Hepatitis Monthly
Volume:18 Issue: 10, Oct 2018

Context: Nigella sativa (NS) has been used as an herbal remedy for the treatment and prevention of a variety of diseases. In this review, we aimed to summarize the current evidence on the effects of NS consumption on non-alcoholic fatty liver disease (NAFLD) characteristics. Evidence Acquisition: We reviewed the existing literature published by the end of 2017 using the following key words: “Nigella sativa”, “black seeds”, “black cumin”, “thymoquinone”, “NAFLD”, “NASH”, and “diabetes”. Papers used in this study were collected by searching the PubMed, Google Scholar, Science Direct and Scopus databases. Our search was limited to English-language articles. All the articles published between 2000 and 2017 meeting the inclusion criteria were included in the study.

The results of current studies indicate that NS has many biological effects such as anti-inflammatory, anti-hyperlipidemic, anti-microbial, anti-cancer, anti-oxidative, anti-diabetic, anti-hypertensive and wound healing activities. In summary, it can be used as a valuable plant for designing therapeutic strategies in NAFLD.

Results from available studies indicate that NS can ameliorate the main metabolic disturbances related to NAFLD including hyperglycemia, hyperlipidemia, and overweight. These effects are mainly attributed to the anti-oxidative and anti-inflammatory properties of thymoquinone. Clinical trials on human subjects are highly essential to confirm the results found in in vivo and in vitro studies

Hepatitis C virus (HCV) infection represents one of the most important causes of chronic liver damage. The development of new therapeutic approaches based on the use of direct-acting antivirals allowed reaching the high rates of sustained virological response and on the other hand, the low rates of drug side effects. The study aimed to evaluate the efficacy and safety of multiple direct-acting antiviral (DAA) therapies against the major HCV genotypes in Campania. We enrolled, in this monocentric observational study, 518 adult patients (> 18-years-old) affected by HCV who received a DAA anti-HCV-based therapy in the routine clinical practice. We collected direct data registered by the Hepatogastroenterology Division of the University of Campania “L. Vanvitelli”, which covers a catchment area from the entire Campania region. A great number (98.2 %) of the 518 enrolled patients was naive to the antiviral treatment and genotype distribution was 1a = 32 (6.2%), 1b = 252 (48.7%), 2 = 146 (28.2%), 3 = 52 (10.1%), and 4 = 36 (6.9%). 300 patients were cirrhotic (57.9%) and most of them had a Child-Pugh A5 score. 79.56 % of the patients belonging to the population of our study were classified as fibrosis Metavir F3 or F4 by Fibroscan. All the enrolled patients completed the treatment with the exception of five (n = 5; 0.96%) who interrupted it due to adverse events. We observed a relapse of infection in three patients treated with Sofosbuvir and Simeprevir for 12 weeks (0.57%). Intention to treat analysis showed an overall rate of 98.46% (n = 510/518) sustained virological response. Six of the eight failure patients had a second line anti-HCV treatment and four of them obtained SVR (two patients are waiting for resistance test results). New antiviral regimens of DAA-based for HCV represent one of the greatest innovations in the scientific context in the last few years. Our prospective observational study confirms the elevated efficacy in terms of SVR12, independently from HCV genotype and disease stage, when these treatments are used as the methods of a good clinical practice

Globally, 10 million injecting drug users (IDUs) are estimated to be HCV-positive, resulting in a prevalence of 67%. We evaluated the previously unassessed HCV infection amongst IDUs in Kosovo. We determined the distribution of HCV genotypes among IDUs in Prishtina, ascertained their phylogenetic relatedness, and investigated the main risk factors associated with the HCV infection.

Samples were obtained from 205 IDUs in Prishtina, Kosovo, during the Biological and Behavioral Surveillance Study (BioBSS). HCV-positive samples were further genotyped and sequenced. The results were linked with epidemiological data obtained in interviews determining the underlying causes of HCV transmission.

The majority of the 205 IDUs participating in the BioBSS were men (89.3%) with a mean age of 36 years and a history of imprisonment, unemployment, and over a decade of injection drug use. Forty-eight percent of the IDUs were positive for anti-HCV antibodies, and HCV RNA was detected in 70 IDUs (70.7% of the anti-HCV positive IDUs). The following HCV subtypes were detected: subtype 1a (64.3%), subtype 3a (34.3%), and subtype 2k (1.4%). Phylogenetic clustering was evident among 66.7% of the HCV subtype 1a samples and 71.4% of the subtype 3a samples. Significant independent predictors for anti-HCV positivity among IDUs were older age, longer duration of drug use, low education level, drug injection in “shooting galleries”, and imprisonment.

In Prishtina, Kosovo, nearly half of the IDUs were determined to be anti-HCV positive and the majority had an active infection. HCV subtype 1a was found to be most prevalent, followed by subtype 3a. Our results emphasize the urgent need for the implementation of harm-reduction programs among IDUs in Kosovo, specifically treatment and prevention through needle/syringe exchange programs directed at gathering places, such as shooting galleries

Although many studies have measured HBV cccDNA molecules in Peripheral Blood Mononuclear Cells (PBMC) from patients with active chronic hepatitis B, the current pilot study found PBMC HBV cccDNA in PBMC among HBsAg-positive mothers and their neonates. However, the risk factor of HBV cccDNA in PBMC among HBsAg-positive pregnant female’s neonates remains unclear.

The aim of this study was to explore influential factors of HBV cccDNA in PBMC among HBsAg-positive pregnant female’s neonates.

