Correlation Between Liver Cirrhosis and Risk of Cardiac Arrhythmias

There are few studies analyzing the correlation between liver cirrhosis and cardiac arrhythmias. Still, factors triggering cardiac arrhythmias occur in many instances in liver cirrhosis.We studied a cohort with patientsdiagnosed with liver cirrhosis hospitalized to Cardiology Department, to the County Hospital of Craiova, between January 2017 and January 2018. We wanted to study the frequency of cardiac arrhythmias at the patients diagnosed with liver cirrhosis and also to evaluate several associated factors.The frequency of cardiac arrhythmias in the presence of risk factors was analysed using x2 test and statistical models.We analized multiple variable including demographics and clinical and biochemical characteristics, frequency of type of arrhythmias and evaluation of the associated factors like diabetes mellitus, hypertension, hypercholesterolemia, hypertriglyceridemia ,hyper/hypokalemia and hyper/hyponatremia. From our group, after exclusion criteria, we have a total of 34 patients with alcoholic liver cirrhosis, 37 patients with chronic HCV infection and 36 patients with HBV infection. From 34 patients with alcoholic liver cirrhosis, 23 patients presented atrial fibrillation(67.65%), from 37 patients with chronic HCV infection 21 were diagnosed with atrial fibrillation(56.76%) and from the patients with HBV infection 19 patients were known with atrial fibrillation(52.78%).We have encounter atrial flutter at 2 patients (5.56%) with chronic HBV infection. Atrial extrasystole was found at 7 patients with chronic HBV infection (19.44%), 4 patients with chronic HCV infection (10.81%) and 1 patients with alcoholic liver cirrhosis (2.94%). Ventricular extrasystole was found at 12 patients with chronic HBV infection (33.33%), 3 patients with chronic HCV infection (8.11%) and 5 patients with alcoholic liver cirrhosis (14.71%).We have also correlate the arrhythmias with different biochemical variables from our cohort. In our study there were many association between hepatic cirrhosis and cardiac abnormalities, which is concordant to reports from literature. Compared to population without liver cirrhosis, the prevalence of arrhythmias was increased in our cohort.

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Screening for chronic hepatitis B and C in migrants from Afghanistan, Iran, Iraq, the former Soviet Republics, and Vietnam in the Arnhem region, The Netherlands

Epidemiology and Infection ◽

10.1017/s0950268813003415 ◽

2014 ◽

Vol 142 (10) ◽

pp. 2140-2146 ◽

Cited By ~ 23

Author(s):

C. RICHTER ◽

G. TER BEEST ◽

E. H. GISOLF ◽

P. VAN BENTUM ◽

C. WAEGEMAEKERS ◽

...

Keyword(s):

Liver Cirrhosis ◽

Hepatitis B ◽

Risk Groups ◽

Hbv Infection ◽

Chronic Hbv Infection ◽

Increased Risk ◽

Chronic Hbv ◽

First Generation Migrants ◽

Chronic Hcv ◽

Former Soviet Republics

SUMMARYMigrants born in hepatitis B virus (HBV) and hepatitis C virus (HCV) endemic countries are at increased risk of being infected with these viruses. The first symptoms may arise when liver damage has already occurred. The challenge is to identify these infections early, since effective treatment has become available. In 2011 we conducted a screening project in first-generation migrants (FGMs) born in Afghanistan, Iran, Iraq, the former Soviet Republics, and Vietnam and living in Arnhem and Rheden. All participants were offered free blood screening for HBV and HCV. In total 959 participants were tested, with the country of origin known for 927, equating to 28·7% of all registered FGMs from the chosen countries. Nineteen percent (n = 176) had serological signs of past or chronic HBV infection and 2·2% (n = 21) had chronic HBV infection. The highest prevalence of chronic HBV infection was found in the Vietnamese population (9·5%, n = 12). Chronic HCV was found in two persons from the former Soviet Republics and one from Vietnam. Twenty-four percent (n = 5) of the newly identified patients with chronic HBV and one of the three patients with chronic HCV received treatment. Three of the patients, two with HCV and one with HBV, already had liver cirrhosis. The highest (9·5%) HBV prevalence was found in FGMs from Vietnam, indicating a high need for focusing on that particular immigrant population in order to identify more people with silent HBV infection. The fact that three patients already had liver cirrhosis underlines the necessity of early identification of HBV and HCV infection in risk groups.

