International Journal of Hepatology最新文献

{"title":"Host Factors in the Natural History of Chronic Hepatitis B: Role of Genetic Determinants.","authors":"Turyadi,&nbsp;Billy Witanto,&nbsp;Korri E El-Khobar,&nbsp;M Luthfi Parewangi,&nbsp;M Rezki Rasyak,&nbsp;Dhita P Wibowo,&nbsp;Meta D Thedja,&nbsp;Irawan Yusuf,&nbsp;Muh Nasrum Massi,&nbsp;Ilhamjaya Patellongi,&nbsp;Din Syafruddin,&nbsp;David H Muljono","doi":"10.1155/2022/6046677","DOIUrl":"https://doi.org/10.1155/2022/6046677","url":null,"abstract":"<p><strong>Background: </strong>The host immune system plays an important role in hepatitis B virus (HBV) infection manifestation. Genetic polymorphisms of several inflammatory cytokines, including TNF-<i>α</i> and IL-10, have been associated with chronic hepatitis B (CHB) progression, although with contradicting results. CHB progression can be categorized into four phases, immune tolerance (IT), immune clearance (IC), low/no replicative (LR), and e-negative hepatitis (ENH), with HBeAg seroconversion as an important milestone. Here, we determined the association of TNF-<i>α</i> (rs1800629) and IL-10 (rs1800896 and rs1800872) SNPs in the context of CHB natural history progression, particularly to HBeAg seroconversion, in Indonesian CHB patients.</p><p><strong>Methods: </strong>A total of 287 subjects were recruited and categorized into distinct CHB phases based on HBeAg, viral load, and ALT levels. TNF-<i>α</i> and IL-10 SNPs were determined using PCR-RFLP and confirmed with direct sequencing. The association between SNP genotypes with CHB dynamics was determined using logistic regression presented as odds ratio (OR) with 95% CI.</p><p><strong>Results: </strong>No significant association was found between IL-10 -592A/C polymorphism and progression of IT and IC to LR, IT and IC to ENH, and LR to ENH phases in all the gene models. IL-10 rs1800896 and TNF-<i>α</i> rs1800629 could not be analyzed using logistic regression. Subjects' age (≥40 years old) was significantly associated with IT and IC to LR (OR: 2.191, 95% CI 1.067-4.578, <i>P</i> = 0.034), IT and IC to ENH (OR: 7.460, 95% CI 3.316-18.310, <i>P</i> < 0.001), and LR to ENH (OR: 5.252, 95% CI 2.010-14.858, <i>P</i> = 0.001). Male gender was associated with LR to ENH (OR: 4.077, 95% CI 1.605-11.023, <i>P</i> = 0.004).</p><p><strong>Conclusions: </strong>Age and male gender were associated with CHB phase progression instead of the TNF-<i>α</i> and IL-10 polymorphisms. It would be beneficial to study not only the effect of host determinants but also the viral factor to understand the mechanisms of CHB phase progression.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":" ","pages":"6046677"},"PeriodicalIF":1.8,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9427277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40344043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice towards Hepatitis B Virus Infection Prevention and Its Associated Factors among Undergraduate Students at Hawassa University College of Medicine and Health Sciences, Hawassa, Sidama, Ethiopia, 2021: Cross-Sectional Study.","authors":"Amdehiwot Aynalem,&nbsp;Bedilu Deribe,&nbsp;Mohammed Ayalew,&nbsp;Abyalew Mamuye,&nbsp;Eskinder Israel,&nbsp;Andualem Mebratu,&nbsp;Dawit Getachew Assefa","doi":"10.1155/2022/2673740","DOIUrl":"https://doi.org/10.1155/2022/2673740","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B virus infection is a major global health burden accounting for 2.7% of all deaths globally. Being part of the health care system, the risk of exposure to hepatitis B viral infection among medical and health science students is found to be high. In Ethiopia, particularly in this study area, very little is known about the practice of students towards hepatitis B virus infection prevention and its associated factors.</p><p><strong>Objective: </strong>The aim of this study was to assess the practice towards hepatitis B virus infection prevention and its associated factors among undergraduate students at Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia, 2021.</p><p><strong>Methods and materials: </strong>An institution-based cross-sectional study was conducted from May 15 to June 15, 2021, among undergraduate students who had clinical exposure. The 404 sampled participants were recruited using a systematic random sampling technique. Data was collected using a structured self-administered questionnaire. Data was entered into EpiData version 4.6.0 and was exported to SPSS version 25 for analysis. Association between the dependent and independent variables was computed using the bivariate and multivariate logistic regression model. Odds ratio was calculated. Results were interpreted as significant if <i>P</i> value is <0.05 at 95% CI.