Update on Anti-Saccharomyces cerevisiae antibodies, anti-nuclear associated anti-neutrophil antibodies and antibodies to exocrine pancreas detected by indirect immunofluorescence as biomarkers in chronic inflammatory bowel diseases: Results of a multicent

AIM: Anti-Saccharomyces cerevisiae antibodies (ASCA), anti-nuclear associated anti-neutrophil antibodies (NANA) and antibodies to exocrine pancreas (PAB), are serological tools for discriminating Crohn’s disease (CrD) and ulcerative colitis (UC). Like CrD, coeliac disease (CoD) is an inflammatory bowel disease (IBD) associated with (auto) antibodies. Performing a multicenter study we primarily aimed to determine the performance of ASCA, NANA and PAB tests for IBD diagnosis in children and adults, and secondarily to evaluate the prevalence of these markers in CoD. METHODS: Sera of 109 patients with CrD, 78 with UC, 45 with CoD and 50 healthy blood donors were retrospectively included. ASCA, NANA and PAB were detected by indirect immunofluorescence (IIF). RESULTS: ASCA+/NANA- profile displayed a positive predictive value of 94.2% for CrD. Detection of ASCA was correlated with a more severe clinical profile of CrD and treatment of the disease did not influence their serum levels. ASCA positivity was found in 37.9% of active CoD.PAB were found in 36.7% CrD and 13.3% CoD patients and were not correlated with clinical features of CrD, except with an early onset of the disease. Fifteen CrD patients were ASCA negative and PAB positive. CONCLUSION: ASCA and PAB detected by IIF are specific markers for CrD although their presence does not rule out a possible active CoD. The combination of ASCA, NANA and PAB tests improves the sensitivity of immunological markers for CrD. Repeating ASCA, NANA, and PAB testing during the course of CrD has no clinical value.

Prevalence of Hepatitis B among Students from the University of Lomé, Togo in 2015

Objective: Hepatitis B virus (HBV) is endemic in sub-Saharan Africa where more than 80 million subjects are chronic carriers. However, screening is not systematic in the population and prevalence data are scarce, especially among the youth population. The objective of this study was to estimate the prevalence of HBV and its correlates among first-year University students at the University of Lomé. Study design: A cross-sectional survey was conducted between November 2015 and January 2016 at the University of Lomé during the annual checkup offered to newly enrolled students. Method: A self-administered questionnaire was used to collect data on demographics and sexual behaviors, and rapid tests were used for the detection of Antigen HBS (HBsAg) and HIV in each participant. A logistic regression model was performed to identify factors associated with HBsAg positivity. Results: A total of 800 students (56.2% were men) were screened among 1505 students who participated in the study. The median age was 20 years (IQR: [18 - 21]). The overall prevalence of HBsAg was 4.6% (95% CI: [3.2 - 6.3]): 5.8% among men and 3.1% among women (p = 0.04). The prevalence of HIV was 0.8;95%CI [0.3% - 1.6%] and one case (0.1%) of coinfection HIV and HBV was identified. Factors associated with HBsAg positivity were male gender [adjusted Odds Ratio (aOR) = 2.08, 95% CI: 1.02 - 5.00, p = 0.0447] and ever having a sexual relationship [aOR = 2.44;95% CI = 1.11 - 5.78, p= 0.0264]. Conclusion: This study among university students demonstrates that the prevalence of HBV is high among this population and that there is a need for prevention programs to target this vulnerable population. This is an additional argument toward HBV screening and treatment among students during annual health check.

Virus-Induced Cancers in Africa: Epidemiology and Carcinogenesis Mechanisms

The resurgence of infectious diseases on the African continent plays a major role in the increase in cancer occurrence. Whereas in developed countries the causes of occurrence of cancers are related mainly to non-infectious factors;cancers of infectious origin become a dramatic particularity in Africa. The proportion of virus-induced cancers may reach up to 75% of cancer cases in certain countries. Oncogenic viruses such as human papilloma virus (HPV), hepatitis viruses B and C, human herpes virus 8 and Epstein Barr virus in association with human immunodeficiency virus are the main viral etiologies of cancers in Africa, representing around 30% of cancers causes. Optimistically, 30% of cancers could be prevented in Africa. However, health burden prevails on the continent due to the weakness of health policy especially regarding preventive medicine, but also the limited technical facilities, poor manpower and insufficient political commitment. We felt urgent to review the state of the art of the question, and necessary to analyze and publicize the current epidemiological advances in oncogenic viruses and virus-induced cancers in Africa. Prevention implies understanding, which is compulsory to reverse the current trends and to potentially instate a control of virus-induced cancers.

不明原因胃肠道出血患者在推进式内镜下阳性结果的预测因子

Background: The diagnostic yield of push enteroscopy (PE) in patients with unexplained overt GI bleeding is about 30%. The aim of this study was to assess for predictive factors of positive findings. Methods: A total of 182 patients referred to two endoscopic centers (European Georges Pompidou Hospital [Paris, France] and Erasmus Hospital [Brussels, Belgium]) for unexplained overt GI bleeding (melena [57%], hematochezia [26%], or hematochezia associated with melena [17%]) were included in this retrospective study. Predictive factors associated with positive findings at upper PE were studied by using uni-and multivariate analysis. Results: The overall diagnostic yield of upper PE was 34%(62/182), but lesions were found beyond the second duodenum in 25%of the patients (45/182). Factors significantly associated with positive findings at upper PE were the following. (1) In univariate analysis: the presence of melena, Hb level < 7 g/dL, blood transfusion >4 units per patient, chronic renal failure, disorder of hemostasis or effective anticoagulant treatment, history of intestinal arteriovenous malformation, and age > 65 years. (2) In multivariate analysis: chronic renal failure and presence of melena. If only jejunal lesions were considered, chronic renal failure was the only predictive factor associated with positive findings at upper PE in multivariate analysis. The severity of GI bleeding did not reach statistical significance (p = 0.06). Delay between GI bleeding and PE, number of previous standard endoscopies and previous episodes of bleeding were not associated with positive findings in upper PE. Conclusions: In patients with unexplained overt GI bleeding, upper PE has a higher diagnostic yield in patients with chronic renal failure and patients with melena (vs. hematochezia).