfusion associated infections. Apart from these when the age is more, the disease progresses with their complication like hepatic injury. The thalassemia patient develops liver fibrosis as a result of iron overload due to excessive blood transfusion and also from excess intestinal absorption. N Sultana et al.6 showed that serum ferritin and serum bilirubin parameter of iron over load and jaundice are correlated.

MULTI-YEAR DYNAMICS OF SPREAD OF HEPATITIS C VIRUS GENOTYPES IN MOSCOW REGION

Aim. Determine spread of hepatitis C vims genotypes, circulating in Moscow Region over the last decade. Materials and methods. The presence of HCV RNA, genotype and subtype of the vims were determined in blood sera samples obtained in 2006 - 2014 from 2847 individuals with the presence of HCV infection, who had or did not have injectable dmg administration in anamnesis. Results, lb and 3a remain the main subtypes, circulating in the population over the last decade. A notable reduction of la subtype circulation took place among injectable dmg users (IDU). Recombinant form RFl_2k/lb of hepatitis vims is present only among this risk group and constitutes 2% of the overall amount of subtypes in both 2007 and 2014. Genotype 4d was detected in 2014, that is not typical for Russian Federation. Genotype 3a is dominant in IDU age groups of 20 - 29 and older than 40, and in the 30 - 39 group the main - subtype lb. Phylogenetic analysis has shown the lack of certain genetic variants of subtypes lb and 3a, characteristic for IDU, that gives evidence on a wide circulation of the main subtypes of the vims in the whole population of individuals, infected by HCV. Conclusion. Spread of main genotypes/subtypes of HCV in the overall population and among IDU in Moscow remains stable over the last decade.

Liver Enzymes in Children with beta-Thalassemia Major: Correlation with Iron Overload and Viral Hepatitis

BACKGROUND:Beta Thalassemia is the most common chronic hemolytic anemia in Egypt (85.1%) with an estimated carrier rate of 9-10.2%. Injury to the liver, whether acute or chronic, eventually results in an increase in serum concentrations of Alanine transaminase (ALT) and Aspartate transaminase (AST).AIM:Evaluating the potentiating effect of iron overload & viral hepatitis infection on the liver enzymes.PATIENTS AND METHODS:Eighty (80) thalassemia major patients were studied with respect to liver enzymes, ferritin, transferrin saturation, HBsAg, anti-HCV antibody and HCV-PCR for anti-HCV positive patients.RESULTS:Fifty % of the patients were anti-HCV positive and 55% of them were HCV-PCR positive. Patients with elevated ALT and AST levels had significantly higher mean serum ferritin than those with normal levels. Anti-HCV positive patients had higher mean serum ferritin, serum ALT, AST and GGT levels and higher age and duration of blood transfusion than the negative group. HCV-PCR positive patients had higher mean serum ferritin and serum ALT and also higher age and duration of blood transfusion than the negative group.CONCLUSION:Iron overload is a main leading cause of elevated liver enzymes, and presence of HCV infection is significantly related to the increased iron overload.

Factors Associated with the Quality of Transient Elastography.

Transient elastography is a noninvasive method for the evaluation of fibrosis in chronic liver disease. However, its reliability is variable, and the factors associated with its accuracy have not been identified completely. To identify the factors associated with the reliability of transient elastography. A total of 2033 transient elastography measurements were taken from March 2009 to October 2013. Reliability was determined according to the interquartile range/median (IQR/M < 0.30 = reliable; IQR/M < 0.10 = very reliable). Other indicators such as the percentage of successful measurements (>60 %), time of performance, and probe size were recorded. Potential factors that could affect the reliability of the procedure were analyzed using multivariate logistic regression. Slightly less than 5 % of the measurements were unsuccessful, and 83 % of the successful measurements were found to be reliable. Factors associated with an unsuccessful measurement were female gender, incorrect probe size, and the presence of HCV infection. Unreliable measurements were associated with use of the procedure as part of a clinical study and success rate. Very reliable evaluations were associated with >10 measurements, the presence of chronic hepatic disease, and a success rate of >60 %. The operator and clinical and anthropometric characteristics are factors that influence the success and reliability of transient elastography. Improvements in the quality of the procedure are needed to provide better diagnostic accuracy in clinical practice.

A New Twist to a Chronic HCV Infection: Occult Hepatitis C.

Background. The prevalence of occult hepatitis C infection (OCI) in the population of HCV-RNA negative but anti-HCV positive individuals is presently unknown. OCI may be responsible for clinically overt recurrent disease following an apparent sustained viral response (SVR) weeks to years later. Purpose. To review the available current literature regarding OCI, prevalence, pathogenic mechanisms, clinical characteristics, and future directions. Data Sources. Searching MEDLINE, article references, and national and international meeting abstracts for the diagnosis of OCI (1990–2014). Data Synthesis. The long-term followup of individuals with an OCI suggests that the infection can be transient with the loss of detectable HCV-RNA in PPBMCs after 12–18 months or alternatively exist intermittently and potentially long term. The ultimate outcome of HCV infection is decided by interplay between host immune responses, antiviral therapies, and the various well-identified viral evasion mechanisms as well as the presence of HCV infection within extrahepatic tissues. Conclusion. The currently widely held assumption of a HCV-cure in individuals having had “SVR” after 8–12 weeks of a course of DAA therapy as recently defined may not be entirely valid. Careful longitudinal followup utilizing highly sensitive assays and unique approaches to viral isolation are needed.