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Studies on Mutual Relationship between Anti-HBx and sFas, IL-10 or IL-12 in Sera of Cases with Chronic Hepatitis B Infection

Infection International ◽

10.1515/ii-2017-0075 ◽

2014 ◽

Vol 3 (2) ◽

pp. 49-53

Author(s):

Ai-kun Ding ◽

Li-wei Guo ◽

Yong-kong Wang ◽

Wei Liu ◽

Cheng Li ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Cirrhosis ◽

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Sandwich Elisa ◽

Hbv Infection ◽

Mutual Relationship ◽

Chronic Hbv Infection ◽

Chronic Hbv

Abstract Objective To study the mutual relationship between anti-HBx and IL-10, IL-12 or soluble Fas (sFas) in sera of patients with chronic HBV infection and to explore the importance of anti-HBx detection as well as its role in the development of chronic HBV infection. Methods Total of 90 cases with chronic HBV infection were randomly selected, including 10 of asymptomatic carriers (ASC), 28 of chronic hepatitis B (CHB), 26 of liver cirrhosis (LC) and 26 patients of hepatocellular carcinoma (HCC). Their clinical data and blood samples were collected, and serum was prepared and stored at -73℃. Anti-HBx was detected with an indirect ELISA established in our earlier research, and levels of IL-10, IL-12 and Fas were determined with commercial double-antibody sandwich ELISA kits. The mutual relationship between anti-HBx and IL-10, IL-12 or sFas in serum were analyzed with the software SPSS 20.0. Results All levels of IL-10, IL-12 and sFas in peripheral blood showed a rising trend with development of chronic HBV infection. The levels of IL-10 in ASC, CHB, LC and HCC groups were 13.93 ± 14.40 ng/L, 39.38 ± 20.77 ng/L, 69.06 ± 46.37 ng/L and 62.82 ± 23.42 ng/L, respectively, levels of IL-12 in the 4 groups were 15.64 ± 23.04 ng/L, 68.50 ± 23.14 ng/L, 76.83 ± 12.82 ng/L and 83.74 ± 24.88 ng/L, respectively, and levels of sFas were 58.17 ± 77.42 ng/L, 179.88 ± 104.36 ng/L, 249.22 ± 107.80 ng/L and 252.98 ± 87.65 ng/L, respectively. Twenty-seven out of 90 patients showed a positive result for anti-HBx detection, including 1 in ASC, 4 in CHB, 12 in LC and 10 in HCC group. The levels of IL-10, IL-12 and sFas were higher in anti-HBx positive group than in negative group. Statistical analysis demonstrated significant differences of IL-10 and IL-12 between the two groups (P < 0.05), but the differences of sFas had no statistical significance (P = 0.094). Conclusions Anti-HBx antibody is not protective, and is closely related to IL-10, IL-12 and sFas. It may be an important serum indicator for aggravation from chronic hepatitis B to liver cirrhosis or hepatocellular carcinoma in patients with chronic HBV infection.

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Serological profile of HBV infection and liver histopathology among injecting drug users with chronic HCV infection in Greece

European Journal of Internal Medicine ◽

10.1016/j.ejim.2005.05.004 ◽

2005 ◽

Vol 16 (7) ◽

pp. 496-500 ◽

Cited By ~ 2

Author(s):

Ioannis S. Elefsiniotis ◽

Brokalaki Hero ◽

Anargiros Mariolis ◽

Konstantinos D. Pantazis ◽

Nikolaos V. Fotos ◽

...

Keyword(s):

Drug Users ◽

Injecting Drug Users ◽

Hcv Infection ◽

Hbv Infection ◽

Serological Profile ◽

Liver Histopathology ◽

Chronic Hcv Infection ◽

Chronic Hcv

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Integrating HBV, HCV and HIV screening in tuberculosis entry screening for migrants in the Netherlands

European Journal of Public Health ◽

10.1093/eurpub/ckz185.503 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

J Bil ◽

P A G Schrooders ◽

M Prins ◽

P M Kouw ◽

J H E Klomp ◽

...

