scholarly journals Chronic hepatitis b associated without/with a delta agent in Kyrgyzstan (epidemiological situation, clinical features)

2019 ◽  
Vol 9 (3-4) ◽  
pp. 577-582
Author(s):  
K. A. Nogoibaeva ◽  
S. T. Tobokalova ◽  
D. S. Bekenova ◽  
J. N Nazarbaeva
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Epidemiological Surveillance ◽  
Kyrgyz Republic ◽  
Case Definitions ◽  
Hbsag Detection ◽  
Significant Difference ◽  
Microsoft Office ◽  
The Right

Objective. To compare epidemiological, clinical and laboratory characteristics of chronic hepatitis B (ChHB) associated with/without delta agent (ChHB+DV) study.Materials and methods. The Kyrgyzstan State Reporting Form No. 12 covering 2010–2017 period was examined. For this, 133 and 130 case histories of ChHB and ChHB+DV patients, respectively, were analyzed. The data were statiastically processed by using Microsoft Office Excel software.Results and discussion. Over the 2010–2017 period, prevalence of the “HBV Carrier” (60.4 ) was higher by 20-fold than that one for ChHB [3.8 , 95% CI (2.4–4.0)] and CVHD [3.4 , 95% CI (2.2–3.4)], as the vast majority of patients were not thoroughly examined after detecting HBsAg, and the HBV Carrier was empirically diagnosed at the primary health care units. As a result, routine case definitions for such conditions were revised and an improved system of epidemiological surveillance of viral hepatitis was developed, according to the 2016 WHO recommendations approved by the Ministry of Health of the Kyrgyz Republic (Order No. 524, dated of July 20, 2018). Asthenia was observed in ~60% of patients in both groups, whereas arthralgia — in ~5–10% of patients, more often in those comorbid with ChHB+DV, and myalgia — in as low as ~3% of cases. Impaired central nervous system functions manifested as headache and restless sleep were evenly recorded in about 10–15% of patients, without significant difference between groups. In contrast, dominating dyspeptic manifestations such as poor appetite (72±3.9% vs. 20.6±3.5%, p < 0,05), nausea (23.8±3.7% vs. 7.3±2.3%, p < 0,05), vomiting (12.3±2.6% vs. 3.3±1.5%, p < 0,05) and flatulence (27±3.9% and 13±2.9%, p < 0,05) were revealed in ChHB+DV patients. Pain in the right hypochondrium was noted in 52–56% of patients, insignificantly differed between patient groups. Incidence of yellowness of the sclera and skin layers as well as skin itching were recorded by 2–3 and 8 times, respectively, more frequently in ChHB+DV patients. A more profound cytolysis and signs of altered bilirubin metabolism were also more common in HBV patients comorbid with the delta agent. Thus, a more severe ChHB+DV course requires that all patients with primary HBsAg detection were mandatorily examined for anti-HDV antibodies to ensure early diagnostics and timely organization of the secondary and tertiary preventive measures in the Kyrgyzstan. 

scholarly journals ANALYSIS OF PLATELET COUNT ON FIBROSIS DEGREE IN CHRONIC HEPATITIS B PATIENTS

2018 ◽  
Vol 24 (2) ◽  
pp. 165
Author(s):  
Hairul Anwar ◽  
Mutmainnah Mutmainnah ◽  
Ibrahim Abdul Samad
Keyword(s):  
Chronic Hepatitis ◽  
Platelet Count ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Complete Blood Count ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
B Virus ◽  
Spearman Correlation Test

Chronic hepatitis B is an infectious liver disease caused by hepatitis B virus that persist for more than 6 months. Fibrosis is a result of fibrogenesis which is the formation of connective tissue (scarring) caused by liver tissue damage. Liver damage will affect the production of thrombopoetin causing disturbances in the balance between destruction and production of platelet resulting in decreased platelet counts. This study was a retrospective cross-sectional study by taking the data from medical records of chronic hepatitis B patients who were tested for complete blood count and fibroScan at the Dr.Wahidin Sudirohusodo Hospital Makassar from January 2014 to July 2016. The result showed a total of 323 chronic B hepatitis patients, 99 with severe fibrosis, 84 with moderate fibrosis and 140 with mild fibrosis. The Spearman correlation test showed a significant correlation between the platelet count and the degree of fibrosis (p <0.001) and showed a positive correlation between both of them with a very strong correlation (r = 0.802). The Kruskal-Wallis test showed a significant difference between platelet count and the degree of fibrosis (p<0.001). The conclusion is that a decreased platelet count is a sign of an increase in the degree of fibrosis in chronic hepatitis B patients. It is suggested to perform another study with larger samples based on the degree of fibrosis. 

