HEPATITIS & LIVER DISEASES

Biography

Kanghong Hu obtained his Ph.D. in Molecular Virology at the University of Düsseldorf, Germany in 1999. Having 7 year Post-doctor fellow career at the University of Düsseldorf and at the University Hospital of Freiburg i. Br., Dr. Hu had been senior scientist in the Institute of Molecular and Cellular Anatomy, University of Regensburg, Germany since 2006. He performed study on viral RNA structure/function relationship and built his team as a Principal Investigator in Wuhan Institute of Virology, CAS in 2008 and has been the Director, Sino-German Biomedical Center at Hubei University of Technology since 2014. His major interests are to explore the underlying replication mechanisms of hepatitis B virus (HBV), the progression of liver fibrosis and the development of hepatocyte carcinoma. He published so far 47 peer-reviewed SCI papers and had 23 international and Chinese Patents being granted.

Abstract

Background: Chronic hepatitis B virus (HBV) infected patients have an almost 100-fold increased risk to develop hepatocellular carcinoma (HCC). However, the understanding of the underlying mechanism of HBV-related HCC remains poor. In our previous study, the block of proliferation 1 (BOP1) and the phosphatidylethanolamine-binding protein 4 (PEBP4) were screened out as potential hub genes for the HBV-related HCC through a weighted gene co-expression network analysis (WGCNA)-based bioinformatics algorithm. In this study, we further investigated the both genes for their correlation with the progression of HCC.

Methods: We explored the biological significance of BOP1 and PEBP4 with over-expression and down-regulation analyses both in vivo and in vitro. The mRNA and expression levels of BOP1 and of PEBP4 in 5 HBV-related HCC patient tissues were measured with quantitative real-time PCR (qRT-PCR) and western blotting, respectively. The relationship between BOP1 or PEBP4 with PI3K/Akt pathway was also investigated by western blotting.

Results: An up-regulation of BOP1 and PEBP4 was observed in tumor tissues compared to their adjacent normal tissues. The same results were obtained in 2 HCC cell lines, HepG2 and Huh7, compared to the normal liver cell line, HL7702. Functionally, the increased BOP1 and PEBP4 expression levels through plasmid transfection into HepG2 promoted the cell proliferation and migration, while the knockdown of expression levels of BOP1 and PEBP4 through shRNA silencing in HepG2 suppressed the cell proliferation and migration and promoted the cell apoptosis. Moreover, the increased BOP1 and PEBP4 level may promote the tumorgenesis and the progression of HCC through activating the phosphorylation of PI3K and Akt and subsequently affecting the PI3K/Akt pathway.

Conclusion: Our findings revealed that BOP1 and PEBP4 are tumor-promoting genes and may represent potential biomarkers or therapeutic targets for HCC.

Biography

El Sherif A., Department of HPB Surgery, liver transplantation, National Liver Institute University of Menofia, Shebin El Kom

Abstract

Background: Hepatocellular carcinoma is one of the most common malignancies worldwide. It is frequently found in association with liver cirrhosis. Viral hepatitis B and C are particularly major risk factors for HCC with incidence varies according to geographic area. Many technological devices have been used to avoid intraoperative bleeding during hepatic parenchymal transaction and to avoid morbidity and mortality, but until now none is complete. The aim of this work is to analyze hepatic resection in cirrhotic patients treated with Habib Sealer and Cavitron Ultrasonic Surgical Aspirator (C.U.S.A) devices in order to evaluate its effectiveness. Patients and method: (413) consecutive patients, (193) cases in left lobe (220) cases in right lobe were randomized to one of different dissection strategies. from August 2007 and September 2016 were analyzed prospectively. The following variables were considered: age, sex, kind of disease, kind of liver resection, number of major/minor resections, total operative time and transaction time, number and time of clamping, blood loss, time of hospitalization, morbidity, and mortality. Results. Between August 2007 and September 2016, all patients were analyzed prospectively, (67% men, 31% woman, 2% pediatric). Ages ranged from months to 84 years. The procedures performed were 46 major hepatectomies (11.2%) and 367 minor hepatectomies (wedge) (88.8%). Hepatic transaction was performed in 35 to 150 min by Habib sealer. 38 cases (9.2%) underwent laparoscopic technique by Harmonic Scalpel with Habib sealer, 18 cases converted to open resection. Total operative time range from 120–480 min. The average blood loss was 325 ml (range 50–600 ml). The mean postoperative stays were nine days for cirrhotic patients and six days for non-cirrhotic patients. Conclusion. Habib sealer device is useful for reducing ischemia–reperfusion damage due to absence the Pringle maneuver and for reducing the risk of morbidity, however ultrasonic dissector (CUSA) easy, versatile take long respectable time, excess blood loss and blood transfusion, other as Harmonic scalpel., good haemostatic device, take short operative time not need Pringle maneuver less blood loss and transfusion. So, the difference in the postoperative morbidity and mortality was statistically significant.