Keyword(s):

The Netherlands ◽

Hiv Infections ◽

Hbv Infection ◽

Hcv Rna ◽

Hiv Screening ◽

Newly Diagnosed ◽

Chronic Hbv Infection ◽

Hbv Prevalence ◽

Chronic Hbv ◽

Chronic Hcv

Abstract We evaluated uptake and diagnostic outcomes of voluntary hepatitis B (HBV) and C virus (HCV) screening offered during routine tuberculosis entry screening to migrants in Gelderland and Amsterdam, the Netherlands, between 2013 and 2015. In Amsterdam, HIV screening was also offered. Overall, 54% (461/859) accepted screening. Prevalence of chronic HBV infection (HBsAg-positive) and HCV exposure (anti-HCVpositive) in Gelderland was 4.48% (9/201; 95% confidence interval (CI): 2.37-8.29) and 0.99% (2/203; 95% CI: 0.27-3.52), respectively, all infections were newly diagnosed. Prevalence of chronic HBV infection, HCV exposure and chronic HCV infection (HCV RNA-positive) in Amsterdam was 0.39% (1/256; 95% CI: 0.07-2.18), 1.17% (3/256; 95% CI: 0.40-3.39) and 0.39% (1/256; 95% CI: 0.07-2.18), respectively, with all chronic HBV/HCV infections previously diagnosed. No HIV infections were found. In univariate analyses, newly diagnosed chronic HBV infection was more likely in participants migrating for reasons other than work or study (4.35% vs 0.83%; odds ratio (OR) = 5.45; 95% CI: 1.12-26.60) and was less likely in participants in Amsterdam than Gelderland (0.00% vs 4.48%; OR = 0.04; 95% CI: 0.00-0.69). Regional differences in HBV prevalence might be explained by differences in the populations entering compulsory tuberculosis screening. Prescreening selection of migrants based on risk factors merits further exploration.

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A Case of Acute Autoimmune Hepatitis Superimposed on Chronic Hepatitis B Infection

Case Reports in Gastrointestinal Medicine ◽

10.1155/2018/2139607 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Vanessa Sostre ◽

Hiren G. Patel ◽

Abdalla Mohamed ◽

Ariy Volfson

Keyword(s):

Autoimmune Hepatitis ◽

Liver Enzymes ◽

Young Male ◽

Normal Liver ◽

Hbv Infection ◽

Laboratory Findings ◽

Chronic Hbv Infection ◽

Elevated Liver Enzymes ◽

Chronic Hbv ◽

Chronic Hcv

Autoimmune hepatitis has been associated with chronic HCV infection, but there are only few cases reported of HBV infection as a possible trigger. We present a case of a young male who was diagnosed with acute autoimmune hepatitis superimposed on existent chronic HBV infection. A 30-year-old Hispanic male with no past medical history presented to the hospital with complaints of few days of generalized weakness. Laboratory findings were significant for elevated liver enzymes: AST, 1164 U/L; ALT, 1461 U/L; total bilirubin, 2 MG/DL; and alkaline phosphatase, 75 IU/L. Extensive workup was done to find the etiology for elevated liver enzymes. Only blood work that came back positive was for chronic HBV infection and elevated immunoglobulin G (IgG) level 1937 mg/dL. HBV viral load was 42,900,000 IU/mL. The patient was started on tenofovir 300 mg daily. Liver biopsy was done which was consistent with autoimmune hepatitis. Prednisone 60 mg daily was started. Six months later, blood work showed completely normal liver enzymes and total IgG. Hepatotropic viruses have been proposed as triggering factors for several autoimmune diseases. There are theories suggesting that similarity in viral epitope and self-proteins expression on liver cells’ surface causes a cross-reactive immunologic response and possible viral-induced autoimmune hepatitis.

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The efficacy and safety of direct-acting antiviral agents in patients with chronic HCV infection and UGT1A1*28 polymorphism

Clinical Microbiology and Antimicrobial Chemotherapy ◽

10.36488/cmac.2020.1.71-80 ◽

2020 ◽

Vol 22 (1) ◽

pp. 71-80

Author(s):

S.P. Lukashyk ◽

I.A. Karpov ◽

M.G. Siniauskaya ◽

N.G. Danilenko ◽

L.A. Anisko ◽

...