Hepatitis C virus infection in Nigerians with diabetes mellitus

It has been reported from several Caucasian studies that there is an epidemiological association between hepatitis c virus infection and diabetes mellitus. The objective of this study was to determine whether any such relationship exists in a black African population. To determine the prevalence of Hepatitis C virus infection in Nigerians with diabetes mellitus in North-Eastern Nigeria. Hospital –based cross-sectional study. Medical outpatient clinic and the Blood bank of the Federal Medical Centre, Yola. Nigeria. From June, 2008 to December 2009, Two hundred and eighty consecutively recruited diabetes mellitus patients comprising 108 males and 172 females were screened for HCV infection. These were compared with five hundred and ninetyfive voluntary blood donors who were screened during the same period. Serological testing for HCV infection was carried out with anti-HCV using Enzyme Linked Immuno-sorbent Assay (ELISA) method. The bio-data of the patients, history and duration of diabetes mellitus, history of jaundice, blood transfusion were recorded on a proforma. Out of the 280 diabetes mellitus patients tested, twenty-six were positive for anti-HCV antibodies giving an infection rate of 9.3% compared with fourteen subjects out of 595 voluntary blood donors 2.4% (p=0.0000105). History of blood transfusion, and jaundice was positively correlated with presence of HCV infection in diabetic patients. Hepatitis C virus is more common in Nigerian patients with diabetes mellitus than in non-diabetic control subjects. It may be necessary to screen patients with diabetes mellitus for hepatitis c virus infection particularly those with history of blood transfusion and jaundice.

Metabolic profiles in patients with chronic hepatitis C: a case–control study

The clinical implications of metabolic profiles in patients with chronic hepatitis C remain controversial. To study the association of metabolic abnormalities with chronic hepatitis C, we conducted a case-control study with special emphasis on serum lipid pattern, fasting blood glucose, and adiponectin. We enrolled 500 patients with chronic hepatitis C and 536 sex and age-matched controls. Unadjusted and adjusted associations of demographic and metabolic variables were estimated. Chronic hepatitis C patients had higher alanine aminotransferase (ALT) and high-density lipoprotein-cholesterol levels, but lower total cholesterol (TC), triglyceride (TG), and low-density lipoprotein-cholesterol levels than controls. Stratifying ALT level according to its upper limit of normal, HCV infection was associated with younger age, female gender, and higher TC levels in chronic hepatitis C patients with normal ALT levels, but with lower TC and lower TG levels in those with abnormal ALT levels. By using multiple linear regression analyses for subjects with available adiponectin data, presence of HCV infection was independently associated with higher serum adiponectin levels. Metabolic profiles of chronic hepatitis C patients are affected by age, gender, serum adiponectin, and ALT levels. Further longitudinal studies are needed to clarify the complex interplay between HCV infection and metabolic profiles.

Activation of the ERK and AKT signalling pathway predicts poor prognosis in hepatocellular carcinoma and ERK activation in cancer tissue is associated with hepatitis C virus infection

The aim of the study was to determine the prognostic relevance of AKT and extracellular regulated kinases (ERK1/2), which are implied in the regulation of cell proliferation and apoptosis, in hepatocellular carcinoma (HCC). This study comprised a series of 208 patients incorporating HCCs treated either by surgical resection (n = 109) or liver transplantation (n = 99). Immunohistochemically demonstrated phospho-ERK1/2 (pERK1/2) and phospho-AKT (pAKT) was correlated with a series of clinico-pathologically relevant parameters (EGFR, Cyclin-D1, HCV/HBV infection, liver cirrhosis, chronic alcohol abuse), proliferative activity, and apoptosis. Activation of ERK1/2 correlated statistically with the presence of HCV infection. pERK1/2 (P < 0.001) and pAKT (P = 0.052) expression showed a significant correlation with a decreased overall survival (OS). In multivariate Cox regression analysis pERK1/2 was identified as an independent prognostic parameter in HCC (P = 0.026). Activation of ERK1/2 in HCC cancer indicates aggressive tumour behaviour and constitutes an independent prognostic factor. Furthermore our data confirm that HCV infection activates the ERK pathway and thereby might contribute to HCC carcinogenesis. Immunohistochemical determination of pERK1/2 status can thus be proposed as a promising candidate for the identification of high risk patients who may benefit from new anticancer drugs targeting the ERK-pathway.