scholarly journals STUDY OF PREVALENCE AND PATTERN OF HEARING LOSS IN PATIENTS OF HEPATITIS B

2019 ◽  
Vol 3 (12) ◽  
Author(s):  
Kapildev Mondal ◽  
Poulomi Saha
Keyword(s):  
Hearing Loss ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Pure Tone ◽  
Control Group ◽  
Hepatitis B Infection ◽  
Cellular Carcinoma ◽  
The Right ◽  
Hep B

Hepatitis B has been documented to cause various extra hepatic manifestations along with known hepatic complications. It has been reported that hepatitis-B patients are more susceptible to inner ear damage and hearing loss. The aim of this study is to evaluate hearing loss among patients of   hepatitis B {all 6 categories Hepatitis B infection: chronic Hepatitis B  infection , hepatitis B cirrhosis ,Hepatitis B virus carriers , occult chronic Hepatitis B and Hepatitis B infection with poly arthritis nodosa, hepato cellular carcinoma with hepatitis B}compared with healthy subjects. METHOD: In this case control study 100 Hepatitis B positive patients and 100 age and gender-matched healthy individuals were included over the period of 5 years. All of them were known cases of chronic hepatitis B positive for   HBsAg at least for 18 months. All   patients were aged 18 to 50 years to exclude presence of presbycusis. After base line investigations, they were subjected for all cases and controls were subjected otoscopic examination and hearing assessment using standard pure tone audiometry. Descriptive statistical analysis has been carried out in this study. RESULT: In patients of Hepatitis B (94 patients,6 patients had of  natural death ) pure tone average (mean thresholds 250,500, 1000,2000,4000 &8000 Hz) was 28.4 dB in the right ear and 27.3 dB in the left (hearing loss).In the control group(96 patients,4 patients dropped out), PTA average was 9.9 dB in the right ear and 9.3dB in the left (normal hearing). In both groups, Speech Discrimination score (SDS) was100% in both ears. The percentage of hearing loss in the right and left ear over the total of six frequencies differed significantly in the two groups. Out of 94 patients of control group, 38 patients (40.4%) patients presented with Chronic Liver Disease (CLD), 14 patients (14.8%) patients presented with cirrhosis with Hepatitis B, 6 (6.3%) patients had Poly arthritis Nodosa with Hep-B, 18(19.1%) patients were diagnosed as carrier of Hepatitis-B , 11(11.7%) patients had occult Hepatitis-B and 7(7.4%) patients were diagnosed with hepato cellular carcinoma. Hearing loss was maximum in patients of   PAN with Hep-B. Second highest mean SNHL was seen in patients of Hep-B with cirrhosis .Third highest mean hearing loss was noted in patients with HCC .Forth highest mean hearing loss was noted in patients with occult Hep-B. Fifth highest mean hearing loss was noted in carriers of Hep-B.Lowest group with SNHL was chronic liver disease. CONCLUSION: Regular audiometric tests are recommended for patients with HBV infection to assess their hearing ability and enable the earlier detection of SNHL. We also suggest that HBV presenting with the sudden onset of hearing loss should be examined for the possibility of acute exacerbation of chronic HBV infection. KEYWORDS: Mean, Sensorineural, Hearing loss, Cirrhosis.

scholarly journals Antiviral Therapy in Lamivudine-Resistant Chronic Hepatitis B Patients: A Systematic Review and Network Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Hui-Lian Wang ◽  
Xi Lu ◽  
Xudong Yang ◽  
Nan Xu
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Rescue Therapy ◽  
Meta Analysis ◽  
Antiviral Effect ◽  
Similar Rate ◽  
Hbv Dna ◽  
Lamivudine Resistance ◽  
Significant Difference

The relative efficacy of different strategies for chronic hepatitis B (CHB) patients with lamivudine resistance (LAM-R) has not yet been systematically studied. Clinical trials were searched in PUBMED, MEDLINE, EMBASE, and CNKI databases up to February 15, 2016. Nine trials including 764 patients met the entry criteria. In direct meta-analysis, TDF showed a stronger antiviral effect than any one of ETV, LAM/ADV, and ADV against LAM-R hepatitis B virus. LAM/ADV therapy was superior to ADV in suppressing viral replication. ETV achieved similar rate of HBV DNA undetectable compared to ADV or LAM/ADV. In network meta-analysis, TDF had higher rates of HBV DNA undetectable compared to ETV (OR, 24.69; 95% CrI: 5.36–113.66), ADV (OR, 37.28; 95% CrI: 9.73–142.92), or LAM/ADV (OR, 21.05; 95% CrI: 5.70–77.80). However, among ETV, ADV, and LAM/ADV, no drug was clearly superior to others in HBV DNA undetectable rate. Moreover, no significant difference in the rate of ALT normalization or HBeAg loss was observed compared the four rescue strategies with each other. TDF appears to be a more effective rescue therapy than LAM/ADV, ETV, or ADV. LAM plus ADV therapy was a better treatment option than ETV or ADV alone for patients with LAM-R.