</p><p><strong>Result: </strong>This study revealed that 277 (69.9%) of the students were in the age group of 20-24 years and 266 (67.2%) were males. Out of 396 participants, about half 199 (50.3%) 95% CI (0.452-553) had a good practice towards hepatitis B virus infection prevention. Only 43.4% of the study participants had been completely vaccinated against hepatitis B virus. Age (20-24 years) (AOR = 2.736), 95% CI (1.130-6.625), and good knowledge (AOR = 1.990), 95% CI (1.207-3.282) were factors significantly associated with the practice towards hepatitis B virus infection prevention. <i>Conclusion and Recommendation</i>. The current study showed that about half of the study participants had good practice towards hepatitis B virus infection prevention but more than half were not completely vaccinated against HBV. Age and knowledge were factors significantly associated. It is recommended to give training for students on hepatitis B virus infection prevention. It is also advisable to screen and vaccinate students before they start their clinical attachments.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":" ","pages":"2673740"},"PeriodicalIF":1.8,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9391155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40629188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy Is Not Associated with an Increased Risk of Decompensation, Transplant, or Death in Compensated Cirrhosis.","authors":"Monica Mullin,&nbsp;Maya Djerboua,&nbsp;Monika Sarkar,&nbsp;Jacquie Lu,&nbsp;Maria P Velez,&nbsp;Susan Brogly,&nbsp;Norah A Terrault,&nbsp;Jennifer A Flemming","doi":"10.1155/2022/9985226","DOIUrl":"https://doi.org/10.1155/2022/9985226","url":null,"abstract":"<p><strong>Background and aims: </strong>Childbirth in women with cirrhosis is increasing and associated with a higher risk of perinatal outcomes compared to the general population. Whether pregnancy influences the risk of liver-related events compared to nonpregnant women with cirrhosis is unclear. This study evaluates the association between pregnancy and liver-related outcomes in women with compensated cirrhosis. <i>Approach and Results</i>. Population-based retrospective matched cohort study in Ontario, Canada, using routinely collected healthcare data. Pregnant women with compensated cirrhosis and without prior history of decompensation between 2000 and 2016 were identified and matched to nonpregnant women with compensated cirrhosis on age, etiology of cirrhosis, and socioeconomic status in a 1 : 2 ratio. The association between pregnancy and the composite outcome of nonmalignant decompensation, liver transplant (LT), and death up to two years after cohort entry was estimated using the multivariate Cox proportional hazard regression adjusting for potential confounders. Overall, 5,403 women with compensated cirrhosis were included (1,801 pregnant; 3,602 nonpregnant; median age 31 years (IQR 27-34); 60% nonalcoholic fatty liver disease, 34% viral hepatitis). After two years of follow-up, only 19 (1.1%) pregnant women had a liver-related event compared to 319 (8.9%) nonpregnant women. Pregnant women with compensated cirrhosis had a lower hazard of a liver-related event compared to nonpregnant women (aHR 0.14, 95% CI 0.09-0.22, <i>P</i> < .001).</p><p><strong>Conclusions: </strong>Pregnancy in women with compensated cirrhosis is not associated with increased liver-related events compared to nonpregnant women. These results can facilitate counselling women with cirrhosis of child-bearing age and suggests that pregnancy may not accelerate liver disease progression.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":" ","pages":"9985226"},"PeriodicalIF":1.8,"publicationDate":"2022-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9279084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40611080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitude, Practices, and Associated Factor towards Hepatitis B Virus Infection among Health Care Professionals at Tibebe Ghion Specialized Hospital, Bahir Dar, Northwest Ethiopia, 2021: A Cross Sectional Study","authors":"Debaka Belete, Dagnaneh Wondale, Teklehaimanot Kiros, Biruk Demissie","doi":"10.1155/2022/3726423","DOIUrl":"https://doi.org/10.1155/2022/3726423","url":null,"abstract":"Background Hepatitis B virus (HBV) infection is the major infectious hazard for health care personnel. The global prevalence of