PON1 status in haemodialysis patients and the impact of hepatitis C infection

Objectives: Paraoxonase-1 (PON1) activity has been reported to decrease in both haemodialysis patients and patients with HCV infection. We aimed to investigate paraoxonase and arylesterase activities, and lipid hydroperoxide levels (LOOH) in haemodialysis patients with or without hepatitis C infection, and to find out whether PON1 activity is affected further by the presence of HCV infection in HD patients. Design and methods: Twenty HCV (+) haemodialysis patients, 26 HCV (−) haemodialysis patients, and 26 controls were enrolled. Paraoxonase and arylesterase activities were measured spectrophotometrically. LOOH levels were measured by ferrous oxidation with xylenol orange assay. Results: Haemodialysis patients with or without HCV infection had lower paraoxonase and arylesterase activities than controls (all p < 0.001), while higher LOOH levels (both p < 0.001). Paraoxonase and arylesterase activities, and LOOH levels were comparable between haemodialysis patients with or without HCV infection ( p > 0.05). Significant inverse correlation was observed between paraoxonase or arylesterase activities, and LOOH levels ( p < 0.05, β = − 0.319 and p < 0.05, β = − 0.348, respectively). Conclusion: We concluded that PON1 activity significantly decreases in both haemodialysis patients with or without HCV infection. Nevertheless, PON1 activity is not affected further by the presence of HCV infection in haemodialysis patients.

Liver damage caused by hepatitis C viral infection and ethyl alcohol consumption

Hepatitis C virus infection (HCV) is a complex disease, most commonly chronicle (80-85%). The aim of this research was to determinate the level of the liver damage in the patients cansed by HCV in conjunction with consuming ethyl alcohol. The research included 15 patients with chronic HCV infection supported by the misuse of ethyl alcohol, as well. The diagnosis of C infection hepatitis was proved using the ELISA test and PCR method. The results of the study showed the liver damage by both HCV infection and ethyl alcohol, which was verified by the presence of biochemical changes and patohystological processing of the patients (liver biopsy and prosection). Patohystological changes were at the level of liver cirrhosis and carcinoma (2 patients). There was a signficant difference between the two subgroups (p < 0.001) regarding the examined values gamma-GT, PLT and PTV. The basic therapeutic procedure was to introduce this category of patients into alcohol abstinence, and, in a few patients, to apply the antivirus therapy, as well. Based on the number of the examined patients (n = 15), we could conclude that a prolonged ethyl alcohol misuse with the presence of HCV infection was in a correlation with the liver disease progression.

JOINT PAIN AND ARTHRITIS IN RENAL TRANSPLANT RECIPIENTS, AND CORRELATION WITH CYCLOSPORINE THERAPY

To determine the prevalence of joint pain and arthritis in renal transplant recipients, and to investigate relationships with various laboratory and clinical parameters.Eighty‐two patients who underwent renal transplantation (RT) and had a joint examination reported on their level of joint pain and arthritis by questionnaire. The patients were then followed for a year, with repeated joint examinations and laboratory tests every 3 months. Thirty‐one of 82 patients (37.8%) complained of joint pain before the RT, and seven of these 31 individuals reported continued pain after the operation. Seventeen of the 82 (20.7%) began to suffer joint pain after the RT. Six (7.3%) and three (3.7%) of the 82 patients developed arthritis before and after the transplantation, respectively. We found no statistical association between the joint pain and sex, age, cause of renal failure, dialysis duration, time since transplantation, bone mineral density, human leukocyte antigen type, serum levels of urate, parathormone, calcium, alkaline phosphatase, phosphorus, C‐reactive protein, erythrocyte sedimentation rate, donor source (living‐related or cadaveric), or presence of HCV infection. However, levels of serum cyclosporine higher than 200 ng/ml were significantly correlated with the joint pain. This study shows that joint pain is common before and after RT. In renal transplant recipients, joint pain is significantly correlated with serum cyclosporine levels.

Cohort effect of HCV infection in liver cirrhosis assessed by a 25 year study.

The role of HCV infection in the development of chronic liver disease is still unclear. Assess the presence of HCV infection in patients with liver cirrhosis. 123 cases of cirrhotic liver randomly selected over a 25 years period (1969-1994) from the autopsy archives of the Pathology Department of the University of Trieste, Italy, were analyzed for the presence of HCV viral genome. Total RNA was extracted from formalin-fixed paraffin-embedded tissues of the cirrhotic liver. Genotype analysis for HCV was performed after RT-PCR by dot-blot hybridization with the three major genotype-specific probes (G1, G2 and G3). The overall HCV genome frequency was 50.4% (62/123). The positivity was quite constant in the 1969-1979 period (35-38%), rose to 65% in 1984, peaked to 77% in 1989 (P<0.005 vs. the previous decade), and decreased to 50% in 1994. HCV genotype G1 was found in 89% of the 62 positive samples. The mean age of death of HCV-positive and HCV-negative patients was comparable (69+/-12 vs. 67+/-16 years, NS). These data show an increasing frequency of HCV infection in cirrhotic liver tissues from 1969 to 1994, which peaked in 1989. The genotype G1 was the almost uniquely associated with cirrhosis. These findings indicate that the HCV infection occurred around the late 1950s-early 1960s, thus supporting the hypothesis of a cohort effect. HCV infection seems not to alter the natural history of liver cirrhosis as indicated by the comparable age at death of HCV positive and HCV negative patients.