Oxidative stress and antioxidant defense in patients with chronic hepatitis C patients before and after pegylated interferon alfa-2b plus ribavirin therapy

BACKGROUND: Oxidative stress could play a role in pathogenesis of hepatitis C virus (HCV) infection. The aim of our study is to determine oxidant/antioxidant status of patients with chronic hepatitis C (CHC), and the effect of pegylated interferon alfa-2b plus ribavirin combination therapy on oxidative stress. METHODS: Nineteen patients with chronic HCV infection and 28 healthy controls were included in the study. In control and patient groups, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, erythrocyte malondialdehyde (MDA) levels, erythrocyte CuZn-superoxide dismutase (SOD), erythrocyte glutathione peroxidase (GSH-Px) activities were measured. After pegylated interferon alfa-2b and ribavirin combination therapy for 48 weeks, these parameters were measured again in the patient group. RESULTS: Serum MDA levels increased significantly in CHC patients (n:19), before the treatment when compared with healthy subjects (n:28) 9.28 ± 1.61, 4.20 ± 1.47 nmol/ml, p < 0.001 respectively. MDA concentration decreased significantly (p < 0.001) after the treatment as well as ALT, AST activity, in erythrocytes of these patients. Average antioxidant enzymes (superoxide dismutase and glutathione peroxidase) were significantly lower in erythrocytes of patients with CHC before treatment compared with the control group (both, p < 0.001). Chronic Hepatitis C patients after pegylated interferon alfa-2b and ribavirin therapy showed values of SOD, GSH-Px were significantly higher than pretreatment levels (both, p < 0.001). CONCLUSION: Our results show that patients with chronic HCV infection are under the influence of oxidative stress associated with lower levels of antioxidant enzymes. These impairments return to level of healthy controls after pegylated interferon alfa-2b plus ribavirin combination therapy of CHC patients. Although interferon and ribavirin are not antioxidants, their antiviral capacity might reduce viral load, and inflammation, and perhaps through this mechanism might reduce virus-induced oxidative stress

Prophylaxis from Infectious Diseases while Traveling

Turkey is a country that has several regional infectious diseases due to different climatic and geographic properties. The preventive measures for traveling both to different regions of the country and to abroad which can be reached at few hours by current speed travel vehicles, have been neglected uptill now although should be taken into account. For persons living in an epidemic area, prevention from infectious diseases (in stead of treatment) should be though firstly. In this review, the general prophylactic approaches which should be thought and administrated before the travel are mentioned again by using current informations

Retrospective Evaluation of Cases with the Diagnosis of Acute Bacterial Meningitis Over a 33-Year Period

Introduction: In this study, we retrospectively evaluated the epidemiological and clinical features, risk factors, laboratory findings, and relations between the therapy duration and mortality rates of cases followed with the diagnosis of acute bacterial meningitis. Materials and Methods: We reviewed data of patients with acute bacterial meningitis admitted to our hospital over a period of 33 years (1977-2010). Clinical, laboratory and demographic data were collected from the official records retrospectively. The data were analyzed through SPSS (Statistical Package for the Social Sciences), version 15.0. Results: One hundred and two of (97.2%) 110 cases were male and 8 (7.3%) were female, and the average age was 22.5 ± 5.93 (minimum 14, maximum 59). Recurrent meningitis had been seen in 10 (9.1%) cases. First admission to the hospital was 3.5 ± 4.1 days after the onset of complaints. While the most important physical examination findings were fever (91.8%), neck stiffness (95.5%) and Kernig’s and Brudzinski signs (84.5%), the most common neurologic sign was confusion (64.5%). In the microbiological analysis of the cerebrospinal fluid, pathogens were determined in 40% of all cases with Gram stain. While 75% of those showed gram-negative morphology, 25% showed gram-positive coccus morphology. Cultivation was detected in 27.3% of cerebrospinal fluid cultures. Conclusion: For acute bacterial meningitis diagnosis, Gram stain examination of cerebrospinal fluid is very important as well as clinical findings and physical examination

Oxidative stress and antioxidant defense in patients with chronic hepatitis C patients before and after pegylated interferon alfa-2b plus ribavirin therapy

