Viral Hepatitis Type Research Articles

Ozone therapy for vial hepatitis. What can be expected? [abstract

Patients with acute viral hepatitis (type A, B, C) should receive high dosage OT at least twice weekly, expecting a fast decline of transaminases and bilirubins, as well as a fast clinical (subjective) recovery. On average, six sessions of OT will suffice. In the author’s experience, this program will avoid the possible chronification of the disease.
 Patients with chronic viral hepatitis (type B, C) normally require longer treatment, with two OT sessions weekly, for at least six weeks, after which the laboratory work should be remade. A reduction of transaminases is expected to occur, signifying a reduction in the intensity of the ongoing inflammatory process. An OT “maintenance” program is then recommended for at least six months, testing the transaminases regularly. Viral load negativization may or may not occur, but should not be THE goal of this treatment. During the OT, the viral load may vary immensely, and we have no sure explanation for this as yet. The author considers the viral load not to be a reliable criterion for the evaluation of the efficacy of ozone therapy for chronic viral hepatitis.
 For legal as well as medical reasons, the author recommends NOT to apply ozone therapy and Interferon / Ribavirin treatments at the same time.
 The real efficacy and long term safety of the newer medicines for acute and chronic viral hepatitis seem very positive, but may / should still be observed / cleared.

Immunization related behaviour among healthcare workers in Europe: Results of the HProImmune survey.

Vaccine preventable diseases (VPDs) continue to pose a significant threat to healthcare workers (HCWs) while immunization among this group remains low. HCWs' behaviours as well as facilitators and barriers towards their vaccination for a number of VPDs were explored through an EU-wide survey. HCWs across the EU answered online survey that explored attitudes and behaviours towards vaccination for a number of VPDs. Response data were adjusted based on weights estimated by HCWs' country and working profession according to WHO statistics. The survey was delivered between October 2012 and April 2014. Analysis was based on responses from 5,424 HCWs from 14 European countries. The majority (86.7%) had a positive attitude regarding immunizations. HCWs considered influenza (86.4%), viral hepatitis type B (71.9%) and tuberculosis (59.1%) as higher risk diseases for occupational exposure in the workplace. However, 43.8% reported not receiving a seasonal influenza vaccine in the last 10 years and 65.6% reported not receiving the pandemic influenza vaccine in 2009. Main enablers towards immunizations included believing in vaccine protection and easy, free of charge access to vaccines in the workplace. Barriers to up-to-date immunizations differed according to disease but included concerns about short- and long-term effects. Although the concept of mandatory vaccination seems to be favoured by many health professionals in Europe, it remains a controversial subject both among HCWs' profession categories and also among different countries. Interventions to increase vaccination among HCWs would benefit by tailoring their approach according to disease and target group.

Liver fibrosis mechanisms – the role of stellate cells, oxidative and nitrosative stress

Liver fibrosis is a chronic and complex pathological process, occuring in patients with chronic liver diseases. The most common cause of liver fibrosis is the alcoholic liver disease, viral hepatitis type B, C and D, as well as autoimmune diseases. Other causes include metabolic dysfunctions like hemachromatosis and Wilson’s disease, biliary duct disorders, damaging effects of medicine and parasite infections. Fibrosis’ dynamics and progres speed depend on the nature of underlying mechanisms and are characterized by accumulation of ECM elements. They vary from patient to patient and are directly correlated to aberrations of homeostasis degradation and production of liver connective tissue. In liver fibrosis the main source of ECM are hepatic stellate cells (HSCS), although other cells are also able to produce ECM such as: portal fibroblasts, narrow-derived cells, biliary duct epithelial cells and epithelial mesenchymal transition hepatocytes. The HSCS activity is stimulated by proinflammatory cytokines, oxidative and nitrosative stress which lead to different pathologies such as: inflammation, steatosis, fibrosis, cirrhosis, liver-cell cancer. Alcohol, the main fibrotic agents is metabolized almost entirely in the liver, so the organ is extremely sensitive to its negative intermediate and mediate influence. Factors influencing alcoholic liver failure are not only oxidative and nitrosative stress and proinflammatory cytokines activity, but also reductive stress, hepatocytes; hypoxia, mucous membranę dysfunction and intestine flora influence, as well as genetic and immunological factors. Though in last several yers there has been a great advancement in our knowledge of liver fibrosis mechanisms, it remains tough to diagnose the proces in its early stages and consequently apply an efficient therapy. The challenge for the futur is finding useful biomarkers and new therapeutic goals.

