Hepatitis Monthly
Volume:17 Issue: 9, Sep 2017

Context: The aim of this systematic review was to assess the association of tattooing with the risk of hepatitis C infection.
Evidence Acquisition: A systematic search was performed in Medline, Web of Science, Scopus, Google scholar, EMBASE, CINAHL, and PubMed up to May 2017. To analyze the data using random effect, odds ratio (OR) with 95% confidence interval (CI) was calculated for each study. We also determined publication bias and heterogeneity among the 162 extracted articles.
We included 163 relevant studies out of the 2353 extracted studies into the meta-analysis process. When all studies were included in the meta-analysis, the association between tattooing and risk of hepatitis C transmission was strongly significant (pooled OR = 2.79, 95% CI: 2.46 - 3.18). Subgroup analysis showed the strongest association between tattooing and the risk of hepatitis C among samples from blood donors groups (OR = 4.09, 95% CI: 2.80 - 5.98).
This meta-analysis study revealed that tattooing is strongly associated with transmission of hepatitis C in all subgroups. Relevant education is recommended for young adults who are more likely to get tattoos as well as for prison inmates who have demonstrated high prevalence of hepatitis C infection. In addition, it seems necessary to implement prevention programs and enforce guidelines for safer tattooing practices in tattoo parlors in order to prevent hepatitis C transmission.

Detection of single-nucleotide polymorphisms (SNPs) near the Interleukin 28B (IL28B) gene, which significantly effects the outcome of chronic hepatitis C virus has a substantial impact on research in the field of personalize medicine. In this study, the researchers investigated the influence of IL28B polymorphisms on spontaneous recovery from hepatitis B (HBV) infection in an Iranian sample.
In this case-control study, 177 patients with chronic HBV infection (n = 83, HBsAg () for > 6 months, anti-HBc (), and anti-HBs (-)) or spontaneous recovery (n = 94; HBsAg (-), anti-HBc (), and anti-HBs ()) were evaluated. All cases were Iranian with an Azeri ethnic background. The SNPs at rs12979860 and rs8099917 near IL28B coding region were assessed by polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP).
Regardless of the condition for HBV infection, rs8099917 TT was most frequently identified (65.0%) followed by rs12979860 CT (52.5%). All other genotypes were detected as well as all types of haplotype combinations, except for rs8099917 GT- rs12979860 CC, which was not identified in any participant. The prevalence of TT rs8099917 was significantly higher in the chronic HBV group than in the spontaneously recovered individuals (P = 0.038, OR = 1.435). Differences were not significant for rs12979860. Using combination of genotypes did not show better odds ratio (P > 0.05).
The SNP upstream of IL28B might have an influence on spontaneous HBV recovery.

Information on hepatitis B virus (HBV) genotypes in immigrant populations living in Italy is rare.
This study aimed at assessing the epidemiological and clinical needs to detect HBV genotypes in immigrants with HBV infection.
A multicenter screening to identify migrants with HBV infection was performed in 5 first-level clinical centers in southern Italy. HBsAg-positive subjects were further investigated at a tertiary unit of infectious diseases.
Of 1727 immigrants investigated, 170 (9.8%) were HBsAg-positive. These 170 subjects were prevalently males (86.5%), aged 31.0 ± 8.5 years and living in Italy for nearly 2.5 years, and most commonly (80%) from sub-Saharan Africa. The HBV DNA was detected in 113 (66.5%) and HBV genotype in 109 cases: genotype-E was found in 69.9%, genotype-A in 16.5%, genotype-D in 11.9%, and genotype-C in 2.7%. Genotype-E was detected in 70 (83.3%) of 84 migrants from sub-Saharan Africa and in 5 of the other areas. Of these 75, 16% were HBeAg-positive (hepatitis B e antigen) and none circulated anti-HDV, 69.3% were inactive HBV carriers, and 22.7% were chronic hepatitis and 8% cirrhosis patients (with multifocal hepatocellular carcinoma (HCC) in 2 patients). The 18 subjects with genotype-A were commonly from sub-Saharan Africa (61%); half of them were inactive HBV carriers, 7 had chronic hepatitis, and 1 had liver cirrhosis. Of the 13 subjects with genotype-D, commonly from Eastern-Europe or India-Pakistani subcontinent, 8 were HBV inactive carriers and 5 had chronic hepatitis.
The data indicate the need to extend HBV screening and vaccination programs to all immigrants from areas at intermediate or high HBV endemicity.

The ‘a’ determinant domain of hepatitis B surface antigen (HBsAg) (positions 124 to 147) is recognized by antibodies raised either naturally or induced by vaccine. Failure to protect against hepatitis B virus (HBV) infection may occur due to the conformational changes of ‘a’ determinant induced by mutations.
The present study analyzed the molecular and three-dimensional (3D) characteristics of the HBsAg ‘a’ determinant mutations among Iranian chronic hepatitis B (CHB) patients, who were vaccine and drug naive.
Eighty patients with HBsAg positive test results were selected according to the data extracted from questionnaires. Serologic and molecular assays were performed using real-time Polymerase Chain Reaction (PCR) and subsequently surface nested PCR on CHB patients. Next, an extensive mutational analysis was applied following direct sequencing on HBsAg amplified genes. The potential impacts of altered antigenic and 3D properties of amino acid substitutions were carried out using bioinformatics approaches.
All patients were negative for HBeAg and positive for anti-HBe. Mutational analysis showed that 60 (75%) of 80 patients had at least one amino acid substitution. Several mutations were found in ‘a’ determinant (P127L, P127T, G130N, and S136Y). Bioinformatics investigations indicated that all mutations induced a conformational change in ‘a’ determinant region. P127L substitution led to a considerable decreased HBsAg antigenicity compared to other mutants.
The current analyses revealed that the studied mutations induced a local change in the ‘a’ determinant conformation. These findings could be useful for the design of HBsAg detection assays, which may significantly improve the ability to detect particular HBsAg mutants.

Giant cell rich hepatic tumors are divided into two types of mesenchymal and epithelial. Mesenchymal tumors are uncommon. Osteoclastoma-like giant cell tumor of the liver is an extremely rare mesenchymal hepatic tumor with very poor prognosis. To the best of our knowledge, only 5 cases have been reported in the English literature so far. Our case was a 64-year-old woman presented with abdominal pain. The patient was operated with the preoperative imaging diagnosis of angiosarcoma that after pathologic examination turned out to be osteoclastoma-like giant cell tumor. Unfortunately, the patient died shortly after surgery.