فهرست مطالب

Hepatitis Monthly
Volume:12 Issue: 12, Dec 2012

  • تاریخ انتشار: 1391/10/11
  • تعداد عناوین: 7
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  • Forough Saki, Zohreh Karamizadeh, Naser Honar, Hossein Moravej, Soheil Ashkani, Esfahani, Mohammad Hossein Namvar Shooshtarian Page 10
    Background
    The prevalence of obesity and its related comorbidities, such as fatty liver, in children is increasing worldwide mostly due to changes in diet and life-style. Many serological markers have been suggested for screening of fatty liver but investigations for finding more reliable factors are still in progress.
    Objectives
    This study aimed to investigate the correlation between the level of retinol binding protein-4 (RBP4) in the serum and sonographic grading of fatty-liver severity in obese Iranian children. Patients and
    Methods
    This case-control, double-blind study involved 51 obese children aged between five and 17 years as the case group. In addition, 35 healthy lean children with no liver problems were selected as the control group. Plasma RBP4 (using an ELISA), serum triglycerides (TG), low-density-lipoproteins (LDL), high-density-lipoproteins (HDL), total-cholesterol (Chol), and body mass index (BMI) were measured. Grading the severity of the fatty liver condition was done by an expert radiologist in the case group.
    Results
    RBP4 levels in obese children (19 482.9 ± 3 302.2 pg/ml) were higher than those found in the lean control group (14 295.68 ± 2 381.3 pg/ml) (P < 0.05). In the obese patients, RBP4 levels showed a significant correlation with the grade of fatty liver and BMI (P < 0.05).
    Conclusions
    It was found that the level of RBP4 had a strong correlation with the severity of fatty liver. Therefore, RBP4 may be considered as a useful, noninvasive predictive biomarker of intrahepatic lipid content in obese children prior to using radiological investigations. In particular, abdominal sonography, for the evaluation of intrahepatic lipid content in obese patients, as the sensitivity of a sonography is decreased due to the increased thickness of the abdominal wall as a result of fat deposits.
    Keywords: Fatty Liver, Obesity, RBP4 Protein, Human, Child, Ultrasonography
  • Bruno Cacopardo, Marilia Rita Pinzone, Filippo Palermo, Giuseppe Nunnari Page 20
    Background
    IL-33 is a novel member of the IL-1 family, which has been shown to play an important role in T helper 2 (Th2)-associated immune responses. Recent studies have suggested a possible role for IL-33 in the pathogenesis of liver damage during acute and chronic hepatitis; furthermore, IL-33 may be involved in the development and progression of liver fibrosis.
    Objectives
    To evaluate serum IL-33 levels in a group of patients with chronic hepatitis C (CHC) genotype 1b at enrolment and after a course of pegylated (PEG)-IFN plus ribavirin.Patients and
    Methods
    60 patients with chronic hepatitis C (CHC) and 65 healthy controls were examined and compared for serum IL-33 levels by ELISA. All CHC patients were submitted to liver biopsy either before starting antiviral treatment or during post-treatment follow up. We evaluated whether post-treatment IL-33 concentration was associated with histologic outcome as well as with virologic response to therapy.
    Results
    Serum IL-33 levels were significantly higher among CHC patients in comparison with healthy controls. IL-33 concentration was lower among patients with a METAVIR fibrosis score F1-F2, compared with those having a more advanced liver disease (METAVIR stage F3-F4). In addition, sustained virologic response (SVR) was associated with a significant drop in IL-33 levels, whereas no changes were found among relapsers and nonresponders. Analogously, patients experiencing liver histologic improvement after antiviral therapy had lower post-treatment IL-33 levels in comparison with baseline values. Contrarily, no variations were detected among subjects with worsened or stable histologic features.
    Conclusions
    IL-33 may represent a new and easy-to-detect biomarker for the diagnosis of liver damage in CHC patients, as it appears to be modulated in parallel with biochemical and histologic parameters, such as ALT levels and liver fibrosis. Furthermore, considering that serum IL-33 concentration was significantly reduced following a successful course of antiviral treatment, this cytokine may also represent a sensitive indicator of SVR.
    Keywords: Hepatitis, Chronic, Disease Progression, Fibrosis, IL33 Protein, Humans, Interferons, Hepatitis C
  • Shahin Ghasemi, Ali Kabir, Mojtaba Ansari Jafari, Mohammad Jalali, Afshin Amini, Amir Hossein Faghihi, Kashani, Seyed Moayed Alavian Page 30
    Background
    Good knowledge, attitude and practice (KAP) of the physicians allow them to handle their patients in such a way that they prevent themselves from contracting, and their patients from spreading, the infection. However, the Iranian standardized KAP questionnaire of physicians about viral hepatitis is not available. So, we developed a standard questionnaire.
