2024-03-28T11:43:41Z
https://mjvh.journals.ekb.eg/?_action=export&rf=summon&issue=750
Medical Journal of Viral Hepatitis
2314-8748
2314-8748
2015
1.1
1
Evolution of treatment of chronic hepatitis C virus infection by directly acting anti-viral therapeutics: A glimmer of hope
Abd-Elkhalek
E.
Kamal
A.
Helmy
A.
HCV was discovered in late 1980s. Few years later the INFα was established as the standard treatment for chronic hepatitis C virus (HCV) infection but with low response rate. This era was followed by consecutive improvements of the INFα based therapy regarding the dosing and pegylationand combined treatment INFα with ribavirin on 1999 which was associated with relative better health related quality of life and favorable clinical outcomes. Recently, the introduction of direct Acting Agents (DAAs) targeting specific viral component revolutionized the treatment of this virus. During the upcoming years, we shall hopefully find a universal and dramatic impact on end-stage liver disease owing to the invention of these oral potent drug protocols against HCV infection.
Hepatitis C virus
Protease inhibitors
Polymerase inhibitors
Sustained viral response
Treatment
2015
11
01
1
11
https://mjvh.journals.ekb.eg/article_4562_5f1574616b0f9b2c6c703fe4a7df33b2.pdf
Medical Journal of Viral Hepatitis
2314-8748
2314-8748
2015
1.1
1
Seroprevalence of hepatitis A virus infection in patients with chronic liver diseases: Do we need to vaccinate?
Helmy
A.
Hasanain
A.
Ali
A.
Samir
W.
Soliman
R.
Shiha
G.
Superinfection of patients with chronic liver disease (CLD) with hepatitis A virus (HAV) may have deleterious effects including hepatic decompensation and fulminant liver failure. The status of HAV infection in these patients needs to beassessed, especially after the availability of an effective HAV vaccine. This study aimed to assess the rate of HAV serology testing in patients with CLD, and their susceptibility to HAV superinfection. Patients and Methods: A total of 638 patientswith CLD (Mean±SD age 46.2±15.8 years, 396(62.1%) males), 517(81%) of them had viral etiology were included. Total anti-HAV, which detect both IgG and IgM; and anti-HAV IgM were tested by a micro particle enzymatic assay (AxSYMsystem (Abbott Diagnostics, USA). Results: HAV serology was done in 190(29.8%) patients, Mean±SD age 46.2±15.8 years 106(55.8%) were males, 119(62.6%) of them had viral etiology. Of these, 33(17%) patients had negative anti-HAV IgG. Positive anti-HAV IgM was accidentally detected in 7(3.7%) patients. Compared to IgG positive patients (immune against HAV), patients with negative anti-HAV IgG (susceptible) had no gender difference (p=0.089). Patients with nonverbal etiology were significantly more susceptible to HAV (OR: 5.2, 95% CI 2.3-11.8; p<0.001). Also, patients >20 years old, and those >40 years old had significantly more anti-HAV IgG seropositivity compared to those who are younger in age (OR: 11.4, 95% CI 4.8-27; p<0.0001 and OR: 3.8, 95% CI 1.7-8.6; p<0.01 respectively). Conclusions: Only 30% of CLD patients are tested for HAV serology, 17% of them are susceptible to HAV infection especially those who areyounger and with non-viral etiology. Detection and vaccination of these subgroups is warranted to avoid superinfection with HAV.
Superinfection
Coinfection
Dual infection
viral hepatitis
Hepatitis A vaccination
serology of hepatitis A
2015
11
01
1
9
https://mjvh.journals.ekb.eg/article_4563_2a6b309779513fe553089f994d21a59c.pdf
Medical Journal of Viral Hepatitis
2314-8748
2314-8748
2015
1.1
1
Demographics of incidentally diagnosed chronic hepatitis B in teenagers in Bangladesh
Karim
F.
Rahman
S.
Al-Mahtab
M.
Ahmed
F.
Jalil
M.