Biography

Michel Samson has got his PhD in 1993 at University of Paris XI (France). He studied as postdoctoral scientist at Université Libre de Bruxelles (Brussels, Belgium) supported by prestigious fellowships (EMBO, European Community, etc..). He passed two years as visiting scientist at Genentech (California, USA). He is now team leader and director of research of Inserm at University of Rennes (France) in UMR 1085 Inserm, vice-director of Institut de Recherche en Santé, Environnement et Travail. He studies the inflammation, cell death and fibrosis in liver pathologies.  He has published more than 90 papers in reputed journals (Nature, Cell, J Exp Med, Hepatology, J Hepatol., etc...), with already more than 8850 citations and H-index 38.

Abstract

Hepatocyte death is a starting point of liver disease progression by promoting inflammatory and regenerative processes. The death of hepatocytes can be induced by the large variety of immune, infectious and toxic agents. The molecular mechanisms regulating these cell death pathways are poorly documented. Innate and acquired immune cells play key roles in the induction or amplification of hepatolysis, mainly mediated by expression and release of death ligands belonging to the TNF-superfamily including TNF-α, FasL and TRAIL.  In this study, we investigated the role of RIPK1, a protein known to regulate cell fate decisions, in the death of hepatocytes using different in vivo models of hepatitis. Acute hepatitis was induced in mice by Concanavalin A (ConA), lipopolysaccharide (LPS), DNA-CpG, recombinant IFN-γ and TRAIL co-administration, FASL, Poly I:C and Murine-Hepatitis virus type 3. Using specific conditional mice deficient in RIPK1 only in liver parenchymal cells (LPC) (Ripk1^LPC-KO), we reveal its necessary function in the protection of hepatocyte during hepatitis. Administration of lipsome-encapsulated Cl2MBP served to investigate the role of Kupffer cells in the establishment of the disease. Moreover, Etanercept, a TNF-decoy receptor, was used to study the contribution of TNF-α during liver injury. All together, these works demonstrate that deletion of RIPK1 sensitizes hepatocytes to TNF-α-induced apoptosis. Thus RIPK1 plays a key role in the protection of hepatocytes during acute and chronic hepatitis.

Biography

Department of Internal Medicine, Gastroenterology unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt

Abstract

HCV direct-acting antivirals revolutionized the treatment outcomes especially in areas considered to be highly endemic as Egypt, where the government adopted a National Treatment Program and successfully reached a large sector of the HCV patients population. High response rate to treatment with Sofosbuvir and Daclatasvir necessitated confirmation of total cure through excluding HCV occult infection. Our aim was to estimate the occurrence of occult HCV in patients treated with Sofosbuvir and Daclatasvir, by detecting HCV RNA in their PBMCs. Quantitative estimation of HCV viral load in serum samples and PBMCs of 40 patients undergoing treatment with Sofosbuvir and Daclatasvir, was done using COBAS AmpliprepTM/COBAS TaqManTM. At the start of treatment serum samples were positive for HCV RNA (ranged from 2.50x10³ – 6101.0x10³). After one month of the treatment our data revealed that serum HCV RNA was negative by PCR. After three months, HCV RNA was detected in PBMCs in 10 out of 40 via RT-PCR. Comparison between the results of HCV RNA in serum and PBMCs by PCR after three months of treatment, showed statistically significant difference of p= 0.001. This reveals the high prevalence of HCV RNA in PBMCs denoting occult HCV infection after combined treatment with Sofosbuvir and Daclatasvir. It also signifies that although the combined treatment was effective in eliminating the virus from the serum, it is less effective in its elimination from the PBMCs. These results also highlight the importance of testing for HCV RNA in PBMCs after end of treatment to confirm total HCV elimination.