scholarly journals Kushenin Combined with Nucleos(t)ide Analogues for Chronic Hepatitis B: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Zhe Chen ◽  
Xiao Ma ◽  
Yanling Zhao ◽  
Jiabo Wang ◽  
Yaming Zhang ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Meta Analysis ◽  
Hbeag Seroconversion ◽  
Low Frequency ◽  
Hbv Dna ◽  
Significant Difference ◽  
Undetectable Serum ◽  
One Year

Objective. To evaluate the efficacy and safety of Kushenin (KS) combined with nucleoside analogues (NAs) for chronic hepatitis B (CHB).Methods. Randomized controlled trials (RCTs) of KS combined with NAs for CHB were identified through 7 databases. Frequencies of loss of serum HBeAg, HBeAg seroconversion, undetectable serum HBV-DNA, ALT normalization, and adverse events at 48 weeks were abstracted by two reviewers. The Cochrane software was performed to assess the risk of bias in the included trials. Data were analyzed with Review Manager 5.3 software.Results. 18 RCTs involving 1684 subjects with CHB were included in the analysis. KS combined with NAs including lamivudine (LAM), entecavir (ETV), adefovir dipivoxil (ADV), and telbivudine (TLV) showed different degree of improvement in CHB indices. KS combined with NAs increased the frequency of loss of serum HBeAg, HBeAg seroconversion, undetectable HBV-DNA levels, and ALT normalization compared with single agents. It also decreased serum ALT and AST level after one-year treatment. However, KS combined with TLV did not show a significant difference in CHB indices. The side-effects of KS combined with NAs were light and of low frequency.Conclusion. KS combined with NAs improves the efficacy of NAs in CHB.

scholarly journals The Reduction in CD8+PD-1+ T Cells in Liver Histological Tissue is Related to Pegylated IFN-α Therapy Outcomes in Chronic Hepatitis B Patients

2020 ◽  
Author(s):  
Ruyu Liu ◽  
Yanhui Chen ◽  
Jiang Guo ◽  
Minghui Li ◽  
Yao Lu ◽  
...  
Keyword(s):  
T Cells ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Mononuclear Cells ◽  
Hbeag Seroconversion ◽  
Active Chronic Hepatitis ◽  
Median Frequency ◽  
Inflammation Response ◽  
Significant Difference

Abstract Background and Aim: Antiviral therapy is recommended for patients with immune-active chronic hepatitis B (CHB) to decrease the risk of liver-related complications. However, the outcomes of the pegylated IFN-α (PEG-IFN-α) therapy vary among CHB patients. We aimed to identify factors that can influence the outcomes in CHB patients who received antiviral PEG-IFN-α monotherapy. Methods: Thirty-two CHB patients who received PEG-IFN-α monotherapy were enrolled in this study. All of the patients underwent two liver biopsies at baseline and 6 months after the initiation of the therapy. CD8+ T cells, CD4+ T cells, CD68+ mononuclear cells, and PD-1 levels in the 64 liver biopsy specimens were examined via immunofluorescence. Results: The overall median frequency of CD8+ T cells in the liver tissues of 32 CHB patients significantly decreased at 6 months after the therapy initiation (p < 0.01). In the FIER (fibrosis and inflammation response with HBeAg seroconversion) group, CD8+PD-1+ T cells significantly decreased at 6 months (p < 0.05), while CD8+PD-1- T cells had no significant difference. On the contrary, in the FIENR (no fibrosis and inflammation response and HBeAg seroconversion) group, CD8+PD-1- T cells significantly decreased after 6 months of PEG-IFN-α treatment (p < 0.05), while CD8+PD-1+ T cells had no significant difference. In addition, the levels of CD68+ mononuclear cells in the FIER group showed an overall increasing trend after treatment (p < 0.05). Conclusions: The changes in the levels of CD8+PD-1+ T cells and CD68+ mononuclear cells may be related to the response to PEG-IFN-α therapy.

scholarly journals Efficacy of Different Nucleoside Analog Rescue Therapies for Entecavir-Resistant Chronic Hepatitis B Patients