Hepatitis E: a largely underestimated, emerging threat.

Hepatitis E virus has two distinct clinical and epidemiological patterns based on the varying genotypes. Genotypes 3 and 4 cause widespread, sporadic infection in high-income countries and are emerging as the most common type of viral hepatitis in much of Europe. These infections carry significant morbidity and mortality in the growing numbers of immunosuppressed patients or in patients with established liver disease. Furthermore the growing extra-hepatic associations of the virus, including neurological and kidney injury, suggest that it may have been misnamed as a 'hepatitis' virus. This review explores current understanding of the epidemiology, virology and clinical presentations of hepatitis E infection and identifies vulnerable patient groups, who are at serious risk from infection. Guidance is offered regarding the diagnosis, treatment and prevention of this growing public health hazard.

Сравнительная оценка антигенности живой и инактивированной вакцины против вирусного гепатита утят типа I

Сравнительная оценка антигенности живой и инактивированной вакцины против вирусного гепатита утят типа I

Knowledge, Attitude and Practice concerning Hepatitis B infection among the health care personnel in selected Primary Health Care Centres in Lucknow

Background: Hepatitis B is a major global health problem and one of the most serious type of viral hepatitis, but it can be prevented with strategies like safe and effective vaccination, increasing awareness and by adhering to universal precautions. Objective: To assess the knowledge, attitude and practice concerning Hepatitis B infection among the health care personnel. Materials and methods: Cross-Sectional study was conducted among health care personnel working at the Primary Health Centres in Lucknow. A total of 89 health care personnel comprising of medical officers, staff nurses, laboratory technicians, pharmacists including class IV workers present on the day of data collection were included in the study and interviewed using pretested questionnaire. Descriptive summary using frequencies, proportions and percentages were used to present study results. Result: Majority (93.4%) of the medical officers were aware about type of hepatitis in comparison to staff nurses, paramedical staff and class IV workers (20.0%, 21.8% and 4.5% respectively). Knowledge about symptoms of hepatitis B was found minimal (9.1%) among class IV workers and paramedical staff (18.7%) as compared to doctors (80.0%) and staff nurse (35.0%). Only 13.6% of class IV worker had concern to report each and every case of needle stick injury. Practice to strictly follow of universal precautions and biomedical waste management guidelines was found to be least (9.1% and 18.1% respectively) among class IV workers. Conclusion: The study revealed sub-optimal KAP (Knowledge, attitude and practices) in concern to several aspects of Hepatitis B infection among primary healthcare personnel. Key words: Hepatitis B, Knowledge, Attitude, Practices, Healthcare personnel

Cross-sectional study to determine viral hepatitis knowledge in different urban populations in Brazil.

AIMTo evaluate viral hepatitis knowledge among individuals from different resource areas and health conditions to identify possible gaps.METHODSA cross-sectional, descriptive study was carried out among 447 individuals from five distinct populations in Brazil: Southeast Viral Hepatitis Ambulatory (n = 100), South (n = 89) and Northeast (n = 114) Health Center, Southeast (n = 77) and Northeast (n = 67) low resource areas. All individuals answered a questionnaire assessing sociodemographic characteristics and viral hepatitis awareness. The perception was scored based on the average number of correct answers of all participants and categorized as “low” (0-28 correct answers) or “desirable” (29-46 correct answers). Associations between sociodemographic characteristics and perception were also evaluated.RESULTSA low level of knowledge was observed in individuals from Northeast Health Center, Northeast and Southeast low resource areas while desirable knowledge was observed in individuals from Viral Hepatitis Ambulatory and South Health Center. According to sociodemographic characteristics, desirable scores were more common among those with secondary education (47.1%), those who declared themselves as white (46.3%), and those who lived in houses with three individuals (25.5%). Multivariate analysis showed an association between viral hepatitis perception and type of population.CONCLUSIONThe results demonstrated high level of knowledge among study participants from health clinics from the Southeast region of Brazil and the importance of education programs in increasing the level of knowledge in low resource areas.