Abstract Background Oxidative stress could play a role in pathogenesis of hepatitis C virus (HCV) infection. The aim of our study is to determine oxidant/antioxidant status of patients with chronic hepatitis C (CHC), and the effect of pegylated interferon alfa-2b plus ribavirin combination therapy on oxidative stress. Methods Nineteen patients with chronic HCV infection and 28 healthy controls were included in the study. In control and patient groups, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, erythrocyte malondialdehyde (MDA) levels, erythrocyte CuZn-superoxide dismutase (SOD), erythrocyte glutathione peroxidase (GSH-Px) activities were measured. After pegylated interferon alfa-2b and ribavirin combination therapy for 48 weeks, these parameters were measured again in the patient group. Results Serum MDA levels increased significantly in CHC patients (n:19), before the treatment when compared with healthy subjects (n:28) 9.28 ± 1.61, 4.20 ± 1.47 nmol/ml, p p Conclusion Our results show that patients with chronic HCV infection are under the influence of oxidative stress associated with lower levels of antioxidant enzymes. These impairments return to level of healthy controls after pegylated interferon alfa-2b plus ribavirin combination therapy of CHC patients. Although interferon and ribavirin are not antioxidants, their antiviral capacity might reduce viral load, and inflammation, and perhaps through this mechanism might reduce virus-induced oxidative stress.</p

Antibody Seroprevalence of Diphtheria in Young Adults

Our study has been planned to search for the susceptibility of the young adult population to diphtheria. For this purpose, 410 soldiers in 20-25 age group have been tested for their antibodies against diphteriae. We have also recorded their ages, education status and geographic regions. Blood samples were taken from a research group of mean age 20.89 ± 0.095 and then 0.5 mL adult type diphtheria-tetanus vaccine (Imogam dT, Pasteur-Merieux, France) was applied. Of 410, the second blood samples of 316 subjects were taken for searching the diphtheria antibodies. Diphtheriae antibody levels were tested by using of Gen-enzyme Virotech GmbH (Löwenplatz 5, Rüsselsheim, Germany) test kit in the first and the second blood samples of these 316 subjects. 24.5% (50/204) of the 20 years age group, 29.4% (30/102) of the 21-24 years age group and 30% (3/10) of the 25 years age group had antibodies under the protective level of 0.01 IU/mL. Prior to vaccination period a statistically insignificant difference between the groups was determined with respect to age, educational status and geographic area (p> 0.05 for all groups). After the vaccination, in all age groups the antibody levels were found as above the protective level. According to these results, it can be concluded that dT vaccination should be considered for the 20 years age group

INVESTIGATION OF OXIDATIVE STRESS AND ANTIOXIDANT DEFENSE IN PATIENTS WITH HEPATITIS B VIRUS INFECTION AND THE EFFECT OF INTERFERON-alpha PLUS LAMIVUDINE COMBINATION THERAPY ON OXIDATIVE STRESS

The aim of our study is to determine the role of oxidative stress on hepatic damage in patients with acute and chronic hepatitis B virus (HBV) infection and the efficacy of antioxidant-enzyme system against oxidative stress. Furthermore, the effect of interferon-alpha (IFN-alpha) plus lamivudine therapy on oxidative stress was also investigated. Nineteen patients with acute hepatitis B virus (AHBV) infection, 17 patients with chronic hepatitis B virus (CHBV) infection, 24 inactive HBsAg carriers and 21 healthy controls were included in the study. In control and patient groups, serum alanine-aminotransferase (ALT) and aspartate aminotransferase (AST) levels, erythrocyte malondialdehyde (MDA) levels, erythrocyte superoxide dismutase (CuZn-SOD) and glutathione peroxidase (GSH-Px) activities were measured. In CHBV group, after IFN-alpha plus lamivudine therapy for 6 months, these parameters were measured again. In all patient groups erythrocyte MDA levels were detected higher than control group (p<0.05). Activity of CuZn-SOD was found to be the highest in AHBV (p<0.05), and the lowest before the treatment in CHBV group (p<0.05) compared with other groups. Activity of GSH-Px was found to be the highest in AHBV compared with inactive HBsAg carriers (p<0.05) and CHBV group before treatment (p<0.05). Activity of GSH-Px was found to be the lowest in CHBV group before treatment compared with other groups (p<0.05). In CHBV group there was a significant decrease of MDA levels after treatment (p<0.05) while there was a significant increase in activity of CuZn-SOD and GSH-Px compared with pretreatment levels (p<0.05). A significant positive correlation was determined between MDA values and serum ALT levels, before and after the treatment (p<0.05). Detection of the increase of MDA levels which is a product of lipid peroxidation in all patient groups, indicates that the oxidative stress is increased in HBV infection. Correlation between the levels of erythrocyte MDA levels and serum ALT levels supports the hypothesis concerning the role of oxidative stress in pathogenesis of HBV infection. Insufficiency of antioxidant capacity in CHBV and inactive HBsAg carrier groups may lead to progression of disease and results in fibrosis. Treatment with IFN-alpha plus lamivudine causes a decrease in products of lipid peroxidation and shows antioxidant activity via increasing the antioxidant enzymes. These data suggest that the addition of antioxidant agents to IFN-alpha and lamivudin combination therapy may be useful in CHBV treatment. Further in-vitro and in-vivo studies are required to enlighten the role of antioxidants on HBV disease progression and treatment