Hepatitis Monthly
Volume:17 Issue: 1, Jan 2017

Context: Despite various studies, there is no overall estimation about the efficacy of Hepatitis B virus (HBV) vaccine among healthcare workers (including healthcare personnel and healthcare students). The present meta-analysis study was conducted to investigate the efficacy of HBV vaccine in healthcare workers in Iran..
Evidence Acquisition: This study was performed according to the PRISMA guidelines for systematic review and meta-analysis studies. A comprehensive search was conducted using national and international databases including: Magiran, Iranmedex, IranDoc, SID, Medlib, Scopus, Pubmed, Science Direct, Cochrane, Embase, Web of Science, Springer, wiley online library, Trials Register, DOAJ, and Google Scholar search engine without time limit up to 2016. Just papers which were qualified according to inclusion criteria were examined. The data were analyzed using meta-analysis method in STATA software Ver.11.1..
1726 healthcare workers had been examined in 12 studies. The efficacy of HBV vaccine, 1 - 6 months after the injection of the third dose was determined to be 93.1% (95% CI: 90.3 - 97); this rate was 95.9% (95% CI: 93.1 - 98.6) for male and 91.3% (95% CI: 87.1% - 95.5%) for female participants. HBV vaccine efficacy was 90.9% (95% CI: 86.5-95.3) for 8 studies conducted on healthcare personnel and 97.3% (95% CI: 94.7-97.7) for 3 studies on healthcare students..
Immunogenicity of HBV vaccine was 90 - 97 in healthcare workers. Hence, the complete course of vaccination is sufficient for prevention of HBV and there is no need for booster dose or dose re-administration..

One of the most important public health concerns in both developing and developed countries is viral hepatitis B. It is an autoimmune liver disease, which imposes a high economic burden on individuals and the society. The aim of our study was to determine economic burden of hepatitis B virus (HBV) infection in Iran. To this end, 300 patients with HBV infection, who referred to hospitals in three cities of Iran during the year 2015, were randomly selected. To estimate the total burden of hepatitis, direct and indirect costs, costs of DALYs and social welfare were calculated which gave the costs of 7500.93 PPP$ and 96782 PPP$, respectively. Finally, our results showed that the total economic burden of HBV in Iran is dramatic which can lead to decreased quality of life of household members and damage the economy of the society. Therefore, the benefit of prevention and control measures will justify the costs from social perspective..

Co-infection of human immunodeficiency virus (HIV) with hepatitis virus accelerates liver injury. Recently, there has been paid more attention to micro RNAs (miRs) as new tools for determination of liver injury. Previous studies revealed that miR-29 inhibits HIV replication. It has been also shown that miR-29 decreases in hepatocytes of hepatitis C virus (HCV) infected patients. The present study aimed to determine the miR-29a-5p expression as a possible diagnostic marker in HIV- and HIV-HCV co-infected patients..
In this cross-sectional study, blood samples were collected from 40 healthy, 44 HIV-positive, and 121 HIV/HCV co-infected subjects. Blood CD4 (cluster of differentiation 4) cell counts were recorded and serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) activities, miR-29a-5p expression, fibrosis-4 (FIB-4), and AST to platelet ratio index (APRI) index were determined. Data were analyzed by SPSS version 16 and p value less than 0.05 was considered statistically significant..
Serum ALT and AST activities and FIB-4 and APRI were significantly higher in HIV-HCV-co-infection group than the control group (P miR-29a-5p was significantly down-regulated in HIV- and HIV/HCV-co-infected patients and showed a correlation with liver injury. Down-regulation of miR-29a-5p was directly associated with CD4 cell counts and reversely correlated with FIB-4 and APRI index. Therefore, the determination of miR-29a-5p may be useful, among other markers, for diagnosis of these diseases..

