Hepatitis Monthly
Volume:20 Issue: 6, Jun 2020

Various frequency rates of occult hepatitis B virus infection (OBI) are reported from different parts of Iran. This systematic review and meta-analysis aimed to characterize the OBI epidemiology in Iran and estimate the pooled prevalence among different populations.

Nine international and Persian electronic databases, as well as some conference proceedings, were searched. Original cross-sectional studies up to December 2018 were included if they investigated the prevalence of OBI by the detection of serum hepatitis B virus surface antigen and hepatitis B virus nucleic acid in at least 30 samples selected with any sampling methods. Comprehensive meta-analysis software was used to analyze the data, and Cochran’s Q-test and I-square statistics were applied to assess the heterogeneity. Meta-regression analysis was performed to assess the impact of the year of study on the OBI frequency. A P value < 0.05 was considered as the level of significance.

Of 412 citations found in electronic sources and 35 relevant citations added by searching the gray literature, 83 non-duplicated non-overlapping studies were evaluated. A total of 55 documents comprising 14,485 individuals from 16 provinces met the inclusion criteria and were used in the analysis. The prevalence of OBI considerably varied in different parts of the country with the highest prevalence (63.1%) reported among the HIV-positive population in Fars province. The rates of the OBI prevalence were estimated at 0.06% (95% CI: 0.02 - 0.16%) among blood donors (BDs) regardless of their anti-HBc status, 7.90% (95% CI: 4.33 - 13.99%) among anti-HBc positive BDs, 2.49% (95% CI: 1.2 - 4.81%) among hemodialysis (HD) patients, 4.44% (95% CI: 1.56 - 12.02%) among HIV-positive patients, and 7.76% (95% CI: 4.57 - 12.86%) among HCV-positive patients. No significant trends were observed in OBI prevalence rates among different groups over time (P > 0.05).

This review revealed high rates of OBI prevalence among high-risk populations in Iran. It is strongly suggested that occult hepatitis B be investigated among populations with a high chance of its occurrence in our country.

Chronic liver disease (CLD) is one of the leading causes of morbidity and mortality worldwide. It is accountable for a multifaceted disease encumbrance upsetting the psychological, physical, and economic health of not only the patients but also their caregivers.

The study purposes to cover the economic aspect of CLD to comprehend the financial burden imposed on the patients.

This cross-sectional study was conducted at a tertiary care hospital in Karachi, Pakistan. The CLD patients presenting in gastroenterology clinics were recruited, and their socio-demographic, financial, and disease-related information including Model for End-stage Liver Disease (MELD) score and Child Turcotte Pugh (CTP) scores were collected. Out of 190 CLD patients enrolled, 127 (67.2%) were males. The mean age was 50.09 years. Variables assessed include self-perceived social/economic status, self-perception of disease responsibility for worsening of social/economic situation, the impact of the disease on economic status due to medical expense, the impact of economic status on treatment compliance due to medical expenses, impact of severity of disease on socioeconomic status and treatment compliance, and impact of gender on disease status and treatment compliance.

Regardless of the disease duration, CLD significantly impacted a patient’s life, as 81% and 69% of the patients blamed their disease responsible for the worsening of social and economic conditions, respectively. In our study, 85% of patients had consumed all savings during their course of illness, and 67% had to borrow money for medical expenses. Nearly half of the patients had to leave or cut short their medicines, skip the physician's appointment, or defer their children's education. One-third of patients had unpaid medical and utility bills or even skipped their meals. The severity of disease affected the socioeconomic status significantly (89% in CTP class C vs. 40% in CTP class A). Patients with worsening socioeconomic status had significantly higher MELD scores as compared to those with stable socioeconomic status.

Chronic liver disease imposes incredible socioeconomic encumbrance on patients and the family unit, and CLD associated expenditures influence the family unit’s everyday working and therapeutic compliance, which is directly linked to the severity of disease expressed in terms of CTP and MELD scores.

Echium amoenum (E. amoenum), as one of the most popular plants in Iran, is traditionally used to treat different types of disorders.

This experimental study aimed to evaluate the modulatory effects of E. amoenum on permethrin (PMN)-induced oxidative stress in rats and to determine the cytoprotective effect of E. amoenum on PMN in SK-Hep-1 cells.

Twenty-four male Wistar rats were randomly divided into four equal groups, including the control (normal saline), orally treated PMN (125 mg/kg of PMN), E. amoenum (100 mg/kg), and E. amoenum + PMN groups for 28 days. The levels of alanine aminotransferase (ALT), alkaline phosphatase (ALP), aspartate aminotransferase (AST), lipid peroxidation (LPO), catalase (CAT), and glutathione peroxidase (GPx), as well as the expression of catalase (CAT) and glutathione peroxidase (GPx), were measured in the liver of all rats. Also, the cytoprotective effect of E. amoenum against PMN was evaluated in the treated SK-Hep-1 cells.

The results indicated that LPO increased significantly in the PMN-treated group, as evidenced by the high concentration of malondialdehyde (MDA) in the liver. Alterations of the antioxidant system were also confirmed by the significant decline in CAT and GPx activities (2.9 ± 0.14 and 0.5 ± 0.03, respectively; P < 0.05) and the significant downregulation of CAT (0.4 ± 0.02 folds) and GPx (0.3 ± 0.01 folds) mRNA expression in the liver (P < 0.05). PMN also stimulated significant changes in hepatic biomarkers and induced pathological changes in the liver. On the other hand, administration of E. amoenum significantly reduced abnormalities in biochemical markers, LPO, antioxidant enzymes, gene expression, and pathological complications induced by PMN (P < 0.05). E. amoenum also exhibited cytoprotective effects against cytotoxicity induced by PMN in SK-Hep-1 cells.

The present results demonstrated that E. amoenum has significant antioxidant, gene-regulating, and cytoprotective effects.

Hepatitis C virus infection is a major health problem in Egypt. Apo lipoprotein E and lipid metabolism are closely associated with the life cycle of the virus and play an important role in facilitating this infection.

To identify the role of apolipoprotein E gene polymorphism on hepatitis C virus disease progression and response to direct-acting antivirals (DAAs).

We included twenty patients with chronic hepatitis C virus infection (CHC) from those who failed to respond to DAAs treatment and 76 subjects from responders. Apo lipoprotein E genotypes were determined using PCR restriction enzyme fragment length polymorphism (RFLP).

Apolipoprotein genotype E3/E3 was prevalent in 75.9% of patients. The distribution for the rest of genotypes was 16.9%, 3.6%, 2.4% and 1.2 % for Apo E3/E4, E2/E3, E4/E4, and E2/E2 respectively. No statistically significant difference was found regarding any of the Apo E genotypes with liver cirrhosis or response to therapy.

No significant impact for any Apo E genotypes on CHC disease severity or response to therapy with direct-acting antivirals was detected among Egyptian patients.

Coronavirus disease 2019 (COVID-19) first emerged in Wuhan, China, in December 2019. Then, it spread to the whole world so that THE World Health Organization (WHO) declared a worldwide pandemic on March 11, 2020. Coronavirus disease 2019 is a novel and mysterious infectious disease that causes respiratory illness, multiorgan failure (MOF), and death. Although pediatric COVID-19 accounts for a small percentage of patients and is often milder than in adults, it can progress to severe disease in some cases. Liver involvement in COVID-19 and its severity have not been clearly investigated. In this paper, we present an 11-year-old boy admitted to a Pediatric Intensive Care Unit (PICU) with COVID-19 diagnosis in combination with elevated liver enzymes and bilirubin.