HBV infection is highly heterogeneous, and the highest prevalence (6.2 and 6.1%) is among the World Health Organization Western Pacific and World Health Organization African regions, respectively. The pooled prevalence of HBV in Ethiopia among health workers was accounted for 5%. The prevalence rate of HBV in health care workers is about 2–10 times higher than the general population in the world. There for, the main aim of this study was to assess the knowledge, attitude and practice, and associated factors towards hepatitis B virus (HBV) infection among health care professionals at Tibebe Ghion Specialized Hospital, Bahir Dar, Northwest Ethiopia, 2021. Method An institutional-based cross-sectional study design was at Tibebe Ghion Specialized Hospital, Bahir Dar, in 2021, and a systematic random sampling technique was used from different professionals, and the separate sample was taken independently from each. A pretested structured questionnaire was constructed and collects data then analyzed by using SPSS version 23. Result A total of 422 health care workers having different professions have participated in this study. 243 (57.6%) of the study subjects were males. The average correctly answered knowledge, attitude, and practice questions were 65.6%, 40.3%, and 34.8, respectively. Multivariable logistic regression analysis showed that being nurse professionals (AOR = 0.17 (0.07, 0.38), P < 0.001), midwives (AOR = 0.19 (0.07, 0.5), P = 0.001), and work experience (AOR = 2.37 (1.38, 4.02), P = 0.002) were associated with knowledge levels. Being degree holders (AOR = 2.49 (1.23, 5.02), P = 0.01) and specialists (AOR = 9.78 (2.69, 35.5), P = 0.001) were associated with attitude levels. Being medical laboratories (AOR = 17.42 (5.02, 60.5), P ≤ 0.001) and pharmacy professionals (AOR = 11.2 (4.02, 31.42), P ≤ 0.001) were associated with practice levels. Conclusion and Recommendation. Based on the current study, most of the health care professionals in this study area have poor knowledge, negative attitude, and malpractice towards HBV infection. Therefore, continual professional training programs on HBV infection include increased vaccination coverage rate and postexposure prophylaxis of heath care workers especially for highly exposed professionals.","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"98 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82228215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics of Patients with Hepatocellular Carcinoma: A Single-Center 3-Year Experience from Somalia","authors":"M. Hassan-Kadle, M. M. Osman, E. Keleş, H. Eker, K. N. Baydili, Hussein Mahdi Ahmed, A. Osman","doi":"10.1155/2022/3370992","DOIUrl":"https://doi.org/10.1155/2022/3370992","url":null,"abstract":"Background To evaluate the relationship between prognosticators representing tumor aggressiveness and socio-demographic, laboratory, and imaging findings in patients with hepatocellular carcinoma (HCC). Methods We retrospectively searched patients with HCC between January 2017 and December 2019 in our tertiary referral hospital. The tumor-related factors and liver damage indicators and their relationship to indicate the value of prognosis were analyzed. Results A total of 268 HCC patients, with a male-to-female ratio of 2.8 : 1. The mean age was 52.6 years. The patient with portal vein thrombosis (PVT) was older, had higher liver laboratory parameters (AST, ALT, total bilirubin, and direct bilirubin), and had larger tumor size. Patients with the larger tumor size had a higher AFP level, had more tumor multifocality. The majority of patients were in Child's A (73.6%) and B (17.2%) classes. The laboratory parameters of HCC patients were increased in Child's C compared to other groups of Child-Pugh classification. Conclusions The presence of PVT and large-sized tumor in patients with HCC indicated a poorer prognosis than non-PVT group and small tumor sizes.","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"20 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2022-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78685258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary BA Indices as Prognostic Biomarkers for Complications Associated with Liver Diseases","authors":"Wenkuan Li, J. Alamoudi, N. Gautam, Devendra Kumar, Macro Olivera, Y. Gwon, Sandeep Mukgerjee, Y. Alnouti","doi":"10.1155/2022/5473752","DOIUrl":"https://doi.org/10.1155/2022/5473752","url":null,"abstract":"Hepatobiliary diseases and their complications cause the accumulation of toxic bile acids (BA) in the liver, blood, and other