Computed tomography and magnetic resonance imaging features of regional portal hypertension

Computed tomography and magnetic resonance imaging features of regional portal hypertension

Tranzientní elastografie - přínos v hodnocení vývoje jaterního onemocnění

Transient elastography, an examination based on the liver stiffness measurement, is a method validated for the non-invasive liver fibrosis staging. This method was recently successfully introduced into routine clinical practice. In accordance with the global- wide screening of viral hepatitis (chronic viral hepatitis type B and type C) and with the increasing effectiveness of antiviral therapy, as well as with the increasing prevalence of non-alcoholic fatty liver disease (NAFLD), the part of population requiring the care of hepatologists is certain to increase. Now more than ever we need a non-invasive, fast, safe, inexpensive and reliable method for evaluating patients with chronic liver disease. A new area of ​​use of elastography appears to be used to measure the stiffness of the spleen as a prediction of the presence of esophageal varices or the stiffness (or rather fibrosis) of transplanted kidneys. The aim of this review is to provide a comprehensive view of transient elastography, its principles, advantages and pitfalls, including its use in everyday clinical practice. Key words: cirrhosis - fibrosis - renal allograft - transient elastography.

Epidemiology of viral hepatitis in Somalia: Systematic review and meta-analysis study.

AIMTo provide a clear understanding of viral hepatitis epidemiology and their clinical burdens in Somalia.METHODSA systematic review and meta-analysis was conducted as Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search of published studies on viral hepatitis was performed from 1977-2016 in PubMed, Google Scholar, Science Direct, World Health Organization African Index Medicus and the Africa Journals Online databases, as well as on the Ministry of Health website. We also captured unpublished articles that were not available on online systems.RESULTSTwenty-nine studies from Somalia and Somali immigrants (United Kingdom, United States, Italy, Libya) with a combined sample size for each type of viral hepatitis [hepatitis A virus (HAV): 1564, hepatitis B virus (HBV): 8756, hepatitis C virus (HCV): 6257, hepatitis D virus (HDV): 375 and hepatitis E virus (HEV): 278] were analyzed. The overall pooled prevalence rate of HAV was 90.2% (95%CI: 77.8% to 96%). The HAV prevalence among different age groups was as follows: < 1 year old, 61.54% (95%CI: 40.14% to 79.24%); 1-10 years old, 91.91% (95%CI: 87.76% to 94.73%); 11-19 years old, 96.31% (95%CI: 92.84% to 98.14%); 20-39 years old, 91.3% (95%CI: 83.07% to 95.73%); and > 40 years old, 86.96% (95%CI: 75.68% to 93.47%). The overall pooled prevalence of HBV was 18.9% (95%CI: 14% to 29%). The overall pooled prevalence among subgroups of HBV was 20.5% (95%CI: 5.1% to 55.4%) in pregnant women; 5.7% (95%CI: 2.7% to 11.5%) in children; 39.2% (95%CI: 33.4% to 45.4%) in patients with chronic liver disease, including hepatocellular carcinoma (HCC); 7.7% (95%CI: 4.2% to 13.6%), 12.4% (95%CI: 6.3% to 23.0%) and 11.8% (95%CI: 5.3% to 24.5%) in age groups < 20 years old, 20-39 years old and > 40 years old, respectively. The HBV prevalence among risk groups was 20% (95%CI: 7.19% to 44.64%) in female prostitutes, 21.28% (95%CI: 7.15% to 48.69%) in hospitalized adults, 5.56% (95%CI: 0.99% to 25.62%) in hospitalized children, 60% (95%CI: 31.66% to 82.92%) in patients with acute hepatitis, 33.55% (95%CI: 14.44% to 60.16%) in patients with ancylostomiasis, 12.34% (95%CI: 7.24% to 20.26%) in patients with leprosy and 20.19% (95%CI: 11.28% to 33.49%) in schistosomiasis patients. The overall pooled prevalence of HCV was estimated as 4.84% (95%CI: 3.02% to 7.67%). The prevalence rates among blood donors, risk groups, children and patients chronic liver disease (including HCC) was 0.87% (95%CI: 0.33% to 2.30%), 2.43% (95%CI: 1.21% to 4.8%), 1.37% (95%CI: 0.76% to 2.46%) and 29.82% (95%CI: 15.84% to 48.98%), respectively. The prevalence among genotypes of HCV was 21.9% (95%CI: 15.36% to 30.23%) in genotype 1, 0.87% (95%CI: 0.12% to 5.9%) in genotype 2, 25.21% (95%CI: 18.23% to 33.77%) in genotype 3, 46.24% (95%CI: 37.48% to 55.25%) in genotype 4, 2.52% (95%CI: 0.82% to 7.53%) in genotype 5, and 1.19% (95%CI: 0.07% to 16.38%) in genotype 6. The overall pooled prevalence of HDV was 28.99% (95%CI: 16.38% to 45.96%). The HDV prevalence rate among patients with chronic liver disease, including HCC, was 43.77% (95%CI: 35.09% to 52.84%). The overall pooled prevalence of HEV was 46.86% (95%CI: 5.31% to 93.28%).CONCLUSIONOur study demonstrates a high prevalence of all forms of viral hepatitis in Somalia and it also indicates that chronic HBV was the commonest cause of chronic liver disease. This highlights needs for urgent public health interventions and strategic policy directions to controlling the burden of the disease.

