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1.  MINI REVIEW
Hepatitis in Malaysia: Past, Present, and Future
Ruksana Raihan
[Year:2016] [Month:January-June] [Volume:6 ] [Number:1] [Pages:92] [Pages No:52-55] [No of Hits : 3341]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10018-1167 | Free

ABSTRACT

Malaysia is multiethnic, with a population of 31,127,247 comprising a mixture of Malays (50.1%), Chinese (22.6%), Indians (6.7%), Aborigines (11.8%), others (0.7%), and noncitizens (8.2%). Like other countries in the region, viral hepatitis is an important public health problem in Malaysia. The 3 most common causes for hepatitis in Malaysia are hepatitis A, B, and C. Hepatitis A has been a reportable disease in Malaysia since 1988. Due to the introduction of government control programs, the national incidence rate has dropped steadily. It is now estimated that 50% of Malaysians less than 30 years of age do not have antibodies to hepatitis A and are therefore susceptible to the disease, which can be prevented by reinforcing the hygiene status of the general population. Malaysia is a country of medium seroprevalence for the hepatitis B virus (HBV) surface antigen (HBsAg) in the general population (1.5-9.8%). The major route of transmission is from infected mother to fetus. There are an estimated 1 million people chronically infected with hepatitis B in Malaysia. Approximately 75% of all viral hepatitis cases are due to hepatitis B infection, with a male-to-female ratio of 2:1. Chronic hepatitis B (CHB) accounts for more than 80% of the hepatocellular carcinoma (HCC) cases seen in Malaysia and HCC is the 3rd most common malignant neoplasm and among the 10 leading causes of death. Most common genotypes are B and C. Incidence rates among Chinese, Malays, and Indians are 36, 26, and 15% respectively. The hepatitis B vaccination program for children was introduced in 1989, which successfully managed to reduce the seroprevalence of infection among Malaysians to 0.01% (graph 4, 2014). But the disease burden will still remain high for some time as the infected people are getting older and living longer. Hepatitis C virus (HCV) infection is a growing problem in Malaysia. An estimated 453,700 people were living with HCV infection in Malaysia in 2009 (2.5% of the population aged 15-64 years), of whom 59% acquired their infection through injection and the most common genotypes found are genotype 3 and 1. The HCV-related disease burden is already high and is forecast to rise steeply over the coming decades under current levels of antiviral treatment. Increased governmental resources to improve HCV screening and treatment rates and to reduce transmission are essential to address the high projected HCV disease burden in Malaysia.

Keywords: Future, Hepatitis, Malaysia, Past, Present.

How to cite this article: Raihan R. Hepatitis in Malaysia: Past, Present, and Future. Euroasian J Hepato-Gastroenterol 2016;6(1):52-55.

Source of support: Nil

Conflict of interest: None

 
2.  MINI REVIEW
Viral Hepatitis in Nepal: Past, Present, and Future
Ananta Shrestha
[Year:2016] [Month:January-June] [Volume:6 ] [Number:1] [Pages:92] [Pages No:59-61] [No of Hits : 842]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10018-1169 | Free

ABSTRACT

Over the last four decades, the diagnosis and therapy of viral hepatitis has evolved substantially all over the world. Although Nepal is a developing nation, it has been keeping pace with these developments in terms of the implementation of diagnostic and therapeutic strategies. However, because of a lack of infrastructure and logistics, Nepal still depends on its neighboring countries for molecular diagnostics in viral hepatitis B and C. Though most of the recent antivirals for hepatitis B and directly acting antivirals for hepatitis C are available at a highly subsidized cost, affordability still remains an issue. A lack of comprehensive national program for hepatitis B and C has been a major barrier for access to health care in patients with chronic viral hepatitis. Similarly, hepatitis E still remains an important public health issue with major epidemics at periodic intervals. Recent developments in understanding hepatitis E virus have unveiled important aspects of the virus, particularly with regard to why these epidemics occur. In this manuscript we try to elaborate the evolution in understanding, diagnosing, and treating viral hepatitis in Nepal.

Keywords: Hepatitis E, Kathmandu valley, Kinetic of hepatitis, Viral hepatitis.

How to cite this article: Shrestha A. Viral Hepatitis in Nepal: Past, Present, and Future. Euroasian J Hepato-Gastroenterol 2016;6(1):59-61.

