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Jose-Abrego A, Trujillo-Trujillo ME, Laguna-Meraz S, Roman S, Panduro A. Epidemiology of Hepatitis C Virus in HIV Patients from West Mexico: Implications for Controlling and Preventing Viral Hepatitis. Pathogens 2024; 13:360. [PMID: 38787212 PMCID: PMC11123714 DOI: 10.3390/pathogens13050360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/24/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
The complex epidemiology of hepatitis C virus (HCV) infection among human immunodeficiency virus (HIV) patients in West Mexico remains poorly understood. Thus, this study aimed to investigate the HCV prevalence, HCV-associated risk factors, and HCV genotypes/subtypes and assess their impacts on liver fibrosis in 294 HIV patients (median age: 38 years; 88.1% male). HCV RNA was extracted and amplified by PCR. Hepatic fibrosis was assessed using three noninvasive methods: transient elastography (TE), the aspartate aminotransferase (AST)-to-platelets ratio index score (APRI), and the fibrosis-4 score (FIB4). Patients with liver stiffness of ≥9.3 Kpa were considered to have advanced liver fibrosis. HCV genotypes/subtypes were determined by line probe assay (LiPA) or Sanger sequencing. The prevalence of HIV/HCV infection was 36.4% and was associated with injection drug use (odds ratio (OR) = 13.2; 95% confidence interval (CI) = 5.9-33.6; p < 0.001), imprisonment (OR = 3.0; 95% CI = 1.7-5.4; p < 0.001), the onset of sexual life (OR = 2.6; 95% CI = 1.5-4.5; p < 0.001), blood transfusion (OR = 2.5; 95% CI = 1.5-4.2; p = 0.001), tattooing (OR = 2.4; 95% CI = 1.4-3.9; p = 0.001), being a sex worker (OR = 2.3; 95% CI = 1.0-5.4; p = 0.046), and surgery (OR = 1.7; 95% CI = 1.0-2.7; p = 0.042). The HCV subtype distribution was 68.2% for 1a, 15.2% for 3a, 10.6% for 1b, 3.0% for 2b, 1.5% for 2a, and 1.5% for 4a. The advanced liver fibrosis prevalence was highest in patients with HIV/HCV co-infection (47.7%), especially in those with HCV subtype 1a. CD4+ counts, albumin, direct bilirubin, and indirect bilirubin were associated with liver fibrosis. In conclusion, HCV infection had a significant impact on the liver health of Mexican HIV patients, highlighting the need for targeted preventive strategies in this population.
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Affiliation(s)
- Alexis Jose-Abrego
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (A.J.-A.); (M.E.T.-T.); (S.L.-M.); (S.R.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Maria E. Trujillo-Trujillo
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (A.J.-A.); (M.E.T.-T.); (S.L.-M.); (S.R.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Saul Laguna-Meraz
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (A.J.-A.); (M.E.T.-T.); (S.L.-M.); (S.R.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Sonia Roman
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (A.J.-A.); (M.E.T.-T.); (S.L.-M.); (S.R.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Arturo Panduro
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (A.J.-A.); (M.E.T.-T.); (S.L.-M.); (S.R.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
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Pham YTH, Huang DQ, Zhang Z, Ng CH, Tan DJH, Nguyen HC, Nguyen TC, Behari J, Yuan JM, Luu HN. Changing global epidemiology of chronic hepatitis C virus-related outcomes from 2010 to 2019: cirrhosis is the growing burden of hepatitis C virus-related disease. Eur J Cancer Prev 2024:00008469-990000000-00137. [PMID: 38568179 DOI: 10.1097/cej.0000000000000885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
BACKGROUND Chronic infection with hepatitis C virus (HCV) has a long-term impact on hepatic consequences. A comprehensive evaluation of the global burden of HCV-related health outcomes can help to develop a global HCV prevention and treatment program. METHODS We used the 2019 Global Burden of Disease (GBD) Study to comprehensively investigate burden and temporal trends in incidence, mortality and disability-adjusted life-years (DALYs) of HCV-related diseases, including liver cancer and cirrhosis and other liver diseases across 264 countries and territories from 2010 to 2019. RESULTS Globally, there were 152 225 incident cases, 141 811 deaths and approximately 2.9 million DALYs because of HCV-related liver cancer, and 551 668 incident cases, 395 022 deaths and about 12.2 million DALYs because of HCV-related cirrhosis in 2019. Worldwide, during the 2010-2019 period, liver cancer incidence declined, however, there was a 62% increase in cirrhosis incidence. In 2019, the Eastern Mediterranean was the region with the highest rates of incidence and mortality of both liver cancer and cirrhosis. Africa was the region with the fastest-growing trend of incidence of cirrhosis in the 2010-2019 period [annual percentage change (APC) = 2.09, 95% confidence interval (CI): 1.93-2.25], followed by the Western Pacific region (APC = 1.17, 95% CI: 1.09-1.22). Americas were the only region observing increased trends in liver cancer and cirrhosis mortality (APC = 0.70 and 0.12, respectively). We identified three patterns of temporal trends of mortality rates of liver cancer and cirrhosis in countries that reported HCV treatment rates. CONCLUSION Urgent measures are required for diagnosis, treatment and research on HCV-related cirrhosis at global, regional and country levels, particularly in Africa, the Western Pacific and the Eastern Mediterranean.
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Affiliation(s)
- Yen Thi-Hai Pham
- University of Pittsburgh Medical Center Hillman Cancer Center
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Daniel Q Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Zhongjie Zhang
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Cheng Han Ng
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Darren Jun Hao Tan
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Hiep C Nguyen
- Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Tin C Nguyen
- Department of Computer Science and Software Engineering, Auburn University, Auburn, Alabama
| | - Jaideep Behari
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Pittsburgh Medical Center
- Pittsburgh Liver Research Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Jian-Min Yuan
- University of Pittsburgh Medical Center Hillman Cancer Center
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Hung N Luu
- University of Pittsburgh Medical Center Hillman Cancer Center
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Sadiq S, Anwar MZ, Shafique H, Manzoor SM, Shoaib S, Hamid R, Hashmi SN, Ashraf NM, Afsar T, Bhat MA, Razak S. Determination of IL-6 Gene Promoter Polymorphism in Patients with Hepatitis C and Its Impact on RNA Secondary Structure. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:368. [PMID: 38541094 PMCID: PMC10971966 DOI: 10.3390/medicina60030368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/14/2024] [Accepted: 02/19/2024] [Indexed: 04/04/2024]
Abstract
Background and Objectives: A polymorphism in the promoter region of the IL-6 gene would influence the level of IL-6 expression in patients with HCV, resulting in a pro-inflammatory response. Few studies have shown the association between -174G>C (rs1800795) and -1363G>T (rs2069827) polymorphisms and HCV infection, and their results have been contradictory. There are no data published in our population to study such an IL-6 stimulus against HCV infection and its impact on RNA secondary structure. Therefore, we isolated human subjects from the province of Punjab, Pakistan. The objective was to screen for IL-6 gene promoter polymorphisms -174G/C and -1363G/T and those correlated with serum concentrations of IL-6 in patients with HCV and compared with a control. Materials and Methods: In conventional PCR, measurement of serum IL-6 by CLIA and statistical analysis were performed to observe the genotype association studies. By integrating bioinformatics and computational tools, our study aimed to provide a comprehensive understanding of how variations in the promoter region of IL-6 may have functional implications on gene expression. Results: The -174G>C and -1363G>T genotypes in the promoter region of patients with HCV were in strong allelic association (Δ = 0.97, p < 0.001). Interestingly, the bioinformatics analysis was well aligned with our experimental data. Conclusions: Based on the data, it can be inferred that IL-6 gene promoter polymorphisms are important in the dysregulation of IL-6 levels in patients with HCV.
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Affiliation(s)
- Sarah Sadiq
- Combined Military Hospital, Khariyan Medical College, Gujrat 49600, Pakistan; (S.S.); (S.N.H.)
| | - Mohammad Zeeshan Anwar
- Combined Military Hospital, Khariyan Medical College, Gujrat 49600, Pakistan; (S.S.); (S.N.H.)
| | - Huma Shafique
- Institute of Cellular Medicine, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Syed Mohsin Manzoor
- Combined Military Hospital, Khariyan Medical College, Gujrat 49600, Pakistan; (S.S.); (S.N.H.)
| | - Shaiza Shoaib
- Combined Military Hospital, Khariyan Medical College, Gujrat 49600, Pakistan; (S.S.); (S.N.H.)
| | - Rabia Hamid
- Combined Military Hospital, Khariyan Medical College, Gujrat 49600, Pakistan; (S.S.); (S.N.H.)
| | - Shoaib Naiyer Hashmi
- Combined Military Hospital, Khariyan Medical College, Gujrat 49600, Pakistan; (S.S.); (S.N.H.)
| | - Naeem Mahmood Ashraf
- School of Biochemistry & Biotechnology, University of the Punjab, Lahore 54590, Pakistan
| | - Tayyaba Afsar
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mashooq Ahmad Bhat
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Suhail Razak
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
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Ezzat WM, Amr KS, Tawfeek S, Elbatae H, Bayomi EA, Heiba A, Elhosary Y. Serum MicroRNA profiles in chronic hepatitis C Egyptian patients before and after combined sofosbuvir and daclatasvir treatment. BMC Infect Dis 2024; 24:67. [PMID: 38195397 PMCID: PMC10775543 DOI: 10.1186/s12879-023-08016-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/18/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND MicroRNAs (miR) are small sequence of nucleotides that can affect multiple genes involved in the hepatitis C virus (HCV) life cycle and disease development. The purpose of the present study was to investigate the clinical significance of serum microRNA profiles in a cohort of Egyptian patients with chronic HCV infection before and after combined sofosbuvir and daclatasvir treatment, as well as to gain a better understanding of the exact interaction mechanism in HCV transcriptional activity via differentially expressed miRNAs. For 12 weeks, 50 patients were eligible for and received sofosbuvir (400 mg daily) and daclatasvir (60 mg daily) treatment. Each patient's blood was obtained twice: once before therapy began and again three months afterwards. RESULTS The current study found that serum levels of circulating miR-122, miR-221, miR-23a, miR-125, miR-217, miR-224, and miR-181a were high in HCV pre-treatment patients, but after 12 weeks of direct-acting antiviral (DAAs) treatment, there was a statistically significant reduction in expression levels of miR-122, miR-221, miR-23a, miR-125, miR-217, and miR-224 (p < 0.001). There is no statistical significance for miR-181a. CONCLUSION The key differentially expressed microRNAs before and after the direct-acting antiviral (DAA) regimen were connected to the dynamics of chronic HCV infection, suggesting their potential as predictive biomarkers for HCV clearance after sofosbuvir and daclatasvir therapy.
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Affiliation(s)
- Wafaa M Ezzat
- Internal Medicine Department, National Research Centre, Cairo, Egypt
| | - Khalda S Amr
- Medical Molecular Genetics Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt.
| | - Salwa Tawfeek
- Internal Medicine Department, National Research Centre, Cairo, Egypt
| | - Hassan Elbatae
- Tropical Medicine Department, Kafr Elsheikh University, Kafr Elsheikh, Egypt
| | - Eman A Bayomi
- Medical Molecular Genetics Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt
| | - Ahmed Heiba
- Internal Medicine Department, National Research Centre, Cairo, Egypt
| | - Yasser Elhosary
- Internal Medicine Department, National Research Centre, Cairo, Egypt
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AbdelMagid AM, Abbassi MM, Ebeid FS, Farid SF, El-Sayed MH. Ledipasvir/Sofosbuvir in Hepatitis C Virus-Infected Children With Hematological Malignancies: A Pharmacokinetic Study. Clin Ther 2024; 46:e12-e22. [PMID: 37925363 DOI: 10.1016/j.clinthera.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/08/2023] [Accepted: 10/09/2023] [Indexed: 11/06/2023]
Abstract
PURPOSE Children with hematological malignancies and chronic hepatitis C virus (HCV) infection are at a higher risk for rapid progression of liver disease and malignancy relapse due to multiple hepatitis flares and chemotherapy interruption. They are therefore potential candidates for microelimination of HCV infection. This study aimed to assess the effect of acute lymphoblastic leukemia (ALL) on the pharmacokinetic (PK) profile of direct-acting antivirals, namely ledipasvir/sofosbuvir (LDV/SOF) and the SOF major metabolite GS-331007. METHODS This was a 24-week, prospective, controlled, open-label, 2-arm PK study of patients receiving 45/200 mg once-daily LDV/SOF orally for 12 weeks. Eligible patients were HCV-RNA-positive, treatment-naive children aged 6 to <12 years and/or weighing 17 to <35 kg with genotype 4 chronic HCV infection without cirrhosis. The primary efficacy and safety end points were the achievement of sustained virologic response for all patients with absence of any adverse events leading to permanent discontinuation of the study drug. Steady-state noncompartmental analysis was performed to determine the PK parameters of SOF, GS-331007, and LDV as the primary PK outcome. Dose suitability was based on the 90% CI of exposure geometric mean ratio percentage within 50% to 200% compared with adults. FINDINGS Ten HCV-infected children with ALL (chemotherapy treatment group) and 12 eligible children with no malignancy (control group) were enrolled and completed the study period. All 22 patients achieved the sustained virologic response with no adverse events leading to interruption or permanent discontinuation of the study drug. Compared with the control group, the ALL group patients had similar SOF, GS-331007, and LDV exposure. Compared with adults, the AUCτ of GS-331007 was lower and the AUCτ and Cmax,ss of SOF and the Cmax,ss of LDV were modestly higher in the ALL group (acceptance limit, 50%-200%). However, the observed efficacy and favorable safety profile made these changes not clinically significant. IMPLICATIONS Weight-based dosing of LDV/SOF (45/200 mg) is highly effective and safe among genotype 4 HCV-infected children weighing 17 to <35 kg and diagnosed with ALL undergoing maintenance chemotherapy. The similarity in the drug exposure, efficacy, and safety clinical end points between patients with and without hematological malignancy support their therapeutic equivalence. Further studies with a larger sample size may be required to confirm the safety of LDV/SOF in patients with ALL and to recommend appropriate dosing in children with hematological malignancies, if needed. CLINICALTRIALS gov identifier: NCT03903185.