Qualitative research of the psychological experience of the main caregivers of hepatocellular carcinoma with hepatitis B virus

Objective To explore the psychological experience of the caregivers of Hepatocellular Carcinoma with Hepatitis B virus. Methods Semi-structured Interviews were performed in a total of 12 main caregivers of Hepatocellular Carcinoma with Hepatitis B in the Chinese Academy of Medical Sciences from October 2016 to March 2017, and the original data was analyzed according to the Colaizzi 7-step method. Results A total of five topics were extracted, including Awareness of relief stress when the diagnosis was informed, Indebtedness and self-blame, fear and sadness of possible loss of loved ones, stressful anxiety (stress of economy, loss of function, worrying about being infected), and joint stigma. Conclusions Many psychological experiences of main caregivers of patients with hepatocellular carcinoma combined with hepatitis B coexist in the course of care. Exploring and providing effective care support based on the psychological experience and needs of caregivers is one way to improve physical and mental health and the quality of care for patients. Key words: Liver neoplasms; Viral hepatitis type B; Caregivers; Psychological experience; Qualitative research

Live attenuated duck hepatitis virus vaccine in breeder ducks: Protective efficacy and kinetics of maternally derived antibodies

Duck viral hepatitis type I is a rapidly spreading infection lethal in young ducklings, caused by the duck hepatitis A virus (DHAV). Vaccination of breeder ducks is a common practice to control DHAV. However, maintaining proper maternal antibody levels in large flocks is difficult. Therefore, a simple vaccination strategy that can induces stable high antibody levels through mass vaccination is desirable. We evaluated a DHAV vaccination strategy for breeder ducks involving oral administration under field conditions, and examined the kinetics of antibody response in the ducks and their progeny. The strategy included a primary intramuscular vaccination, followed by secondary and tertiary oral vaccinations. Five weeks after the primary vaccination, virus-neutralizing antibody titers increased by 8.4 ± 1.3 log2. The titers remained stable at around 9.0 ± 1.1 log2 for up to 36 weeks. None of the progeny died when challenged with virulent DHAV at 1, 7 or 14 days of age. The transfer percentage of antibodies from the breeder ducks to their progeny was 12.8 ± 3.0%. When antibody levels of the progeny were measured from the day of hatching to 20 days of age, the levels steadily declined, reaching a mean titer of 0 log2 at 20 days. The half-life of the maternally derived antibodies against DHAV was 3.4 ± 1.1 days. Our vaccination strategy might be effective in breeder ducks because it can be easily applied and induced strong immunity. Moreover, our results might provide a foundation for the mechanistic study of maternally derived antibodies in passive protection.

Study on early warning threshold values for 7 common communicable diseases in Gansu province, 2016

Objective: To optimize the warning threshold values of common communicable diseases in Gansu province, and improve the early warning effect. Method: An early warning model was set up for influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, viral hepatitis type E and hand foot and mouth disease (HFMD) respectively in Gansu by using the moving percentile method and cumulative sum method. By calculating the sensitivity, specificity, predictive value of positive test, predictive value of negative test, Youden' index and receiver-operating characteristic curve, the optimum early warning threshold values for communicable diseases in Gansu were selected. Results: The optimum early warning boundary values of influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, and viral hepatitis type E were P(90), P(80), P(95), P(90), P(80) and P(90) respectively. The optimum early warning parameters of HFMD were k=1.2, H=5σ. Under the optimum early warning boundary values/parameters, the early warning sensitivities of influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, viral hepatitis type E and HFMD were 86.67%, 100.00%, 91.67%, 100.00%, 100.00%, 100.00% and 100.00%, the specificities were 86.49%, 62.22%, 75.00%, 100.00%, 97.92%, 89.13% and 74.47%. The predictive values of positive test were 72.22%, 29.17%, 52.38%, 100.00%, 80.00%, 54.55% and 29.41%, and the predictive values of negative test were 94.12%, 100.00%, 96.77%, 100.00%, 100.00%, 100.00% and 100.00%, and the Youden' indexes were 0.73, 0.62, 0.67, 1.00, 0.98,0.89 and 0.74. Receiver-operating characteristic curve showed that the values/parameters of this warning boundary were the points closest to the upper left of the coordinate diagram. Conclusion: The early warning thresholds of influenza, other infectious diarrheal diseases, dysentery and hepatitis E in Gansu may be raised appropriately and the early warning parameters of HFMD need to be adjusted to improve the effectiveness of early warning.

