Advanced liver disease in Russian children and adolescents with chronic hepatitis C

Russia has one of the highest prevalences of paediatric chronic hepatitis C infection (CHC). Our aim was to provide a detailed characterization of children and adolescents with CHC including treatment outcomes.Thus, an observational study of children with CHC aged <18 years was conducted in three hepatology centres from November 2014 to May 2017. Of 301 children(52% male), 196(65%) acquired HCV vertically, 70(23%) had a history of blood transfusion or invasive procedures, 1 injecting drug use and 34(11%) had no known risk factors. Median age at HCV diagnosis was 3.1[IQR 1.1,8.2] and 10.8[7.4,14.7] at last follow-up. The most common genotype was 1b(51%), followed by 3(31%). Over a quarter of patients (84,28%) had raised liver transaminases. Of 92 with liver biopsy, 38(41%) had bridging fibrosis (median age 10.4[7.1,14.1]). Of 223 evaluated by transient elastography (TE), 67(30%) had liver stiffness ≥5.0kPa. For each year increase in age mean stiffness increased by 0.09kPa(95%CI 0.05,0.13, p<0.001). There was significant correlation between liver stiffness and biopsy results (Tau-b=0.29, p=0.042). Of 205 treated with IFN-based regimens, 100(49%) had SVR24. Most children (191,93%) experienced adverse reactions, leading to treatment discontinuation in 6(3%). In conclusion, a third of children acquired HCV via non-vertical routes and a substantial proportion of those with liver biopsy had advanced liver disease. Only half of children achieved SVR24 with IFN-based regimens highlighting the need for more effective and better tolerated treatments with direct-acting antivirals. Further studies are warranted in Russia on causes and prevention of non-vertical transmission of HCV in children. This article is protected by copyright. All rights reserved

A New Saurolophine Dinosaur from the Latest Cretaceous of Far Eastern Russia

Background: Four main dinosaur sites have been investigated in latest Cretaceous deposits from the Amur/Heilongjiang Region: Jiayin and Wulaga in China (Yuliangze Formation), Blagoveschensk and Kundur in Russia (Udurchukan Formation). More than 90% of the bones discovered in these localities belong to hollow-crested lambeosaurine saurolophids, but flat-headed saurolophines are also represented: Kerberosaurus manakini at Blagoveschensk and Wulagasaurus dongi at Wulaga. Methodology/Principal Findings: Herein we describe a new saurolophine dinosaur, Kundurosaurus nagornyi gen. et sp. nov. from the Udurchukan Formation (Maastrichtian) of Kundur, represented by disarticulated cranial and postcranial material. This new taxon is diagnosed by four autapomorphies. Conclusions/Significance: A phylogenetic analysis of saurolophines indicates that Kundurosaurus nagornyi is nested within a rather robust clade including Edmontosaurus spp. Saurolophus spp. and Prosaurolophus maximus, possibly as a sister-taxon for Kerberosaurus manakini also from the Udurchukan Formation of Far Eastern Russia. The high diversity and mosaic distribution of Maastrichtian hadrosaurid faunas in the Amur-Heilongjiang region are the result of a complex palaeogeographical history and imply that many independent hadrosaurid lineages dispersed without any problem between western America and eastern Asia at the end of the Cretaceous. © 2012 Godefroit et al.SCOPUS: ar.jinfo:eu-repo/semantics/publishe