tissues, which may exacerbate the underlying condition and lead to unfavorable prognosis. To develop and validate prognostic biomarkers for the prediction of complications of cholestatic liver disease based on urinary BA indices, liquid chromatography-tandem mass spectrometry was used to analyze urine samples from 257 patients with cholestatic liver diseases during a 7-year follow-up period. The urinary BA profile and non-BA parameters were monitored, and logistic regression models were used to predict the prognosis of hepatobiliary disease-related complications. Urinary BA indices were applied to quantify the composition, metabolism, hydrophilicity, and toxicity of the BA profile. We have developed and validated the bile-acid liver disease complication (BALDC) model based on BA indices using logistic regression model, to predict the prognosis of cholestatic liver disease complications including ascites. The mixed BA and non-BA model was the most accurate and provided higher area under the receiver operating characteristic (ROC) and smaller akaike information criterion (AIC) values compared to both non-BA and MELD (models for end stage liver disease) models. Therefore, the mixed BA and non-BA model could be used to predict the development of ascites in patients diagnosed with liver disease at early stages of intervention. This will help physicians to make a better decision when treating hepatobiliary disease-related ascites.","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"3 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79119405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disproportionate Distribution of HBV Genotypes A and D and the Recombinant Genotype D/E in the High and Low HBV Endemic Regions of Uganda: A Wake-Up Call for Regional Specific HBV Management.","authors":"Hussein Mukasa Kafeero,&nbsp;Dorothy Ndagire,&nbsp;Ponsiano Ocama,&nbsp;Charles Drago Kato,&nbsp;Eddie Wampande,&nbsp;Henry Kajumbula,&nbsp;David Kateete,&nbsp;Abdul Walusansa,&nbsp;Ali Kudamba,&nbsp;Kigozi Edgar,&nbsp;Fred Ashaba Katabazi,&nbsp;Maria Magdalene Namaganda,&nbsp;Jamilu E Ssenku,&nbsp;Hakim Sendagire","doi":"10.1155/2022/3688547","DOIUrl":"https://doi.org/10.1155/2022/3688547","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B virus (HBV) is the leading cause of liver-related diseases. In Uganda, there is a regional disparity in the HBV burden. Our study was aimed at establishing the circulating genotypes in a low and a high endemic region to give plausible explanations for the differences in regional burden and guide the future management of the disease.</p><p><strong>Methods: </strong>A total of 200 HBsAg-seropositive subjects were recruited into the study by convenience sampling. The HBsAg Rapid Test Strip (Healgen Scientific Limited Liability Company, Houston, TX77047- USA) was used to screen for HBsAg while the Roche machine (Roche, Basel Switzerland/Abbot Technologies (USA)) was used to determine the viral load. The Chemistry Analyzer B120 (Mindray, China) was used for chemistry analysis. For HBV genotyping, total DNA was extracted from whole blood using the QIAamp® DNA extraction kit. Nested PCR amplification was performed using Platinum Taq DNA Polymerase (Invitrogen Corporation, USA) to amplify the 400 bp HBV polymerase gene. Purification of nested PCR products was performed using Purelink PCR product purification kit (Life Technologies, USA). Automated DNA sequencing was performed using BigDye Terminator v3.1 Cycle Sequencing Kit on 3130 Genetic Analyzer (Applied Biosystems, USA). The NCBI HBV genotyping tool (https://www.ncbi.nlm.nih.gov/projects/genotyping/formpage.cgi) was used for determination of genotype for each HBV sequence. Pearson's chi-square, multinomial logistic regression, and Mann-Whitney <i>U</i> tests were used for the analysis. All the analyses were done using SPSS version 26.0 and MedCalc software version 19.1.3 at 95% CI. A <i>p</i> < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Majority of our study subjects were female (64.5%), youth (51.0%), and married (62.0%). Overall, genotype A was the most prevalent (46%). Genotype D and the recombinant genotype D/E were proportionately more distributed in the high endemic (38.2%) and low endemic (36.5%) regions, respectively. Genotype D was significantly more prevalent in the high endemic region and among the elderly (<i>p</i> < 0.05). Genotype D was significantly associated with elevated viral load and direct bilirubin (<i>p</i> < 0.05). The recombinant genotype D/E was significantly associated with elevated viral load (<i>p</i> < 0.05). Similarly, genotype A was significantly associated with elevated AST and GGT, lowered viral load, and normal direct bilirubin levels (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>There is disproportionate distribution of genotypes A and D and the recombinant genotype D/E in the low and high endemic regions of Uganda. This probably could explain the differences in endemicity of HBV in our country signifying the need for regional specific HBV management and control strategies.