The Change in the Susceptible Populations with the Shift in Hepatitis A Epidemiology

Aim: The incidence of hepatitis A (HepA) has decreased due to vaccination and improved hygiene conditions. However, the age of onset of the disease has shifted from childhood to adulthood. Children with HepA are mildly symptomatic, whereas the course of the disease in adults may be severe. The aim of this study was to examine the change in HepA seroprevalence and identify the population susceptible to HepA. Material and Methods: A total of 10132 patients who were tested anti-Hepatitis A virus immunoglobulin G (anti-HAV IgG) between 2016 and 2019 were reviewed retrospectively, and included in this study. The patients were divided into five groups according to their age, and seropositivity rates were compared between age groups. The relevant data of the healthcare professionals were also evaluated separately. Results: The overall seropositivity rate was 60.1% (n=6088). The seropositivity rate was found 29.0% (n=944) in the 18 to 24 years range, 49.7% (n=837) in the 25 to 29 years range, 60.6% (n=689) in the 30 to 34 years range, 76.6% (n=784) in the 35 to 39 years range, and 93.3% (n=2834) in the ≥40 years groups. The seropositivity rate was found 36.1% (n=1781) and 82.9% (n=4307) in patients <30 and ≥30 years groups, respectively (p<0.001). Conclusion: In recent decades, there has been a significant change in HepA seroprevalence. This change has resulted in the emergence of a young adult population susceptible to possible HepA outbreaks. Thus, seronegative young adults may be considered at risk for HepA and routine vaccination may be considered

Assessment of endothelial function in patients with nonalcoholic fatty liver disease

In this study, we aimed to evaluate the endothelial functions in patients with nonalcoholic fatty liver disease (NAFLD). In this observational case-control study, a total of 51 patients with NAFLD in study group and a total of 21 with age- and sex-equivalent individuals in control group were enrolled. In both patients and control groups, levels of asymmetric dimethylarginine (ADMA), systemic endothelial function (brachial artery flow-mediated dilation) (FMD) and carotid artery intima-media thickness (C-IMT) were measured. FMD and C-IMT were evaluated by vascular ultrasound. Plasma levels of ADMA were measured by ELISA. C-IMT was significantly higher in patients with NAFLD group than control group (0.67 +/- A 0.09 vs. 0.52 +/- A 0.11 mm, P < 0.001). The average C-IMT measurements were found in groups of control, simple steatosis, and NAFLD with (borderline and definite) NASH as 0.52 +/- A 0.11, 0.63 +/- A 0.07, and 0.68 +/- A 0.1 mm, respectively. The differences between groups were significant (P < 0.001). Measurement of brachial artery FMD was significantly lower in patients with NAFLD group compared to control group (7.3 +/- A 4.8 vs. 12.5 +/- A 7.1 %, P < 0.001). FMD measurements in groups of control, the simple steatosis, and NAFLD with NASH as 12.5 +/- A 7.1, 9.64 +/- A 6.63, and 7.03 +/- A 4.57 %, respectively, and the differences were statistically significant (P < 0.001). The increase in C-IMT and decrease in FMD was independent from metabolic syndrome and it was also more evident in patients with simple steatosis and NASH compared to control group. There was no significant difference between the control and NAFLD groups in terms of plasma ADMA levels (0.61 +/- A 0.11 vs. 0.69 +/- A 0.37 mu mol/L, P = 0.209). Our data suggested that NAFLD is associated with endothelial dysfunction and increased earlier in patients with atherosclerosis compared to control subjects

Plasma Fibrinogen-Like Protein 2 Levels in Patients with Non-Alcoholic Fatty Liver Disease

Background/Aims: Fibrinogen-like protein 2 (fgl2), has recently been identified as a new member of the fibrinogen-like family of proteins. In this study we assayed plasma levels of fgl2 in patients with biopsy proven non-alcoholic fatty liver disease (NAFLD) and examined their association with clinical, biochemical and histological phenotypes. Methodology: Levels of plasma fgl2 were measured by enzyme linked immunosorbent assay and compared between the study groups. Moreover, concentrations of fgl2 were assessed in relation to the general characteristics of the study participants and the results of the liver biopsy. Results: Levels of fgl2 were significantly higher in patients with definite non-alcoholic steatohepatitis (NASH) (788 +/- 190pg/mL, p<0.001) and borderline NASH (710 +/- 140pg/mL, p<0.001) compared with controls (515 +/- 174pg/mL). No significant differences were found in patients with simple steatosis (649 +/- 162pg/mL) as compared with controls. There were no associations between the plasma fgl2 levels with the fibrosis stage and steatosis grade. Conclusions: Although subject to future confirmation, our data suggest that fgl2 levels are elevated in the more severe forms of NAFLD