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Affiliation(s)
- Aya M AbdelMagid
- Clinical Pharmacy Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
| | - Maggie M Abbassi
- Clinical Pharmacy Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Fatma S Ebeid
- Pediatric Hematology, Oncology and BMT Department, Ain Shams University, Cairo, Egypt; Faculty of Medicine, Ain Shams University Research Institute-Clinical Research Center (MASRI-CRC), Cairo, Egypt
| | - Samar F Farid
- Clinical Pharmacy Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Manal H El-Sayed
- Pediatric Hematology, Oncology and BMT Department, Ain Shams University, Cairo, Egypt; Faculty of Medicine, Ain Shams University Research Institute-Clinical Research Center (MASRI-CRC), Cairo, Egypt
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Hafez HA, Atoom AM, Khafaga RHM, Shaker SA, Kamel MA, Assem NM, Mahmoud SA. Direct-Acting Antiviral Drug Modulates the Mitochondrial Biogenesis in Different Tissues of Young Female Rats. Int J Mol Sci 2023; 24:15844. [PMID: 37958828 PMCID: PMC10647297 DOI: 10.3390/ijms242115844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/28/2023] [Accepted: 10/28/2023] [Indexed: 11/15/2023] Open
Abstract
(1) Background: Hepatitis C virus (HCV) infection is endemic in Egypt, with the highest prevalence rate worldwide. Sofosbuvir (SOF) is a nucleos(t)ide analog that specifically inhibits HCV replication. This study aimed to explore the possible effects of the therapeutic dose of SOF on the mitochondrial biogenesis and functions of the liver, muscle, and ovarian tissues of young normal female rats. (2) Methods: This study was conducted on 20 female Wistar rats, classified into two groups, the control group and the exposed group; the latter was orally supplemented with 4 mg/kg/day of SOF for 3 months. (3) Results: The exposure to SOF impairs mitochondrial biogenesis via mitochondrial DNA copy number decline and suppressed mitochondrial biogenesis-regulated parameters at mRNA and protein levels. Also, SOF suppresses the DNA polymerase γ (POLG) expression, citrate synthase activity, and mitochondrial NADH dehydrogenase subunit-5 (ND5) content, which impairs mitochondrial functions. SOF increased lipid peroxidation and oxidative DNA damage markers and decreased tissue expression of nuclear factor erythroid 2-related factor 2 (Nfe2l2). (4) Conclusions: The present findings demonstrate the adverse effects of SOF on mitochondrial biogenesis and function in different tissues of young female rats, which mostly appeared in ovarian tissues.
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Affiliation(s)
- Hala A. Hafez
- Department of Biochemistry, Medical Research Institute, Alexandria University, Alexandria 21561, Egypt; (R.H.M.K.); (S.A.S.); (N.M.A.); (S.A.M.)
| | - Ali M. Atoom
- Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman 19111, Jordan;
| | - Rana H. M. Khafaga
- Department of Biochemistry, Medical Research Institute, Alexandria University, Alexandria 21561, Egypt; (R.H.M.K.); (S.A.S.); (N.M.A.); (S.A.M.)
| | - Sara A. Shaker
- Department of Biochemistry, Medical Research Institute, Alexandria University, Alexandria 21561, Egypt; (R.H.M.K.); (S.A.S.); (N.M.A.); (S.A.M.)
| | - Maher A. Kamel
- Department of Biochemistry, Medical Research Institute, Alexandria University, Alexandria 21561, Egypt; (R.H.M.K.); (S.A.S.); (N.M.A.); (S.A.M.)
| | - Nagwa M. Assem
- Department of Biochemistry, Medical Research Institute, Alexandria University, Alexandria 21561, Egypt; (R.H.M.K.); (S.A.S.); (N.M.A.); (S.A.M.)
| | - Shimaa A. Mahmoud
- Department of Biochemistry, Medical Research Institute, Alexandria University, Alexandria 21561, Egypt; (R.H.M.K.); (S.A.S.); (N.M.A.); (S.A.M.)
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Baraka K, Abozahra RR, Badr E, Abdelhamid SM. Study of some potential biomarkers in Egyptian hepatitis C virus patients in relation to liver disease progression and HCC. BMC Cancer 2023; 23:938. [PMID: 37798688 PMCID: PMC10552374 DOI: 10.1186/s12885-023-11420-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 09/19/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Egypt has the greatest prevalence of hepatitis C worldwide according to the WHO reports, accounting for 13% of the global HCV infections. HCV is a substantial precursor for fibrosis, cirrhosis, and hepatocellular carcinoma. This study aimed to investigate the potential relevance of some cytokines, miR-122 and miR-221 for the diagnosis of liver disease progression associated to HCV infection. METHODS One hundred and twenty blood samples were collected from patients with chronic liver disease, HCC, and healthy individuals. Total bilirubin, alanine aminotransferase, aspartate aminotransferase, platelet count, albumin, and creatinine were measured. Serum level of selected cytokines was conducted by ELISA. Serum miRNA expression was detected by RT-PCR. RESULTS IL-2R was higher among HCC patients and the mean concentration of both TNF-αRII and IL-6R was higher among cirrhotic patients. The expression of miRNA-122 showed a little fold decrease in all studied groups; the highest level was observed in HCC patients. The expression of miRNA-221 showed a significant fold increase in HCC and cirrhotic groups. CONCLUSIONS This study revealed that there is no difference in liver disease progression in patients regarding sex and age. Routine liver function tests performed poorly in terms of early diagnosis of liver disease progression; however, serum total bilirubin gave somewhat useful guide for discrimination between fibrotic, cirrhotic and HCC cases. IL-2R showed a significant consistent increase in its level with disease progression. The miR-221 serum level showed significant fold increase with liver disease progression. Therefore, making miR-221 a potential non-invasive biomarker for liver disease progression in the diagnostic setting is recommended.
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Affiliation(s)
- Kholoud Baraka
- Microbiology and Immunology Department, Faculty of Pharmacy, Damanhour University, El Gomhoreya Street, Damanhour, El Behira Egypt
| | - Rania R. Abozahra
- Microbiology and Immunology Department, Faculty of Pharmacy, Damanhour University, El Gomhoreya Street, Damanhour, El Behira Egypt
| | - Eman Badr
- Microbiology and Immunology Department, Faculty of Pharmacy, Damanhour University, El Gomhoreya Street, Damanhour, El Behira Egypt
| | - Sarah M. Abdelhamid
- Microbiology and Immunology Department, Faculty of Pharmacy, Damanhour University, El Gomhoreya Street, Damanhour, El Behira Egypt
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Lilhore UK, Manoharan P, Sandhu JK, Simaiya S, Dalal S, Baqasah AM, Alsafyani M, Alroobaea R, Keshta I, Raahemifar K. Hybrid model for precise hepatitis-C classification using improved random forest and SVM method. Sci Rep 2023; 13:12473. [PMID: 37528148 PMCID: PMC10394001 DOI: 10.1038/s41598-023-36605-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 06/07/2023] [Indexed: 08/03/2023] Open
Abstract
Hepatitis C Virus (HCV) is a viral infection that causes liver inflammation. Annually, approximately 3.4 million cases of HCV are reported worldwide. A diagnosis of HCV in earlier stages helps to save lives. In the HCV review, the authors used a single ML-based prediction model in the current research, which encounters several issues, i.e., poor accuracy, data imbalance, and overfitting. This research proposed a Hybrid Predictive Model (HPM) based on an improved random forest and support vector machine to overcome existing research limitations. The proposed model improves a random forest method by adding a bootstrapping approach. The existing RF method is enhanced by adding a bootstrapping process, which helps eliminate the tree's minor features iteratively to build a strong forest. It improves the performance of the HPM model. The proposed HPM model utilizes a 'Ranker method' to rank the dataset features and applies an IRF with SVM, selecting higher-ranked feature elements to build the prediction model. This research uses the online HCV dataset from UCI to measure the proposed model's performance. The dataset is highly imbalanced; to deal with this issue, we utilized the synthetic minority over-sampling technique (SMOTE). This research performs two experiments. The first experiment is based on data splitting methods, K-fold cross-validation, and training: testing-based splitting. The proposed method achieved an accuracy of 95.89% for k = 5 and 96.29% for k = 10; for the training and testing-based split, the proposed method achieved 91.24% for 80:20 and 92.39% for 70:30, which is the best compared to the existing SVM, MARS, RF, DT, and BGLM methods. In experiment 2, the analysis is performed using feature selection (with SMOTE and without SMOTE). The proposed method achieves an accuracy of 41.541% without SMOTE and 96.82% with SMOTE-based feature selection, which is better than existing ML methods. The experimental results prove the importance of feature selection to achieve higher accuracy in HCV research.
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Affiliation(s)
- Umesh Kumar Lilhore
- Department of Computer Science and Engineering, Chandigarh University, Gharuan, Mohali, Punjab, 140413, India
| | - Poongodi Manoharan
- College of Science and Engineering, Qatar Foundation, Hamad Bin Khalifa University, Doha, Qatar.
| | - Jasminder Kaur Sandhu
- Department of Computer Science and Engineering, Chandigarh University, Gharuan, Mohali, Punjab, 140413, India
| | - Sarita Simaiya
- Apex Institute of Technology (CSE), Chandigarh University, Gharuan, Mohali, Punjab, 140413, India
| | - Surjeet Dalal
- Amity School of Engineering and Technology, Amity University Haryana, Gurugram, India
| | - Abdullah M Baqasah
- Department of Information Technology, College of Computers and Information Technology, Taif University, Taif, 21974, Saudi Arabia
| | - Majed Alsafyani
- Department of Computer Science, College of Computers and Information Technology, Taif University, P. O. Box 11099, Taif, 21944, Saudi Arabia
| | - Roobaea Alroobaea
- Department of Computer Science, College of Computers and Information Technology, Taif University, P. O. Box 11099, Taif, 21944, Saudi Arabia
| | - Ismail Keshta
- Computer Science and Information Systems Department, College of Applied Sciences, AlMaarefa University, Riyadh, Saudi Arabia
| | - Kaamran Raahemifar
- College of Information Sciences and Technology, Data Science and Artificial Intelligence Program, Penn State University, State College, PA, 16801, USA
- School of Optometry and Vision Science, Faculty of Science, University of Waterloo, 200 University, Waterloo, ON, N2L3G1, Canada
- Faculty of Engineering, University of Waterloo, 200 University Ave W, Waterloo, Canada
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Omar MA, Omran MM, Farid K, Tabll AA, Shahein YE, Emran TM, Petrovic A, Lucic NR, Smolic R, Kovac T, Smolic M. Biomarkers for Hepatocellular Carcinoma: From Origin to Clinical Diagnosis. Biomedicines 2023; 11:1852. [PMID: 37509493 PMCID: PMC10377276 DOI: 10.3390/biomedicines11071852] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/15/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
The incidence of hepatocellular carcinoma (HCC) and HCC-related deaths has increased over the last few decades. There are several risk factors of HCC such as viral hepatitis (B, C), cirrhosis, tobacco and alcohol use, aflatoxin-contaminated food, pesticides, diabetes, obesity, nonalcoholic fatty liver disease (NAFLD), and metabolic and genetic diseases. Diagnosis of HCC is based on different methods such as imaging ultrasonography (US), multiphasic enhanced computed tomography (CT), magnetic resonance imaging (MRI), and several diagnostic biomarkers. In this review, we examine the epidemiology of HCC worldwide and in Egypt as well as risk factors associated with the development of HCC and, finally, provide the updated diagnostic biomarkers for the diagnosis of HCC, particularly in the early stages of HCC. Several biomarkers are considered to diagnose HCC, including downregulated or upregulated protein markers secreted during HCC development, circulating nucleic acids or cells, metabolites, and the promising, recently identified biomarkers based on quantitative proteomics through the isobaric tags for relative and absolute quantitation (iTRAQ). In addition, a diagnostic model used to improve the sensitivity of combined biomarkers for the diagnosis of early HCC is discussed.
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Affiliation(s)
- Mona A. Omar
- Chemistry Department, Faculty of Science, Damietta University, New Damietta 34517, Egypt;
| | - Mohamed M. Omran
- Chemistry Department, Faculty of Science, Helwan University, Cairo 11795, Egypt;
| | - Khaled Farid
- Tropical Medicine Department, Faculty of Medicine, Mansoura University, Mansoura 35524, Egypt;
| | - Ashraf A. Tabll
- Microbial Biotechnology Department, National Research Centre, Cairo 12622, Egypt
- Immunology Department, Egypt Center for Research and Regenerative Medicine (ECRRM), Cairo 11517, Egypt
| | - Yasser E. Shahein
- Molecular Biology Department, National Research Centre, Cairo 12622, Egypt
| | - Tarek M. Emran
- Clinical Pathology Department, Faculty of Medicine, Al-Azhar University, New Damietta 34517, Egypt;
| | - Ana Petrovic
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (A.P.); (N.R.L.); (R.S.); (T.K.)
| | - Nikola R. Lucic
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (A.P.); (N.R.L.); (R.S.); (T.K.)
| | - Robert Smolic
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (A.P.); (N.R.L.); (R.S.); (T.K.)
| | - Tanja Kovac
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (A.P.); (N.R.L.); (R.S.); (T.K.)
| | - Martina Smolic
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (A.P.); (N.R.L.); (R.S.); (T.K.)
