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David D, Raghavendran A, Goel A, Bharath Kumar C, Kodiatte TA, Burad D, Abraham P, Ramakrishna B, Joseph P, Ramachandran J, Eapen CE. Risk factors for non-alcoholic fatty liver disease are common in patients with non-B non-C hepatocellular carcinoma in India. Indian J Gastroenterol 2017; 36:373-379. [PMID: 28975595 DOI: 10.1007/s12664-017-0785-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 09/05/2017] [Indexed: 02/04/2023]
Abstract
AIM OF THE STUDY The aim of the study was to analyze the prevalence of risk factors for non-alcoholic fatty liver disease (NAFLD) in patients with non-B non-C hepatocellular carcinoma (HCC). METHODS Between June 2012 and November 2014, patients with HCC, negative for hepatitis B surface antigen and hepatitis C virus antibody, were included in this study. All patients were assessed for risk factors for NAFLD such as diabetes mellitus (DM), hypertension, dyslipidemia, metabolic syndrome, and obesity. RESULTS Forty-seven patients with non-B non-C HCC (males, 37; age, 60±10 years; mean±SD) were studied. Model for end-stage liver disease score was 11±4. Twenty-five patients were in Child's class A. History of significant alcohol intake was noted in 11 (23%) patients. Prevalence of risk factors for NAFLD were obesity 24 (51%), DM 22 (47%), metabolic syndrome 21 (45%), hypertension 16 (34%), and dyslipidemia 13 (28%). Forty (85%) patients had at least one risk factor for NAFLD. The mean duration of at least one NAFLD risk factor was 7.5 years, prior to diagnosis of HCC. Thirteen (28%) patients were positive for anti-HBc; however, none of the study patients had detectable HBV DNA in blood. CONCLUSIONS Eighty-five percent of the patients with non-B non-C HCC had at least one risk factor for NAFLD. None of the study patients had occult hepatitis B infection. NAFLD is emerging as the major etiological contributing factor for non-B non-C HCC in India.
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Affiliation(s)
- Deepu David
- Department of Gastroenterology, Division of Gastrointestinal Sciences, Christian Medical College and Hospital, Vellore, 632 004, India.
| | | | - Ashish Goel
- Department of Hepatology, Christian Medical College and Hospital, Vellore, 632 004, India
| | - C Bharath Kumar
- Department of Gastroenterology, Division of Gastrointestinal Sciences, Christian Medical College and Hospital, Vellore, 632 004, India
| | - Thomas Alex Kodiatte
- Department of Pathology, Christian Medical College and Hospital, Vellore, 632 004, India
| | - Deepak Burad
- Department of Pathology, Christian Medical College and Hospital, Vellore, 632 004, India
| | - Priya Abraham
- Department of Virology, Christian Medical College and Hospital, Vellore, 632 004, India
| | - Banumathi Ramakrishna
- Department of Pathology, Christian Medical College and Hospital, Vellore, 632 004, India
| | - Philip Joseph
- Department of Surgery, Christian Medical College and Hospital, Vellore, 632 004, India
| | - Jeyamani Ramachandran
- Department of Hepatology, Christian Medical College and Hospital, Vellore, 632 004, India
| | - C E Eapen
- Department of Hepatology, Christian Medical College and Hospital, Vellore, 632 004, India
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Fletcher GJ, Raghavendran A, Sivakumar J, Samuel P, Abraham P. Diagnostic reliability of Architect anti-HCV assay: Experience of a tertiary care hospital in India. J Clin Lab Anal 2017; 32. [PMID: 28657153 DOI: 10.1002/jcla.22245] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 03/28/2017] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND & AIMS Anti-HCV assays are prone to false positive results. Thus, accurate detection of HCV infection is critical for the timely therapeutic management. This study ascertained the reliability of Architect anti-HCV assay (Abbott) and to estimate the agreement of this assay with Ortho HCV 3.0 ELISA Test System with Enhanced SAVe (Ortho), HCV Tri-dot (Tri-dot) and HCV-PCR in a tertiary care setting. METHODS A total of 78 788 consecutive sera were routinely screened for anti-HCV antibodies using Architect. All repeatedly reactive anti-HCV sera (n=1000) and anti-HCV negative sera (n=300) were tested in Ortho and in Tri-dot assays. Representative proportions of sera (n=500) with various signal-to-cut-off (S/Co) ratio were also compared with HCV-PCR. RESULTS When Architect was compared with Ortho, Tri-dot, and HCV-PCR, the level of agreement as assessed by kappa were .26, .16, and .27 respectively. Using Latent class analysis (LCA), we found that sensitivity and specificity were 100% and 36.1% for Architect, 93.8% and 100% for Ortho and 63.8% and 100% for Tri-dot respectively. The median S/CO ratio of Architect and Ortho anti-HCV assays were significantly different between HCV-PCR positive and negative results (P<.0001). Furthermore, Architect S/CO ratio of >8 showed higher accuracy indices in both anti-HCV assays. CONCLUSIONS Architect can be used as a screening assay because of its high sensitivity, high throughput, and short turnaround time. However, S/Co ratios of ≥1 to <8 in Architect necessitates HCV PCR to identify current infection and or EIA to distinguish true positivity from false biological positivity.
