فهرست مطالب esmaeil sanei moghadam
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BackgroundChronic hepatitis B is a major public health problem, especially, in developing countries. T helper 17 (th17) cells produce cytokines that have been shown to mediate host defensive mechanisms in various infections, but their role in HBV infection has not been well characterized.ObjectivesThe aim of this study is to determine the level of interleukin 17 (IL-17) in patients with chronic hepatitis B infection and assess the relationship between different titers of viremia with serum IL-17 and liver enzyme levels.MethodsPatients with chronic hepatitis B virus infection (HBV) who were referred to Hepatitis Clinic at Boo-Ali Hospital, Zahedan, Iran, were divided into three major groups according to their viral load and subsequently IL-17 and serum alanine aminotransferase (ALT) levels were measured. The data analysis was examined by Kruskal-Wallis and Mann-Whitney tests.ResultsIn this cross-sectional study, 143 untreated patients with chronic hepatitis B infection were divided into three main groups. Seventy-four patients with HBV DNA less than 2000 IU/mL; 53 patients with HBV DNA between 2000 - 107 IU/mL and 16 patients with HBV DNA more than 107 IU/mL. The mean of serum IL-17 levels in these three groups was 30.66, 26.87 and 24.42 pg/mL, respectively. There was no significant difference between different levels of HBV DNA with the serum level of IL-17 and ALT (P > 0.05).ConclusionsAlthough IL-17 may contribute to disease progression and liver injury in chronic HBV infected patients, the association between serum levels of IL-17 with viral load was not detected in this study.Keywords: Viral Load, Hepatitis B, IL-17}
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BackgroundThe hepatitis C virus (HCV) and hepatitis B virus (HBV) infections are significant concerns in patients with inherited disorders of hemoglobin (IDH).ObjectivesThis study aimed to assess the prevalence of HCV and HBV infections in a large cohort of patients with IDH in Sistan and Baluchistan province, Iran.MethodsIn this retrospective study, 2391 patients with IDH in Sistan and Baluchistan were enrolled. The anti-HCV antibody (HCV Ab) and hepatitis B surface antigen (HBsAg) were assessed using ELISA.ResultsA total of 2387 patients with a mean age of 12.7 years were included in the final analysis. Most of the patients were residents of Zahedan city (28.1%) and suffered beta-thalassemia major (99.2%). The prevalence of HCV Ab was 5.87% (95% CI = 5.0% - 6.89%) and HBsAg was detected in 0.29% (95%CI = 0.14% - 0.6%) of the patients. The prevalence of HCV Ab was associated with the age of patients, and there was a great difference in the prevalence of HCV Ab between patients with IDH who born before and after 1996 (17.2% vs. 5.1%; P < 0.05). Among 101 patients with positive results for HCV Ab who were tested for HCV RNA, 53 (52.5%; 95% CI = 42.8% - 61.9%) had HCV RNA in their serum samples. Moreover, 40 patients had results for HCV genotyping including 29 (72.5%) HCV genotype 3 and 11 (27.5%) HCV genotype 1.ConclusionsHepatitis C had a high seroprevalence of 5.87% in patients with IDH in Sistan and Baluchistan while hepatitis B had a low seroprevalence of 0.29% that is unusual in a region with > 3% prevalence of hepatitis B in the general population.Keywords: Hepatitis C, Hepatitis B, Thalassemia, Iran}
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BackgroundIt is important to differentiate whether isolated anti-HBc is due to false positive results or the prior exposure to hepatitis B virus, because individuals with false-positive anti-HBc can benefit from vaccination and their blood can be safely transfused. To distinguish between these two conditions, we evaluated the serologic response to hepatitis B vaccine.MethodsNinety subjects with isolated anti-HBc (cases) and 100 subjects with totally negative hepatitis B serologic markers (controls) were recruited to receive three doses of hepatitis-B (HB) vaccine. Thirty days after the first dose of the vaccine, anti-HBs titers were checked and individuals with anti-HBs titer >50 mIU/mL did not receive additional doses of the vaccine. However, others completed the vaccination course, and another blood sample was collected 30 days after the third dose to measure anti-HBs level.ResultsNineteen (21.1%) cases and three (3%) controls had no sero-conversion (anti-HBs titers <10 mIU/mL) 30 days after the third dose (p<0.0001). Primary response, defined as the development of anti-HBs antibody titers ≥10 mIU/mL 30 days after the third dose, was observed in 43 (47.8%) cases and 92 (92%) controls (p<0.0001). Also, 31.1% of cases developed anti-HBs titers ≥ 50 mIU/mL 30 days after the first dose of vaccine, but the rate was significantly lower (5%) in the control group (p<0.0001). Furthermore, half of the individuals with positive isolated anti-HBc developed protective levels of anti-HBs after three doses of HB vaccination.ConclusionMore than 75% of individuals with positive isolated anti-HBc can benefit from vaccination and can be included in donor pool. Also, one fifth seemed to have occult HBV infection. So HB vaccination may be used as a diagnostic tool for clarifying the situation of the subjects with isolated anti-HBc.Keywords: Hepatitis B Core Antigens_Hepatitis B Vaccine_Blood Donors}