Source of support: Nil

Conflict of interest: None

 
3.  MINI REVIEW
Viral Hepatitis in Indonesia: Past, Present, and Future
Mulyanto
[Year:2016] [Month:January-June] [Volume:6 ] [Number:1] [Pages:92] [Pages No:65-69] [No of Hits : 830]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10018-1171 | Free

ABSTRACT

Since Indonesia is a huge archipelago country, the prevalence of hepatitis virus infection highly varies among islands. In average the prevalence of clinical hepatitis in Indonesia was 0.6% in the year 2007. Of 82 clinical acute hepatitis patients treated in hospitals in several cities, acute hepatitis A accounted for 28.0%, acute hepatitis B 13.4%, and acute hepatitis C 1.2%; 35.4% patients were infected by unknown etiology. In 1980s, the prevalence of anti-HAV in the age group 10- to 14-years was almost 100% in smaller towns and 45 to 60% in big cities. About 30 years later, anti-HAV prevalence decreased to around 13% in the same smaller town. Outbreaks of hepatitis A were reported between 2006 and 2009 in several cities in Java island. The prevalence of HBsAg in the islands other than Java island (8.5%) was significantly higher than in Java island (4.9%). In 1,409 viremic subjects, 4 genotypes of HBV were found, i.e., genotype B (60%), followed by genotype C (33%), genotype D (7%), and genotype A (0.3%). In contrast, the prevalence of hepatitis C was much higher in Java island compared to other islands. In blood donors in Java island, the prevalence of anti-HCV and HCV RNA were 1.5 and 1.1% respectively, while in other islands, the prevalence were only 0.7 and 0.2% respectively. Hepatitis D was very rare in Indonesia, and so was hepatitis E. Outbreaks of hepatitis E were reported between 1989 and 1993 in West Kalimantan. Afterward, the incidence of hepatitis E was reported sporadically.

Keywords: Epidemiology, HBsAg, HCV RNA, Indonesia.

How to cite this article: Mulyanto. Viral Hepatitis in Indonesia: Past, Present, and Future. Euroasian J Hepato-Gastroenterol 2016;6(1):65-69.

Source of support: Nil

Conflict of interest: None

 
4.  MINI REVIEW
Viral Hepatitis in Cambodia: Past, Present, and Future
Bun Sreng, Chhith Sophal, Sok Srun, Chham Samnang, Eng Huot
[Year:2016] [Month:January-June] [Volume:6 ] [Number:1] [Pages:92] [Pages No:45-48] [No of Hits : 777]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10018-1165 | Free

ABSTRACT

The prevalence of viral hepatitis represents Cambodia as 1 of the highest endemic countries in the world. But the prevalence of viral hepatitis B among 5-year-olds is on a decreasing trend due to the effect of nationwide vaccination against hepatitis B. There are key interventions to address viral hepatitis by the Cambodian Ministry of Health. There are so far no comprehensive national guidelines for the prevention, care, and treatment of viral hepatitis.
In 2014, the coverage of hepatitis B vaccine at birth and HepB3 vaccine was very high, at 87 and 97% respectively. Other interventions include the screening of viral hepatitis B and C among blood donors; the enhancement of infection prevention and control at health facilities; the program for People Who Use Drugs (PWUDs) and People Who Inject Drugs (PWIDs); control and prevention of HIV/AIDS and sexually transmitted diseases (STDs); and improved sanitation, clean water, and food safety.
The diagnosis of viral hepatitis B and C could be made only at the national and provincial referral hospitals and there are no specific antiviral therapies for people who are infected with hepatitis B and C.

Keywords: Hep B vaccine, Infection prevention and control, People Who Inject Drugs (PWIDs), Viral hepatitis.

How to cite this article: Sreng B, Sophal C, Srun S, Samnang C, Huot E. Viral Hepatitis in Cambodia: Past, Present, and Future. Euroasian J Hepato-Gastroenterol 2016;6(1):45-48.

Source of support: Nil

Conflict of interest: None

 
5.  MINI REVIEW
Past, Present, and Future of Viral Hepatitis in Bangladesh
Mamun-Al-Mahtab
[Year:2016] [Month:January-June] [Volume:6 ] [Number:1] [Pages:92] [Pages No:43-44] [No of Hits : 594]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10018-1164 | Free

ABSTRACT

Viral hepatitis poses huge burden to the health care delivery system as well as to the economy of Bangladesh. Hepatitis E virus is the leading cause of acute hepatitis in this country, however with the improvement of economic status and sanitation this seems to be on the decline. Hepatitis B virus remains the leading cause in all forms of chronic liver diseases in this country. This virus has been extensively studied in Bangladesh, including from epidemiology to pathogenosis. Clinical trials with innovative therapy conducted in Bangladesh have shown promise. Hepatitis C virus follows hepatitis B virus as the second commonest cause of chronic liver diseases here. However patients in Bangladesh have started benefitting from the local generic versions of the newly introduced direct acting anti-virals.

Keywords: Bangladesh, Hepatitis B virus, Hepatitis C virus, Hepatitis E virus.

