The seroprevalence of hepatitis C virus infection among children and their mothers attending for dental care in Glasgow, Scotland, United Kingdom

This paper describes a voluntary anonymous survey to investigate the seroprevalence of Hepatitis C (HCV) in children in Glasgow, UK attending a Dental Hospital and the proportion of HCV positive mothers who have a child who is HCV seropositive. The study was undertaken among children and accompanying parents and household contacts attending a general anaesthetic assessment clinic at Glasgow Dental Hospital and School. Children were asked to provide an oral fluid specimen for HCV testing. Accompanying adults were asked to provide demographic data on the child and information on familial risk factors for HCV infection using a standardised questionnaire. Birth mothers were also asked to provide an oral fluid specimen. Specimens and questionnaires were linked by a unique anonymous study number. Between June 2009 and December 2011, samples were collected from 2141 children and 1698 mothers. None of the samples from the children were HCV seropositive but 16 (0.9%, 95% CI 0.6% to 1.5%) of the specimens from mothers were HCV antibody positive. In summary, the prevalence of HCV seropositivity in the birth mothers of the children was similar to that estimated in the general population served by the hospital and showed no evidence of mother-to-child transmission of HCV

International genome-wide meta-analysis identifies new primary biliary cirrhosis risk loci and targetable pathogenic pathways.

Primary biliary cirrhosis (PBC) is a classical autoimmune liver disease for which effective immunomodulatory therapy is lacking. Here we perform meta-analyses of discovery data sets from genome-wide association studies of European subjects (n=2,764 cases and 10,475 controls) followed by validation genotyping in an independent cohort (n=3,716 cases and 4,261 controls). We discover and validate six previously unknown risk loci for PBC (Pcombined<5 × 10(-8)) and used pathway analysis to identify JAK-STAT/IL12/IL27 signalling and cytokine-cytokine pathways, for which relevant therapies exist

Is indeterminate colitis really indeterminate?

A 26-year-old student was referred to the Gastroenterology Department by the general practitioner because of persistent rectal bleeding. At presentation, the patient reported a 3-month history of recurrent frank blood per rectum on defaecation. He had had similar episodes 2–3 years previously but this had subsided. This was not present all the time and his stools were of variable consistency. There was no associated abdominal pain. His appetite was normal and his weight stable. He was not on any medication. The patient originated from Sudan and..

A case presentation of a pulmonary complication of ulcerative colitis.

We present the case of a 25-year-old Afro-Caribbean man with a longstanding history of ulcerative colitis and primary sclerosing cholangitis. The patient presented to clinic and reported pleuritic-type chest pain. A routine chest radiograph requested from the clinic revealed an incidental right middle zone opacity in the right lung. A subsequent high-resolution CT showed multiple lung nodules. The patient also had a positive cytoplamic anti-neutrophil cytoplasmic antibody (cANCA) and proteinase 3 antibodies. Bronchoscopy was inconclusive. A video-assisted thoracoscopic surgery biopsy was then taken. The histology revealed changes suggestive of bronchiolitis obliterans organising pneumonia. The pulmonary manifestations of inflammatory bowel disease are poorly characterised. Our literature search has revealed cases hypothesising that immune system dysregulation could display pulmonary complications of ulcerative colitis. The aetiology is thought to be related to the treatment with mesalazine. However, our patient also had a positive vasculitic screen. Previous cases have resolved with supportive management or steroid therapy

Response to an extra dose of hepatitis B vaccine and specific antibody persistence in non-responders to primary immunization

BACKGROUND: In a campaign to vaccinate health care workers, a three-dose schedule (0, 1, and 6 months) and a four-dose schedule (0, 1, 2, and 14 months) with hepatitis B (HB) vaccine were used. After primary immunization 26 subjects vaccinated with the 3-dose schedule and 4 subjects vaccinated with the 4-dose schedule had undetectable anti-HBs titres. METHODS: All these 30 non-responders received an extra dose of the same vaccine 2 months after primary immunization and a booster dose with a yeast-derived vaccine 6 years later. Anti-HBs levels were evaluated 1 month after the extra dose and after the booster dose. RESULTS: One month after the extra dose 26.9% (7 of 26) of the subjects vaccinated with the 3-dose schedule became positive for anti-HBs. Six years later only two of these subjects had detectable anti-HBs. After the booster dose the seven subjects who responded to the extra dose showed an anamnestic type of response, and five additional subjects became positive for anti-HBs. Responders to the extra dose were significantly younger than the non-responders. In the four-dose group only one subject responded to the extra dose, and that subject maintained protective anti-HBs. CONCLUSION: About 25% of non-responders to primary HB vaccination could benefit from an extra dose, and these subjects show an anamnestic type of response to HBs antigen even after 6 years. This response seems to be influenced by age