2020 ◽  
Author(s):  
Jin Shang ◽  
Juan Zhou ◽  
Huan Liu ◽  
You Tu ◽  
Jinqiu Ran ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Combination Therapy ◽  
Chronic Hepatitis B ◽  
Therapy Group ◽  
Virologic Response ◽  
Hbv Dna ◽  
Combination Therapy Group ◽  
Clinical Issue ◽  
Significant Difference

Abstract Background Entecavir (ETV) is recommended as a first-line anti-HBV treatment. However, many chronic hepatitis B patients initiate anti-HBV treatment such as lamivudine and telbivudine with low genetic barriers in China, which leads to compensatory mutations and increases the rate of ETV resistance. The management of ETV resistance in China is an essential clinical issue. Methods Patients from 2011 to 2017 with nucleos(t)ide analog resistance were screened and 72 patients with ETV resistance were included. These patients received different rescue therapies including an ETV and adefovir (ADV) combination therapy group (n = 25), a tenofovir (TDF) monotherapy group (n = 27), and an ETV and TDF combination therapy group (n = 20). Virologic, biochemical, and serologic responses were compared among the three groups. Results The rate of ETV resistance increased form 6.04% in 2011 to 15.02% in 2017. Regarding the rates of negative HBV DNA at 48 weeks, no significant differences occurred in the TDF monotherapy and TDF combination groups (74.07% vs 70.00%), while the ETV and ADV group showed the worst virologic response (28.00%). TDF monotherapy and TDF combination therapy showed similar decline of HBV DNA at weeks 12, 24, and 48. There was no significant difference in the rates of HBeAg clearance, ALT normalization, and abnormal renal function between the three groups. Conclusions TDF monotherapy showed a comparable virologic response to TDF and ETV combination therapy and a better virologic response than ETV and ADV combination therapy. Thus, TDF monotherapy is the preferred rescue therapy for ETV resistance.

scholarly journals CORRELATION OF AA INDEX (AFP APTT) WITH DEGREE OF LIVER FIBROSIS IN CHRONIC HEPATITIS B PATIENTS

2019 ◽  
Vol 25 (2) ◽  
pp. 170
Author(s):  
Rika Andriany ◽  
Ibrahim Abdul Samad ◽  
Mansyur Arif
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Cross Sectional Study ◽  
Serum Marker ◽  
Cross Sectional ◽  
Significant Difference ◽  
Spearman Correlation Test ◽  
Aa Index

A liver biopsy is the gold standard for diagnosing and staging liver fibrosis in chronic hepatitis B patient but with many disadvantages so it is difficult to use as a routine examination. Research on index based on serum marker is helpful in predicting liver fibrosis. We conducted a study of the alpha-fetoprotein (AFP) and partial activated thromboplastin time (APTT) index or AA index in relation to the degree of liver fibrosis in chronic hepatitis B patients. This study was a retrospective cross-sectional study in dr.Wahidin Sudirohusodo Hospital Makassar by taking the data from medical records of chronic hepatitis B patients from January 2015 to December 2016. Samples were chronic hepatitis B patients who were tested for AFP, APTT and Fibroscan. The result showed the total of 79 chronic hepatitis B patients, 23 with severe fibrosis, 9 with moderate fibrosis, 26 with mild fibrosis, and 21 with no fibrosis. Spearman correlation test showed a significant correlation between the AA index and the degree of fibrosis (p <0.001) and showed a positive correlation between both of them with a very strong correlation (r = 0.830). Oneway Anova test showed a significant difference between the AA index and the  degree of fibrosis (p<0.001). The results of this study indicate that the AA index can be used as a predictor of fibrosis in chronic hepatitis B patients. It is suggested to do another study with larger sample based on the degree of fibrosis.

scholarly journals Decreased levels of serum zonulin and copeptin in chronic Hepatitis-B patients

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Mustafa Kerem Calgin ◽  
Yeliz Cetinkol
Keyword(s):  
Chronic Hepatitis ◽  
Viral Load ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Normal Population ◽  
Antiviral Treatment ◽  
Inverse Correlation ◽  
Systemic Circulation ◽  
Hbv Dna ◽  
Significant Difference