How to cite this article: Al-Mahtab M. Past, Present, and Future of Viral Hepatitis in Bangladesh. Euroasian J Hepato-Gastroenterol 2016;6(1):43-44.

Source of support: Nil

Conflict of interest: None

 
6.  ORIGINAL ARTICLE
Reduced Glutathione suppresses Oxidative Stress in Nonalcoholic Fatty Liver Disease
Makoto Irie, Tetsuro Sohda, Akira Anan, Atsushi Fukunaga, Kazuhide Takata, Takashi Tanaka, Keiji Yokoyama, Daisuke Morihara, Yasuaki Takeyama, Satoshi Shakado, Shotaro Sakisaka
[Year:2016] [Month:January-June] [Volume:6 ] [Number:1] [Pages:92] [Pages No:13-18] [No of Hits : 532]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10018-1159 | Free

ABSTRACT

Background and aims: Insulin resistance and cytokine production are key mechanisms leading to fatty change in the liver and may produce nonalcoholic steatohepatitis (NASH). Oxidative stress may also contribute to clinical progression from simple fatty liver (FL) to NASH. A therapy for insulin resistance and antioxidant has been applied to treat NASH, yet these treatments are not fully established. In the present study, we have evaluated whether an antioxidant agent, glutathione, prevents the development of NASH from FL.

Materials and methods: Five patients with FL and 10 with NASH were enrolled in the study. Three hundred milligrams per day of glutathione was given orally to patients with nonalcoholic fatty liver disease (NAFLD) every day, and an oxidative stress marker and biochemical tests were analyzed before treatment and 1 and 3 months after starting the treatment. We measured serum levels of 8-hydroxy- 2-deoxyguanosine (8-OHdG) and gamma-glutamyltranspeptidase (GGT). Immunohistochemistry for glutathione was performed on formalin fixed liver specimens obtained from liver biopsies.

Results: Before treatment, the NASH group had higher serum 8-OHdG and lower serum glutathione levels than the FL group. Immunohistochemistry revealed that a strong expression of glutathione was observed in zone 3 in both NASH and FL before treatment. Serum levels of alanine transaminase and 8-OHdG were significantly decreased after treatment in the NASH group. Gamma-glutamyltranspeptidase was decreased after treatment, although the decrease was statistically not significant.

Discussion: The present pilot study demonstrated that antioxidant therapy with glutathione may reduce the pathological oxidative stress in the liver in NASH, preventing the progression from NAFLD to NASH.

Keywords: 8-Hydroxy-2-deoxyguanosine, Gamma-glutamyltranspeptidase, Glutathione, Nonalcoholic fatty liver disease, Nonalcoholic steatohepatitis.

How to cite this article: Irie M, Sohda T, Anan A, Fukunaga A, Takata K, Tanaka T, Yokoyama K, Morihara D, Takeyama Y, Shakado S, Sakisaka S. Reduced Glutathione suppresses Oxidative Stress in Nonalcoholic Fatty Liver Disease. Euroasian J Hepato-Gastroenterol 2016;6(1):13-18.

Source of support: Nil

Conflict of interest: None

 
7.  MINI REVIEW
Epidemiology of Viral Hepatitis and Liver Diseases in Bangladesh
Mamun-Al-Mahtab
[Year:2015] [Month:January-June] [Volume:5 ] [Number:1] [Pages:66] [Pages No:26-29] [No of Hits : 738]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10018-1124 | FREE

ABSTRACT

Bangladesh is a South Asian country with a homogeneous population. However, some difference has been demonstrated in the distribution of liver disease in different parts of the country. Hepatitis E remains the principal cause of acute hepatitis in Bangladesh, while chronic liver disease in Bangladesh, including hepatocelullar carcinoma, is predominantly due to hepatitis B virus. Hepatitis B has been extensively studied and characterized in Bangladesh, and some major clinical trials with HBV-related antigens have also been conducted.

Keywords: Epidemiology, Viral hepatitis, Liver disease, Bangladesh.

How to cite this article: Al-Mahtab M. Epidemiology of Viral Hepatitis and Liver Diseases in Bangladesh. Euroasian J Hepato-Gastroenterol 2015;5(1):26-29.