Keyword(s):

Liver Cirrhosis ◽

Antiviral Agents ◽

Hcv Infection ◽

Efficacy And Safety ◽

Svr12 Rate ◽

Direct Acting Antiviral ◽

Chronic Hcv Infection ◽

Chronic Hcv ◽

Direct Acting ◽

Direct Acting Antiviral Agents

Objective. To determine the efficacy and safety of direct-acting antiviral agents (DAA) in patients with chronic HCV infection and UGT1A1*28 polymorphism. Materials and Methods. An open-label, non-randomized, observational study to assess efficacy and safety of DAA in patients (n = 143) with chronic hepatitis C (CHC) and liver cirrhosis and UGT1A1*28 polymorphism was performed. A total of 139 patients with chronic HCV infection were included in the efficacy analysis (absence of HCV RNA in blood by PCR) by the rate of sustained virologic response at week 12 (SVR12). Results. The SVR12 rate in patients with CHC and HCV-CP was 92.5% and 87.9%, respectively (p = 0.508), regardless of the presence of UGT1A1*28 polymorphism. The SVR12 rate in patients with chronic HCV infection and (TA)7/(TA)7 was 84.8%, with (TA)6/(TA)7 – 92.2% compared with (TA)6/ (TA)6 – 90,5% (p = 0.518). The rate of SVR12 in patients with CHC and (TA)7/(TA)7 or (TA)6/(TA)7 was 80% and 95%, respectively, with (TA)6/(TA)6 – 95.2%. The rate of SVR12 in patients with liver cirrhosis and (TA)7/(TA)7 or (TA)6/(TA)7 was 92.3% and 87.5%, respectively, with (TA)6/(TA)6 – 85.7%. The rate of SVR12 in patients with 12- and 24-week treatment duration was 88.2% and 96.6%, respectively (p = 0.30). As many as 96.2% of patients with the previous treatment with interferon and ribavirin had SVR12 compared to 88.5% of patients who have not previously taken antiviral drugs (p = 0.486). Grade 1 adverse events (AE) occurred in 24% of patients with chronic HCV infection treated with DAA; two patients developed Grade 4 AE. Conclusions. The treatment with DAA was shown to be effective and safe in patients with chronic HCV infection and UGT1A1*28 polymorphism.

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HBsAg level as a predictor of disease activity in patients with chronic hepatitis B infection with delta-agent

Infekcionnye bolezni ◽

10.20953/1729-9225-2020-4-149-152 ◽

2020 ◽

Vol 18 (4) ◽

pp. 149-152

Author(s):

M.A. Abdukadyrova ◽

◽

S.M. Sharapov ◽

A.S. Khikmatullaeva ◽

◽

...

Keyword(s):

Liver Cirrhosis ◽

Chronic Hepatitis ◽

Hepatitis B ◽

Disease Activity ◽

Chronic Hepatitis B ◽

Hbv Dna ◽

Hbv Infection ◽

Hbsag Level ◽

Chronic Hbv Infection ◽

Chronic Hbv

We have conducted a pilot study to identify the association between the HBsAg level and activity of the pathological process in the liver, as well as possibility of quantitative assessment of HBsAg for monitoring chronic liver diseases caused by hepatitis B virus (HBV) and hepatitis D virus (HDV). Objective. To assess the possibility of using HBsAg levels as a predictor of disease activity and prognosis in patients with chronic HBV infection with delta-agent. Patients and methods. We analyzed serum specimens from 30 patients with HDV and HBV co-infection. Among 15 patients with chronic hepatitis B with delta-agent, there were 5 HBV DNA positive and 10 HBV DNA negative. Among patients with liver cirrhosis, HBV DNA was detected in 11 individuals, while 4 individuals had undetectable HBV DNA levels. Results. We found that mean HBsAg level in patients with chronic HBV infection and negative HBV DNA was 1.9 ± 0.56 IU/mL. Mean HBsAg level in patients with chronic HBV infection with delta-agent and positive HBV DNA was 4.3 ± 0.62 IU/mL (p < 0.05). High HBsAg levels correlated with elevated ALT in patients with chronic hepatitis B and delta-agent. Patients with liver cirrhosis caused by HDV had normal ALT levels, but elevated bilirubin concentrations regardless of HBV DNA presence and HBsAg level. Conclusion. High levels of HBsAg can be considered as a predictor of active disease in patients with chronic HBV infection with delta-agent and also a marker of transformation of chronic hepatitis B with delta-agent into liver cirrhosis. Key words: chronic hepatitis B with delta agent, liver cirrhosis, enzyme-linked immunosorbent assay, HBsAg levels, polymerase chain reaction

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