Background & Objective: Liver and intestines are anatomically and physiologically linked. Zonulin is a protein modulating intercellular tight junctions and regulating intestinal permeability. Copeptin was studied as a marker of systemic circulation disorders in research about vasopressin and was associated with liver disease prognosis. Serum zonulin and copeptin levels were measured in patients with diagnosis of chronic hepatitis B (CHB) with the aim of easing antiviral treatment management in clinical applications and to investigate the association with normal population and viral load. Methods: Analysis included the serum of 30 CHB patients and 17 controls. HBV-DNA real-time PCR tests were completed. CHB patients were divided into three subgroups according to viral load in serum. Zonulin and copeptin levels were measured using ELISA kits. Results: Serum zonulin and copeptin levels were significantly low in CHB patients compared to controls (p<0.001). When CHB subgroups are investigated in terms of serum zonulin and copeptin levels, there was an inverse correlation observed with significant difference (p<0.01, p<0.05). Conclusion: The negative correlation between serum zonulin and copeptin with HBV-DNA load revealed in our study shows they may be used to monitor treatment. Zonulin and copeptin assays provide the possibility of developing new approaches to CHB diagnosis and monitoring. doi: https://doi.org/10.12669/pjms.35.3.144 How to cite this:Calgin MK, Cetinkol Y. Decreased levels of serum zonulin and copeptin in chronic Hepatitis-B patients. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.144 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Assessment of Hepatic Steatosis in Patients with Chronic Hepatitis B Using Fibroscan and its Relation to Insulin Resistance

2019 ◽  
Vol 9 (1) ◽  
pp. 70-78
Author(s):  
Reham M. Gameaa ◽  
Nehad Hawash ◽  
Rehab Badawi ◽  
Sherief Abd-Elsalam ◽  
Gamal K. Kasem ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Hepatic Steatosis ◽  
Chronic Hepatitis B ◽  
P Value ◽  
Fasting Insulin ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background & Aim: Simple hepatic steatosis is a benign condition, but it may cause serious liver damage as it may lead to steatohepatitis, fibrosis and cirrhosis. The Controlled Attenuation Parameter (CAP) of fibroscan assesses hepatic steatosis. The aim of this work was to assess hepatic steatosis in patients with chronic hepatitis B infection using FibroScan and to detect its relation to insulin resistance. Methods: Seventy-seven patients with chronic HBV were enrolled in this study. Body mass index, complete lipid profile, fasting insulin, HOMA-IR, pelviabdominal ultrasound and fibroscan were assessed in all patients. Results: According to the presence of significant steatosis, seventy-seven patients enrolled in this study were divided into different groups, such as group I 47 patients (61.04%) with CHB virus infection with non-significant steatosis and group II 30 patients (38.96%) with CHB infection with significant steatosis. There was a statistically significant increase in fasting insulin and HOMA-IR in group II (p-value <0.001). CAP results ranged from 100-396 db/m with no significant difference in liver stiffness measurements in two studied groups (P value= 0.886). There was a significant positive correlation between the degree of hepatic steatosis measured by fibroscan and fasting insulin blood level, HOMA-IR, serum cholesterol and LDL. At cutoff > 222 db/m steatosis measured by fibroscan had a sensitivity of 63.33% and specificity of 82.35% for the detection of insulin resistance. Conclusion: In CHB infected patients, steatosis measurement by fibroscan was a strong predictor of Insulin Resistance (IR) and vice versa.

scholarly journals PLATELET INDICES FOR PREDICTING LIVER FIBROSIS IN PATIENTS WITH CHRONIC HEPATITIS B INFECTION

2019 ◽  
Vol 25 (1) ◽  
pp. 35
Author(s):  
Shendy Sherly Soeliauwan ◽  
Darwati Muhadi ◽  
Mutmainnah Mutmainnah
Keyword(s):  
Chronic Hepatitis ◽  
Platelet Count ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
P Value ◽  
Severe Liver ◽  
Distribution Width ◽  
Platelet Size ◽  
Significant Difference

Chronic Hepatitis B involves liver parenchymal destruction leading to fibrosis. Decreased serum thrombopoietin associated with liver cell failure is thought as the leading cause of thrombocytopenia. Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) describe platelet size and degree of variation in platelet size respectively. The researchers intended to investigate whether platelet count, MPV, and PDW were variables to determine the severity of liver fibrosis in chronic hepatitis B patients. An observational study was carried out at the Dr. Wahidin Sudirohusodo Hospital Makassar from January 2015 until December 2016. A total of 100 chronic hepatitis B patients with negative HBeAg who underwent Fibroscan and complete blood count test were included in this study. A total of 100 chronic hepatitis B patients comprising, 11 with severe liver fibrosis, 16 with moderate liver fibrosis, 46 with mild liver fibrosis, and 27 with normal liver. There were significant differences in platelet count and MPV among liver fibrosis groups with p-value <0.001 and 0.046 respectively. No significant difference was observed for PDW among liver fibrosis groups (p=0.131). This study showed that platelet count and MPV were significantly different among the normal group, mild liver fibrosis group, moderate liver fibrosis group and severe liver fibrosis group in chronic hepatitis B patients. The researchers recommend to carry out studies with larger samples in number and distributed more evenly.

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