Polymorphisms in methylenetetrahydrofolate reductase gene: Their impact on liver steatosis and fibrosis of chronic hepatitis c patients

Aim & Background: The mechanism of steatosis in Hepatitis C virus infection is multifactorial;therefore, it is complex and unclear. The aim of this study was to investigate the effects of methylentetrahydrofolate reductase (MTHFR) gene polymorphisms on the course of chronic hepatitis C virus infection and the development of steatosis due to hepatitis C virus. Methods: This study included 109 patients with chronic hepatitis C virus infection. Necroinflammatory activity, degrees of fibrosis and steatosis and MTHFR gene polymorphisms were investigated. Polymerase chain reaction-restriction fragment length polymorphism was used to determine MTHFR C677T and A1298C polymorphisms. Results: Fibrosis was correlated with age (r = 0.336, p = 0.002), platelet (r = ?0.448, p < 0.0001), ALT (r = 0.241, p = 0.026), AST (r = 0.361) and GGT (r = 0.224, p = 0.039). Steatosis was only correlated with fibrosis. MTHFR C677T and A1298C polymorphisms did not have a significant effect on the degree of steatosis (p = 0.857, p = 0.202 respectively). There was a relation between MTHFR C677T and the degree of fibrosis but not A1298C (p = 0.014, p = 0.187 respectively). Conclusion: We found that MTHFR C677T polymorphism contributed to the development of fibrosis in patients with chronic hepatitis C virus infection.

Erythrocyte Membrane Protein Band 3 Predicts Interferon Ribavirin-Induced Anemia

Aim & Background: It was proposed that the differences in erythrocyte membrane protein contents—especially band 4—take a role in the serious anemia related to interferon plus ribavirin (I/R). The aim of this study is to evaluate whether the erythrocyte membrane protein contents predict anemia related to I/R or not. Methods: 180 mcg interferon α 2a once a week and weight adjusted ribavirin daily were given for 48 weeks to fifty patients with chronic hepatitis C. It was diagnosed as anemia when haemoglobin concentration was Results: Anemia developed in 17 patients (34%). The levels of erythrocyte membrane proteins were as;spectrin: 20.468 ± 2.5902, ankyrin: 4.576 ± 1.2706, B3: 19.240 ± 2.8358, B4.1: 5.628 ± 1.8832, and B4.2: 5.848 ± 1.8030. When the relation between the development of anemia and erythrocyte membrane proteins was investigated, a relation was only found at B3 which was not statistically significant (p = 0.058). When ROC analysis was performed, 95% CI p = 0.035 for B3 (0.517 - 0.792) was found. In patients whose B3 level was below 17.7%, the sensitivity of anemia development risk was calculated as 64.7% and the specificity thereof was calculated as 66.7%. Erythrocyte membrane protein contents by gender were only different at B3 (p = 0.042). Anemia developed in 17 patients (34%). 14 of these patients were of female and 3 were of male gender;the gender played a significant role in terms of anemia (p = 0.003). Conclusions: Erythrocyte membrane protein B3 is not only useful in predicting the patient under the risk of developing anemia, but also it may be useful in preventing it and it may explain why women inclined to anemia.

Greater Biosynthetic Liver Dysfunction in Primary Sclerosing Cholangitis Suggests Co-existent or Impending Cholangiocarcinoma

Background and Aim:Patients with primary sclerosing cholangitis (PSC) who develop cholangiocarcinoma (CCA)have a median survival of less than 6 months.In half of cases,PSC and CCA will be diagnosed either concurrently or within a year of one another.The aim of the present study is to demonstrate that the degree of biochemical liver dysfunction is associated with concomitant or impending CCA.Methods:We did a chart review of patients diagnosed with PSC and CCA up to 18 months from presentation (“CCA” group) as well as patients with PSC that underwent transplantation with no sign of CCA in their explanted liver (“nCCA” group).Along with demographic data and follow-up length,we recorded their presenting liver function tests,including alanine and aspartate aminotransferases (ALT,AST),total bilirubin (TBil),alkaline phosphatase (ALP),international normalization ratio (INR),and serum Ca 19-9 levels.Differences between mean values of the two groups were analyzed with a student's t-test.Results:Twenty-four patients were included.The “CCA”group consisted of eight patients,and the “non-CCA” group had 16 patients.There was no significant difference between the two groups in their presenting values of ALT,ALP,or serum Ca 19-9.However,the “CCA” group had significantly higher levels of AST,TBil,and INR.Conclusion:Patients with PSC and concurrent or impending CCA appear to exhibit significantly greater biochemical liver dysfunction than those who do not develop CCA.Therefore,newly-diagnosed PSC patients presenting with these findings may warrant more rigorous evaluation.