Filamin A expression predicts early recurrence of hepatocellular carcinoma after hepatectomy.

Recurrence of hepatocellular carcinoma (HCC) after hepatectomy is very high. A predictive marker of early recurrence (ER) capable of personalizing follow-up and developing a new target therapy would be beneficial. The overexpression of Filamin-A (FLNA), a cytoskeleton protein with scaffolding properties, has recently been associated with progression in tumours. The aim of this study was to test the expression of FLNA in a cohort of patients operated for HCC. A retrospective cohort of patients who underwent hepatic resection at Humanitas Clinical and Research Center between January 2004 and December 2014 was analysed. FLNA was tested, using a tissue microarray, in the HCC and in the surrounding tissues. The endpoint was the role of FLNA expression in predicting ER of HCC after hepatectomy. Analyses were performed following the REMARK guidelines. A total of 113 patients were considered. FLNA was expressed only in the tumoral tissue. Several variables, including T stage, tumour number, tumour size, type of viral hepatitis, type of hepatectomy and intra and peritumoral immune-reactivity to FLNA were significantly associated with ER by univariate analysis. With multivariate analysis, only T stage (HR=2.108; P=.002), tumour number (HR=1.586; P=.023), intra-tumoral (HR=2.672; P<.001) and peritumoral immune-reactivity to FLNA (HR=2.569; P<.001), significantly correlated with ER. The logistic regression analysis revealed that advanced T stage (OR=2.985; P=.001), HCV-infection (OR=1.219; P=.008) and advanced tumour grading (OR=2.781; P=.002) were associated with intratumoral FLNA immune-reactivity. FLNA expression predicts recurrence of HCC after hepatectomy. This finding provides important insights that would help physicians to personalize follow-up strategies.

Knowledge of Hepatitis B Virus Infection and Mode of Transmission among Women of Reproductive Age in Work and Study Programme of Ebonyi State University Abakaliki, Nigeria

Background: Hepatitis B virus is the most serious type of viral hepatitis and can cause both acute and chronic infections. The aim of the study was to assess the knowledge of hepatitis B virus infection and its mode of transmission among women of reproductive age in Work and Study programme of Ebonyi State University Abakaliki, Nigeria&#x0D; Methodology: This was a descriptive cross-sectional study. A systematic sampling technique was used to select 326 respondents. Information was obtained using a pre-tested, self-administered questionnaire. Statistical Package for Social Sciences, version 22 was used in the analysis.&#x0D; Results: Majority (77.6%) of the respondents were aware of hepatitis B virus infection and the major (50%) source of information was health workers. Knowledge on method of transmission of the virus included blood transfusion, 62.3%; unprotected sexual intercourse, 54.0%; mother to child transmission, 40.5% while for prevention, screening of blood before transfusion had 62.6%; vaccination, 48.8% and use of condom, 42.6%. A minor proportion (32.5%) had been vaccinated with the Hepatitis B vaccine and only 39.6% had received the recommended three doses. The major (50%) reason for non-vaccination was ignorance. Out of 27.0% who had been screened for the virus 1.5% knew they tested positive for hepatitis B surface antigen.&#x0D; Conclusions: Majority of the respondents were aware of hepatitis B virus infection. Though most of the respondents had good knowledge of the transmission of the virus, their understanding of the methods of prevention was poor. There is need for public enlightenment on the burden of hepatitis B virus infection in Nigeria and the availability and importance of the hepatitis B vaccine.