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":" ","pages":"3688547"},"PeriodicalIF":1.8,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8767397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39854096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Clinical Characteristics and Outcomes of Liver Diseases Unique to Pregnancy at a Tertiary Hospital in Ethiopia: A Retrospective Cohort Study.","authors":"Sintayehu Mekonnen,&nbsp;Henok Fisseha,&nbsp;Tewodros Getinet","doi":"10.1155/2022/9894407","DOIUrl":"https://doi.org/10.1155/2022/9894407","url":null,"abstract":"Background Liver disease is a rare complication of pregnancy that can lead to several consequences and require specific intervention with implications for both the mother and fetus. This study is aimed at assessing the clinical profile and associated complications of liver diseases unique to pregnancy at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methodology. This study is a retrospective cohort study of all identified cases admitted to the obstetrics ward and intensive care unit (ICU) from January 2018 to December 2020 at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Medical records were reviewed for clinical features, biochemical profiles, and fetomaternal complications. Data were analyzed using SPSS version 26. A chi-square test was done to look for an association with a p value less than 0.05 considered statistically significant, and an odds ratio was determined to assess the effect size. Results From 95 cases identified, preeclampsia/eclampsia with liver dysfunction accounted for 43 (45%), followed by hemolysis elevated liver enzyme and low platelet (HELLP syndrome) 35 (36.8%), hyperemesis gravidarum with liver dysfunction 9 (9.5%), acute fatty liver of pregnancy (AFLP) 7 (7.4%), and intrahepatic cholestasis of pregnancy 1 (1.1%). When compared to HELLP syndrome, AFLP showed significantly higher median (IQR) values (p < 0.05) for total bilirubin 13.3 (7.3-16.3), direct bilirubin 9.73 (6.87-11.9) mg/dL, prothrombin time 23 (20.4-25.7) seconds, international normalization ratio 2.2 (1.9-2.4), white blood count 23.8 (17.8-26.6)∗103/μL, creatinine 3.5 (2.44-5.6) mg/dL, and lower hemoglobin level of 7.9 (6.2-10) g/dL. There were 4 (4.2%) maternal hospital deaths, with a case fatality rate of HELLP syndrome being 8.6% and 14.3% in AFLP. The overall hospital fetal mortality was 33 (34.7%). In this study, 42 patients with HELLP syndrome and AFLP had an increased risk of maternal ICU admission (OR = 25.5, 95% CI: 5.48-118.6, p value = 0.001), acute kidney injury requiring dialysis (OR = 12.2, 95% CI: 1.46-102.2, p value = 0.009), placental abruption (OR = 14.2, 95% CI: 1.72-117.1, p value = 0.004), and stillbirth (OR = 7.2, 95% CI: 2.38-21.7, p value = 0.001). Conclusion Preeclampsia with liver dysfunction and HELLP syndrome accounted for the majority of cases. It also demonstrated key biochemical characteristics that can be used to distinguish between HELLP syndrome and AFLP. Emphasis has to be given to the risk of requiring maternal ICU admission, dialysis, abruption of the placenta, and stillbirths while managing patients diagnosed with HELLP syndrome and AFLP.","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2022 ","pages":"9894407"},"PeriodicalIF":1.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9792252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10452822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of High-Density Lipoprotein Cholesterol (HDL-C) as a Clinical Predictor of Decompensation in Patients with Chronic Liver Disease (CLD).","authors":"Harshavardhan Rao B,&nbsp;Priya Nair,&nbsp;Anoop K Koshy,&nbsp;S Krishnapriya,&nbsp;C R Greeshma,&nbsp;Rama P Venu","doi":"10.1155/2021/1795851","DOIUrl":"https://doi.org/10.1155/2021/1795851","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic inflammation triggered by bacterial products like lipopolysaccharides (LPS) in the circulation is an important factor leading to decompensation in patients with chronic liver disease (CLD). High-density lipoprotein cholesterol (HDL-C) has a significant role in innate immune response to LPS in the circulation and could therefore increase the risk for decompensation in patients with CLD. In this study, we have explored the role of HDL-C as a prognostic marker for decompensation.