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10
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Mahmoud Farhan S, Mahmoud Abd El-Baky R, Mohammad Abdalla SA, Osama El-Gendy A, Farag Azmy A. Efficacy of Amikacin and Imipenem Against Multi-Drug Resistant Gram-Negative Bacteria Isolated from Wound Infections, Egypt. IRANIAN JOURNAL OF MEDICAL MICROBIOLOGY 2023; 17:218-229. [DOI: 10.30699/ijmm.17.2.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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11
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Syms R, Taylor-Robinson SD, Trovato G. Circular Medicine - Being Mindful of Resources and Waste Recycling in Healthcare Systems. Risk Manag Healthc Policy 2023; 16:267-270. [PMID: 36852329 PMCID: PMC9961144 DOI: 10.2147/rmhp.s396667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/10/2023] [Indexed: 02/22/2023] Open
Abstract
In the light of the COP27 Climate Change Conference, the concept of the circular economy has come to the fore with promotion of reuse and recycling of appliances and materials from electronics to clothes. This concept has not been widely taken up by healthcare systems. In this perspective article, we discuss the idea of the circular economy and how, by extension, the concept of "circular medicine" with optimised hospital and medical clinic waste recycling might be promoted in the context of better stewardship of resources in healthcare management.
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Affiliation(s)
- Richard Syms
- Department of Electrical and Electronic Engineering, Imperial College London, London, UK
| | - Simon D Taylor-Robinson
- Department of Department of Surgery and Cancer at St Mary’s Hospital Campus, Imperial College London, London, UK
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George Michael T, Anwar CA, Ahmed OA, Sarhan I, Elshazly Y, Shaker MK, Eltabbakh M, Hashem W, Tawfic SR, Kamel SY, Kandil DM, Naguib GG, Khedr A, Ghanem EA, Dabbous H, Doss W, El-Sayed MH. Micro-elimination of hepatitis C in patients with chronic kidney disease: an Egyptian single-center study. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2022. [DOI: 10.1186/s43162-022-00139-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background and aims
Micro-elimination of hepatitis C in renal patients is crucial. This study aims to assess the efficacy and safety of directly acting antivirals in chronic kidney disease patients and the effect of treatment on kidney functions.
Results
This prospective cohort study included 77 chronic HCV-infected patients with chronic kidney disease. Patients were consented and treated for 12 weeks with either sofosbuvir and daclatasvir ± ribavirin if glomerular filtration rate was > 30 mL/min per 1.73m2 or ritonavir-boosted paritaprevir-ombitasvir-ribavirin if it was < 30 mL/min per 1.73m2. Patients were divided into two categories (responders versus non-responders). Predictors of response to treatment were statistically analyzed through logistic regression analysis. Sixty-two patients received ritonavir-boosted paritaprevir-ombitasvir-ribavirin, 3 received sofosbuvir and daclatasvir, and 12 received sofosbuvir and daclatasvir plus ribavirin. Most patients were on hemodialysis (n = 36) while 31 were stage 3 kidney disease. All patients completed their treatment course; ribavirin doses were adjusted or stopped in patients who developed anemia (40%). Seventy-two patients (93.5%) achieved sustained virological response 12 weeks following end-of-treatment. Five patients (6.5%) were non-responders, 4 of whom were on hemodialysis (p = 0.179). All non-responders were on ritonavir-boosted paritaprevir-ombitasvir-ribavirin. The mean serum creatinine level at weeks 4 and 8 of treatment demonstrated significant improvement compared to pretreatment values (p < 0.001) in patients on conservative therapy.
Conclusion
Treatment of chronic kidney disease patients for chronic hepatitis C with directly acting antivirals is safe, efficacious with high response rates and likely to improve renal functions if started early in the course of kidney disease.
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Impact of prothrombin and factor V Leiden mutations on the progression of fibrosis in patients with chronic hepatitis C. PLoS One 2022; 17:e0276592. [DOI: 10.1371/journal.pone.0276592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/11/2022] [Indexed: 11/12/2022] Open
Abstract
Background
The role of thrombotic factors in the pathogenesis and progression of liver fibrosis remains obscure. We aimed to study the relationship between prothrombin G20210A (PT20210) and factor V Leiden (FVL) mutations and the progression of fibrosis and liver function in chronic HCV patients.
Methods
The study included 100 subjects, 88 patients with HCV-related cirrhosis (compensated: 38, decompensated: 50), and 12 controls. Patients with other viral hepatitis or coinfection, inherited metabolic disease, autoimmune hepatitis, hepatic or extrahepatic malignancy, in addition to patients with causes of hypoalbuminemia, elevated bilirubin or prolonged INR not related to cirrhosis were excluded from the study. Relevant clinical data were collected and basic laboratory tests were performed. Liver fibrosis was assessed using APRI and FIB-4 scores. FVL and PT20210 mutations were analyzed.
Results
FVL and PT20210 mutations were significantly higher in decompensated vs. compensated patients (32% vs. 5.3%, P = 0.001; 20% vs. 5.3%, 0.043, respectively) and absent in controls. Both mutations significantly correlated to the duration of infection, platelet count and fibrosis scores. PT20210 mutation significantly correlated to serum albumin and INR. Both mutations significantly predicted fibrosis scores, especially PT20210 (AUROC: 0.833 for APRI and 0.895 for FIB-4).
Conclusions
Both mutations are significantly correlated to fibrosis progression and liver profile and could be considered as markers predicting the need for early and different intervention.
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Veracruz N, Gish RG, Cheung R, Chitnis AS, Wong RJ. Global trends and the impact of chronic hepatitis B and C on disability-adjusted life years. Liver Int 2022; 42:2145-2153. [PMID: 35753064 DOI: 10.1111/liv.15347] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 06/12/2022] [Accepted: 06/24/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND AIMS Advances in hepatitis B virus (HBV) and hepatitis C virus (HCV) therapies have improved morbidity and mortality, but global disparities in viral hepatitis outcomes remain. We evaluate global trends in the impact of HBV and HCV on disability-adjusted life years (DALYs). METHODS Using data from the 2010-2019 Global Burden of Diseases Study (GBD), overall all-cause DALYs for patients with acute HBV or HCV, HBV- or HCV-related cirrhosis, and HBV- or HCV-related hepatocellular carcinoma (HCC) was calculated as the sum of years of life lost because of premature death and years lived with disability. DALYs were presented as age-standardized rates per 100 000 population stratified by age and sex. RESULTS From 2010 to 2019, the overall global impact of HBV on DALYs per 100 000 decreased from 27.6 to 20.9 for acute HBV and 168.6 to 129.8 for HBV-related cirrhosis but remained stable for HBV-related HCC. The impact of HCV on DALYs per 100 000 decreased from 5.23 to 3.3 for acute HCV, 159.2 to 146.2 for HCV-related cirrhosis, and 37.5 to 34.9 for HCV-related HCC. We observed significant differences in the impact of HBV and HCV on DALYs when stratified by world regions. CONCLUSION Decreases in HBV and HCV DALYs from 2010 to 2019 were observed. Disparities in DALY improvements across world regions suggest unequal access to viral hepatitis care and treatment. Achieving goals of viral hepatitis elimination will require enhanced prevention efforts and funding for high-burden regions and regions that have not had substantial reductions in DALYs because of HBV and HCV.
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Affiliation(s)
| | - Robert G Gish
- Hepatitis B Foundation, Doylestown, Pennsylvania, USA
| | - Ramsey Cheung
- Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Healthcare System, Palo Alto, California, USA.,Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA
| | - Amit S Chitnis
- Tuberculosis Section, Division of Communicable Disease Control and Prevention, Alameda County Public Health Department, San Leandro, California, USA
| | - Robert J Wong
- Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Healthcare System, Palo Alto, California, USA.,Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA
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15
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Rim CH, Lee WJ, Musaev B, Volichevich TY, Pazlitdinovich ZY, Nigmatovich TM, Rim JS. Challenges and Suggestions in Management of Lung and Liver Cancer in Uzbekistan: The Second Report of the Uzbekistan-Korea Oncology Consortium. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11727. [PMID: 36142000 PMCID: PMC9517504 DOI: 10.3390/ijerph191811727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
The health burden of cancer increases in Uzbekistan as the country develops and the life expectancy increases. Management of such a burden requires efficient screening, treatment optimization, and investigation of the causes of cancer. The Ministry of Health of Uzbekistan formed an advisory consortium, including clinical oncology and healthcare management experts from Uzbekistan and South Korea, to design a strategy for cancer management. Our consortium has analyzed six cancer types with high morbidity and mortality in Uzbekistan by classifying them into three categories (breast, cervical (gynecologic cancers), lung, liver (cancer common in men), stomach, and colorectal cancers (gastrointestinal cancers)). Lung and liver cancers are common causes of death in men after middle age-they can yield a serious health burden on the country and ruin the livelihood of families. In this review, we will analyze the oncologic literature and suggest practical recommendations for the treatment and prevention of lung and liver cancer in Uzbekistan. Data from South Korea, which has conducted nationwide screening for two decades and made progress in improving prognosis, will be discussed as a comparative control.
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Affiliation(s)
- Chai Hong Rim
- Department of Radiation Oncology, Korea University Ansan Hospital, Korea University, Seoul 02841, Korea
| | - Won Jae Lee
- Department of Healthcare Management, Gachon University, Seongnam 13120, Korea
| | - Bekhzood Musaev
- Ministry of Health of the Republic of Uzbekistan, Tashkent 100086, Uzbekistan
| | - Ten Yakov Volichevich
- Republican Specialized Scientific Practical-Medical Center of Oncology and Radiology, Farobiy Street 383, Tashkent 100179, Uzbekistan
| | - Ziyayev Yakhyo Pazlitdinovich
- Republican Specialized Scientific Practical-Medical Center of Oncology and Radiology, Farobiy Street 383, Tashkent 100179, Uzbekistan
| | | | - Jae Suk Rim
- Department of Oral & Maxillofacial Surgery, Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro 2-dong, Guro-gu, Seoul 08308, Korea
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16
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Hagag RS, Fakhry MM, Ahmed OA, Abdalgeleel SA, Radwan MA, Naguib GG. Assessment of efficacy and safety of two Egyptian protocols for treatment-experienced HCV patients: an observational study. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2022. [DOI: 10.1186/s43162-022-00126-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The devastating adverse effects of interferon (IFN) for the treatment of hepatitis C virus (HCV) lead to the emerging of direct acting antiviral agents (DAAs). This investigation was undertaken to assess safety and efficacy of two Egyptian DAA protocols for HCV: sofosbuvir (SOF)/daclatasvir (DCV)/simeprevir (SMV)/ribavirin (RBV) and sofosbuvir (SOF)/ombitasvir (OMB)/paritaprevir (PTV)/ritonavir (RTV)/RBV for 12 weeks in treatment-experienced HCV Egyptian patients.
Methods
It is a retrospective study where 139 patients, out of 400 patients, were divided according to their documented treatment protocol into two groups (Gp1: SOF/DCV/SMV/RBV and Gp2: SOF/PTV/OMB/RTV/RBV). All patients’ physical examination, disease history, laboratory baseline, and end of treatment data were collected from their profiles, evaluated and compared.
Results
Gp1 and Gp2 regimens had achieved sustained virologic response rates (SVR12) of 96.6% and 95.1%, respectively. Hemoglobin, ALT, and AST had decreased significantly (P < 0.05) in the two groups. Total bilirubin level had increased significantly in Gp1 and Gp2 (P = 0.002 and < 0.001, respectively). Creatinine level had increased significantly (P = 0.002) in Gp1 at end of treatment, while Gp2 remained unchanged. Headache and fatigue were the most common side effects in both protocols.
Conclusions
SOF/DCV/SMV/RBV and SOF/PTV/OMB/RTV/RBV regimens achieved high similar efficacy in Egyptian treatment-experienced HCV patients. Even though the outcome was with tolerable side effects, a better treatment regimen was recommended to abate these side effects for the welfare of Egyptian HCV patients.
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17
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Waked I. Case study of hepatitis C virus control in Egypt: impact of access program. Antivir Ther 2022; 27:13596535211067592. [PMID: 35491550 DOI: 10.1177/13596535211067592] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although Egypt was the country with the highest prevalence of hepatitis C in the world, the availability of sofosbuvir based therapies enabled Egypt to be the first country to eliminate hepatitis C and cure more than 4 million chronically infected patients. PURPOSE This is a small tribute to John Martin. METHODOLOGY AND CONCLUSION Here I present a summary of the HCV problem in Egypt, and how we, through Gilead's Access program under his leadership, were able to eliminate the disease.
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Affiliation(s)
- Imam Waked
- RinggoldID:68873National Liver Institute, Shebeen El Kom, Egypt
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18
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Non-Invasive Diagnosis of Liver Fibrosis in Chronic Hepatitis C using Mathematical Modeling and Simulation. ELECTRONICS 2022. [DOI: 10.3390/electronics11081260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hepatitis C is a viral infection (HCV) that causes liver inflammation, and it was found that it affects over 170 million people around the world, with Egypt having the highest rate in the world. Unfortunately, serial liver biopsies, which can be invasive, expensive, risky, and inconvenient to patients, are typically used for the diagnosis of liver fibrosis progression. This study presents the development, validation, and evaluation of a prediction mathematical model for non-invasive diagnosis of liver fibrosis in chronic HCV. The proposed model in this article uses a set of nonlinear ordinary differential equations as its core and divides the population into six groups: Susceptible, Treatment, Responder, Non-Responder, Cured, and Fibrosis. The validation approach involved the implementation of two equivalent simulation models that examine the proposed process from different perspectives. A system dynamics model was developed to understand the nonlinear behavior of the diagnosis process over time. The system dynamics model was then transformed to an equivalent agent-based model to examine the system at the individual level. The numerical analysis and simulation results indicate that the earlier the HCV treatment is implemented, the larger the group of people who will become responders, and less people will develop complications such as fibrosis.