Source of support: Nil

Conflict of interest: None

 
8.  REVIEW ARTICLE
Current Concepts in Hepatocellular Carcinoma and Liver Transplantation: A Review and 2014 Update
Andrew Ofosu, Ahmet Gurakar
[Year:2015] [Month:January-June] [Volume:5 ] [Number:1] [Pages:66] [Pages No:19-25] [No of Hits : 692]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10018-1123 | FREE

ABSTRACT

Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide. Multiple treatment modalities for HCC are available, depending on size and number of tumor. Liver transplantation offers the most reasonable option for curative treatment, because it simultaneously removes the burden of the diseased liver. The Milan criteria currently remain the benchmark for the selection of patients with HCC for transplantation. However, there is considerable and promising interest in expanding the eligibility criteria to include the University of California San Francisco criteria. Liver transplantation (LT) has progressed during the past decade. The introduction of living donor LT has provided a means of expanding organ transplant, but with some inherent concerns. Herein, we reviewed the diagnosis and management of HCC with emphasis on the current concepts of liver transplantation for the treatment of HCC.

Keywords: Hepatocellular carcinoma, Liver transplantation, Milan criteria, University of California San Francisco criteria, Living donor liver transplantation.

How to cite this article: Ofosu A, Gurakar A. Current Concepts in Hepatocellular Carcinoma and Liver Transplantation: A Review and 2014 Update. Euroasian J Hepato-Gastroenterol 2015;5(1):19-25.

Source of support: Nil

Conflict of interest: None

 
9.  MINI REVIEW
Epidemiology of Viral Hepatitis and Liver Diseases in Pakistan
Amna Subhan Butt
[Year:2015] [Month:January-June] [Volume:5 ] [Number:1] [Pages:66] [Pages No:43-48] [No of Hits : 689]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10018-1129 | FREE

ABSTRACT

Pakistan is among ten most populous countries in world. All sorts of hepatitis are highly prevalent in Pakistan. Due to lack of proper mechanisms to handle sewerage, disinfection and lack of clean water supply across the country, hepatitis A and E are endemic in Pakistan. Moreover, Pakistan ranked in intermediate prevalence zone for hepatitis B and C. Also, prevailing socioeconomic conditions, political statuses and unstable healthcare delivery system are not suitable for tackling further progression of hepatitis viruses and its complications. The notable factors related to epidemiology of different hepatitis viruses have been described in this communication.

Keywords: Hepatitis in Pakistan, Liver diseases in Pakistan, Hepatitis B and C in Pakistan.

How to cite this article: Butt AS. Epidemiology of Viral Hepatitis and Liver Diseases in Pakistan. Euroasian J Hepato-Gastroenterol 2015;5(1):43-48.

Source of support: Nil

Conflict of interest: None

 
10.  ORIGINAL ARTICLE
Evaluation of a Rapid One-step Real-time PCR Method as a High-throughput Screening for Quantification of Hepatitis B Virus DNA in a Resource-limited Setting
SM Rashed-Ul Islam, Munira Jahan, Shahina Tabassum
[Year:2015] [Month:January-June] [Volume:5 ] [Number:1] [Pages:66] [Pages No:11-15] [No of Hits : 666]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10018-1121 | FREE

ABSTRACT

Virological monitoring is the best predictor for the management of chronic hepatitis B virus (HBV) infections. Consequently, it is important to use the most efficient, rapid and cost-effective testing systems for HBV DNA quantification. The present study compared the performance characteristics of a one-step HBV polymerase chain reaction (PCR) vs the two-step HBV PCR method for quantification of HBV DNA from clinical samples. A total of 100 samples consisting of 85 randomly selected samples from patients with chronic hepatitis B (CHB) and 15 samples from apparently healthy individuals were enrolled in this study. Of the 85 CHB clinical samples tested, HBV DNA was detected from 81% samples by one-step PCR method with median HBV DNA viral load (VL) of 7.50 × 103 IU/ml. In contrast, 72% samples were detected by the two-step PCR system with median HBV DNA of 3.71 × 103 IU/ml. The one-step method showed strong linear correlation with two-step PCR method (r = 0.89; p < 0.0001). Both methods showed good agreement at Bland-Altman plot, with a mean difference of 0.61 log10 IU/ml and limits of agreement of -1.82 to 3.03 log10 IU/ml. The intra-assay and interassay coefficients of variation (CV%) of plasma samples (4-7 log10 IU/ml) for the one-step PCR method ranged between 0.33 to 0.59 and 0.28 to 0.48 respectively, thus demonstrating a high level of concordance between the two methods. Moreover, elimination of the DNA extraction step in the one-step PCR kit allowed time-efficient and significant labor and cost savings for the quantification of HBV DNA in a resource limited setting.

Keywords: HBV DNA viral load, One-step PCR, Two-step PCR, Resource limited settings.

How to cite this article: Rashed-Ul Islam SM, Jahan M, Tabassum S. Evaluation of a Rapid Onestep Real-time PCR Method as a High-throughput Screening for Quantification of Hepatitis B Virus DNA in a Resource-limited Setting. Euroasian J Hepato-Gastroenterol 2015;5(1):11-15.

Source of support: Nil

Conflict of interest: None

 
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