This study reports hepatitis B serologic test results among foreign-born Asian Americans. In 2013 - 2014, a sample of foreign-born Asian American adults, (≥ 18 years of age) were drawn from community-based organizations in the Baltimore-Washington Metropolitan Area. Hepatitis B screening tests were administered, including tests for HBsAg, anti-HBs, and anti-HBc. Among total of 600 people who completed screening, 33 (5.5%) tested positive for HBsAg, indicating chronic hepatitis B virus (HBV) infection.
About 44% (n = 263) tested positive for anti-HBc, indicating a previous exposure to HBV. Asian Americans from Vietnam (53.2%) had the highest exposure to HBV, followed by Asian Americans from Korea (43.4%) and China (34.8%) (P

The association between liver enzymes and cardiovascular disease (CVD) was previously demonstrated. This study investigated the possible association between liver enzymes and the 10-year risk of cardiovascular events..
The study consisted of 3199 subjects. Two risk-assessment methods, the framingham risk score (FRS) and American college of cardiology and American heart association (ACC/AHA) tools, were used to predict 10-year cardiovascular risks. The association between liver enzymes and ≥ 7.5%, ≥ 10%, and ≥ 20% 10-year CVD risks were evaluated..
In the multivariate analysis, alkaline phosphatase (ALP) was significantly associated with 10-year CVD risks in both men and women (P While ALP exhibited an independent positive association with 10-year CVD risks in both genders, ALT showed an inverse association with10-year CVD risks in men and with some levels of risks in women..

The combination of sofosbuvir and daclatasvir can be used to treat all genotypes of hepatitis C. Current guidelines for treating hepatitis C cirrhosis do not clarify weather 12 weeks or 24 weeks of treatment is appropriate..
In the present study, we aimed at evaluating the efficacy of sofosbuvir, daclatasvir, and ribavirin given for 12 weeks in treating cirrhotic patients with hepatitis C genotypes 1 and 3 infections..
One hundred patients with hepatitis C and cirrhosis infected with Genotypes 1 and 3 were included in the present study. They were treated with 1 tablet of a combination pill of 400 mg sofosbuvir and 60 mg daclatasvir daily and weight-based ribavirin for 12 weeks. Response to treatment was assessed 12 weeks after the end of the treatment with a sensitive assay (SVR12). This study was registered with ClinicalTrials.gov, ID: NCT02596880..
One patient developed increased creatinine level following severe diarrhea and gastroenteritis and was excluded, 1 patient died due to unrelated reasons and 4 others were lost to follow-up. Among the 94 patients who finished the study, 92 achieved SVR12 (98%, per-protocol, 92% intention-to-treat). None of the patients reported any side effects. Of the 100 original patients, 56 were Genotype 1 and 44 were Genotype 3. One of the two patients not achieving SVR12 was Genotype 1, and the other two were Genotype 3..
The fixed-dose combination drug of sofosbuvir and daclatasvir given together with weight-base ribavirin for 12 weeks is extremely effective and safe in treating HCV patients with Genotypes 1 and 3 and cirrhosis..

Olynyk et al. studied the liver iron concentration (LIC) by MRI of 52 consecutive patients of northern European origin who were referred to a tertiary hospital for hyperferritinemia (HF). They described three groups according to HFE mutations and the transferrin saturation index (TSI) (group A: no predisposing mutations (PM) for hereditary hemochromatosis (HH) and TSI > 45 %, group B: PM for HH and TSI > 45 %; group C: no PM for HH and normal TSI). In the Basque country, HH predisposing mutations differ, with prevalence of the H63D/H63D mutation..
To study the importance of HFE mutations and the TSI in determining LIC of HF patients attending the outpatient clinic at a secondary hospital..
Prospective study of 132 consecutive patients with HF. In 120 HFE study was available. In 79 LIC was obtained by MRI. In 71 patients values of HFE mutations, TSI, and LIC by MRI were available..
Mean age: 55.68 ± 14.26 (23 - 83), 55 men and 16 women. The mean LIC in men was 35.66 ± 36.85; women 38.81 ± 29.75. The mean LIC in group A: 38.80 ± 45.18 (5 - 210), group B: 48.96 ± 37.51 (15 - 160), group C: 28.12 ± 18.85 (5 - 75). We compared the LIC mean values of the 3 groups with no significant differences..
LIC values are similar in different groups of patients referred to a secondary hospital for HF, despite variable predisposition to HH..