</p><p><strong>Methods: </strong>This was a prospective, observational, cohort study where consecutive patients with CLD were included. Patients with cholestatic liver disease and hepatocellular carcinoma were excluded. Fasting lipids were measured in all patients at the time of recruitment. Each patient was carefully followed up for development of decompensation events such as new-onset/worsening ascites, hepatic encephalopathy, or variceal bleed during follow-up.</p><p><strong>Results: </strong>A total of 170 patients were included (mean age 60 ± 11.5 years, M : F = 6 : 1). At the end of follow-up, 97/170 patients (57%) had decompensation events. Mean HDL-C levels were significantly lower among patients with decompensation (27.5 ± 15 mg/dL vs. 43.5 ± 13.9 mg/dL; <i>p</i> value 0.004). Using ROC analysis, cut-off for HDL-C of 36.4 mg/dL was identified. On multivariate analysis, HDL-C (OR = 6.072; 95% CI 2.39-15.39) was found to have an independent association with risk of decompensation.</p><p><strong>Conclusions: </strong>HDL-C level (<36.4 mg/dL) is a reliable marker for risk of decompensation and can be a useful addition to existing prognostic scoring systems in CLD. It can be a valuable tool to streamline treatment protocols and prioritise liver transplantation.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2021 ","pages":"1795851"},"PeriodicalIF":1.8,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8720002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39781583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diastolic Dysfunction Is a Predictor of Poor Survival in Patients with Decompensated Cirrhosis.","authors":"Manas Kumar Behera,&nbsp;Surendra Nath Swain,&nbsp;Manoj Kumar Sahu,&nbsp;Gaurav Kumar Behera,&nbsp;Debakanta Mishra,&nbsp;Jimmy Narayan,&nbsp;Ayaskant Singh,&nbsp;Shobhit Agarwal,&nbsp;Pradeep Kumar Mallick","doi":"10.1155/2021/5592376","DOIUrl":"https://doi.org/10.1155/2021/5592376","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular diastolic dysfunction (LVDD) appears to be the earliest cardiac disturbance in cirrhosis patients. There are many previous reports reporting the significance of severity of LVDD on the outcome of liver transplantation or TIPS insertion, a few Indian studies have addressed the role of LVDD on survival in decompensated cirrhosis. The objective of this study is to assess the effect of LVDD on the survival of decompensated cirrhotic patients.</p><p><strong>Methods: </strong>We prospectively evaluated 92 decompensated cirrhotic patients from April 2015 to March 2017 at IMS and SUM Hospital, Bhubaneswar, India. 2D echocardiography with tissue Doppler imaging was used to evaluate cardiac function, as per the American society of echocardiography guidelines. The primary endpoint was to evaluate the effect of LVDD on overall mortality.</p><p><strong>Results: </strong>Ninety-two decompensated cirrhotic patients were evaluated in this prospective cohort study. Twenty-eight out of 92 patients (30%) died due to liver-related complications after a follow-up of 24 months. The decompensated cirrhotic patients with MELD score ≥ 15 had a significantly higher <i>E</i>/<i>e</i>' ratio (11.94 ± 4.24 vs. 8.74 ± 3.32, <i>p</i> < 0.001) suggesting severe LV dysfunction in advanced cirrhosis. Patients with <i>E</i>/<i>e</i>' ratio > 10 had significantly higher MELD score and Child-Pugh score (19.88 ± 7.72 vs. 14.31 ± 5.83; 10.25 ± 1.74 vs. 9.02 ± 1.74, <i>p</i> < 0.01, respectively) as compared to the<i>E</i>/<i>e</i>' ratio < 10 group. In Cox proportional hazard multivariate analysis, <i>E</i>/<i>e</i>' ≥ 10 (HR 2.72, 95% CI 1.07-6.9, <i>p</i> = 0.03) and serum albumin (HR 0.32, 95% CI 0.14-0.7, <i>p</i> < 0.01) were found to be independent predictors of mortality in decompensated cirrhotic patients.</p><p><strong>Conclusion: </strong>: The presence of LVDD and low serum albumin were independent predictors of mortality in decompensated cirrhotic patients. Hence, LVDD is an indicator of advanced cirrhosis and mortality.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2021 ","pages":"5592376"},"PeriodicalIF":1.8,"publicationDate":"2021-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8660240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39719711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}