Hepatitis B (HBV) is endemic in Bangladesh. A prevalence of 2.4-9.7 % in adult population has been documented in various studies. The magnitude of HBV infection among Bangladeshi children and adolescents is less known.Chronic hepatitis B (CHB) in teenagers commonly present with Immune tolerant phase. Subsets of these patients present in Immune clearance, Inactive carrier or Reactivation phase. However both Immune tolerant and Reactivation phase need evaluation in decision making during treatment. Teenagers between 13-19 year presenting with incidental diagnosis of HBsAg positivity with either HBeAg positive or negative chronic hepatitis B, with normal or minimally raised aminotransferase level with low or high HBV DNA were included in this study. This was a prospective randomized study.CHB patients were divided into two groups, Group A which was HBeAg positive (Immune tolerant) and Group B was HBeAg negative (Reactivation phase). All 21 patients were asymptomatic. 11 patients with HBeAg positivity(M:F = 10:1), 10 patients with HBeAg negativity (M:F = 7:1). ALT range in HBeAg positive population was 15-77 U/L (Mean 45.8 U/L), in HBeAg negative population was 16-46 U/L (Mean 30.6 U/L). HBV DNA level in HBeAg positive patients was 105 -1012, mean 1010, in HBeAg negative patients was 103 -107, mean 106, However HBV DNA was mostly low in HBeAg negative variety. Necro-inflammation 7 and above was present in 8 patients (72.72 %) in group A, 7 patients (70 %) in group B. Stage 3 fibrosis (F3)was present in 1 patient (9 %) in group A, 1 patient (10 %) in group B presentingwith similar histologic activity index and fibrosis scores in both groups. Teenagers with chronic Hepatitis B are potential treatment candidates. So demographic studies with histologic scoring is needed as a guide to start treatment. Present study reveals presence of Group B (HBeAg negative) variant in teenagers. As compared to adult population Group B in teenagers presents with relatively benign disease in those having normal or minimally raised alanine aminotransferase levels.
Teenagers
Chronic hepatitis B
(CHB)
Hepatitis B virus
(HBV)
Serum ALT
Serum bilirubin
2015
11
01
1
9
https://mjvh.journals.ekb.eg/article_4564_95dbe82b07a66c060d447243c250b522.pdf
Medical Journal of Viral Hepatitis
2314-8748
2314-8748
2015
1.1
1
Liver histopathology detects more chronic hepatitis B virus genotype D patients who need to be treated
Helmy
A.
Ali
A.
Elbasiony
M.
Shiha
G.
Patients with chronic hepatitis-B-virus (HVB) infection may exhibit significant liver pathology despite alanine aminotransferase (ALT) and HBV-DNA levels below current treatment guideline’s cut-off values. This study evaluated thecandidacy for HBV therapy if baseline histopathological changes were considered. Clinical, biochemical, serological, virological, and histopathological (Metavir Score) data of a cohort of 161 consecutive patients [129 (80.1 %) males, mean ± SD age 35.2 ±11.2 years, 130 (80.7% HBeAgnegative, 149 (90.1 %) genotype D] were collected and analyzed. Our results showed that significant pathology (F≥2 and/or A≥2) and significant fibrosis (F≥2 ± A≥2) were found in 98/161(60.9 %) and 81/161(50.3 %) patients respectively. Based on HBV-DNA (>2000 iu/mL or >20000 iu/mL accordingto HBeAg status) and ALT level >2x40 u/L (the standard cut-off value), only 36/161(22.4 %) patients were candidate for therapy. This increased to 71/161(44.1 %) patients when the new ALT cut-off values (30 u/L for males, and 19 u/L for females) were applied. Relying on either (F≥2 and/or A≥2) or (F≥2±A≥2) increases the treatment candidacy by 62/161(38.5 %) or 45/161(28 %), and further increases the candidacy for treatment by 27/161(16.8 %) or 10/161(6.2 %) patients when standard and new ALT cut-off values are applied respectively. Finally, liver histopathology is more reliable than ALT and HBV-DNA levels in the decision to treat patients with chronic HBV infection.
HBV genotype D
Pathology
fibrosis
Viral load
transaminases
Therapy
2015
11
01
1
14
https://mjvh.journals.ekb.eg/article_4565_cff4ed88b4e567a90e95617638b79806.pdf