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Govaresh, Volume:18 Issue: 4, 2014, PP 240 -243BackgroundRecent studies have shown a critical role for HLA-DQ2 and HLA-DQ8 in the pathogenesis of celiac disease. No study has been performed on the prevalence of these two HLA types in Iranian celiac patients.Materials And MethodsWe enrolled 24 celiac patients and 37 first-degree relatives in whom the diagnosis of celiac was excluded by serologic tests. HLA typing for HLA-DQ2 (DQB1*02), HLA-DQ8 (DQB1*03), HLA-DQ B1*05 and HLA-DQ B1*06 was performed using polymerase chain (PCR) reaction.ResultsTwenty two (91.7%) celiac patients and twenty seven (73%) controls were positive for the HLA-DQ2 and/or HLA-DQ8 heterodimers. There was no significant difference between the two groups (p=0.068). However, celiac patients were statistically more positive for homozygote HLA-DQ2, whereas non-celiac participants were more positive for homozygote HLA-DQ8 (p<0.05).Conclusionother hand, the higher prevalence of homozygote HLA-DQ2 in celiac patients shows its stronger role in diseas pathogenesis. Further studies on larger populations are needed in Iran.Keywords: Celiac disease, HLA, DQ2, HLA, DQ8, Iran, HLA typing, Disease risk}
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زمینه و هدفامروزه انتقال ویروس هپاتیت B در بین اعضاء خانواده، یکی از مشکلات مهم بهداشتی است و به صورتهای مختلفی رخ میدهد. این مطالعه با هدف بررسی وضعیت حالت ناقلی هپاتیت B و عوامل مرتبط با آن در بین اعضای خانواده ناقلین HBsAg در زاهدان انجام گردیده است.روش هادر این مطالعه که به روش توصیفی مقطعی و تحلیلی انجام شده است، اطلاعات مربوط به تعداد 454 نفر ناقل HBsAg مثبت و 1817 نفر از اعضای خانواده آنان بوسیله پرسشنامه و به روش مصاحبه جمع آوری شده و در پرسشنامه مورد اشاره اطلاعات دموگرافیک، آزمایشگاهی، بالینی و سوالات اختصاصی درباره اعضای خانواده ناقلین هپاتیت B طراحی گردیده و به علاوه در اعضای خانواده ناقلین، شاخصهای هپاتیت B ازجمله Anti-HBc، HBsAg و Anti-HBs در پرسشنامه درج و مورد بررسی قرار گرفته است. بعلاوه نمونه های خون از افراد گرفته شده و برای تعیین شاخص های هپاتیت B مورد آنالیز قرار گرفت و سرانجام یافته های توصیفی (همچون فراوانی، درصد، میانگین و انحراف معیار) برای آنالیز داده ها مورد استفاده گرفته است.یافته هادر این مطالعه تعداد 454 ناقل مزمن (66% مذکر و 34% مونث) با سن متوسط 10 ± 36 سال و 1817 نفر اعضای خانواده آنان شرکت داشتند. فراوانی HBsAg و HBcAb در اعضای خانواده به ترتیب 3/19% (351 نفر) و 1/51% (576 نفر) بود و بالغ بر 3 درصد آنان فقط HBcAb مثبت بودند. فراوانی شاخصهای هپاتیت در گروه های سنی مختلف متفاوت بود. بالاترین فراوانی HBsAg (35%) و HBcAb (32%) در گروه سنی 30-21 ساله بود. بالاترین درصد HBsAg مثبت در مادران ناقل هپاتیت B و کمترین میزان در همسران آنان یافت شد (2/53% در مقابل 4/8% p<0.001).نتیجه گیریدر این مطالعه مشخص شد که در اعضای خانواده ناقلین ویروس هپاتیت B اختلاف معنی داری بین شاخصهای سرولوژیک وجود دارد و فراوانی آن نسبت به جامعه بسیار بالاتر است. بنابراین پزشکان باید سعی کنند تمام اعضای خانواده بیماران مبتلا به هپاتیت B از جمله همسر، فرزندان، خواهر و برادر و والدین آنها غربالگری گردند و سپس کلیه افراد واجد شرایط، واکسینه شوند. علاوه بر این مشاوره قبل از ازدواج، غربالگری مادران باردار و آموزش بهداشت به اعضای خانواده ناقلین هپاتیت B مخصوصا مادران آلوده و باردار میتواند یکی از مهمترین راهکارهای پیشگیری باشد. سرانجام پیگیری مادران آلوده و پروفیلاکسی نوزادان آنها در پیشگیری از انتشار بیماری در جامعه نقش بسزایی خواهد داشت.
کلید واژگان: هپاتیت B, انتقال خانوادگی, پیشگیری, زاهدان}Background And AimsThe household transmission of hepatitis B virus (HBV) is a major health problem. The prevalence rate of this infection is reported about 11% to 57% among family members of HBsAg carriers. This study conducted to evaluate serological determinants of chronic hepatitis B infection, especially HBsAg positivity among family members of asymptomatic HBsAg positive carriers in Zahedan city (Southeastern Iran).Materials And MethodsIn a cross-sectional study, data were collected for a total of 454 HBsAg – positive cases and 1817 members of their family by trained interviewers and a validated questionnaire. Additionally blood samples were obtained and tittered to detect serologic markers of hepatitis B.ResultsIn this study totaly, 454 chronic HBsAg carriers (66% male and 34% female) with an average age of 36 ± 10 years and 1817 of their family members were included. The prevalence rate of HBsAg and HBc-Ab positivity among household members were 19.3% (n = 351) and 51% (n = 573), respectively. The frequency of HBV markers was different by age groups. The highest prevalence rate of HBsAg (35%) and HBc-Ab (32%) positivity were found in the age group of 21-30 years old. Importantly, the mothers of index cases had the highest prevalence of HBsAg positivity compared with their spouses who had the lowest proportion (53.2% vs. 8.4%, p<0.001).ConclusionIn family members, HBsAg-positivity was greater than the general indigenous population. Suggesting the importance of close contacts for transmission. It was more prevalent in mothers of index cases than their spouses. Suggesting the more efficient mother to child transmission than sexually transmission of HBV. And in those having a history of hepatitis B in maternal family in comparison with the paternal one, which may be due to more efficient transmission from infected mothers to children.Keywords: Hepatitis B, Transmission, Intra, familial, Prevention, Zahedan}
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