Role of Plasma Osteopontin Level as a Predictor of Hepatic Fibrosis Regression and Response to Antiviral Treatment in Patients with Chronic HBV or Chronic HCV Infection

Background: Hepatitis B virus and Hepatitis C virus infection is one of the public health problems in Egypt. So we aimed to evaluate the efficacy of serum osteopontin as predictor of hepatic fibrosis regression and virological response in patients with chronic HBV or HCV infection. Methods: This study has been conducted on 74 HBeAg + ve chronic HBV infection, 74 chronic HCV infection and 74 healthy controls. HBV patients treated with Entecavir. HCV patients treated with sofosbuvir, daclatasvir with or without ribavirin. One year post HBeAg seroconversion and 3 months after end of regular antiviral treatment for patients with chronic HBV and chronic HCV infection respectively, hepatic condition was reevaluated. Results: 14.9% of patients with HBV, failed to achieve undetectable HBV DNA or HBeAg seroconversion and 2.7% of patients with HCV infection, failed to achieve SVR. In chronic HBV, pretreatment high serum osteopontin predict failure of virological response and hepatic fibrosis regression at a cutoff > 115.5, with 90.91% sensitivity, 82.54% specificity. Also high degree of liver stiffness predicts failure of hepatic fibrosis regression at a cutoff > 8.7, with 81.8% sensitivity, 73% specificity. Conclusions: In chronic HBV infection low osteopontin predicts good virological response and hepatic fibrosis regression. But it has no role in predicting SVR or hepatic fibrosis regression in chronic HCV infected patients.

Evaluation of CD64 Index in HBV and in Chronic HCV Infections

Background and aims: CD64 [Fc gamma receptor 1 (FcγRI)] is a promising biomarker used in predicting severe bacterial infection. The study was designed to assess their level in all stages of HBV infection and in chronic HCV infection before and after treatment with direct acting antiviral therapy as a possible biomarker of inflammation. Patients and methods: A case-control study was conducted, 50 patients with different disease stages of HBV infection (10 acute, 15 chronic hepatitis, 15 liver cirrhosis (LC) and 10 with hepatocellular carcinoma (HCC)), twenty patients with chronic HCV and 15 as a control group. Laboratory and imaging studies were evaluated. The levels of CD64 expressions in peripheral blood and CD64 Index were measured for all patients by flowcytometry using fluorescein isothiocyanate (FITC)-conjugated anti-CD64 monoclonal antibody. Results: The levels of CD64 expressions in peripheral blood and CD64 index were significantly higher in patients with HBV and HCV than in control group (P value = 0.01, 0.01 and 0.000, 0.000 respectively). They were increased significantly with disease progression in patients with HBV infection, acute hepatitis B infection showed the highest values. Their levels were significantly decreased in patients with HCV infection post treatment than before treatment. Conclusions: The levels of CD64 expressions in peripheral blood and CD64 index are considered good biomarkers of inflammation in viral hepatitis both B and C and could detect disease progression and also suppression of inflammation after antiviral therapy.

Rapid Urease Test and Faecal Antigen Detection for Rapid Diagnosis of Helicobacter pylori Infection in Dyspepsia

Background: Helicobacter pylori (H. pylori) is considered as one of the most prevalent gastric infections which cause chronic gastritis and predispose to cancer stomach. So, diagnosis and eradication should be rapid to decrease the risk of gastric cancer. Aim of the study: To evaluate the role of rapid urease test (RUT) and faecal antigen test (FAT) added to serological test for rapid diagnosis of active H. pylori infection. Patients and methods: 270 patients with dyspepsia and positive serology for H. pylori infection were included. Two antral and two corporal gastric biopsies were taken for RUT and Histopathological examination. Fresh stool samples were obtained from all patients for FAT. Results: The mean age of the studied patients was 45 ± 25. H. pylori infection was found in 256 (94.8%) of the included patients: 236 (92.18%) with positive all tests, 5 (1.95%) with positive both RUT and FAT, 8 (3.12%) with positive both histology and RUT and 7 (2.73%) with positive histology and FAT. The sensitivity, specificity and positive predictive values for RUT were as follows: 97.27%, 85.71% and 99.20% respectively and 96.88%, 85.71% and 99.20% respectively for FAT. Conclusions: RUT or FAT in patients with positive serological test could be used for rapid diagnosis of active H. pylori infection with good sensitivity and specificity without waiting for the results of histology or culture.

The Interplay Between Schistosomiasis and Hepatitis C Virus:Battling on Two Fronts

Schistosomiasis is a prevalent health issue in numerous countries in Africa,Asia,and South America.Data regarding the coinfection of schistosomiasis with hepatitis C virus(HCV)is limited,yet this coinfection is prevalent in regions where schistosomiasis is endemic.The extent of the coinfection issue is evident in countries with a high prevalence of both diseases,such as Egypt.Coinfections with schistosomiasis result in more pronounced liver damage compared with an HCV infection alone.Schistosomiasis has been found to disrupt HCV-specific T-cell responses,resulting in high viral load,increased likelihood of HCV chronicity,and accelerated development of comorbidities in individuals with coinfection.Introducing new,directly acting antivirals for HCV treatment resulted in a marked shift in the disease landscape.This shift may have an impact on the incidence of coinfection with schistosomiasis.This review emphasizes the notable influence of schistosomiasis on the vulnerability to HCV coinfection,the gravity of the consequent liver pathology,and the effectiveness of HCV antiviral therapy.

Diagnostic Efficacy of Serum Factor IV Collagen of Hepatic Fibrosis Regression in Chronic Hepatitis B Virus Infected Patients

Purpose: Chronic hepatitis B virus infection affects more than 3 million people worldwide. The present study aimed to evaluate the role of pretreatment factor IV collagen as predictor of post treatment virological response with hepatic fibrosis regression. Materials and Methods: This prospective cohort study has been conducted on 74 naieve patients with chronic HBV infection with variable degree of hepatic fibrosis (F2, F3, ≥F4), viral load, and variable degree of abnormality in laboratory parameters of liver functions. All patients treated with Entecavir 0.5 mg/day or 1 mg/day according to severity of hepatic condition for 1 year. Liver fibrosis assessed using fibroscan, factor IV collagen, (APRI) and (FIB-4) scores evaluation. Results: All included patients in our study achieve post treatment Virological response with undetectable HBV DNA PCR ( Conclusion: Low pretreatment factor IV collagen is significantly correlated with virologial response and hepatic fibrosis regression post Entecavir therapy in patients with chronic HBV infection.

Predictors of Recurrence of Hepatocellular Carcinoma after Transarterial Chemoembolization: Role of Hepatocyte Growth Factor

Background: Hepatocellular carcinoma is the third leading cause of tumor related mortality and develops mostly in patients with chronic liver disease and liver cirrhosis. Human hepatocyte growth factor (HGF) is produced in various organs of the body and is characterized as a multifunctional factor with various biologic activities. Aim: Our aim was to investigate the predictive factors of recurrence specially the role of HGF in patients with HCC treated with TACE. Patients and Methods: one hundred HCC patients treated by TACE who achieved complete response were included and divided into two groups according to disease free survival (DFS) status at 1 year: the non-early recurrence (NER) group (1) and the early recurrence (ER) group (2). Univariate binary logistic regression analysis for the possible risk factors of recurrence showed that AFP, multinodularity and HGF level were significant. Conclusion: high AFP, multinodularity and high HGF were inter-related possible risk factors for 1-year recurrence of HCC in patients with initial remission following TACE.