فهرست مطالب
Hepatitis Monthly
Volume:18 Issue: 12, Dec 2018
- تاریخ انتشار: 1397/09/30
- تعداد عناوین: 4
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Page 1ContextHepatitis C virus (HCV) infection is a significant cause of chronic liver disease in patients with human immunodeficiency virus (HIV) infection. Introduction of HCV direct-acting antiviral agents (DAAs) revolutionized the treatment of hepatitis C in patients with HIV/HCV co-infection. In this study, we systematically reviewed the treatment of chronic HCV infection in patients with HIV/HCV co-infection.Evidence AcquisitionIn this systematic review, electronic databases including PubMed, Scopus, ScienceDirect, and Web of Science were comprehensively searched using appropriate strategies containing all related keywords of “HCV”, “HIV” and “DAA”. Studies assessed the effectiveness of interferon-free HCV antiviral therapies in patients with HIV/HCV co-infection were evaluated for inclusion in the systematic review.ResultsAfter the screening of 728 records, we included 33 articles in our study, and seven different HCV antiviral regimens were evaluated. Ten studies for sofosbuvir plus simeprevir (SVR ranged from 72.2% to 100%), eight studies for sofosbuvir plus ribavirin (SVR ranged from 51.6% to 91.6%), 12 studies for sofosbuvir/ledipasvir (SVR ranged from 88.8% to 100%), eight studies for sofosbuvir plus daclatasvir (SVR ranged between 84.6% and 100%), two studies for grazoprevir/elbasvir (SVR ranged from 86.6% to 96.5%), six studies for ombitasvir/paritaprevir/ritonavir plus dasabuvir (SVR ranged from 90.6% to 100%), and just one study for sofosbuvir/velpatasvir with 95.2% SVR rate.ConclusionsThis study found that treatment of HCV infection with DAAs can result in high SVR rate in patients with HIV/HCV co-infection.Keywords: Hepatitis C, Therapy, Human Immunodeficiency Virus, Direct-Acting Antiviral Agents, Systematic Review
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Page 2BackgroundChronic hepatitis B (CHB) and non-alcoholic fatty liver disease (NAFLD) are two leading hepatic diseases that cause severe public health problems. The relationship between the severity of NAFLD and liver fibrosis in CHB patients remains controversial.ObjectivesThis study aimed at further clarifying the association between them.MethodsA total of 272 CHB patients and 31 NAFLD patients without CHB, who underwent liver biopsies and routine blood tests were included. The NAFLD activity scores (NAS) for NAFLD patients and the METAVIR scoring system for all the patients were used to evaluate the liver pathology. The associations between steatosis or NAS score and liver fibrosis were statistically analyzed.ResultsMETAVIR F0-4 was identified in 10.0%, 30.5%, 36.0%, 13.2%, and 10.3% of all the CHB patients, respectively. The prevalence of hepatic steatosis in CHB patients was 39.7% (n = 108). Among them, 26.9% (n = 29) of patients had NAS ≥ 5. The severity of fibrosis was not related to the degree of steatosis nor NAS score (P > 0.05) in NAFLD patients without CHB. Similarly, the results suggested that there was no significant difference in the severity of liver fibrosis in CHB patients with varying degrees of steatosis (P > 0.05). However, the severity of liver fibrosis increased with NAS score (P = 0.004) in CHB patients with NAFLD.ConclusionsThe severity of liver fibrosis in CHB patients was associated with NAS score, yet not with fat content.Keywords: Liver Fibrosis, The NAFLD Activity Score, Chronic Hepatitis B, Non-Alcoholic Fatty Liver Disease
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Page 3BackgroundDuring the last decade, lifestyle changes considerably leading to an increase in non-communicable diseases such as nonalcoholic fatty liver disease (NAFLD) accounted as the most common cause of chronic liver disease in children.ObjectivesThe present study aimed to assess the prevalence and clinical characteristics of NAFLD overweight and obese children.MethodsThis is a cross-sectional study. A total of 200 overweight and/or obese children aged 12 to 18 years were enrolled by a multi-stage sampling method. All participants underwent an abdominal ultrasound after six hours of fasting. Beside liver function tests, lipid profile, and fasting blood glucose were measured after 12 hours of fasting.ResultsThe NAFLD was reported in 108 individuals (54%). The prevalence of NAFLD was significantly higher in obese children compared to overweight ones (69.1% vs. 35.6%, P < 0.001). The logistic regression results show that there was a significant relationship between age, sex, and BMI and the prevalence of NAFLD (P < 0.001).ConclusionsThe results indicate that NAFLD is present in approximately half of the overweight and/or obese adolescents. Therefore being overweight and/or obese could be considered as main risk factors in development of NAFLD.Keywords: Non-Alcoholic Fatty Liver Disease, Metabolic Syndrome, Childhood Obesity, Childhood Overweight
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Page 4BackgroundOne of the challenges to treat hepatitis C virus (HCV) infection is the activation of hepatitis B virus (HBV) that occurs during treatment of HCV infection with direct-acting antivirals (DAAs) in some patients. The detection of serum or liver HBV DNA in the absence of serum HBsAg (HBV surface antigen) is described as occult HBV infection (OBI).ObjectivesThe current study aimed at determining the prevalence of OBI in Iranian DAA-naïve HCV-infected patients with hemophilia.MethodsThe current study was conducted on 100 patients with hemophilia receiving DAAs. The sera obtained from these patients were tested for the presence of HBsAg. Then, the presence of the HBV DNA was detected in peripheral blood mononuclear cell (PBMC) and also plasma samples using nested polymerase chain reaction (PCR).ResultsAmong the 100 study subjects, 81 (81%) were male and 19 (19%) female. The mean age of the patients was 37 ± 10.50 years. All patients had previously received HBV vaccine. In the current study, HBV DNA was observed in 1% of plasma and in 3% of PBMC samples. In addition, none of the patients who had positive result for HBV detection test previously had markers of HBV infection (anti-HBc (HB core antigen) antibodies, anti-HBs antigens, and positive result of DNA PCR) and all had negative results for HCV RNA after treatment.ConclusionsGenerally, the prevalence of OBI was low, but however, HBsAg negativity was not sufficient to completely exclude the presence of HBV DNA. Thus, the serological markers of HBV infection should be confirmed by molecular tests for the presence of possible occult infection.Keywords: Hepatitis B Virus_Hepatitis C Virus_Direct-Acting Antivirals_Occult HBV