Hepatitis Monthly
Volume:20 Issue: 2, Feb 2020

Lifestyle intervention is considered first-line therapy for Nonalcoholic Fatty Liver Disease (NAFL).

Here, we aimed to compare the effect of combined Aerobic Training (AT) and Vitamin D (Vit D) supplementation on NAFLD in elderly women with Vit D deficiency.

We recruited 40 women (60 - 65 years) with NAFLD (second or third grade) and Vit D deficiency. Then, using simple randomization, the subjects were assigned to four groups including aerobic training (AT; 60% - 75%, 20 - 40 min/day, 3 days/wk running and walking), vitamin D supplementation (Vit D; 50,000 IU one day/week), aerobic training plus vitamin D supplementation (AT + Vit D), and sedentary control (C; placebo). The data were analyzed using paired t-test and one-way analysis of variance and Tukey’s post hoc test with SPSS21 at a significance level of P < 0.05.

After eight weeks of intervention, fatty liver grade markedly reduced in the AT + Vit D, AT, and Vit D groups (60%, 38.88%, and 22% respectively). However, it increased by 17.60% in the control group. The combination of AT + Vit D significantly reduced liver enzymes, anthropometric indices, and glycemic indices and improved lipid profile. All groups demonstrated a significant inverse correlation between vitamin D and fatty liver grade.

A sedentary lifestyle and Vit D deficiency accelerate the NAFLD probably by deteriorating hepatic risk factors. Additionally, adequate levels of plasma vitamin D are necessary to achieve the beneficial metabolic effects of aerobic training.

A large number of central nervous system impairments occur in subjects with chronic HCV infection regardless of liver disease. Brain-derived neurotrophic factor (BDNF) plays an essential role in the adult brain concerning its development and proper functioning. Our study aimed at contributing to the discussion on the involvement of BDNF in neurocognitive disorders associated with HCV infection.

We aimed to evaluate the prevalence of neurocognitive disorders in a cohort of HCV-infected subjects, to measure serum BDNF levels in the same cohort according to the degree of neurocognitive disorders, and to evaluate serum BDNF level modification in HCV-infected patients after direct antiviral agents (DAA) therapy.

We enrolled patients scheduled for DAA therapy in January 2018 from three infectious disease units in Eastern Sicily. Each participant was evaluated for neurocognitive status with MoCA score at baseline and 12 and 24 weeks after the end of therapy. Moreover, we measured serum BDNF levels at baseline and 12 weeks after the end of therapy.

Of 70 HCV-infected patients, 42 (60%) were males. The average age was 57 ± 19 years and the average ALT level was 79 ± 24 UI/mL; 38 (54.3%) individuals had HCV genotype 1 infection and 23 (32.8%) and 25 (35.7%) individuals had F1 and F2 fibrosis stages, respectively. Moreover, 67 (95.7%) individuals achieved sustained virological response. The MoCA score at baseline identified four groups of patients. Higher MoCA scores 24 weeks after the end of therapy highlighted the improvement of neurocognitive status in all groups. Serum BDNF levels in the same four groups, measured 12 weeks after the end of DAA therapy, appeared significantly modified compared to baseline serum BDNF levels, matching the improvement of MoCA score results obtained 24 weeks after DAA therapy.

The serum BDNF level may represent a useful marker of cognitive dysfunction in patients with HCV infection and a useful index for assessing the post-therapy follow-up.

Non-alcoholic fatty liver disease (NAFLD) is a condition with a global prevalence of 24%. A broad spectrum of liver complications has been attributed to this condition.

This study was conducted to determine the incidence of NAFLD and its potential risk factors in a seven-year follow-up study in Iran.

This is a prospective cohort population-based study conducted in the northern region of Iran. In phase I of the cohort study, 2,461 participants were selected, between 2009 and 2010, using the stratified randomization method based on the sex and age of individuals. Ultrasonographic examination was performed again after a seven-year follow-up between 2016 and 2017. The multiple binary regression analysis was applied to evaluate the association between the development of NAFLD and potential risk factors.

The incidence of NAFLD was 27.88% (95% CI: 25.41% - 30.35%) in men and 30.17% (95% CI: 27.40% - 32.94%) in women (P = 0.226) in a seven-year follow-up period. Based on the multiple binary logistic regression analysis, body mass index (BMI) [OR = 1.219 (95% CI: 1.162 - 1.278) P < 0.001], triglyceride (TG) [OR = 1.003 (95% CI: 1.001 - 1.005); P = 0.005] and high-density lipoprotein (HDL) [OR = 0.986 (95% CI: 0.972 - 0.999); P = 0.046] showed a significant association with the incidence of NAFLD in men. In contrast, the marital status [OR = 2.141 (95% CI: 1.286 - 3.565); P = 0.003], BMI [OR = 1.165 (95% CI: 1.121 - 1.211); P < 0.001] and homeostatic model assessment for insulin resistance (HOMA-IR) [OR = 1.164 (95% CI: 1.041 - 1.301); P = 0.007] had a significant relationship with the incidence of NAFLD in women.

It seems that NAFLD is markedly rising in the northern part of Iran. Higher levels of BMI, TG, and HDL are considered independent risk factors for the development of NAFLD in men, while the marital status, BMI, and HOMA-IR exhibited independent risk factors with the incidence of NAFLD in women.

Hepatitis D virus (HDV) infection, as the main coinfection in patients with chronic hepatitis B, leads to progressive liver disease. Elucidating the global distribution of HDV genotypes may be beneficial for the development of HDV vaccines and antiviral agents.

Through this systematic review, we aimed to present a clear picture of HDV genotype dispersal at the global and regional levels.

A systematic search was performed in Scopus, PubMed, and Web of Science using the relevant keywords of hepatitis D and HDV genotype. The old HDV genotype classification (HDV I, II, and III) and African HDV genotypes (HDV-5, -6, -7, and -8) were used for showing the HDV genetic dispersion. The data of the country-level distribution of HDV genotypes were translated to the regional and global distributions of HDV genotypes.

Among all 1,318 unique titles, 71 studies were screened in the qualitative synthesis consisting of 77 records from 33 countries (sampling locations). In Africa, themost common genotype was HDV I, followed by African HDV genotypes. In Asia, themost frequent genotype was HDV II, followed by HDV I. In Europe and Oceania, the most common HDV genotype was HDV I, followed by HDV II and African genotypes. In the Middle East and North America, the most frequent HDV genotype was HDV I. In South America, the most common HDV genotype was HDV III, followed by HDV I and African genotypes.

We found HDV I is distributed globally. Other HDV genotypes are observed regionally: HDV II mainly in East Asia, HDV III exclusively in South America, and African genotypes mainly in West Africa.