Figure:

c², p:  c² and p values for Chi square test for comparing between the two groups

*: Statistically significant at p ≤ 0.05 b

Biography

Ghazal Rubi is a UK trained Clinical Molecular Biologist with MPhil degree in Human Genetics & Molecular Biology and PhD Thesis in Human Genetics and Molecular Biology with more than 18 years of experience in molecular biology Pathology Laboratory services. Five years of experience of teaching to M.Phil graduates of a medical students. Working in Molecular Pathology in an international organization. Representing on national as well as international Forum. Doing different projects of Hepatitis C in different groups, ageing of HCV, diabetes & HCV in different groups of Pakistan. Keen to know the latest update on diagnosis and therapeutics to lead the services of making people free from Hepatitis. Working on HCV diagnosis and therapeutic. Being a woman of third world country hard working and devoted as working on different main desks.

Abstract

Background: Serum HBV DNA is a useful and reliable marker to diagnose and monitor HBV infection. The limitation of HBV DNA is that it is expensive and that the assays lack uniformity and standardization. Hence there is a need for more economical and reliable marker. HBsAg quantitation is one such surrogate serological marker. The objective of the current study is to compare the serum hepatitis B virus DNA quantitative Real Time PCR with Hepatitis B reverse transcription PCR (rt-PCR).

Methods: Patients with HBV attending to the outpatient clinic of all departments were enrolled in the study. Patients with undetectable HBV DNA levels and those co-infected with HCV or HIV were excluded from the study. All patients were tested for serological markers like HBsAg, HBeAg, and HBV DNA-PCR. HBsAg quantification was done using conventional ELISA immunoassay. Chi-square was used to compare between HBV DNA (RT-PCR) and (rt-PCR) quantitation. Statistical analysis was done using SPSS and P value of <0.05 was considered significant.

Results: A total of 661 patients were enrolled in the study. Out of 373 serum samples were analyzed by HBV RT-PCR while 281 by HBV rt-PCR. 38.9% were females in group of HBV RT-PCR while, 32.7% in group of HBV rt-PCR and mean age of patients in the entire study group was 33.01 years in group of HBV RT-PCR while, 34.61 years in group of HBV rt-PCR. The mean ALT level was 57.6 U/L in group of HBV RT-PCR while, 51.00 in group of HBV rt-PCR. 16.5% (n=61) in group of HBV RT-PCR while, 8.9% (n=33) in group of HBV rt-PCR were HBeAg positive. 94.9% (n=351) in group of HBV RT-PCR while, 73.2% (n=271) in group of HBV rt-PCR were HBsAg positive. Mean HBV DNA Positive 44.3% in group of HBV RT-PCR while, 14.6% in group of HBV rt-PCR. HBV DNA (positive) levels were significantly higher in HBV RT-PCR patients compared with HBV rt-PCR patients (164 versus 54; p=0.001). Neither HBsAg levels nor HBeAg levels were significant (p=0.573, 0.057). HBV Real Time RT-PCR is best for diagnosis of HBV DNA PCR. Clinical significant result obtained from such test. HBV RT-PCR has become a useful and important technology for diagnosis of HBV DNA PCR, it must be used appropriately.

Conclusions: There is a significant difference between HBV DNA Real Time PCR (RT-PCR) with HBV DNA reverse transcription PCR (rt-PCR) patients with hepatitis B virus but not in HBsAg and HBeAg.

Keywords: Hepatitis B Virus, Real Time PCR, reverse transcription PCR, HBsAg quantitation

Biography

Mother and Baby Care Global Foundation , Department of Obstetrics and Gynaecology Rivers State University Teaching Hospital, RAHI Foundation. State AIDS and STIs Control Program, Rivers State Ministry of Health, Port Harcourt, Department of Obstetrics and Gynaecology University of Port Harcourt Teaching Hospital. Correspondence: Dr Eli S MB BS, FWACS.

Abstract

Introduction:

Hepatitis especially the B and C strains are increasingly common among adolescents especially in developing countries of the world. These group of persons are vulnerable and engage in high risk behaviour such as unprotected sexual intercourse and use of unsterilized intravenous drug.

Aim:

To determine the awareness of  hepatitis B infection amongst female adolescents in Rivers State, Nigeria. 

Method:

It was a cross sectional study of female adolescents attending holiday camp in Port Harcourt, Rivers State, Nigeria. Questionnaire were distributed and information was coded and analysed using SPSS version 23.