    Objectives
    The purpose of this study was to provide a standard questionnaire as a basic tool for assessment of the present situation of the KAP of clinicians. It can also be used for evaluating educational programs and interventions on physicians in addition to any trends in their KAP about viral hepatitis.Patients and
    Methods
    In order to design and standardize a 29-item self-administered questionnaire, we developed a cross sectional pilot study on 60 Iranian physicians. Ten experts in the field of liver diseases and/or designing the questionnaire answered questions about its validity. Cronbach’s Alpha (on 60 physicians that participated in a congress) and factor analysis (on 370 persons; participants of two viral hepatitis congresses in Tehran and Zanjan and physicians of two university hospitals in Ahvaz) were used in the analysis.
    Results
    Reliability was 0.7 according to Cronbach’s Alpha score. Face validity was higher than 80%. Content validity of the whole parts of the questionnaire was 96.25% for clarity, 91.56% for relevancy, 96.25% for simplicity and 98.44% for consistency of each question with the questions’ set. Factor analysis showed that 13 components account for 67.4% of the total variance.
    Conclusions
    This study provided evidence that our questionnaire is a feasible, valid and reliable measure of physicians’ KAP status in Iran. The factor analysis did not reveal a strong cluster structure. This questionnaire should be interpreted as a one-dimensional element by the sum of all items, rather than a multi-dimensional instrument.
    Keywords: Hepatitis, Questionnaires, Validation Studies, Reliability, Physicians
  • Heidar Sharafi, Ali Pouryasin, Seyed Moayed Alavian, Bita Behnava, Maryam Keshvari, Shima Salimi, Leila Mehrnoush, Ahmad Fatemi Page 40
    Background
    IL28B polymorphism is recognized as one of the most prominent predictors of hepatitis C spontaneous and treatment-induced clearance. Interestingly, the favorable genotypes of IL28B are found to be more frequent in Asian ethnicity than Caucasian and African populations, respectively. A few studies reported that there is a mysterious association between the IL28B polymorphism and the hepatitis C virus (HCV) genotype in patients with chronic hepatitis C but they did not give any reason for this phenomenon.
    Objectives
    The foremost purpose of this study was to compare the distribution of IL28B genotypes between Iranian healthy individuals and patients with chronic hepatitis C.Patients and
    Methods
    In this study, 921 patients with chronic hepatitis C and 142 healthy individuals were included. The IL28B rs12979860 and rs8099917 polymorphisms were genotyped using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.
    Results
    The frequency of IL28B rs12979860 CC, CT, and TT genotypes in chronic hepatitis C patients was 38%, 48.8%, and 13.2% and in healthy individuals was 43.7%, 48.6%, and 7.7%. Also, the frequency of IL28B rs8099917 TT, GT, and GG genotypes in chronic hepatitis C patients was 58.3%, 37.1%, and 4.6% and in healthy individuals was 64.1%, 32.4% and 3.5%. The differences in the distribution of IL28B rs12979860 and rs8099917 genotypes between patients with chronic hepatitis C and healthy individuals were not statistically significant. When we compared the distribution of IL28B genotypes between the healthy group and the HCV infected patients by HCV genotype, we found 9.8% higher frequency of rs12979860 CC genotype in the healthy individuals than HCV genotype 1 infected patients (P = 0.03) however there was no significant difference in the distribution of rs12979860 genotypes between the healthy and HCV genotype 3 infected groups (P = 0.46).
    Conclusions
    It seems that the impact of IL28B polymorphism on the spontaneous clearance of HCV genotype 1 is more prominent than HCV genotype 3 which results in the observation of higher rs12979860 C allele frequency in chronic hepatitis C patients with HCV genotype 3 than HCV genotype 1.
    Keywords: Polymorphism, Genetic, Hepatitis C, IL28B Genotype, Human, Persian Gulf, Iran
  • Pegah Karimi Elizee, Romina Karimzadeh Ghassab, Azam Raoofi, Seyyed Mohammad Miri Page 50
    Background
    The impact factor (IF), as the most important criterion for journal’s quality measurement, is affected by the self-citation and number of publications in each journal.
    Objectives
    To find out the relationship between the number of publications and self-citations in a journal, and their correlations with IF.
    Materials And Methods
    Self-citations and impact factors of nine top gastroenterology and hepatology journals were assessed during the seven recent years (2005-2011) through Journal Citation Reports (JCR, ISI Thomson Reuters).