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19
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Lopes H, Baptista-Leite R, Franco D, Serra MA, Escudero A, Martín-Moreno JM. Let's End HepC: Modelling Public Health Epidemiological Policies Applied to Hepatitis C in Spain. Front Public Health 2022; 9:735572. [PMID: 35071151 PMCID: PMC8777247 DOI: 10.3389/fpubh.2021.735572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/17/2021] [Indexed: 11/24/2022] Open
Abstract
Background: The WHO has defined international targets toward the elimination of hepatitis C by 2030. Most countries cannot be on track to achieve this goal unless many challenges are surpassed. The Let's End HepC (LEHC) tool aims to contribute to the control of hepatitis C. The innovation of this tool combines the modelling of public health policies (PHP) focused on hepatitis C with epidemiological modelling of the disease, obtaining a unique result that allows to forecast the impact of policy outcomes. The model was applied to several countries, including Spain. Methods: To address the stated objective, we applied the “Adaptive Conjoint Analysis” for PHP decision-making and Markov Chains in the LEHC modelling tool. The tool also aims to be used as an element of health literacy for patient advocacy through gamification mechanisms and country comparability. The LEHC project has been conducted in several countries, including Spain. The population segments comprised in the project are: People Who Inject Drugs (PWID), prisoners, blood products, remnant population. Results: A total of 24 PHP related to hepatitis C were included in the LEHC project. It was identified that Spain had fully implemented 14 of those policies to control hepatitis C. According to LEHC's model forecast, the WHO's Hepatitis C elimination goal on reducing the number of patients living with Hepatitis C to 10% can be achieved in Spain by 2026 if current policies are maintained. The model estimates that the total population in Spain, by 2026, is expected to comprise 26,367 individuals living with hepatitis C. Moreover, if the 24 PHP considered for this study are fully implemented in Spain, the elimination goal may be achieved in 2024, with 29,615 individuals living with hepatitis C by that year. Conclusion: The findings corroborate the view that Spain has set great efforts in directing PHP toward Hepatitis C Virus (HCV) elimination by 2030. However, there is still room for improvement, namely in further implementing 10 of the 24 PHP considered for the LEHC project. By maintaining the 14 PHP in force, the LEHC model estimates the HCV elimination in the country by 2026, and by 2024 if further measures are employed to control the disease.
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Affiliation(s)
- Henrique Lopes
- Institute of Health Sciences, Catholic University of Portugal, Lisbon, Portugal
| | - Ricardo Baptista-Leite
- Institute of Health Sciences, Catholic University of Portugal, Lisbon, Portugal.,Faculty of Health, Medicine and Life Sciences, Department of International Health, Care and Public Health Research Institute - CAPHRI, Maastricht University, Maastricht, Netherlands
| | - Diogo Franco
- Institute of Health Sciences, Catholic University of Portugal, Lisbon, Portugal
| | - Miguel A Serra
- Digestive Medicine Service, University of Valencia, Valencia, Spain
| | - Amparo Escudero
- Department of Medicine, University of Valencia, Valencia, Spain
| | - José M Martín-Moreno
- Department of Preventive Medicine and Public Health and INCLIVA, University of Valencia, Valencia, Spain
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Farrugia A, Fomiatti R, Fraser S, Moore D, Edwards M, Birbilis E, Treloar C. Hepatitis C cure as a 'gathering': Attending to the social and material relations of hepatitis C treatment. SOCIOLOGY OF HEALTH & ILLNESS 2022; 44:830-847. [PMID: 35365924 PMCID: PMC9325418 DOI: 10.1111/1467-9566.13467] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/22/2022] [Accepted: 03/14/2022] [Indexed: 05/05/2023]
Abstract
Since the advent of direct-acting antiviral hepatitis C treatments, widespread enthusiasm about disease elimination has emerged. This article examines experiences of hepatitis C treatment and cure in this period. Mobilising Fraser and Seear's (Making disease, making citizens: The politics of hepatitis C, Ashgate, 2011) approach to hepatitis C as a 'gathering', we analyse cure not as a biomedical phenomenon but as a social and material event. To do so, we take a Science and Technology Studies-inspired approach to analyse three complementary cases drawn from an Australian project on experiences of hepatitis C, treatment and cure. First, we analyse the ways a friendship between two women combines with adjustments to treatment access to produce a gathering that makes cure possible. Second, we analyse the forces that gather and distribute responsibility when a cure does not occur in a context shaped by oversimplified treatment logics. Third, we analyse a gathering of relations in which hepatitis C lingers, thereby limiting the cure's possible transformative effects. We argue that, even in an era defined by highly effective medicines, the hepatitis C cure is not necessarily straightforward, but an unpredictable gathering constituted by a fragile coalescing of social and material forces.
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Affiliation(s)
- Adrian Farrugia
- Australian Research Centre in Sex, Health and SocietyLa Trobe UniversityMelbourneVictoriaAustralia
- National Drug Research InstituteCurtin UniversityPerthWestern AustraliaAustralia
| | - Renae Fomiatti
- Australian Research Centre in Sex, Health and SocietyLa Trobe UniversityMelbourneVictoriaAustralia
| | - Suzanne Fraser
- Australian Research Centre in Sex, Health and SocietyLa Trobe UniversityMelbourneVictoriaAustralia
- Centre for Social Research in HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - David Moore
- Australian Research Centre in Sex, Health and SocietyLa Trobe UniversityMelbourneVictoriaAustralia
| | - Michael Edwards
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNew South WalesAustralia
| | - Elizabeth Birbilis
- Prevention and Population and Health BranchPublic Health DivisionDepartment of HealthVictoria State GovernmentMelbourneVictoriaAustralia
| | - Carla Treloar
- Australian Research Centre in Sex, Health and SocietyLa Trobe UniversityMelbourneVictoriaAustralia
- Centre for Social Research in HealthSocial Policy Research CentreUniversity of New South WalesSydneyNew South WalesAustralia
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21
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Kamal A, Matta C, Mohsin HA, Elhadidi AS, Ghazy RM, Omar HH, Tahoun M, Mohamed NA. ASSESSING PREDICTORS OF DIRECTLY ACTING ANTIVIRALS' FAILURE AS A FURTHER STEP TOWARDS MORE EFFICIENT HCV ELIMINATION PROGRAMS: IL28B (IFNL4) GENE POLYMORPHISM HAS NO ROLE WHILE HIGHER ESTIMATED CREATININE CLEARANCE IS A FORGOTTEN FACTOR. ARQUIVOS DE GASTROENTEROLOGIA 2022; 59:177-183. [PMID: 35830025 DOI: 10.1590/s0004-2803.202202000-33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 01/17/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Sustained virologic response (SVR) rates after directly acting antivirals (DAAs) for hepatitis C virus (HCV) exceed 95%. This encouraged policymakers to put plans to achieve HCV elimination by 2030. The remaining percentage of non-SVR12 can affect HCV eradication strategies in the real-world especially the compliance of large numbers of treated persons to follow up for assessment of virologic response cannot be guaranteed. OBJECTIVE We aimed to assess predictors of failure to achieve SVR after receiving sofosbuvir plus NS5A inhibitor as an important step towards achieving better HCV eradication strategies. METHODS During the period from 1st November 2018 to 1st November 2019, 1581 treatment-naive patients received sofosbuvir plus daclatasvir ± ribavirin at our unit and 10 patients were referred to us with HCV relapse after the same regimens. A total of 163 out of the 1581 patients were lost for follow-up before assessment of virologic response and excluded from the analysis. 20 out of the remaining patients failed to achieve SVR12. Data from the 30 patients with non-SVR12 were included in the case-control analysis. RESULTS Every unit increase in estimated creatinine clearance using modification of diet in renal disease study (MDRD) score, total bilirubin, and INR was associated with 1.03, 13.92, and 80.08 times greater odds of non-SVR12 (P<0.001, P=0.0016, P=0.02) respectively. The presence of liver cirrhosis on ultrasonography increases the odds by 10.03. (P=0.009). CONCLUSION Higher MDRD score, INR, total bilirubin, and presence of sonographic features of liver cirrhosis are predictors of failure to achieve SVR12 using sofosbuvir plus NS5A inhibitor.
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Affiliation(s)
- Ahmed Kamal
- Internal Medicine and Hepatology department. Faculty of Medicine, Alexandria University, Egypt
| | - Cecil Matta
- Developmental Genetics department, Faculty of Science, Alexandria University, Egypt
| | - Heba Akram Mohsin
- Cell biology and genetics fellow, Faculty of Science, Alexandria University, Egypt
- College of pharmacy-Al-Zahraa University for Women, Iraq
| | - Abeer Shawki Elhadidi
- Clinical and chemical pathology department, Faculty of Medicine, Alexandria University, Egypt
| | - Ramy Mohamed Ghazy
- Tropical health department, High Institute of Public Health, Alexandria University, Egypt
| | - Heba Hany Omar
- Clinical Pharmacist at Alexandria Main University hospitals, Alexandria University, Egypt
- Microbiology department, Faculty of Pharmacy, AL Salam University, Egypt
| | - Mona Tahoun
- Clinical and chemical pathology department, Faculty of Medicine, Alexandria University, Egypt
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22
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Ahmed YM, Badawy SS, Abdel-Haleem FM. Dibenzo-18-Crown-6-based Carbon Paste Sensors for the Nanomolar Potentiometric Determination of Daclatasvir Dihydrochloride: An Anti-HCV Drug and a Potential Candidate for Treatment of SARS-CoV-2. Microchem J 2022; 177:107276. [PMID: 35169329 PMCID: PMC8830182 DOI: 10.1016/j.microc.2022.107276] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/13/2022] [Accepted: 02/07/2022] [Indexed: 12/24/2022]
Abstract
Daclatasvir dihydrochloride (DAC) is an anti-hepatitis C virus (HCV) drug that has recently proven to be a promising candidate for the treatment of SARS-CoV-2. Still, there is a lack of sensitive potentiometric methods for its determination. In this work, carbon paste sensors based on dibenzo-18-crown-6 (DB18C6) were fabricated and optimized for the sensitive and selective potentiometric determination of DAC in Daclavirocyrl® tablets, serum, and urine samples. The best performance was obtained by two sensors referred to as sensor I and sensor II. Both sensors exhibited a wide linear response range of 5×10−9 − 1×10−3 mol/L, and Nernstian slopes of 29.8 ± 1.18 and 29.5 ± 1.00 mV/decade, with limits of detection, 4.8×10−9 and 3.2×10−9 mol/L, for the sensors I and II, respectively. Sensors I and II displayed fast response times of 5–8 and 5–6 s, respectively, with great reversibility and no memory effect. Moreover, the sensors exhibited a lifetime of 16 days. For the study of sensors morphology and elucidation of the interaction mechanism, the scanning electron microscope (SEM), Fourier-transform infrared spectroscopy (FTIR), and nuclear magnetic resonance (1H NMR) techniques were performed. A selectivity study was performed, and the proposed sensors exhibited good discrimination between DAC and potentially coexisting interferents with sensor II displaying better selectivity. Finally, sensor II was successfully applied for the determination of DAC in the above-mentioned samples, with recovery values ranging from 99.25 to 101.42%, and relative standard deviation (RSD) values ranging from 0.79 to 1.53% which reflected the high accuracy and precision.
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Affiliation(s)
- Yomna M Ahmed
- Chemistry Department, Faculty of Science, Cairo University, Giza, Egypt
| | - Sayed S Badawy
- Chemistry Department, Faculty of Science, Cairo University, Giza, Egypt
| | - Fatehy M Abdel-Haleem
- Chemistry Department, Faculty of Science, Cairo University, Giza, Egypt.,Center for Hazards Mitigation, Environmental Studies and Research (CHMESR), Cairo University, Giza, Egypt
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23
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Mohamed EI, El-Ghnam SM, Bayoumi AM, Abdel-Mageed SM, Ghareeb DA, Ross B. Electronic nose versus quadrupole mass spectrometry for identifying viral hepatitis C patients. J Viral Hepat 2022; 29:147-155. [PMID: 34773341 DOI: 10.1111/jvh.13630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/13/2021] [Accepted: 11/02/2021] [Indexed: 12/12/2022]
Abstract
Hepatitis C is a leading cause of liver disease and transplantation and is a significant burden on public health worldwide. This study aimed to apply the Electronic Nose (E-Nose) and quadrupole Mass Spectrometry (MS/MS) technologies for screening blood samples from hepatitis C patients and healthy controls. We analysed volatile organic compounds (VOCs) in the headspace over blood samples to identify those VOCs characteristic for diagnosing hepatitis C patients. The study comprised 150 acute hepatitis C patients with age range: 24-59 years, and mean age ±SD: 41.5 ± 12.8 years and 150 age-matched healthy controls (age range: 24-51 and mean age: 40.11 ± 4.89 years) from the Hospital of the Medical Research Institute, Alexandria University, Alexandria, Egypt. Collected blood samples were analysed qualitatively and quantitatively using the E-Nose and MS/MS techniques, respectively. Principal component analysis of the E-Nose 10-sensor responses accurately classified blood samples from hepatitis C patients and healthy controls. The first two principal components explained over 98.35% of the variance in signals with no false-positive (healthy controls) or false-negative (hepatitis C patients) results. MS/MS showed two fragmentation ions at m/z of 104 and 151 Da with the positive electrospray ionization mode (ESI+) in blood samples for hepatitis C patients, but not for healthy controls or background water samples. We identified the two specific fragmentation ions at m/z 104 and m/z 151 Da as malonic acid (MF: C3 H4 O4 ; MW: 104.06 g/mol) and monosaccharide pentose (MF: C5 H10 O5 ; MW: 150.13 g/mol) in VOCs of the headspace over blood samples for hepatitis C patients. This provides a rationale for developing diagnostic tests for hepatitis C virus based on altered trace VOCs concentrations using the relatively inexpensive, easy-to-use, portable and non-invasive E-Nose technology.