Peripheral blood samples and clinical data were collected from 151 pregnant females, who were positive for hepatitis B surface antigen (HBsAg) in the Third People Hospital of Taiyuan City. Blood samples from 152 neonates were collected before immune prophylaxes administration and tested for HBV markers, HBV DNA in serum, and HBV DNA in PBMC. Bayesian logistic regression with Cauchy prior were used to measure the association between maternal characteristics, neonatal characteristics, and HBV cccDNA in PBMC of neonates.

Among neonates of HBsAg-positive mothers, the positive rate of cccDNA in PBMC was 4.61% (7/152). Maternal PBMC HBV cccDNA positivity (OR = 18.411, 95%CI: 3.025 - 66.022) and neonates PBMC rcDNA positivity (OR = 13.529, 95% CI: 1.948 - 93.690) were associated with HBV cccDNA in neonatal PBMC, respectively.

The study suggested that HBV cccDNA can be detected in PBMC of HBsAg-positive mother’s neonates. Maternal PBMC HBV cccDNA positivity and neonatal PBMC rcDNA positivity are risk factors of HBV cccDNA in PBMC of neonates

Reducing the risk of transfusion transmitted infections (TTI) is one of the main concerns of blood transfusion systems. Evaluation of HCV risk factors in HCV infected blood donors is critical for donor selection and ensuring blood safety. The aim of this study was to evaluate known and putative risk factors of HCV infection in Iranian blood donors. This matched case-control study was conducted on serologically confirmed HCV positive blood donors (cases) and serologically negative HCV blood donors came back to Iranian Blood Transfusion centers over the country from November 2015 to May 2017. Cases and controls were matched by donation status and interviewed for demographic, medical, and risk histories. Penalized conditional logistic regression model with backward selection method was used in data analysis. STATA software version 13 was used for statistical analysis. A total of 271 cases and 794 controls were interviewed. Age (AOR (5 year), 1.27; 1.13 - 1.42), intravenous drug abuse (AOR, 24.89; 10.2 - 60.82), religious self-flagellation (AOR, 7.02; 2.02 - 24.4), non-injecting drug abuse (AOR, 6.13; 2.49 - 15.13), history of blood transfusion (AOR, 5.22; 1.52 - 17.92), imprisonment (AOR, 4.81; 2.43 - 9.53), sharing personal razor (AOR, 4.55; 1.45 - 14.28), tattooing (AOR, 4.46; 2.37 - 8.38), extramarital sexual activity (AOR, 2.88; 1.40 - 5.87), cupping in outpatient place (AOR, 2.44; 1.08 - 5.52), tooth extraction (AOR, 2.35; 1.46 - 3.78), surgery (AOR, 1.98; 1.22 - 3.21), and intramuscular injection (AOR, 1.68; 1.06 - 2.68) found to be current independent risk factors for HCV infection demonstrated in 98.52% of cases. This is the first study to perform penalized conditional logistic regression model in data analyzing to control some statistical bias in the evaluation of HCV risk factors among Iranian blood donors. According to the results, intravenous drug abuse is a primary HCV risk factor. In addition, the study emphasizes on the role of other high-risk behaviors such as religious self-flagellation and high-risk procedures such as cupping in outpatient place in HCV transmission. Increasing donor education regarding HCV risk factors and more accurate donor selection needs to improve blood safety and protect recipients from potential HCV infection risk

Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death globally (1). Sorafenib, amulti-tyrosinekinaseinhibitor, remainsthestandardof care for patients with inoperable or advanced-stage HCC. In resource-limited settings without access to surgical or locoregionaltherapy,sorafenibmaybetheonlyoptionfor treating HCC. However, due to a modest survival benefit, aswellasthelimitingcostof sorafenibincertainregions, appropriate selection of patients for treatment is essential. Evaluationof BarcelonaClinicLiverCancer(BCLC)criteria in resource-limited settings is frequently unachievable due to a variety of reasons. Using a cohort from the South American liver research network (1336 HCC cases), we created a cost-effective prognostic scoring system to helpidentifypatientslikelytohaveasurvivalbenefitonsorafenibtreatment,usingsimplelaboratoryvariables(2).

InordertodesignthePlatelet-INR-Bilirubin(PIB)Score, we assigned each patient in the sorafenib cohort, with available laboratory and survival data, one point for each of the following: (1) total bilirubin ≤ 3.0 mg/dL, (2)
platelets≤250×109/L,(3)INR≤1.6,followingthemethodologypreviouslydescribedbyDiConstanzoetal. (3). Each of these variables showed a similar significant difference in predicting survival and therefore were chosen for this score. Our group previously identified these variables as prognostic factors for improved survival on sorafenib in a South American population (4). The PIB score has a hypothetical score range of 0 to 3. Measures of central tendency were expressed as medians (Q1 - Q3). Kaplan-Meyer survival curves were constructed to graphically compare scores. HazardratioswerederivedusingCoxproportional hazard regression with the Breslow method for ties. The log-rank test was used to assess the equality of survivor functions. A level of evidence of P ≤ 0.05 was taken as the criterion for significance. A biostatistician was consulted for review of our data analysis. Statistical analysis was performed using STATA V. 14.2 (Statacorp, College Station, TX). This study was approved by the Institutional Review Board (IRB) of Hennepin County Medical Center. In addition,eachcenterwasresponsibleforobtainingappropriateIRBapproval.

Of the total 1336 patients with HCC, 127 patients were treated with sorafenib. Of these, 86 had complete labora
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