فهرست مطالب
Hepatitis Monthly
Volume:18 Issue: 8, Aug 2018
- تاریخ انتشار: 1397/06/04
- تعداد عناوین: 6
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Page 1BackgroundAutoimmune hepatitis (AIH) is an inflammatory liver disorder that commonly affects women. The T cells and one of their major products, IFN-γ, are critically involved in the pathogenesis of AIH. Therefore, targeting of IFN-γ can probably be therapeutically useful while avoiding the long-term side effects of conventional immunosuppressive therapy. RNA interference, provides an ideal way to achieve this purpose. Thus, the aim of this study was to investigate the effect of IFN-γ-siRNA on IFN-γ expression in human peripheral blood mononuclear cells of patients with AIH.MethodsIn order to evaluate the anti-cytokine therapy with IFN-γ-siRNA, the PBMCs of AIH patients were cultured and transfected with IFN-γ-siRNA. After validation of transfection efficiency, the effects of gene silencing were tested with quantitative real-time polymerase chain reaction and intracellular flow cytometry.ResultsThe efficiently transfected cells, with the targeted IFN-γ-siRNA, without affecting cell viability showed a strong gene knockdown. The IFN-γ gene expression was significantly decreased in transfected cells (PConclusionsCollectively, the results of the present study suggested that modifying the cytokine profile without inducing apoptosis using siRNA-based technology could be a promising tool for therapeutic intervention in T cells-dependent inflammatory diseases like AIH.Keywords: Autoimmunity, Autoimmune Hepatitis, Cytokine, IFN-?-siRNA, Transfection
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Page 2BackgroundIn the interferon era, patients with HCV-related cirrhosis were considered hard to treat due to contraindications to therapy, safety issues, and poor response.ObjectivesWe investigated interferon-free regimens in cirrhotic patients in real-world practice.MethodsWe analyzed data of HCV infected patients with liver cirrhosis conducted in 22 Polish hepatology centers. They were assigned to a treatment schedule based on physician decision. Data were collected retrospectively by an online questionnaire.ResultsIn total, 1113 patients infected with genotype 1 HCV were enrolled to the analysis, 96.6% presented GT1b infection. A total of 56% were treatment-experienced, mostly with PegIFN RBV, 77.2% of group presented comorbidities with the most frequent hypertension and diabetes,73.2% patients were treated with concomitant medications, and 31% of cohort was assigned to RBV-free regimen, majority of them to OBV/PTV/r DSV. Overall, 94.7% patients achieved the sustained virological response in intent-to-treat analysis, with comparable rate for RBV-free and RBV-containing options (94.2% vs. 94.9%). Treatment course was more often modified in RBV-containing group, whereas rate of discontinuation was the same for both cohorts. Adverse events were observed in 41% with the most common weakness/fatigue; more frequently in RBV-containing regimens (43% vs. 36.6%). Serious adverse events were reported in 4.1% patients. A total of 16 deaths not related to study drugs were documented, mostly in RBV-containing group.ConclusionsWe confirmed effectiveness of the interferon-free regimens without ribavirin in real-world cohort of cirrhotic patients with chronic HCV infection genotype 1. Therapy was well tolerated with infrequent adverse events.Keywords: Hepatitis C Virus_Genotype 1_Liver Cirrhosis
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Page 3BackgroundInfection with Hepatitis B virus (HBV) is still a leading cause of cirrhosis and hepatocellular carcinoma around the world.ObjectivesHaving recently received reports of high HBV prevalence in the South Khorasan Province in the Esfandiar village, we aimed to evaluate the prevalence of HBV in this region in comparison to neighboring villages, with associations to risk factors.MethodsThis was a cross sectional study that included the Esfandiar village and neighboring villages, Marghoub, and Zenowghan. All of the Esfandiar and certain neighboring villages were summoned and blood sampling was performed along with the completion of a questionnaire. Positivity for HBsAg, anti-HBc along with the seromarkers of HCV and HDV were assayed using