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Affiliation(s)
- Ehab I Mohamed
- Department of Medical Biophysics, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Sameh M El-Ghnam
- Department of Physics, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Amani M Bayoumi
- Department of Physics, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Samir M Abdel-Mageed
- Department of Physics, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Doaa A Ghareeb
- Department of Biochemistry, Faculty of Science, Alexandria University, Alexandria, Egypt.,Pre-Clinical Center, Scientific Research and Technology Applications City, Borg Al-Arab, Alexandria, Egypt
| | - Brian Ross
- Northern Ontario School of Medicine, Lakehead University, Ontario, Canada
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24
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Matboli M, Hassan MK, Ali MA, Mansour MT, Elsayed W, Atteya R, Aly HS, Meteini ME, Elghazaly H, El-Khamisy S, Agwa SHA. Impact of circ-0000221 in the Pathogenesis of Hepatocellular via Modulation of miR-661-PTPN11 mRNA Axis. Pharmaceutics 2022; 14:pharmaceutics14010138. [PMID: 35057034 PMCID: PMC8778063 DOI: 10.3390/pharmaceutics14010138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/29/2021] [Accepted: 01/05/2022] [Indexed: 02/01/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death in Egypt. A deep understanding of the molecular events occurring in HCC can facilitate the development of novel diagnostic and/or therapeutic approaches. In the present study, we describe a novel axis of hsa-circ-0000221–miR-661–PTPN11 mRNA proposed by in silico and in vitro analysis and its role in HCC pathogenesis. We observe a reduction in the expression levels of hsa-circ-0000221 and PTPN11 mRNA in HCC patients’ sera tested compared with control subjects. The reduction occurs with a concomitant increase in the expression of miR-661. Furthermore, the introduction of exogenous hsa-circ-0000221 into Hep-G2 or SNU449 cell lines results in detectable decrease in cellular viability and an increase in apoptotic manifestations that is associated with G1 accumulation and CCDN1 overexpression. Altogether, these findings indicate the tumor-suppressive role of hsa-circ-0000221 in HCC, which acts through miR-661 inhibition, along with a subsequent PTPN11 mRNA increase, where PTPN11 is known to inhibit cell proliferation in many forms of cancer. Our study encourages further investigation of the role of circRNAs in cancer and their potential use as molecular biomarkers.
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Affiliation(s)
- Marwa Matboli
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Ain Shams University, Abbassia, Cairo 11381, Egypt;
- Correspondence: (M.M.); (S.H.A.A.)
| | - Mohmed Kamal Hassan
- Center for Genomics, Helmy Institute for Medical Sciences, Zewail City for Science and Technology, Giza 12578, Egypt; (M.K.H.); (W.E.); (R.A.)
- Biotechnology Program, Biology Division, Zoology Department, Faculty of Science, Port Said University, Port Said 42526, Egypt
| | - Mahmoud A. Ali
- Department of Biomedical Research, Armed Forces College of Medicine (AFCM), Cairo 11774, Egypt; (M.A.A.); or (M.T.M.)
| | - Mohamed Tarek Mansour
- Department of Biomedical Research, Armed Forces College of Medicine (AFCM), Cairo 11774, Egypt; (M.A.A.); or (M.T.M.)
| | - Waheba Elsayed
- Center for Genomics, Helmy Institute for Medical Sciences, Zewail City for Science and Technology, Giza 12578, Egypt; (M.K.H.); (W.E.); (R.A.)
| | - Reham Atteya
- Center for Genomics, Helmy Institute for Medical Sciences, Zewail City for Science and Technology, Giza 12578, Egypt; (M.K.H.); (W.E.); (R.A.)
| | - Hebatallah Said Aly
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Ain Shams University, Abbassia, Cairo 11381, Egypt;
| | - Mahmoud El Meteini
- Department of General Surgery, The School of Medicine, University of Ain Shams, Abbassia, Cairo 11382, Egypt;
| | - Hesham Elghazaly
- Oncology Department, Faculty of Medicine, Medical Ain Shams Research Institute (MASRI), Ain Shams University, Cairo 11382, Egypt;
| | - Sherif El-Khamisy
- The Healthy Lifespan Institute, The Institute of Neuroscience, Department of Molecular Biology and Biotechnology, University of Sheffield, Sheffield S10 2TN, UK;
- The Institute of Cancer Therapeutics, West Yorkshire BD7 1DP, UK
| | - Sara H. A. Agwa
- Clinical pathology and Molecular Genomics Unit, Faculty of Medicine, Medical Ain Shams Research Institute (MASRI), Ain Shams University, Cairo 11382, Egypt
- Correspondence: (M.M.); (S.H.A.A.)
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25
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El Maguid HA, Heiba A, El Sayed E, El-Hariri H, Tolba H, Abdel Ghaffar M. Assessment of Renal Function in Egyptian HCV Patients Treated with Combination Therapy of Sofosbuvir and Daclatasvir. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: According to the most recent Egyptian demographic health census, the estimated Hepatitis C virus (HCV) prevalence in the 15–59 age range was 14.7%. Globally, the incidence of renal impairment in HCV-positive individuals is 40% higher than in HCV-negative patients. HCV-induced renal impairment can range from mild-to-severe, and it frequently complicates the treatment outcome of HCV infection.
AIM: This study aimed to explore the changes in renal function in Egyptian HCV patients treated with a combination of Sofosbuvir (SOF) and Daclatasvir (DCV).
METHODOLOGY: Six hundred and eleven chronic HCV patients treated with SOF-DCV were enrolled. Patients were classified into three groups according to their baseline renal function: unimpaired group (estimated glomerular filtration rate [eGFR] ≥ 90 ml/min/1.73 m2), mildly impaired group (eGFR of ≥60–89 ml/min/1.73 m2), and moderately impaired group (eGFR of ≥30–59 ml/min/1.73 m2). Every month during treatment and at 24 weeks after treatment (sustained virological response 24), the eGFR level was evaluated.
RESULTS: Our findings indicated that the eGFR level was significantly increased (p < 0.001) in all groups during the treatment but subsequent decline (p < 0.001) in all groups was documented after 6 months of treatment. Multivariate analysis identified baseline renal impairment (<90 ml/min/1.73 m2, p < 0.001) and baseline anemia (p < 0.001) as independent risk factors for renal function deterioration at the end of treatment.
CONCLUSION: Clinical physicians should closely monitor renal function in patients treated with SOF-DCV. Furthermore, anemia therapy prior to SOF-DCV treatment should be recommended.
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26
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Elghoroury EA, Abdelghaffar EE, Awadallah E, Kamel SA, Kandil D, Hassan EM, Hassan M, Kamel MM, Gomaa MM, Fathalla LA. Detection of exosomal miR-18a and miR-222 levels in Egyptian patients with hepatic cirrhosis and hepatocellular carcinoma. Int J Immunopathol Pharmacol 2022; 36:3946320221097832. [PMID: 35467432 PMCID: PMC9047801 DOI: 10.1177/03946320221097832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is known to be the second leading cause of cancer-related mortality worldwide. For improving the prognosis as well as reducing the rate of mortality, early diagnosis of HCC is a must. AIMS This study was conducted to assess the ability of the serum expression of exosomal miR-18a and miR-222 to differentiate and diagnose patients with HCC, patients with liver cirrhosis, and healthy controls. METHODS This study included 51 patients with liver cirrhosis, 51 patients with HCC on top of hepatitis C virus (HCV) infection, and 50 healthy controls. RESULTS miR-18a and miR-222 were assessed using reverse transcription-polymerase chain reaction. MiR-18a and miR-222 levels were significantly higher in the liver cirrhosis and HCC groups than the control group (p ˂ 0.001). However, no statistically significant difference was found between patients with HCC and liver cirrhosis (p = 0.4 for miR-18a and p = 0.1 for miR-222). ROC curve analyses to evaluate the diagnostic performances of the two miRNAs as important noninvasive diagnostic markers revealed a best cutoff value of 2 for miR-18a to differentiate between liver cirrhosis, HCC, and healthy controls. And for mir-222, a cutoff value of 1.7 and 1.9 showed the highest specificity for discrimination between liver cirrhosis, HCC, and healthy controls, respectively. Moreover, logistic regression model revealed that miR-18a expression was independent predictive factor in HCC patients (p = 0.004), while miR-222 expression was independent predictive factor in liver cirrhosis patients (p < 0.001). CONCLUSION miR-18a and miR-222 were significantly discriminative markers between patients with liver cirrhosis and HCC and healthy individuals. Therefore, they have a prognostic rather than a diagnostic value. Moreover, miR-18a and miR-222 could be useful in identifying liver injuries, including fibrosis and cirrhosis.
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Affiliation(s)
- Eman A Elghoroury
- Clinical and Chemical Pathology Department, 68787National Research Centre, Dokki, Cairo, Egypt
| | - Esmat E Abdelghaffar
- Clinical and Chemical Pathology Department, 68787National Research Centre, Dokki, Cairo, Egypt
| | - Eman Awadallah
- Clinical and Chemical Pathology Department, 68787National Research Centre, Dokki, Cairo, Egypt
| | - Solaf A Kamel
- Clinical and Chemical Pathology Department, 68787National Research Centre, Dokki, Cairo, Egypt
| | - Dina Kandil
- Clinical and Chemical Pathology Department, 68787National Research Centre, Dokki, Cairo, Egypt
| | - Eman M Hassan
- Clinical and Chemical Pathology Department, 68787National Research Centre, Dokki, Cairo, Egypt
| | - Mirhane Hassan
- Clinical and Chemical Pathology Department, 68787National Research Centre, Dokki, Cairo, Egypt
| | - Mahmoud M Kamel
- Clinical and Chemical Pathology Department, 68804National Cancer Institute, Cairo University, Cairo, Egypt
| | - Mohammed M Gomaa
- Department of Diagnostic and Interventional Radiology, 68804National Cancer Institute, Cairo University, Cairo, Egypt
| | - Lamiaa A Fathalla
- Clinical and Chemical Pathology Department, 68804National Cancer Institute, Cairo University, Cairo, Egypt
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27
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Role of liver biopsy versus non-invasive biomarkers for diagnosis of significant fibrosis and cirrhosis: a web-based survey. EGYPTIAN LIVER JOURNAL 2021. [DOI: 10.1186/s43066-021-00166-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Liver biopsy is the standard reference for staging hepatic fibrosis. Non-invasive methods for assessment of hepatic fibrosis and cirrhosis are becoming increasingly popular.
Objective
We aimed at exploring the change in practice regarding the use of liver biopsy and non-invasive methods for staging hepatic fibrosis and cirrhosis among hepatologists.
Methods
We performed a survey-based study that recruited hepatologists from various Egyptian institutions. Physicians were deemed eligible if they had a degree in internal medicine with hepatology as a subspecialty. We utilized an online-based survey that assessed the acceptability and reliability of liver biopsy, serum biomarkers, and radiological tools for evaluating liver fibrosis and cirrhosis.
Results
A total of 573 responses were retrieved (response rate = 80.3%). Out of them, 58% were having more than 15 years of experience as a hepatologist.
Liver biopsy is still considered the gold standard for assessment of hepatic fibrosis and cirrhosis by 61% of participants. Liver biopsy was accepted by 44% of their patients. 84% reported the need for a more practical alternative to liver biopsy to assess disease progression or response to treatment. 78.34% of participants know serum biomarkers, 84.08% reported that they were acceptable by their patients, 37.79% thought they are reliable. 95.4% were familiar with radiological methods of non-invasive assessment of hepatic fibrosis, 89.1% reported that radiological methods were acceptable by their patients, 62% think that they are reliable and 78% reported they were applicable in clinical practice. Sixty-five percent think that combining non-invasive methods is better than using a single method. Forty percent of participants thought that radiological methods are easier to use for assessment of hepatic fibrosis followed by a combination of non-invasive methods, serum biomarkers, and liver biopsy respectively.
Conclusion
In conclusion, liver biopsy is still considered the most reliable method for evaluation and staging of liver cirrhosis by hepatologists in Egyptian institutions, despite the modest acceptance by the patients. Nonetheless, non-invasive methods are gaining acceptance by Egyptian physicians and patients, and most of them consider these methods as reliable and applicable tools for predicting the course of liver cirrhosis.
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28
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Nada A, Sabry A, Elabd NS, Abdu Allah AM, Elnaidany N, Abbasy M. B-type natriuretic peptide (BNP) in HCV-positive Egyptian patients: the impact of HCV eradication on plasma BNP levels. EGYPTIAN LIVER JOURNAL 2021. [DOI: 10.1186/s43066-021-00133-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Chronic hepatitis C virus (HCV) infection represents a major health-related burden in Egypt. HCV is considered as a major cardiovascular risk factor. BNP (B-type natriuretic peptide) has been determined as a credible diagnostic and prognostic cardiac biomarker. We aimed to assess plasma BNP in HCV-positive Egyptian patients prior and after HCV eradication by direct-acting antiviral agents (DAAs) therapy. Eighty-nine chronic HCV-positive patients were enrolled in our prospective research. They were provided with DAAs therapy in the form of sofosbuvir and daclatasvir without or with ribavirin for 12 weeks. History, clinical evaluation, and laboratory assessment: CBC, liver and kidney function tests, viral markers (HCVAb, HBVsAg, and HIVAb) by ELISA, HCV RNA by real-time PCR, and BNP by ELISA were assessed. FIB-4 and aspartate aminotransferase-to-platelet ratio index (APRI) scores were ranked.
