Hepatitis Monthly
Volume:20 Issue: 7, Jul 2020

Genetic polymorphism in the miRNA sequence might alter miRNA expression and/or maturation, which is associated with the development and progression of hepatocellular carcinoma (HCC) in liver transplant patients.

Therefore, the prevalence of miRNA-146a G > C (rs2910164), miRNA-499A > G (rs3746444), miRNA-149C > T (rs2292832), and miRNA-196a-2 C > T (rs11614913) gene polymorphisms was evaluated in liver recipients with HCC with or without experiencing graft rejection.

In a cross-sectional study, tissue samples were collected from 60 HCC patients who underwent liver transplant surgery at Namazi Hospital, Shiraz, Iran, in 2013 - 2015. A control group consisting of 120 individuals was randomly selected, as well. The genomic DNA was extracted from collected tissues and blood samples. The miRNA-146a (rs2910164), miRNA-499 (rs3746444), miRNA-149 (rs2292832), and miRNA-196a-2 (rs11614913) gene polymorphisms were evaluated in patients with HCC using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.

The CC genotype and C allele of the miRNA-146a (rs2910164) polymorphism were significantly associated with the increased risk of transplant rejection in patients with HCC (P = 0.05 and P = 0.05, respectively). The CC genotype and C allele of the miRNA-146a (rs2910164) were also significantly more frequent in male liver transplant patients who experienced acute rejection than in non-rejected ones (P = 0.05 and P = 0.03, respectively). However, no significant association was found between the genotypes and alleles of miRNA-499 (rs3746444), miRNA-149 (rs2292832), and miRNA-196a-2 (rs11614913) polymorphisms and HCC outcomes in liver transplant recipients.

The importance of the CC genotype and C allele of the miRNA-146a (rs2910164) polymorphism in increasing the risk of transplant rejection was confirmed, but it needs further studies in larger populations.

Studies are limited on the relationship between vitamin D levels and liver fibrosis in patients with hepatitis B.

A study was conducted to investigate the relationship between 25-hydroxyvitamin D levels and liver stiffness in patients with hepatitis B.

In a cross-sectional study, serum 25-hydroxyvitamin D levels and liver stiffness, measured by transient elastography (TE), were evaluated in 281 patients with hepatitis B. The predictors of liver stiffness and its relationship with 25-hydroxyvitamin D level, coinfection with hepatitis D, age, and viral load were determined using multivariate analysis.

A significant correlation was observed between 25-hydroxyvitamin D deficiency and liver stiffness. Based on multivariate analysis, factors that were independently associated with advanced liver fibrosis included vitamin D level (P < 0.001), coinfection with hepatitis D (P < 0.001), and age (P < 0.001). Among 281 patients, the frequency of vitamin D deficiency (< 10 ng/mL), insufficiency (≥ 10 and < 20 ng/mL), and adequacy (≥ 30 ng/mL) was 40 (14.2%), 150 (53.4%), and 91 (32.4%), respectively.

In hepatitis B patients, vitamin D deficiency was independently associated with advanced liver fibrosis. An increase in age and coinfection with hepatitis D were also directly related to liver stiffness.

The prevalence of non-alcoholic fatty liver disease (NAFLD) has increased in recent decades. There are some concerns about the efficacy and side effects of drugs used for the treatment of NAFLD.

Therefore, new treatment methods and modalities are needed. This study aimed to determine the efficacy of Beta vulgaris extract in the treatment of NAFLD.

This is a double-blind, parallel-group, randomized clinical trial. This clinical trial was conducted from November 2018 to April 2019 in Shahid Beheshti Hospital of Kashan, Iran. Among 143 NAFLD patients who met the inclusion criteria, 120 patients agreed to participate in the study. Subsequently, they were divided into two equal groups via simple randomization. The Beta vulgaris group received Beta vulgaris extract, alongside standard NAFLD treatment, including vitamin E and Silybum marianum extract (Livergol). The placebo group received standard NAFLD treatment, as well as a placebo instead of Beta vulgaris extract. The levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), fasting blood sugar (FBS), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were evaluated and compared between the groups. Variables were measured at the beginning of the study and after three and six months.