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Affiliation(s)
| | | | | | - Prasanna Samuel
- Department of Bio-statistics, Christian Medical College, Vellore, India
| | - Priya Abraham
- Department of Clinical Virology, Christian Medical College, Vellore, India
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Radhakrishnan K, Karunakaran A, Jindal S, Raghavendran A, Goel A, Kattiparambil Gangadharan S, Zachariah U, Eapen C, Abraham P. Indian experience with use of sofusbuvir for treatment of hepatitis C virus infection: Preliminary data from southern India. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Ismail AM, Raghavendran A, Sivakumar J, Radhakrishnan M, Rose W, Abraham P. Mother to child transmission of hepatitis B virus: a cause for concern. Indian J Med Microbiol 2015; 33 Suppl:140-3. [PMID: 25657134 DOI: 10.4103/0255-0857.150931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Mother to child transmission of hepatitis B virus (HBV) is an important public health issue. India introduced HBV vaccine in 10 states as part of its Universal Immunization Program (UIP). Here we show evidence of mother-to-child transmission of HBV in three families from Jharkhand and Bihar states where HBV vaccination is not yet included in the UIP. This report illustrates the need for active screening of HBV in pregnant women and implementation of HBV vaccine across all states in India to reduce the burden of disease.
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Affiliation(s)
| | | | | | | | | | - P Abraham
- Department of Clinical Virology, Christian Medical College, Vellore - 632004, Tamil Nadu, India
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Laprise C, Madathil SA, Allison P, Abraham P, Raghavendran A, Shahul HP, ThekkePurakkal AS, Castonguay G, Coutlée F, Schlecht NF, Rousseau MC, Franco EL, Nicolau B. No role for human papillomavirus infection in oral cancers in a region in southern India. Int J Cancer 2015; 138:912-7. [PMID: 26317688 DOI: 10.1002/ijc.29827] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 08/14/2015] [Indexed: 01/11/2023]
Abstract
Oral cancer is a major public health issue in India with ∼ 77,000 new cases and 52,000 deaths yearly. Paan chewing, tobacco and alcohol use are strong risk factors for this cancer in India. Human papillomaviruses (HPVs) are also related to a subset of head and neck cancers (HNCs). We examined the association between oral HPV and oral cancer in a sample of Indian subjects participating in a hospital-based case-control study. We recruited incident oral cancer cases (N = 350) and controls frequency-matched by age and sex (N = 371) from two main referral hospitals in Kerala, South India. Sociodemographic and behavioral data were collected by interviews. Epithelial cells were sampled using Oral CDx® brushes from the oral cancer site and the normal mucosa. Detection and genotyping of 36 HPV genotypes were done using a polymerase chain reaction protocol. Data collection procedures were performed by qualified dentists via a detailed protocol with strict quality control, including independent HPV testing in India and Canada. HPV DNA was detected in none of the cases or controls. Associations between oral cancer and risk factors usually associated with HPV infection, such as oral sex and number of lifetime sexual partners, were examined by logistic regression and were not associated with oral cancer. Lack of a role for HPV infection in this study may reflect cultural or religious characteristics specific to this region in India that are not conducive to oral HPV transmission. A nationwide representative prevalence study is needed to investigate HPV prevalence variability among Indian regions.
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Affiliation(s)
- Claudie Laprise
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Sreenath A Madathil
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada
| | - Paul Allison
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Priya Abraham
- Department of Clinical Virology, Christian Medical College, Vellore, India
| | | | - Hameed P Shahul
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | | | - Geneviève Castonguay
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - François Coutlée
- Department of Microbiology and Infectious Diseases, Hôpital Notre-Dame Du Centre De Recherche Du Centre Hospitalier De L'université De Montréal, Montreal, QC, Canada
| | - Nicolas F Schlecht
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY
| | - Marie-Claude Rousseau
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada
| | - Eduardo L Franco
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Belinda Nicolau
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
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Bhageerathy PS, Cecilia M, Sebastian A, Raghavendran A, Abraham P, Thomas A, Peedicayil A. Human papilloma virus-16 causing giant condyloma acuminata. J Surg Case Rep 2014; 2014:rjt126. [PMID: 24876329 PMCID: PMC3913431 DOI: 10.1093/jscr/rjt126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A 28-year-old multiparous lady presented to the Gynaecology outpatient department with a 12 × 5 cm warty growth in the vulva. A biopsy of the growth revealed condyloma acuminata of the vulva. Simple vulvectomy was done. A PCR of the specimen detected the presence of human papilloma virus (HPV)-16 which is usually considered as a high-risk HPV type for carcinogenesis.
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Affiliation(s)
| | - Maria Cecilia
- Department of Obstetrics and Gynaecology, Christian Medical College Hospital, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Ajit Sebastian
- Department of Obstetrics and Gynaecology, Christian Medical College Hospital, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Anantharam Raghavendran
- Department of Clinical Virology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Priya Abraham
- Department of Clinical Virology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Anitha Thomas
- Department of Obstetrics and Gynaecology, Christian Medical College Hospital, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Abraham Peedicayil
- Department of Obstetrics and Gynaecology, Christian Medical College Hospital, Christian Medical College Hospital, Vellore, Tamil Nadu, India
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