Results
Plasma BNP displayed a non-significant (p = 0.124) increase of its serum mean values in post eradication of HCV than its baseline values. Baseline BNP exhibited a significant positive correlation with FIB4 (r = 0.411, P < 0.001) and APRI score (r = 0.418, p < 0.001) with a considerably negative correlation with platelets (r = − 0.274, p = 0.009), in addition to higher pretreatment BNP values in cirrhotic than in non-cirrhotic patients (p < 0.001), while non-significant relations were found regarding sex, BMI, and drug regimen (with or without ribavirin) (p = 0.950, 0.845, and 0.738, respectively). Additionally, plasma BNP values considerably decreased post-treatment in patients presented with higher baseline BNP values and more advanced liver disease (higher FIB4, APRI, and the presence of liver cirrhosis).
Conclusion
Our findings propose on the one side, the necessity of cardiac monitoring during chronic HCV infection and, on the other, the valuable impacts of HCV eradication on HCV-associated cardiac morbidities.
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Hepatitis C liver disease during COVID-19 pandemic in Egypt: Challenges and way forward. ETHICS, MEDICINE, AND PUBLIC HEALTH 2021; 19:100702. [PMID: 34778505 PMCID: PMC8575068 DOI: 10.1016/j.jemep.2021.100702] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 01/23/2023]
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30
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AbdElHady MS, Ibrahim ST, Adam A, Elnekidy A, Lewis N, Gawesh RI. DO VITAMIN D DEFICIENCY AND HEPATITIS C VIRUS INFECTION PLAY A ROLE IN OXIDATIVE STRESS IN PATIENTS ON MAINTENANCE HEMODIALYSIS? ALEXANDRIA JOURNAL OF MEDICINE 2021. [DOI: 10.1080/20905068.2021.1956831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Mahmoud S. AbdElHady
- Department of Internal Medicine and Nephrology Department, Kafr ELSheikh University, Egypt
| | - Sara T Ibrahim
- Department of Internal Medicine and Nephrology Department, Faculty of Medicine, Alexandria University, Alexandria Egypt
| | - Ahmed Adam
- Department of Internal Medicine and Nephrology Department, Faculty of Medicine, Alexandria University, Alexandria Egypt
| | - Abelaziz Elnekidy
- Department of Radiodiagnosis Faculty of Medicine Alexandria University, Egypt
| | - Neveen Lewis
- Department of Clinical Pathology Department, Alexandria University Hospital, Egypt
| | - Rasha Ibrahim Gawesh
- Department of Internal Medicine and Nephrology Department, Faculty of Medicine, Alexandria University, Alexandria Egypt
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Motawi TMK, Sabry D, Shehata NI, William MM, Fahim AT. Impact of FOXP1 rs2687201 genetic variant on the susceptibility to HCV-related hepatocellular carcinoma in Egyptians. J Biochem Mol Toxicol 2021; 36:e22965. [PMID: 34783112 DOI: 10.1002/jbt.22965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 08/25/2021] [Accepted: 10/26/2021] [Indexed: 12/24/2022]
Abstract
Hepatocellular carcinoma (HCC) constitutes a challenging health problem in Egypt due to the high incidence of hepatitis C virus (HCV) infection. Improved understanding of genetic mechanisms underlying the individual predisposition to HCC will lead to enhancements in the early diagnosis, treatment, and prevention of this disease. Transcription factor forkhead box P1 (FOXP1) is involved in the cellular processes of proliferation, differentiation, metabolism, and longevity. In addition, it has been implicated in hepatic tumorigenesis. The present study explored the association of C/A single-nucleotide polymorphism in the FOXP1 gene (rs2687201) with HCC susceptibility in HCV Egyptian patients. The study included 108 patients with HCV-dependant HCC, 86 HCV patients, and 80- age and gender-matched healthy controls. rs2687201 genotyping was performed by allelic discrimination method using TaqMan real-time PCR assays while FOXP1 gene expression and protein level were determined using qRT-PCR and enzyme-linked immunoassay, respectively. Our results revealed a significant association between FOXP1 rs2687201 and HCC risk where (A) allele was significantly more frequent in patients with HCC compared to controls (odds ratio [OR]: 1.88, 95% confidence interval [CI]: 1.17-3.04, p = 0.01) and to HCV patients (OR: 1.85, 95% CI: 1.62-2.94, p = 0.012). Furthermore, FOXP1 gene and protein expression levels were remarkably higher in (CA + AA) than in CC genotype carriers in a dominant model. The (CA + AA) genotype displayed a significantly shorter overall survival than the CC genotype in HCC patients. In conclusion, FOXP1 gene polymorphism rs2687201 is significantly associated with HCC, but not with HCV infection, in Egyptian patients.
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Affiliation(s)
| | - Dina Sabry
- Department of Medical Biochemistry and Molecular Biology, Cairo University, Cairo, Egypt
| | | | - Mira Magdy William
- Department of Biochemistry, Faculty of Pharmacy, October 6 University, Cairo, Egypt
| | - Atef Tadros Fahim
- Department of Biochemistry, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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Butaru AE, Gheonea DI, Rogoveanu I, Diculescu M, Boicea AR, Bunescu M, Streba CT, Oancea CN. Micro-Elimination: Updated Pathway to Global Elimination of Hepatitis C in Small Communities and Industrial Settings during the COVID 19 Pandemic. J Clin Med 2021; 10:jcm10214976. [PMID: 34768496 PMCID: PMC8584569 DOI: 10.3390/jcm10214976] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/19/2021] [Accepted: 10/24/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND In response to the goal of the World Health Organisation to eliminate hepatitis C virus infections by 2030, Romania is striving for national elimination. An already successful micro-elimination project was expanded to test-and-treat specific populations and at-risk groups. The aim of this project was to identify the individuals with HCV infection in disadvantaged regions who do not have proper medical care access. MATERIALS AND METHODS Our two-arm interventional cross-sectional study used rapid anti-HCV antibody testing on two population groups from the Romanian southwestern region of Oltenia, approached between September 2020 and May 2021. The first group consisted of predominantly over 40 years old individuals, recruited through five family doctors from two medium-sized towns (community lot-CL). We approached a second group, aged 18-65, through 11 medical offices of five large factories in the same region (industry lot, IL). A 12-items questionnaire was given to each participant, to determine risk factors and record demographic data. Eligible patients initiated antiviral therapy using direct-acting antivirals (DAAs). RESULTS We enrolled 15,383 individuals between all 16 locations. The overall prevalence by antibody testing was 0.77% (119 cases). Of these, 57 subsequently received treatment with DAAs. We identified blood transfusions as a risk factor within the CL. Participants in the IL reported a relatively high risk for the following situations: sharing of personal hygiene belongings with another person, performing previous blood transfusions, dental interventions and previous surgery. CONCLUSIONS In this global context, the use of micro-elimination allows interventions to be faster and more efficient. This is possible by targeting smaller and specific HCV risk groups.
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Affiliation(s)
- Anca Elena Butaru
- Department of Infectious Disease, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Dan Ionuț Gheonea
- Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.I.G.); (I.R.)
| | - Ion Rogoveanu
- Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.I.G.); (I.R.)
| | - Mircea Diculescu
- Department of Gastroenterology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Ancuța-Ramona Boicea
- Department of Labor Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.-R.B.); (M.B.)
| | - Marius Bunescu
- Department of Labor Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.-R.B.); (M.B.)
| | - Costin-Teodor Streba
- Research Center of Gastroenterology and Hepatology of Craiova, 200638 Craiova, Romania
- Department of Pulmonology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Correspondence: ; Tel.: +40-722-38-99-06
| | - Carmen Nicoleta Oancea
- Department of Analytical Chemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
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El Sayed ML, Gouda TES, Khalil ELSAM, Al Arman MMES, Mohamed IE. Clinical profile and outcome among patients with acute-on-chronic liver failure admitted in the intensive care unit. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2021. [DOI: 10.1186/s43162-021-00061-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Acute-on-chronic liver failure (ACLF) has been recently defined as a clinical form including acute hepatic decompensation and high 28-day mortality. ACLF usually follows a precipitating event on the background of established cirrhosis. ACLF is considered the most frequent indication for admission to the ICU among cirrhotic patients. Our research aimed to reveal the clinical profile and outcome among patients with ACLF to detect an allocation system of these patients to the intensive care unit (ICU), and a decision tool for clinical practice. It is a prospective study of 60 patients with ACLF. Patients are divided into group A that included 30 patients with ACLF admitted to the hepatology and gastroenterology ward and group B that also included 30 patients with ACLF admitted to the ICU. Each group is subdivided into subgroups regarding the grade of ACLF.
Results
The most common precipitating factor of ACLF is SBP 78.3% (80% in ICU, 73.6% inward). Renal failure is the most common organ failure in ACLF in both groups. CLIF-C ACLF is assumed to be a highly prognostic score for mortality in ACLF patients better than other scores. ROC curve of CLIF-C ACLF with AUC: 0.972 and CI: 0.919, 1.025 showed a cutoff point = 57.0 above which intensive care admission does not seem to benefit ACLF patients. The sensitivity at the optimal cut point is 88.89% and the specificity is 100%. There is a significant difference between the 3 ACLF groups regarding 1-month and 3-month mortalities in patients admitted to the ICU. ACLF1 shows the least 1-month and 3-month mortality rates while ACLF3 shows the highest mortality rates in ICU patients ((1-month mortality: 20%, 60%, 100% in ACLF1, 2, 3 respectively), (3-month mortality: 50%, 80%, 100% in ACLF1, 2, 3 respectively)).
Conclusion
Mortality is high in ACLF and increases with the number of organ failures (40% in ACLF1 to 100% in ACLF3). CLIFC-ACLF is the most prognostic scoring system with a cut-off value of 57; above this value, mortality is a fact.
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Heiza M, Elmola K, Salama B. Unsafe Practices Associated with HCV Infection Among Adults: A Case Control Study. Int J Prev Med 2021; 12:60. [PMID: 34447502 PMCID: PMC8356959 DOI: 10.4103/ijpvm.ijpvm_94_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 12/01/2020] [Indexed: 12/05/2022] Open
Abstract
Background: Infection with the hepatitis C virus (HCV) occurs globally. It is a substantial cause of chronic liver disease, cirrhosis and hepatocellular carcinoma. Egypt one the countries that has the highest hepatitis C burden in the world. The occurrence of HCV is directly related to the number of individuals who regularly share injection instruments and to the prevalence of inappropriate parenteral procedures in healthcare facilities. The study aimed to identify unhealthy community practices related to HCV infection. Methods: a nested case control study carried out in Damietta Governorate, Egypt. Where150 cases (positive for HCV) and 300 controls (negative for HCV) were randomly chosen. Results: Participant who shared shaving razor was 8.4times more likely to acquire HCV infection followed by IV fluid and needle or sharp stick (about six times more risk).while acupuncture, cupping, tattooing and traditional cauterization carried 1.6 to 3.6 timesmorerisk for HCV infection. Conclusions: Unhealthy community practices carried a higher risk for acquiring HCV infection. It is highly advocated to strengthen infection prevention and control program in health care facilities and health education programs to enhance community awareness and empowerment.
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Affiliation(s)
- Mohamed Heiza
- Department of Tropical Medicine, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Khaled Elmola
- Department of Tropical Medicine, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Basem Salama
- Community Medicine, Damietta Faculty of Medicine, Al-Azhar University, Egypt
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Liver Cirrhosis, Etiology and Clinical Characteristics Disparities Among Minority Population. J Immigr Minor Health 2021; 24:1122-1128. [PMID: 34453643 DOI: 10.1007/s10903-021-01263-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2021] [Indexed: 10/20/2022]
Abstract
Liver cirrhosis (LC) is a common disease with varied primary causes and ethnic disparities. Clinical characteristics and outcomes of Arab Bedouin (AB) and Jewish patients with LC were retrospective collected and compared. We included 1048 patients, 95 (9%) Arab Bedouin and 953 (91%) Jewish patients. The incidence of cirrhosis was much lower among AB. Age at diagnosis was 47 ± 18 years among Bedouins compared to 61 ± 13 years (p < 0.001) among Jews. The most frequent causes of cirrhosis among Bedouin patients were fatty liver 21.1%, cryptogenic 20%, hepatitis B 17.9% and autoimmune hepatitis 15.8%, while hepatitis C (39.2%), fatty liver (17.2%) and alcoholic liver disease (14.4%) were most common among Jewish patients. An all-cause mortality of 48.4% was observed in AB patients compared to 66.4% in Jewish patients (p < 0.001). Significant disparities regarding incidence, clinical characteristics and outcomes of cirrhosis among Arab Bedouin compared with Jewish population were found.
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Homaeigohar S, Liu Q, Kordbacheh D. Biomedical Applications of Antiviral Nanohybrid Materials Relating to the COVID-19 Pandemic and Other Viral Crises. Polymers (Basel) 2021; 13:2833. [PMID: 34451371 PMCID: PMC8401873 DOI: 10.3390/polym13162833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/12/2021] [Accepted: 08/20/2021] [Indexed: 01/19/2023] Open
Abstract
The COVID-19 pandemic has driven a global research to uncover novel, effective therapeutical and diagnosis approaches. In addition, control of spread of infection has been targeted through development of preventive tools and measures. In this regard, nanomaterials, particularly, those combining two or even several constituting materials possessing dissimilar physicochemical (or even biological) properties, i.e., nanohybrid materials play a significant role. Nanoparticulate nanohybrids have gained a widespread reputation for prevention of viral crises, thanks to their promising antimicrobial properties as well as their potential to act as a carrier for vaccines. On the other hand, they can perform well as a photo-driven killer for viruses when they release reactive oxygen species (ROS) or photothermally damage the virus membrane. The nanofibers can also play a crucial protective role when integrated into face masks and personal protective equipment, particularly as hybridized with antiviral nanoparticles. In this draft, we review the antiviral nanohybrids that could potentially be applied to control, diagnose, and treat the consequences of COVID-19 pandemic. Considering the short age of this health problem, trivially the relevant technologies are not that many and are handful. Therefore, still progressing, older technologies with antiviral potential are also included and discussed. To conclude, nanohybrid nanomaterials with their high engineering potential and ability to inactivate pathogens including viruses will contribute decisively to the future of nanomedicine tackling the current and future pandemics.