Results:

One hundred questionnaires were distributed and 89 retrieved. The mean age was 16 ± 2 years. Fifty seven(64.0%) were in secondary school while 32(36.0%) of the adolescents were undergraduates. Twelve(13.5%) were sexually active compared to 69(77.5%) who were not sexually active. Thirty eight (42.7%) of the adolescents were aware of their hepatitis B infection while 48(53%) had no knowledge of hepatitis infection. The media was the most common means of information 25(28%) of the infection. Heterosexual intercourse 24(27%) was the most common means of transmission of the infection.

 Conclusion:

The study revealed that hepatitis B awareness amongst female adolescents in Rivers state, Nigeria was poor, as revealed by 42.7% of the respondents. Enlightenment programme is highly recommended to prevent its negative health consequences.

Biography

Zaw Zaw Aung got his MBBS from University of Medicine, Mandalay in 2017. Just after graduation, he volunterred in intergrated HIV care services in govenment hospitals as medical officer. Now he is working as a sub-investigator in the demonstration project on assessment of  simplified antiviral  treatment strategy for Hepatitis C in Myanmar.

Abstract

Background Nearly 5 million of Myanmar people are living with hepatitis B. HBV/HCV coinfected patients are increased risk of cirrhosis, hepatic decompensation and hepatocellular carcinoma. There is currently no data for hepatitis B vaccine utilization in HCV positive patients and their antibody response.

Methodology From February 2018 to May 2018, consented participants at or above 18 years were tested with anti-HCV RDT. Those who tested HCV positive (n=165) were further tested with hepatitis B profile and asked about their hepatitis B vaccination history and risk factors.

Results HCV positive participants (n=165) were categorized into previously vaccinated 64% (n=106) and unvaccinated 36% (n=59) There were three characteristics groups- PWID monoinfected (n=77), GP monoinfected (n=22) and HIV/HCV coinfected participants (n=66). Unvaccinated participants were highest in HIV/HCV, with 68%(n=45) followed by GP (23%, n=5) and PWID (12%, n=9) . Among previously vaccinated participants, the highest percentage was PWID (88%, n=68), the second highest was GP (77%, n=17) and lowest in HIV/HCV patients (32%, n=21). 53% of participants who completed 3 dose of hepatitis B were non-responders (n=34): PWID (47%, n=16), HIV/HCV (35%, n=12) and GP (18%, n=6)

Conclusion Even in the presence of effective and safe hepatitis B vaccine, uptake is low among high risk groups especially PLHIV that needs to be improved. Integration or collaboration of hepatitis B vaccination program, ARV and hepatitis C treatment centers is desirable. Half of vaccinated participants were non-responders so that optimal doses, schedule and follow-up testing need to be addressed carefully for those groups.

Biography

Gastroenterologist since1997
- Internist since1994
- PhD in Health Government politics 2007
- Vice president of the Syrian Medical Syndicate since 2015 until now.
- President of the SSGE( Syrian Society of Gastroenterology) since 2017 until now
- President of the Syrian Commission for Gastroenterology Specialty 2011- 2014
- Editor-in-Chief of the Arabic Medical Journal 2010-2017
- Council member of the ASSLD /ِ Arab Society for Study of Liver Diseases/ since2008
- Chief of the G.I & Liver Depart-Swaida National Hospital1999-2010
- Chief coordinator for liver diseases in the governorate health authorities 2006

Abstract

Hepatitis A is a benign infection, which in the developing world affects mainly children; the majority of adults are immune by the age of 30. In the last decade or so, a shift in the prevalence pattern of hepatitis A virus (HAV) infection from a low-to a high-age group has appeared in the developed countries. In the present study,314 Syrian of age between 11-30 year-old groups and both sexes almost equaly were tested by enzyme-linked immunosorbent assay technique for the seroprevalence of hepatitis A IgG antibody (anti-HAV IgG). It was observed that anti-HAV IgG was present in71% Syrian population; with 68% in the11-20 year age group and 77% in the 21-30 year age group, and 81% in male and 70% in female. These results demonstrate that HAV infection in Syria is mostly acquired during childhood and no need for vaccination .. This study is the 2nd study in Syria, in comparing with the 1st one which have been done 12 years ago : there is an improvement in the whole ratio (78%),this shift has been attributed to an improvement in the socio-economic and hygienic conditions.