Evaluation of prothrombin induced by vitamin K absence, macrophage migration inhibitory factor and Golgi protein-73 versus alpha fetoprotein for hepatocellular carcinoma diagnosis and surveillance

Hepatocellular carcinoma (HCC) represents a challenging malignancy of worldwide importance. It is the third most common cause of cancer-related death globally as most patients present with unresectable disease. Alpha-fetoprotein (AFP) is the widely and solely used biomarker for HCC diagnosis; yet, its usefulness is hampered by low sensitivity and specificity. We aimed to identify more sensitive biomarkers for HCC diagnosis and a surveillance algorithm that may facilitate early detection of HCC. A total of 305 Egyptian and Saudi participants grouped as healthy controls, cancer controls, benign hepatic lesions, chronic viral hepatitis and HCC were included. Serum AFP, prothrombin induced by vitamin K absence-II (PIVKA-II), macrophage migration inhibitory factor (MIF) and Golgi protein-73 (GP-73) levels were quantitated by enzyme immunoassay. Significantly higher levels of GP-73 and PIVKA-II were detected in the HCC group than in all other groups, while MIF showed a highly significant increase in HCC from all groups except the cancer control group. The HCC group showed no significant difference between the studied biomarkers and the type of chronic viral hepatitis. On the basis of multiple ROC curve analyses, GP-73 and PIVKA-II showed the highest sensitivity and specificity for surveillance and diagnosis. In conclusion, PIVKA-II and GP-73 offer an effective approach for early HCC diagnosis and surveillance of high-risk groups with a higher accuracy than AFP. MIF may serve as a promising screening tumor marker for the detection of gastrointestinal tract (GIT) malignancy.

Estimation of Hepatitis A Virus Infection Prevalence Among Eastern Mediterranean and Middle Eastern Countries: A Systematic Review and Pooled Analysis

Context: Hepatitis A virus (HAV) infection is the most common type of acute viral hepatitis that has been proposed as an important public health issue. Most of the countries in WHO Eastern Mediterranean region (EMR) and Middle East (ME) have a high endemicity of HAV infection. To provide a comprehensive estimation of the epidemiology of HAV in this region, we carried out a systematic review on the literature reporting the prevalence of HAV infection in the EMR and ME. Evidence Acquisition: We conducted a systematic search in the databases including PubMed, Scopus, Science Direct, and Web of science using appropriate search strategies. Observational studies published between January 1990 and July 2016 with clearly stated data regarding HAV Ab (IgG) in non-high-risk groups from countries of EMR and ME were examined. We estimated the prevalence of HAV infection and 95% confidence interval based on the pooled data from all included studies for each country, and the regions were weighted according to the population size of each country in that region. Results: The HAV prevalence in ME, WHO EMR, and in total was 61.60 (61.31 - 61.89), 65.74 (65.39 - 66.09), and 62.60 (62.32 - 62.89), respectively. We found no eligible study for Bahrain, Djibouti, Libya, Oman, Qatar, and Sudan. Cyprus had the lowest prevalence rate of HAV (2.61% (1.53 - 4.17)) that along with UAE and Kuwait, it had a prevalence rate below 50%. The most HAV prevalence rates were related to Afghanistan (99.01 (95.51 - 99.89)), Iraq (96.35 (95.97 - 96.70)), Somalia (96.00 (94.16 - 97.33)), and Palestine (93.70 (90.96 - 95.77)), in sequence. Conclusions: The countries of EMR and ME need more and constant programs for prevention and control of HAV infection. Also, further primary original epidemiological studies are needed in some countries of the region.

Knowledge, attitude and practice on hepatitis-B infection among infected patients in a Homoeopathy Medical Center in Dhaka City, Bangladesh

Viral hepatitis is the commonest liver disease in Bangladesh. About 10 million people in Bangladesh have been suffering from hepatitis B. Hepatitis B is a potentiality life threatening liver infection caused by HBV. It is a major global health problem and the most serious type of viral hepatitis. The aim of this study is to assess the knowledge, attitude and practice on Hepatitis B Virus infection among the selected patients in Essence Homoeopathy Medical Center, Dhaka. A descriptive type of cross sectional study was carried out among 150 samples by using non-randomized purposive sampling technique and by the help of pretested modified questionnaire. Statistical association was calculated by chi-square test and all the Hepatitis B related data were analyzed by the help of SPSS (version 16). The study showed that 73.3% of the respondents’ age ranged from 15-35 years with mean age (32.44±10.54) and of them 96.7% was found to be Muslims. Among injectable drug users (IDUs) (19.3%), 27.6% was sharing same needle. Approximately 5% of the respondents had a history of taking unscreened blood among 28% of the respondents who experienced blood transfusion. Another concerning issue was that 77% of the respondents practiced polygamy sex and among them only 38.8% used protecting device during sexual activity. Majority (70.7%) of the respondents did not take HBV vaccine. Significant statistical association was found between education and vaccination against HBV (p-0.000). To prevent this deadly disease mass awareness has to be created among the people of active age group through media education and policy implementation.South East Asia Journal of Public Health Vol.6(1) 2016: 27-31