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Affiliation(s)
- Shahin Homaeigohar
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, UK;
| | - Qiqi Liu
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China;
| | - Danial Kordbacheh
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, UK;
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Dennis BB, Naji L, Jajarmi Y, Ahmed A, Kim D. New hope for hepatitis C virus: Summary of global epidemiologic changes and novel innovations over 20 years. World J Gastroenterol 2021; 27:4818-4830. [PMID: 34447228 PMCID: PMC8371499 DOI: 10.3748/wjg.v27.i29.4818] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/20/2021] [Accepted: 07/13/2021] [Indexed: 02/06/2023] Open
Abstract
Hepatitis C virus (HCV) is a global health concern associated with significant morbidity and mortality. Before the approval of second-generation direct-acting antiviral agents (DAAs), interferon therapy and liver transplantation constituted the mainstay of treatment. The introduction of well-tolerated oral DAAs in late 2013 has revolutionized HCV management with over 95% cure rates. The predominance of HCV-related liver transplantations has declined following the widespread approval of DAAs. Despite the unparallel efficacy observed among these novel therapies, pharmaceutical costs continue to limit equitable access to healthcare and likely contribute to the differential HCV infection rates observed globally. To reduce the burden of disease worldwide, essential agenda items for all countries must include the prioritization of integrated care models and access to DAAs therapies. Through transparent negotiations with the pharmaceutical industry, the consideration for compassionate release of medications to promote equitable division of care is paramount. Here we provide a literature review of HCV, changes in epidemiologic trends, access issues for current therapies, and global inequities in disease burden.
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Affiliation(s)
- Brittany B Dennis
- Department of Medicine, McMaster University, Hamilton L8S 4L8, ON, Canada
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA 94304, United States
| | - Leen Naji
- Department of Family Medicine, McMaster University, Hamilton L8P 1H6, ON, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton L8S 4K1, ON, Canada
| | - Yasmin Jajarmi
- Department of Medicine, McMaster University, Hamilton L8S 4L8, ON, Canada
| | - Aijaz Ahmed
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA 94304, United States
| | - Donghee Kim
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA 94304, United States
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Anwar S, El Kharrat E, Bakhoum A, El-Sadr WM, Harris TG. Association of sociodemographic factors with needle sharing and number of sex partners among people who inject drugs in Egypt. Glob Public Health 2021; 17:1689-1698. [PMID: 34283695 DOI: 10.1080/17441692.2021.1950798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
People who inject drugs (PWID) are at a high risk for HIV. We conducted an evaluation of socio-demographic factors associated with injecting and sexual behaviour among PWID who had two or more visits at a drug outreach clinic in Cairo, Egypt from 2013 to 2017. Routinely collected information on socio-demographics and HIV risk behaviours were abstracted from client records. Bivariate analysis and logistic regression were conducted to evaluate associations between socio-demographics and HIV risk factors. All PWID who tested HIV-positive at the initial visit were excluded from analyses. PWID who were married were more likely to share needles or syringes in the last month of their baseline visit [adjusted odds ratio (aOR) = 4.3, 95% confidence interval (CI) = 1.4-13.1] as were unemployed PWID [aOR = 3.9, 95% CI = 1.5-10.3]. Married PWID were less likely to discontinue sharing needles/syringes [aOR = 0.4, 95% CI = 0.2-0.8] as were those living outside of the Shobra, downtown, and Imbabah districts within Greater Cairo [aOR = 0.2, 95% CI = 0.1-0.5]. No significant associations were found between socio-demographics and number of sex partners in the six months prior to the initial visit. At follow-up visit, 4.4% tested HIV-positive for an incidence rate of 3.9 per 100 person years. Sociodemographic factors should be considered when designing preventive services for PWID.
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Affiliation(s)
- Sakia Anwar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | | | - Wafaa M El-Sadr
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.,ICAP at Columbia University, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Tiffany G Harris
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.,ICAP at Columbia University, Mailman School of Public Health, Columbia University, New York, NY, USA
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Naga IS, Kamel AAF, Ooda SA, Elbab HMF, El-Sharkawy RM. Effect of directly acting anti-viral agents on immunological imprints in chronic HCV-4a patients: interleukin-10 and vascular endothelial growth factor genes expression level. EGYPTIAN LIVER JOURNAL 2021. [DOI: 10.1186/s43066-021-00108-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Hepatitis C virus infection is a global health challenge with Egypt being one of the highly affected countries. IL-10 has been suggested as a suitable marker to assess necroinflammation and to monitor the progression of liver damage. Vascular endothelial growth factor (VEGF) is a potent angiogenic factor playing a central role in many physiological as well as pathological processes. Several factors can be predictive of the response to treatment and achievement of SVR; some of which are host-related, and others are virus-related. The gene expression of IL-10 and VEGF have multiple effects for treatment response. The aim of the present work was to study the effect of treatment with directly acting agents (DAA) on the expression of VEGF and IL-10 genes in chronic hepatitis C virus-infected Egyptian genotype-4a patients. Twenty-five HCV subjects where evaluated for IL-10 and VEGF gene expression before and after treatment with DAA.
Results
IL-10 expression was downregulated in 92% of the cases. VEGF expression was heterogeneous showing spreading of values along a wide range with 64% of the cases being downregulated.
Conclusion
DAAs do not completely reverse the immunological imprints established upon chronic HCV infection.
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Impact of IL10, MTP, SOD2, and APOE Gene Polymorphisms on the Severity of Liver Fibrosis Induced by HCV Genotype 4. Viruses 2021; 13:v13040714. [PMID: 33924242 PMCID: PMC8074775 DOI: 10.3390/v13040714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/11/2021] [Accepted: 04/14/2021] [Indexed: 12/13/2022] Open
Abstract
Complications of hepatitis C virus (HCV) chronic infection cause ~400,000 deaths worldwide annually. One complication, liver fibrosis, is influenced by host genetic factors. Genes influencing fibrosis include immune, metabolic, oxidative stress, and viral entry genes, such as interleukin 10 (IL10), microsomal triglyceride-transfer protein (MTP), superoxide dismutase-2 (SOD2), and apolipoprotein E (APOE)-encoding genes, respectively. Thus, correlating variations in these genes with HCV-induced fibrosis represents an attractive biomarker for the prognosis of fibrosis severity in chronically infected patients. Here, we aimed to test whether polymorphisms in IL10, MTP, SOD2, and APOE genes correlated with the severity of fibrosis induced by HCV genotype 4 (HCV-gt4) in a cohort of chronically infected Egyptian patients. Our results demonstrate a significant association between the severity of fibrosis and specific SNPs in IL-10, SOD2, and ApoE-encoding genes. Haplotype-combination analysis for IL10, MTP, SOD2, and APOE showed statistically significant associations between specific haplotype combinations and fibrosis severity. Identifying biomarkers correlating with the severity of HCV-gt4-induced fibrosis would significantly impact precision prophylaxis and treatment of patients at risk.
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Elmekawy HA, Belal F, Abdelaziz AE, Abdelkawy KS, Ali AA, Elbarbry F. Pharmacokinetic interaction between atorvastatin and fixed-dose combination of sofosbuvir/ledipasvir in healthy male Egyptian volunteers. Eur J Clin Pharmacol 2021; 77:1369-1379. [PMID: 33791829 DOI: 10.1007/s00228-021-03130-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/25/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Comorbid conditions of heart and liver disorders added to HCV-induced hepatic steatosis make co-administration of statins, and direct-acting antivirals is common in clinical practice. This study aimed to evaluate the pharmacokinetic interaction of atorvastatin and fixed-dose combination of sofosbuvir/ledipasvir "FDCSL" with rationalization to the underlying mechanism. METHODS A randomized, three-phase crossover study that involves 12 healthy volunteers was performed. Participants received a single-dose of atorvastatin 80 mg alone, atorvastatin 80-mg plus tablets containing 400/90 mg FDCSL, or tablets containing 400/90 mg FDCSL alone. Plasma samples were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) for atorvastatin, sofosbuvir, ledipasvir, and sofosbuvir metabolite "GS-331007," and their pharmacokinetics parameters were determined. RESULTS Compared to atorvastatin alone, the administration of FDCSL caused a significant increase in both areas under the concentration-time curve from time zero to infinity (AUC0-∞) and maximum plasma concentration (Cmax) of atorvastatin by 65.5% and 156.0%, respectively. Also, atorvastatin caused a significant increase in the AUC0-∞ and Cmax of sofosbuvir by 32.0% and 11.0%, respectively. Similarly, AUC0-∞ and Cmax of sofosbuvir metabolite significantly increased by 84.0% and 74.0%, respectively. However, ledipasvir AUC0-∞ showed no significant change after atorvastatin intake. The elimination rate in all drugs revealed no significant changes. CONCLUSION After concurrent administration of FDCSL with atorvastatin, the AUC0-∞ of both atorvastatin and sofosbuvir were increased. Caution should be taken with close monitoring for possible side effects after co-administration of atorvastatin and FDCSL in clinical practice.
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Affiliation(s)
- H A Elmekawy
- Department of Clinical Pharmacy, Faculty of Pharmacy, Kafrelsheikh University, Kafr El-Sheikh, 33511, Egypt
| | - F Belal
- Department of Analytical Chemistry, Faculty of Pharmacy, University of Mansoura, Mansoura, 35516, Egypt
| | - A E Abdelaziz
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Kafrelsheikh University, Kafr El-Sheikh, Egypt
| | - K S Abdelkawy
- Department of Clinical Pharmacy, Faculty of Pharmacy, Kafrelsheikh University, Kafr El-Sheikh, 33511, Egypt
| | - A A Ali
- Department of Clinical Pharmacy, Faculty of Pharmacy, Kafrelsheikh University, Kafr El-Sheikh, 33511, Egypt
| | - F Elbarbry
- Pacific University Oregon School of Pharmacy, Hillsboro, OR, 97123, USA.
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Hassanin A, Kamel S, Waked I, Fort M. Egypt's Ambitious Strategy to Eliminate Hepatitis C Virus: A Case Study. GLOBAL HEALTH: SCIENCE AND PRACTICE 2021; 9:187-200. [PMID: 33795369 PMCID: PMC8087425 DOI: 10.9745/ghsp-d-20-00234] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 02/10/2021] [Indexed: 12/24/2022]
Abstract
A national hepatitis C virus elimination strategy rooted in mass screening and treatment can be effective in many middle-income countries. A strong public health infrastructure, political commitment, and technological advances are essential to such initiatives. Introduction: Chronic hepatitis C virus (HCV) infection is a major public health problem in many low- and middle-income countries. In 2015, Egypt's HCV infection prevalence of 7% among adults was among the highest in the world and accounted for 7.6% of the country's mortality. In 2014, Egypt embarked on an aggressive screening and treatment program that evolved into a national strategy to eliminate HCV as a public health threat by 2021. Methods: In this qualitative case study, we analyzed Egypt's HCV control strategy using the Kingdon framework to understand how the problem, policy, and political streams merged to create an opportunity to achieve an ambitious elimination goal. We describe key aspects of the implementation, identify lessons learned, and provide recommendations for other low- and middle-income countries aiming to eliminate HCV. Results: Between 2014 and 2020, Egypt screened more than 50 million and treated more than 4 million residents for HCV. Five key elements contributed to Egypt's successful HCV elimination program: (1) sufficient and reliable epidemiologic data to quantify and monitor public health threats; (2) a robust public health care infrastructure; (3) inclusive care that reached all sectors of society; (4) political commitment to public health through increased health care spending and a comprehensive long-term national control strategy; and (5) innovative scientific research and use of information technology. Conclusion: Egypt conducted a successful HCV screening program that covered more than 50 million residents and treated more than 4 million. It is poised to be the first country in the world to eliminate HCV within its borders. The lessons learned from this experience can inform the elimination plans of other low- and middle-income countries with high HCV burden.
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Affiliation(s)
- Ahmed Hassanin
- Westchester Medical Center/New York Medical College, NY USA.
| | | | - Iman Waked
- National Liver Institute, Shebeen El Kom, Egypt
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Suef RA, Mohamed EEM, Mansour MTM, Weigand K, Farag MMS. Differential expression of viral pathogen-associated molecular pattern receptors mRNA in Egyptian chronic hepatitis C virus patients. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2021. [DOI: 10.1186/s43042-021-00133-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Abstract
Background
One possible mechanism utilized by hepatitis C virus (HCV) to escape from the host’s innate immune surveillance is modification of its pathogen-associated molecular patterns (PAMPs) by altering or hiding its RNA which interfering with toll-like receptors (TLRs) signaling and ultimately hindering the production of proinflammatory cytokines, chemokines, and interferons (IFNs). This study aimed to examine the expression levels of TLR3, TLR7, and IFN-α to investigate the correlated expression pattern among them in chronic HCV patients. Patients included in this study were categorized into two different groups, non-treated chronic HCV patients and treated chronic HCV patients, in addition to healthy volunteers as a control group. The blood samples were assessed for HCVAb, HCVRNA, HCV genotypes, and different biochemical analyses. The mRNA levels of TLR3, TLR7, and IFN-α in peripheral blood of chronic HCV patients were quantitatively measured in comparison to healthy controls.
Results
The expression levels of TLR3, TLR7, and IFN-α were significantly downregulated in non-treated chronic HCV patients compared to both treated HCV patients and control subjects. On the other hand, treated HCV patients showed non-significant downregulation of the same three sensing receptors (TLR3, TLR7, and IFN-α) compared to control group. Obviously, the expression levels of IFN-α were positively correlated with the levels of both TLR3 and TLR7.
