Hepatitis Monthly
Volume:18 Issue: 6, Jun 2018

Context: Hepatitis B viral infection, specially in children, is an unsolved global health issue. National and international vaccination programs, as the main means to prevent this infection, have been operating for years. This meta-analysis study was launched to investigate the vaccination efficacy in under five-year-old children in Iran.
Evidence Acquisition: In this research, all national databases including, SID, Magiran, Iran medex, Iran doc, and Medlib, as well as international databases, including PubMed, Medline, and ISI were searched for published articles associated with evaluation of seroconversion rates after hepatitis-B vaccination in Iranian children. The search was performed in the Persian and/or English language and in under five-year-old children in Iran. The variance of each study was calculated using the binomial distribution formula. The results of studies were combined using random-effects meta-analysis model. Data were analyzed using STATA version 12.
In the present research, 11 studies, performed from 2000 to 2017, were investigated. The number of samples in these 11 studies were 3063 children (1592 males and 1471 females). In the studies, the efficacy range of the hepatitis-B vaccine in under five-year-old children in Iran was 89% (95% CI: 86% - 93%) with high heterogeneity (P value for heterogeneity was 0.001, I2 = 92.9). Range of efficacy for males and females was 85% (95% CI: 78 to 91) and 88% (95% CI: 83 to 93), respectively.
The hepatitis B virus (HBV) vaccination program in Iran seems to be highly effective although some questions, such as the effect of gender on responsiveness to vaccine and heterogeneity of different data, remain unclear.

Context: The emergence of direct - acting antiviral agents (DAAs) with high sustained virological responses (SVR) is an epoch - making revolution. However, the value of antiviral agents in the field of hepatitis C - related hepatocellular carcinoma (HCC) is not clear. Further, the risk of tumor occurrence or recurrence following an antiviral regimen is not yet reached a consensus.
Evidence Acquisition: All scientific evidence was collected through a systematic review of studies discussing DAA regimen and hepatitis C-related HCC, in PubMed, EMBASE, and Web of Science. The relevant articles were obtained and reviewed carefully before working on the paper.
The current review study aimed at discussing recent studies on hepatitis C - related HCC in the era of DAAs, including application of DAAs in the field of treatment of hepatitis C virus (HCV), efficacy of DAAs on HCV-associated HCC, and the effect of DAAs on occurrence and recurrence of HCC.
It was shown that DAAs had a relatively poor therapeutic effect on HCV patients with HCC, based on the current studies. After analyzing the existing data, the conclusion cannot yet be reached that DAA treatment influences the risk of HCC in patients with HCV infection.

Non-alcoholic fatty liver disease (NAFLD) as a severe health problem is the leading cause of morbidity and mortality from the chronic liver disease worldwide. NAFLD is tightly associated with dyslipidemia although the etiology is still unclear. ATP binding cassette subfamily A member 1 (ABCA1) is involved in cholesterol efflux, fatty acid oxidation, and inflammation. Although some reports show that the ABCA1 polymorphisms affect the lipids metabolism and severity of clinical liver diseases, the effects of ABCA1 polymorphisms on the development of NAFLD are unknown.
The current study was performed to investigate the association between the ABCA1 polymorphisms and the development of NAFLD and the effect of the four ABCA1 SNPs on the serum lipid levels.
The ABCA1 polymorphisms (rs1800977, rs2066714, rs2066715, and rs2230808) were determined in 265 NAFLD patients and 126 healthy controls using the sequencing and polymerase chain reaction analysis. Serum lipid profiles and liver enzymes were examined using standard clinical laboratory methods.
There was a significant difference (P We first demonstrated the association between the ABCA1 polymorphisms and the risk of NAFLD in a Chinese Han population. The ABCA1 rs1800977 may be a protective factor against the development of NAFLD. The ABCA1 rs2066714 C allele could increase the serum LDL cholesterol level, and the ABCA1 rs2230808 T allele could decrease the serum HDL cholesterol level in NAFLD patients.

Hepatic fibrosis is part of chronic liver disorders such as chronic hepatitis, cirrhosis, or metabolic disorders. Two-dimensional shear wave elastography (2D SWE) is one of the newest elastography techniques, which enables the assessment of the liver fibrosis in a non-invasive way.
The aim of the study was to determine how many measurements are necessary to assess liver fibrosis in a healthy population and patients with hepatitis B and C.
We analyzed the retrospective data of 642 patients who underwent the complex ultrasonic abdomen examination and liver 2D SWE examination. We analyzed the statistical differences and the interclass correlation coefficient between the value of the first measurement, the median value of the first three measurements, and the median value of all five measurements.
There was no statistical difference between the 2D SWE value of the first measurement and the median value of the first three and the first five measurements in healthy controls. In the group of patients with hepatitis B, the median value of the first five 2D SWE measurements was significantly higher than the value of the first 2D SWE measurement. Our study presented no statistical difference between the median of the first three measurements and the median value of all five measurements in the group of HCV positive patients. The analysis of the assignment to the METAVIR groups with respect to the median value of the first three 2D SWE measurements revealed no statistical difference in comparison with the assignment of patients with respect to the all five 2D SWE measurements of the liver.
Depending on the patients’ condition, different numbers of 2D SWE measurements can affect the median values of liver stiffness although they do not affect the assignment to the METAVIR scale.

Hepatitis A is globally spread and is an important public health problem.
This study aimed at investigating the seroepidemiology of hepatitis A in students aged seven to eighteen years in Birjand, during year 2016.
This study was a descriptive-analytic research, in which 300 school children aged seven to eighteen years in Birjand city were selected through the cluster sampling method. Subsequently, participants and their parents were requested to fill the questionnaire and were referred to the laboratory for blood sampling in order to examine hepatitis A antibody titer. Data were analyzed using SPSS-21 software and the chi-square test.
Hepatitis A antibody test was positive for only 111 out of 300 participants (37%). Females (P = 0.009) and teenagers (P = 0.0001) had significantly higher levels of antibody against HAV. There was a significant difference between the presence of hepatitis A antibody, education level of the mothers of the studied individuals (P = 0.042), and the social level and size of the family (P = 0.041). However, no difference was seen regarding fathers’ literacy level (P = 0.284).
The findings of the study showed that immunity against HAV was reduced during the past years. The reduced level of immunity against HAV along with several major risk factors for HAV infection, such as neighboring with Afghanistan and health hazards of hepatitis A for Iranian pilgrims visiting Karbala-based shrines in Iraq suggest anti-HAV vaccination as an essential priority.