Prevalence of Hepatitis C Virus and its genotypes among a cohort of drug users in Kenya

Background: Prevalence of hepatitis C virus and that of its main genotypes varies between the worlds geographic regions. The risk factors for infection with HCV include blood transfusion, tattoing and injecting drug use. Objectives: To examine the prevalence of HCV and determine its main genotypes among a cohort of drug users in Kenya. Design: A laboratory based study. Setting: Hepatitis research laboratory in the Centre for Virus Research at the Kenya Medical Research Institute, Nairobi. Subjects: Three hundred and fourteen male and 19 female intravenous and non-intravenous drug users aged between 15-55 years. Results: Seventy four (22.2%) out of 333 samples tested positive for anti-HCV. Sixty nine out of the 74 serum samples were assayed for HCV RNA and 38 (55.5%) were positive. The RNA positive samples were further subjected to sequencing and 19 (73%) of the samples were classified as genotype la, while seven (27%) samples were classified as genotype 4. Genotypes 2, 3, 5 and 6 were not identified in this study. Conclusions: These results demonstrate a high HCV infection prevalence among this cohort of drug users (22.2 %) as compared to that of the general population, which is estimated to be 0.2- 0.9%. The study also confirms the presence of at least two major genotypes among Kenyan drug users (genotypes 1 and 4). East African Medical Journal Vol. 85 (7) 2008: pp. 318-32

Measurement of hepatitis B virus core-related antigen is valuable for identifying patients who are at low risk of lamivudine resistance

ArticleLIVER INTERNATIONAL. 26(1): 90-96 (2006)journal articl

Histological Remission during Corticosteroid Therapy of Overlapping Nonalcoholic Steatohepatitis and Autoimmune Hepatitis: Case Report and Literature Review

Concurrence of nonalcoholic steatohepatitis (NASH) with autoimmune hepatitis (AIH) is a rare condition that is challenging to diagnosis, due to the relatively high prevalence of autoantibodies in NASH. It is also difficult to determine the most effective treatment as corticosteroids are likely to worsen NASH despite being effective in the treatment of AIH. In this case report, we present a female diagnosed with NASH-AIH overlap with accompanying diabetes mellitus, who successfully achieved normalization of serum alanine aminotransferase levels following prednisolone therapy and weight loss. A follow-up liver biopsy performed 40 months after the initial diagnosis showed only minimal inflammatory infiltrates in the portal area without any NASH histology. Resolution of NASH, in conjunction with a reduction in hepatic fibrosis, might suggest that prednisolone itself does not aggravate steatohepatitis, but rather prevents disease progression. Appropriate immunosuppressive treatment may therefore be an important component of the optimum therapy for NASH-AIH overlap

Treatment of hepatocellular carcinoma with major portal vein thrombosis by combined therapy with subcutaneous interferon-α and intra-arterial 5-fluorouracil; role of type 1 interferon receptor expression

We previously reported the beneficial effects of combination therapy of interferon (IFN)-α/5-fluorouracil (FU) for advanced hepatocellular carcinoma (HCC) with tumour thrombi in the major portal branches. This report describes the results of longer follow-up and includes more than double the number of patients relative to the original report, and evaluates the role of IFN-α/type 2 interferon receptor (IFNAR2) expression on the response to the combination therapy. The study subjects were 55 patients with advanced HCC and tumour thrombi in the major branches of the portal vein (Vp3 or 4). They were treated with at least two courses of IFN-α/5-FU without major complication. In the 55 patients, 24 (43.6%) showed objective response (eight (14.5%) showed complete response, 16 (29.1%) partial response), four (7.3%) showed no response, and 27 (49.1%) showed progressive disease. Immunohistochemically, IFNAR2 expression was detected in nine out of 13 (69.2%) patients. There was significant difference in the time-to-progression survival (P=0.0002) and the overall survival (P<0.0001) between IFNAR2-positive and -negative cases. There was a significant correlation between IFNAR2 expression and response to IFN-α/5-FU combination therapy in univariate analysis (P=0.0070). IFN-α/5-FU combination therapy is a promising modality for advanced HCC with tumour thrombi in the major portal branches and could significantly depend on IFNAR2 expression

Serum Wisteria Floribunda Agglutinin-Positive Mac-2 Binding Protein Values Predict the Development of Hepatocellular Carcinoma among Patients with Chronic Hepatitis C after Sustained Virological Response

Measurement of Wisteria floribundaagglutinin-positive human Mac-2 binding protein (WFA+-M2BP) in serum was recently shown to be a noninvasive method to assess liver fibrosis. The aim of this study was to evaluate the utility of serum WFA+-M2BP values to predict the development of hepatocellular carcinoma (HCC) in patients who achieved a sustained virological response (SVR) by interferon treatment. For this purpose, we retrospectively analyzed 238 patients with SVR who were treated with interferon in our department. Serum WFA+-M2BP values were measured at pre-treatment (pre-Tx), post-treatment (24 weeks after completion of interferon; post-Tx), the time of HCC diagnosis, and the last clinical visit. Of 238 patients with SVR, HCC developed in 16 (6.8%) patients. The average follow-up period was 9.1 years. The cumulative incidence of HCC was 3.4% at 5 years and 7.5% at 10 years. The median pre-Tx and post-Tx WFA+-M2BP values were 1.69 (range: 0.28 to 12.04 cutoff index (COI)) and 0.80 (range: 0.17 to 5.29 COI), respectively. The WFA+-M2BP values decreased significantly after SVR (P 60 years), sex (male), pre-Tx platelet count ( 2.0 COI) were associated with the development of HCC after SVR. Conclusion: Post-Tx WFA+-M2BP (> 2.0 COI) is associated with the risk for development of HCC among patients with SVR. The WFA+-M2BP values could be a new predictor for HCC after SVR

Radiationless deactivation of an intramolecular charge transfer excited state through hydrogen bonding: Effect of molecular structure and hard-soft anionic character in the excited state

Energy-gap dependency for radiationless deactivation from excited states of various molecules having strong intramolecular charge transfer (ICT) character has been investigated by observing fluorescence quenching on addition of alcohols. Molecules having strong ICT excited states were classified into three groups: (a) molecules that underwent considerable fluorescence quenching by ethanol (quenching constant, KSV > 20 M-1) and for which radiationless deactivation in protic solvents was much faster than anticipated from the ordinary energygap law observed in aprotic solvents, (b) molecules whose fluorescence exhibited substantial red shifts, and (c) molecules whose fluorescence were barely affected by the addition of ethanol (KSV < 1 M-1) and for which the energy-gap dependences on radiationless deactivation in protic solvents were not so different from those in aprotic solvents. Typical fluorophores for each case, i.e., a, b, and c, were aminoanthraquinone, aminophthalimide, and aminocoumarin, respectively. Differences in the fluorescence quenching phenomena are discussed in terms of the molecular structure and the hard-soft anionic character of the excited states, governed by changes in charge density on the carbonyl oxygen. An excited molecule having a hard anionic character on a specific site within the molecule, classified as group a, was concluded to undergo considerable fluorescence quenching through an intermolecular hydrogen bonding interaction with an alcohol having a hard cationic character. On the other hand, fluorescence of an excited molecule having a soft anionic character, classified as group c, cannot be quenched well by an alcohol because of the weak interaction on the carbonyl oxygen. The anomalous behavior of the excited aminophthalimides (group b), which are classified as hard anions but do not undergo fluorescence quenching, suggested the possibility that molecular rigidity is another factor controlling the radiationless deactivation process induced by hydrogen bonding