Conclusion
The exhausted innate immunity against HCV may correlate to HCV downregulation of TLR3 and TLR7 expression on innate immune cells with a subsequent decrease in INF-α production and the possibility of targeting these receptors to enhance the immune response and clear the infection needs further studies.
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NS34A resistance-associated substitutions in chronic hepatitis C in Upper Egypt and regression of liver fibrosis after direct-acting antiviral therapy. EGYPTIAN LIVER JOURNAL 2021. [DOI: 10.1186/s43066-021-00080-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Abstract
Background
Viral resistance-associated substitutions (RASs) can develop in the setting of DAAs therapy (i.e., emerging RASs). Long-term monitoring of fibrosis regression after achieving SVR to simiprevir (SMV)/sofosbuvir (SOF) is essential. The aim of this study was to determine the prevalence of baseline and emerging NS34A RASs in chronic HCV patients in Upper Egypt and to assess the impact of SMV/SOF therapy on liver stiffness.
Results
The enrolled 59 patients had HCV genotype 4a without any baseline RASs in the NS34A region. 96.6% (57/59) of patients achieved sustained virological response (SVR12). Of the two patients who failed to achieve SVR12, one of them developed emerging RASs Q80K in the NS34A region. Seventy-two weeks after SMV/SOF therapy, the percentage of patients with liver fibrosis stage (F2, F3, and F4) decreased from 75.4% before treatment to 42.1% after treatment. The combination of SOF and SMV appeared to be well tolerated.
Conclusions
All patients had HCV genotype 4a without any baseline RASs in the NS34A region. In addition, there was improvement of non-invasive measures of liver fibrosis in patients who achieved SVR, 72 weeks after SMV/SOF therapy.
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Amer IF, El Shennawy EM, El Batea H, Ahmed MH, El Sharawy S, Mahros AM. Accuracy of noninvasive tests in the prediction of portal hypertensive gastropathy in Egyptian patients with cirrhosis. JGH OPEN 2021; 5:286-293. [PMID: 33553669 PMCID: PMC7857295 DOI: 10.1002/jgh3.12486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/11/2020] [Accepted: 12/19/2020] [Indexed: 11/23/2022]
Abstract
Background and Aim Liver cirrhosis (LC) is commonly associated with portal hypertensive gastropathy (PHG), and it causes gastrointestinal (GI) bleeding. Esophagogastroduodenoscopy (EGD) is the gold standard in diagnosing PHG. Besides its invasiveness, the disadvantages of EGD include psychological and financial problems. We aimed to evaluate the diagnostic accuracy of different noninvasive screening tools in predicting PHG. Methods This cross‐sectional study was conducted on 100 patients with LC who were divided into two groups based on EGD: group (A), 50 patients with LC with PHG, and group (B), 50 patients with LC without PHG. All patients were subjected to history taking, full clinical examination, laboratory investigations, abdominal–pelvic ultrasonography, and EGD. Results To predict PHG, the respective sensitivity and specificity of portal vein diameter (>10.5 mm) were 86 and 67%, of gallbladder wall thickness (GBWT) (>3.5 mm) were 64 and 68%, of platelets/GBWT (<40) were 68 and 78%, of aspartate aminotransferase (AST)/platelet ratio index (APRI) score (>1.1) were 60 and 66%, of platelet/spleen diameter (<1290) were 88 and 72%, of right liver lobe diameter/albumin ratio (>4) were 74 and 80%, and of AST/alanine aminotransferase (ALT) ratio (>1.1) were 50 and 58% (P = 0.353). Conclusion Portal vein diameter, platelet/spleen diameter, and right liver lobe diameter/albumin ratio were independently associated with PHG and were good predictors of the PHG, whereas AST/ALT ratio and King score are poor predictors.
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Affiliation(s)
- Ibrahim F Amer
- Gastroenterology, Hepatology and Infectious Diseases, Faculty of Medicine Kafrelsheikh University Kafr el-Sheikh Egypt
| | - Eslam M El Shennawy
- Gastroenterology, Hepatology and Infectious Diseases, Faculty of Medicine Kafrelsheikh University Kafr el-Sheikh Egypt
| | - Hassan El Batea
- Gastroenterology, Hepatology and Infectious Diseases, Faculty of Medicine Kafrelsheikh University Kafr el-Sheikh Egypt
| | - Mohammed Hussien Ahmed
- Gastroenterology, Hepatology and Infectious Diseases, Faculty of Medicine Kafrelsheikh University Kafr el-Sheikh Egypt
| | - Shimaa El Sharawy
- Tropical Medicine Department, Faculty of Medicine Tanta University Tanta Egypt
| | - Aya M Mahros
- Gastroenterology, Hepatology and Infectious Diseases, Faculty of Medicine Kafrelsheikh University Kafr el-Sheikh Egypt
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The Safety of The Directly Acting Antiviral Treatment For Hepatitis C Virus According To The Egyptian National Program Protocol In Patients With Midrange Ejection Fraction. Glob Heart 2021; 16:3. [PMID: 33598383 PMCID: PMC7792459 DOI: 10.5334/gh.906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background The Egyptian National Committee of Viral Hepatitis program is the leading national hepatitis C virus (HCV) management program globally. However, limited data is available about the effect of the new directly acting antiviral agents on the cardiovascular system. Objectives Our study aimed to assess the safety of the relatively new directly acting antiviral agents approved by the National Health Committee in Egypt to treat patients infected with hepatitis C virus who have midrange left ventricular ejection fraction. Methods This multicenter study included 400 successive patients with an ejection fraction (40-49%) from May 2017 to December 2019. We classified them into two groups: Group I (Child A), who received Sofosbuvir and Daclatasvir for twelve weeks, and Group II (Child B), who received Sofosbuvir, Daclatasvir, and Ribavirin for twelve weeks. Patients were evaluated for their symptoms, ejection fraction, brain natriuretic peptide, lipid profile, fasting blood glucose, fasting insulin, Homeostatic Model Assessment of Insulin Resistance levels, and Holter monitoring (just before the start of treatment and within three days after completing therapy). Results We found New York Heart Association Class, ejection fraction, brain natriuretic peptide, premature ventricular contractions burden, as well as highest and lowest heart rate did not show a statistically significant difference in both groups after treatment. The treatment did not cause bradycardia or non-sustained ventricular tachycardia. Fasting blood glucose and fasting insulin levels declined, with improved insulin resistance after treatment in both groups. Both low and high-density lipoprotein cholesterol increased after treatment in Group II. Conclusions Both regimens of directly acting antiviral agents used in Egypt to treat chronic hepatitis C virus infection are safe in patients with New York Heart Association Class I and II with midrange left ventricular ejection fraction (40-49%). There are beneficial metabolic changes following HCV clearance as an improvement of insulin resistance.
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Lopes H, Baptista-Leite R, Franco D, Pirker R, Gschwantler M. Integrating public health policies in the epidemiological modeling of hepatitis C with LEHC tool: application in Austria. Wien Klin Wochenschr 2020; 133:461-469. [PMID: 33331968 PMCID: PMC8116292 DOI: 10.1007/s00508-020-01774-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 11/10/2020] [Indexed: 11/24/2022]
Abstract
Background Eliminating hepatitis C requires addressing issues other than medicines or therapies. Public health policies focused on the hepatitis C virus (HCV) must be emphasized and worked to know the impacts on its epidemiologic dynamics. This research aims to provide a tool to evaluate and simulate alternatives by redefining policies meeting specific needs in each country towards the HCV elimination target by 2030. Methods The development of a gamified model with 24 public health policies focused on HCV was conducted to evaluate the impact of measures in the disease epidemiologic dynamics. The Let’s End HepC (LEHC) project encompassed key populations (people who inject drugs [PWID], prisoners, blood products and remnant population) in Austria and other countries, presenting prospects for every year from 2019 to 2030. The LEHC epidemiological model comprised an integrated solution for HCV, with adaptive conjoint analysis (ACA) and Markov chains constituting its main processes. Results Despite Austria’s efforts towards achieving the HCV elimination goal by 2030, the LEHC model forecast quantitative analysis predicts that it is still not enough to meet the target; however, prospects are very optimistic if public health policies are adapted to the country’s needs, being possible to achieve the goal as early as 2026. Conclusion In Austria, the LEHC tool allowed to forecast the HCV elimination year anticipation to 2026, instead of being achieved after 2030. This target will only be valid if adequate management of the 24 public health policies focused on this pathology is further implemented.
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Affiliation(s)
- Henrique Lopes
- Institute of Health Sciences, Public Health Unit, Catholic University of Portugal, Palma de Cima, 1649-023, Lisbon, Portugal.
| | - Ricardo Baptista-Leite
- Institute of Health Sciences, Public Health Unit, Catholic University of Portugal, Palma de Cima, 1649-023, Lisbon, Portugal.,Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Diogo Franco
- Institute of Health Sciences, Public Health Unit, Catholic University of Portugal, Palma de Cima, 1649-023, Lisbon, Portugal
| | - Roxana Pirker
- Department of Internal Medicine IV, Wilhelminenspital, Vienna, Austria
| | - Michael Gschwantler
- Department of Internal Medicine IV, Wilhelminenspital, Vienna, Austria.,Sigmund Freud University, Vienna, Austria
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Mohamed AA, Hemeda AA, Aziz RK, Abdel-Hakeem MS, Ali-Tammam M. Body mass index (BMI) and alpha-fetoprotein (AFP) level correlate with the severity of HCV-induced fibrosis in a cohort of Egyptian patients with chronic HCV. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2020. [DOI: 10.1186/s43094-020-00085-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Abstract
Background
Viral hepatitis is the seventh leading cause of mortality globally, and half of this mortality is attributed to hepatitis C virus (HCV). Egypt has the highest HCV prevalence worldwide, with an estimated 14.7% of the population being HCV-positive. HCV infection is the primary cause of liver fibrosis, cirrhosis, and hepatocellular carcinoma. Liver fibrosis varies in severity during chronic HCV infection, and 10–20% of chronic hepatitis C (CHC) patients with severe fibrosis develop cirrhosis. The goal of this work was to assess the clinico-demographic predictors of severity of HCV-induced fibrosis in a cohort of Egyptian patients.
Results
A cohort of Egyptian patients with chronic HCV genotype 4a infection showed significant association between severe fibrosis stages and obesity, represented by a higher body mass index (BMI), low albumin level, high alpha-fetoprotein (AFP) level, low thyroid-stimulating hormone (TSH) level, and high alkaline phosphatase (ALP) level. Multivariate analysis delineated BMI, TSH, and ALP as independent significant variables that could predict the risk of fibrosis severity in HCV infections.
Conclusion
This study argues in favor of using the biomarker profile of CHC patients infected with HCV genotype 4a to identify patients at higher risk of developing severe fibrosis, which is a necessary first step towards precision medicine via patient stratification.
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Gibriel AA, Al-Anany AM, Al-Arab MAE, Azzazy HME. Investigating circulatory microRNA expression profiles in Egyptian patients infected with hepatitis C virus mediated hepatic disorders. Meta Gene 2020. [DOI: 10.1016/j.mgene.2020.100792] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Aboul Enein AA, Khaled IAA, Khorshied MM, Abdel-Aziz AO, Zahran N, El Saeed AM, Shousha HI, Abdel Rahman HA. Genetic variations in DNA-repair genes (XRCC1, 3, and 7) and the susceptibility to hepatocellular carcinoma in a cohort of Egyptians. J Med Virol 2020; 92:3609-3616. [PMID: 32281666 DOI: 10.1002/jmv.25873] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 01/01/2023]
Abstract
Chronic hepatitis C (CHC) is a worldwide etiology of chronic hepatic insult particularly in Egypt. DNA-repair systems are responsible for maintaining genomic integrity by countering threats posed by DNA lesions. Deficiency in the repair capacity due to genetic alterations in DNA-repair genes can lead to genomic instability and increased risk of cancer development. The present work aimed at studying the possible association between XRCC1-G28152A (rs25487), XRCC3-C18067T (rs861539), and XRCC7-G6721T (rs7003908) single nucleotide polymorphisms (SNPs) and the susceptibility to hepatocellular carcinoma (HCC) in Egyptian population. The study was conducted on 100 newly diagnosed HCC patients and 100 age- and sex-matched healthy controls. Laboratory workup revealed that all HCC patients have chronic hepatitis C viral infection. Genotyping of the studied SNPs was performed by real-time PCR. The heteromutant genotype of XRCC1 (GA) conferred an almost two-fold increased risk of HCC (OR , 2.35; 95% CI, 1.33-4.04). Regarding XRCC7, the heteromutant (TG) genotype conferred a two-fold increased risk of HCC (OR , 2.17; 95% CI, 1.23-3.82). Coinheritance of the polymorphic genotypes of XRCC1 and 7 was significantly higher in HCC cases than controls and was associated with an 11-fold increased risk of HCC (OR , 11.66; 95% CI, 2.77-49.13). The frequency of XRCC3 polymorphic genotypes in HCC patients was close to that of the controls.
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Affiliation(s)
- Azza Ahmed Aboul Enein
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Iman Abdel Aziz Khaled
- Department of Clinical and Chemical Pathology, Theoder Bilharz Research Institute, Cairo, Egypt
| | - Mervat Mamdooh Khorshied
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Nariman Zahran
- Department of Clinical and Chemical Pathology, Theoder Bilharz Research Institute, Cairo, Egypt
| | - Asmaa Mohamed El Saeed
- Department of Clinical and Chemical Pathology, Theoder Bilharz Research Institute, Cairo, Egypt
| | - Hend Ibrahim Shousha
- Department of Tropical Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hala Aly Abdel Rahman
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
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