Overall, 52% of the participants were male. The mean (SD) age of Beta vulgaris and placebo groups was 47.5 (10.5) and 46.4 (8.7) years, respectively. The results of between-group analysis revealed that AST significantly reduced in the Beta vulgaris group, compared to the placebo group (P = 0.04). Conversely, ALT reduction was not significant in the groups. The significant interaction between time and groups indicated that the effect of Beta vulgaris on ALT increased over time (P < 0.001). Moreover, the ALP, FBS, LDL, and HDL levels significantly improved in the Beta vulgaris group compared to the placebo group (P < 0.05).

Integration of Beta vulgaris extract in the standard treatment of NAFLD could significantly improve AST, ALP, FBS, LDL, and HDL. This study also revealed that the effect of Beta vulgaris on ALT increased over time.

Viral infections are a public health problem.

We would like to evaluate the seroprevalence of hepatitis B, C, and human immunodeficiency virus infections (HIV) in a large sample of the Afghanistan population in Kabul.

In total, 196516 Afghani citizens went to Fateme-al-Zahra clinic to perform obligatory checkup for traveling to Iran. The serum samples were primarily checked by rapid tests for HBV, HCV, and HIV, and in case of positive results, a commercial ELISA kit used as the confirmatory test.

Out of 196516 participants, 153763(78%) were men and 42753 (22%) were women. The seroprevalence of HBV, HCV, and HIV infections was 1.23% (2430), 0.13% (265) and 0.018% (16), respectively. The prevalence of HCV and HIV was significantly higher in males than females (m/f: 0.097%/0.037% vs. m/f: 0.008%/0%, respectively; P < 0.05). The simultaneous co-infection of HBV-HCV and HBV-HIV was 0.004% and 0.0005 %, respectively.

This study showed a low prevalence of HBV, HCV, and HIV among the study group. Considering the selection bias, sensitivity, and specificity of rapid tests, the real prevalence expected to be quite higher. Proper strategies to improve the social awareness and implement preventive vaccination for HBV can decrease the incidence of these infections.

The current treatments of liver diseases are not sufficiently effective, and there has been no therapy that can successfully prevent liver failure and its complications. Previous studies have suggested that resveratrol could inhibit the progression of hepatic diseases based on its antioxidative and anti-inflammatory potentials.

The present study evaluated the hepato-protective effects of resveratrol in thioacetamide (TAA)-induced acute liver damage in rats using neurobehavioral and biochemical parameters.

Forty-eight healthy adult Wistar rats were divided into four groups: C1: healthy control group, C2: non-treated liver failure, E1: liver failure treated with resveratrol 5 mg/kg/day, and E2: liver failure treated with resveratrol 10 mg/kg/day. Aspartate aminotransferase/alanine aminotransferase (AST/ALT), alkaline phosphatase (Alk), total bilirubin (TB), and plasma-ammonia (NH4) were analyzed, and histopathological evaluations of the specimens were carried out after sacrificing the models. Hepatic encephalopathy (HE) grading, open-field, elevated plus arms, and forced-swimming tests were performed in the study.

The resveratrol-treated groups had lower serum concentrations of NH4, ALT, and AST than the C2 group (P < 0.05). The pathological evaluations demonstrated that resveratrol-treated groups had better outcomes in inflammatory cell infiltration, apoptosis, vacuolization, liver tissue necrosis, and liver damage stage than the C2 group (P < 0.05). They also showed lower grades of HE, higher locomotor activity (open-field test), and diminished levels of depression (forced-swimming) when compared to the C2 group (P < 0.05).

Resveratrol supplementation can improve liver damage as AST, ALT, NH4, and tissue damages were decreased after administering the agent in TAA-induced liver damage. Resveratrol can also improve the neurobehavioral manifestations in animal models of liver failure.