    Results
    Although impact factors of all journals increased during the study, five out of nine journals increased the number of publications from 2005 to 2011. There was an increase in self-citation only in the journal of HEPATOLOGY (499 in 2005 vs. 707 in 2011). Impact factors of journals (6.5 ± 3.5) were positively correlated with total number of publications (248.6 ± 91.7) (R: 0.688, P < 0.001). Besides, the self-citation rate (238.73 ± 195.317) was highly correlated with total number of publications in each journal (248.6 ± 91.7) (R: 0.861, P < 0.001). On the other hand, impact factor without self-citation (6.08 ± 3.3) had a correlation (R: 0.672, P < 0.001) with the number of published items (248.6 ± 91.7).
    Conclusions
    The number of articles and self-citation have definite effects on IF of a journal and because IF is the most prominent criterion for journal’s quality measurement, it would be a good idea to consider factors affecting on IF such as self-citation.
    Keywords: Self, Citation, Journal Impact Factor, Gastroenterology
  • Masoomeh Sofian, Arezoo Aghakhani, Ali Asghar Farazi, Mohammad Banifazl, Ali Eslamifar, Niloofar Rashidi, Akbar Khadem Sadegh, Amitis Ramezani Page 60
    Background
    T-helper (Th) lymphocyte cytokine production may be important in the immune pathogenesis of hepatitis C virus (HCV) infections. Th1 cytokines such as; interleukin- 2 (IL-2), and interferon gamma (IFN-gamma) are necessary for host antiviral immune responses, while Th2 cytokines (IL-4, IL-10) can inhibit the development of these effector mechanisms.
    Objectives
    The aim of the present study was to assess the serum profile of Th1 and Th2 cytokines in treated and non-treated HCV infected individuals.Patients and
    Methods
    This study was carried out in 63 HCV infected patients (31 under treatment and 32 untreated) and 32 matched HCV-sero negative healthy subjects. Serum samples were checked with an enzyme-linked immune sorbent assay (ELISA) for IL-2, IL-4, IL-10 and IFN-gamma.
    Results
    Levels of circulating IL-2, IL-4, IL-10 and IFN-gamma were significantly elevated in HCV patients versus normal controls (2 822.6 ± 1 259.92 vs. 950.8 ± 286.9 pg/mL; 1 987 ± 900.69 vs. 895.91 ± 332.33 pg/mL; 1 688.5 ± 1 405.1 vs. 519.03 ± 177.64 pg/mL and 1 501.9 ± 1 298 vs. 264.66 ± 71.59 pg/mL, respectively; P < 0.001). The serum levels of all cytokines were significantly lower in the patients under treatment than those of the untreated patients (P < 0.001).
    Conclusions
    On the basis of our data, the simultaneous increase of Th1 and Th2 related cytokines may indicate that both Thl and Th2 cytokines are involved in the pathogenesis of HCV infections. Moreover, this activated T-cell response in HCV infected patients may be regulated by treatment.
    Keywords: Th1 Cells, Th2 Cells, Cytokines, Hepatitis C
  • Seyed Moayed Alavian, Kamran B. Lankarani, Mario Rizzetto, Alfredo Marzano, Mohsen Moghadami, Saman Nik, Eghbolian, Amin Bahrani Page 70
    Hepatitis B infection is the main cause of liver related mortality in many countries including Iran. Liver transplantation in cirrhosis due to HBV infection before 1990 was an absolute contraindication. Recurrent infection was a significant event in post liver transplant setting and resulted in increased risk of graft failure and death except successful transplanted individuals. Advances in antiviral prophylaxis have now made graft reinfection majority patients as a rare event. Graft and patient survival have been improved significantly during the past two decades, and consequences of transplantation for hepatitis B virus are now superior to those achieved for most other indications. This has encouraged many centers including the major liver transplantation center of Iran, in Shiraz, to provide liver transplantation to more patients with HBV related end stage liver disease. Management of these patients begins before transplantation along with special care after transplantation. There are some myths and doubts in the management of these patients and one should always balance the cost and efficiency. One of the major concerns is the high economic and social cost of recurrence and all possible efforts should be performed to avoid the ominous consequences of reinfection. Having a clear scientific grasp on the management of HBV cirrhosis before and after liver transplantation, options and protocols, and changing the concept which HBV infected are contraindicated ones for liver transplantation, and future hopes in increasing patients survival after liver transplantation using the new nucleosides analogues and availability of hepatitis B immunoglobulin in the transplantation setting. This scientific report paper outlines the insights communicated at the HBV and liver transplantation symposium during 10th Congress of the Iranian Society for Organ Transplantation, May 2011, Shiraz, Iran.
    Keywords: Liver Transplantation_Hepatitis B Virus_Hepatitis B Hyperimmune Globulin_Liver Cirrhosis_Iran