ELISA method. Statistical analysis was performed using the SPSS software with chi-square tests, logistic regression, and risk-estimation analysis.ResultsFrom total 1.245 participants, 856, 172, and 217 cases were from the Esfandiar, Marghoub, and Zenowghan villages, respectively. The prevalence of anti-HBc in the Esfandiar, Marghoub, and Zenowghan were 48.7%, 20.3%, and 7.8%, respectively (P-value: 0.001). The figures for HBsAg were 17.8 %, 1.7 %, and 0.5 %, respectively (P-value: 0.001). HBV was more prevalent among those with a history of experimental dentistry, traditional phlebotomy, war veterans, endoscopy, and familial history of HBV. In Esfandiar, prevalence of HBsAg among below and above 22 years- old (beginig of natoinal HB vaccination) were 2.3% and 22.4%, respectively (P-valueConclusionsThere was a very high prevalence of HBV in this small endemic region. The result showed the impressive effect of neonatal vaccination on reducing the incidence of hepatitis B, by 89.7%. Thus, the high prevalence requires an urgent consideration of organizing health programs and certain sociocultural behaviors.Keywords: Hepatitis B Virus_HBV_HBsAg_Vaccine_Prevalence_Iran
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Page 4ObjectivesThe treatment of hepatitis C has dramatically improved since the introduction of new direct-acting antivirals (DAAs). The aim of this study was to assess the efficacy and safety of all oral DAAs, with or without ribavirin, in the treatment of naive and treatment experienced hepatitis C virus (HCV) Lebanese patients.MethodsThis study reviewed all cases approved for hepatitis C treatment with DAAs, according to Lebanese guidelines for treatment of HCV at the Ministry of Public Health from October 2015 to December 2016. Available data on age, gender, genotype (GT) and subtype, fibrosis stage, previous treatment (if present), new DAAs treatment, and sustained virological response at week 12 (SVR12) were collected.ResultsDuring a period of 15 months, a total of 186 patients were treated with DAAs. In total, 57% were male. The mean age of the patients was 54.3 years. Genotype 1 was the most prevalent (45%), followed by genotype four (34%) and genotype three (12%). More than 72% of patients had advanced fibrosis (F3 - F4) before starting DAAs and 42% of patients were treatment experienced. Regarding the different DAAs protocols used, SVR12 was achieved in 93% of cases, while 4% did not achieve SVR. Furthermore, 3% of cases were either lost to follow up or had major adverse events. Sustained virological response at week 12 was 93%, 96%, and 94% in GT1, GT3, and GT4, respectively. In cirrhotic patients, SVR12 was 90%. There was no difference in SVR12 between treatment naive and treatment-experienced patients. Hepatocellular carcinoma developed in five patients during the period of the study.ConclusionsThis is the first real world Lebanese data concerning hepatitis C treatment with DAAs. It showed a satisfactory response rate irrespective of previous treatments or the stage of fibrosis.Keywords: Hepatitis C, Fibrosis, Genotype, Antivirals
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Page 5BackgroundHepatitis B (HBV) and hepatitis C (HCV) are viral infections which attack the liver and can cause both acute and chronic diseases.ObjectivesThe aim of this study was to investigate the knowledge, risk factors, and prevalence of hepatitis B and C infections among high-risk populations of Guilan province, North of Iran.MethodsThe current cross-sectional study was conducted on three high-risk groups, including nurses, municipal workers and barbers as well as the control group from the general population.ResultsA total of 3391 subjects were recruited for this study. The results of the ANOVA test showed that knowledge about HBV and HCV and their components are statistically different among the groups (P valueConclusionsRegarding the low prevalence of HBV and HCV infection in high-risk groups, it seems that mandatory vaccination has had a significant role in recruiting or obtaining work permits. However, given the low level of knowledge, it was suggested that authorities should pay more attention in general education and specialized courses for high-risk groups.Keywords: Knowledge, Risk Factors, Hepatitis B, Hepatitis C