Morphological characteristics of endometrium in patients of reproductive age with viral hepatitis type C

Aim: The purpose of the study was to investigate the morphological features of endometrium in patients with viral hepatitis type C.Materials and methods: A morphological survey was conducted involving endometrium sections stained with hematoxylin and eosin and Van Gieson‘s picrofuchsin collected from 140 women of reproductive age, among them 70 patients were diagnosed with chronic hepatitis type C (CHC) infection with minimal (40 patients) and moderate activity (30 patients), and 70 women suffered from endometrial proliferative diseases without viral hepatitis (comparison group). In addition, 36 women with CHC and 36 women without CHC underwent immune histochemical test (IHC) of paraffin sections aimed at investigating the expression level of estrogen (ERα) and progesterone (PR) receptors and proliferation marker Ki-67. Endometrial biopsy samples were collected on the 10th to 14th day and the 15th to 18th day of the menstrual cycle.Results: Focal changes of endometrium in the form of uneven entering of the endometrium into the next phase of the menstrual cycle with the dominating proliferative phase were found in chronic hepatitis C patients. The number of patients having proliferative activity in the endometrium combined with inflammation increased as viral hepatitis became more active. Immune histochemical test showed the prevalence of the expression levels of ERα and PR receptors in the endometrial stroma. Increased expression of Ki-67 was observed mainly in the glandular epithelium and accrued together with the increment in the CHC activity.Conclusion: Endometrial pathology in patients of reproductive age with chronic hepatitis type C is characterized primarily by proliferative forms with the increasing mismatch between the nature of structural changes and mucous phase of the menstrual cycle prompting suggestions that direct effect of hepatitis C virus on endometrium is possible.

Comparison of collagen proportionate areas in liver fibrosis quantification between chronic hepatitis B and C.

Few studies have compared the distinct hepatic collagen morphometrics of chronic hepatitis B (CHB) and chronic hepatitis C (CHC). This study compared the discrepancies between CHB and CHC in liver fibrosis (F) quantification by using the collagen proportionate area (CPA) and liver stiffness (LS) measured with shear wave velocity (SWV).This study enrolled 274 eligible consecutive patients diagnosed with CHB (n = 137) or CHC (n = 137). Their ages ranged from 20 to 80 years (median = 50). In total, 154 patients (56.2%) were male. Participant LS was measured by using acoustic radiation force impulse elastography preceding an immediate percutaneous liver biopsy. The total proportion of the collagen stained with picrosirius red to the total tissue area was expressed as the CPA percentage, which was stratified into portal-bridging (PB) and perisinusoidal (PS) proportionate areas (PAs).Based on the METAVIR F staging system, 36 (26.3%), 36 (26.3%), 28 (20.4%), and 37 (27.0%) participants in the CHB group and 34 (24.8%), 45 (32.9%), 34 (24.8%), and 24 (17.5%) participants in the CHC group were staged as F1, F2, F3, and F4, respectively. Both the total CPAs and PBPAs were significantly (P < 0.05) higher in the CHC group than in the CHB group within all F-stratified subgroups. The SWVs were significantly (P < 0.05) higher in the CHC group than in the CHB group only within the F2, F3, and F4 subgroups. However, the PSPAs did not differ significantly between the CHC and CHB groups within all subgroups. Multiple regression analysis revealed that viral hepatitis etiology (P < 0.001), METAVIR F stages (P < 0.001), and platelet count (P = 0.007) were independent factors correlated with the CPA (R = 0.543, P < 0.001).In conclusion, both the F stage-stratified CPAs and SWVs tended to be higher in cases of CHC than in those of CHB. The type of viral hepatitis significantly affected both the CPA and SWV values. The PBPAs were more closely correlated with F stages and SWV than were the PSPAs.