Regardless of all efforts to guarantee safety of blood, hepatitis B residual risk is the highest among transfusiontransmitted diseases [1]. HBV DNA was detected in 3.3% of blood donors negative for hepatitis B surface antigen (HbsAg) and hepatitis B surface antibody (HBsAb) but positive for anti-HBc [2].The frequency of HBsAg in Egyptian blood donors is 4.3% [3]. There are no available data about the frequency of either hepatitis B core antibody (HBcAb) or HBsAb in Egyptian blood donors. In order to evaluate the role of HBcAb in blood screening for HBV infection, 150 blood donors (negative for HBsAg, HBsAb, hepatitis C virus antibody, and human immunodeficiency virus) were tested for HBcAb (total). In the anti-HBc-positive samples (n = 20), HBV-DNA polymerase chain reaction (PCR) assay tests were performed. HBV-DNA was detected in only 2 (10%) out of the 20 HBcAb-positive samples. Isolated anti-HBc that tested negative for HBV DNA was detected in 18 (12%) of the 150 samples that tested negative for HBsAg.Isolated anti-HBc was reported in 2% of the 6,035 consecutive Saudi blood donors [4]. In a single Brazilian study, it was 10% [5]. In our institution, however, the prevalence of isolated HBcAb in tested samples was 13.3%. Isolated anti-HBc serologic profile may be associated with occult chronic HBV infection with undetectable HBsAg, remote HBV infection with loss of measurable HBsAb, passive transfer of anti-HBc, nonspecific crossreacting antibody, or the period when HBsAg has disappeared and anti-HBs has not been detected. The higher prevalence of isolated anti-HBc in our study may be related to the absence of donor selection.Molecular methods have demonstrated the presence of the virus in patients with HBcAb alone with frequencies of 0.8% and 12.2% in a Brazilian [6] and an Iranian [7] study, respectively. In our study, the overall prevalence of HBV-DNA in healthy blood donors was 10% among isolated anti-HBc-positive individuals. Such wide discrepancy, not completely understood, could result from virological, immunological, methodological, or epidemiological factors. The detection of HBV DNA by PCR in these individuals rules out the possibility of false positive results and remote HBV infection. At the same time, it confirms the presence of occult HBV infection.Individuals with isolated anti-HBc who tested negative for HBV DNA constituted 12% of our tested populations. These subjects may have remote infection, false positive result, or represent an immunological window period. We have tested subjects for total HBcAb rather than IgM and IgG isotypes. Therefore, the differentiation between acute and chronic HBV infection was difficult.The exclusion of all anti-HBc positive blood donors leads to unnecessary blood shortage in blood banks (12%
Background: Polycyclic aromatic hydrocarbons (PAHs) are among the most carcinogenic, mutagenic and toxic contaminates. Their exposure and metabolism to DNA-reactive metabolites in the body are considered to contribute to the etiology of many types of the human cancers.Objectives: To find out if exposure to polycyclic aromatic hydrocarbons is a risk factor for development of hepatocellular carcinoma (HCC) among the exposed cases, to detect if the smoking is an augmented factor for development of hepatocellular carcinoma among exposed cases, and to find the effect of sociodemographic characteristics of cases of hepatocellular carcinoma exposed to hydrocarbons. Subjects and Methods:A case control study was conducted between the period from the first of March 2015 to end of August 2017. The study was conducted in the outpatient clinic of the Department of Hepatology and Gastro-entrology at Theodor Bilharz Research Institute (TBRI). The minimum sample size required for the present study was calculated using Epi info program, considering following data: Two sided confidence level = 95%, power of test = 80%, ratio of control: cases = 1:1, percent of control exposed = 21%, percent of cases exposed = 42 %, and odds ratio = 2.8. Kelsey estimated number of cases = 77 and number of control = 77 subjects. All subjects of both groups were interviewed. Every patient was subjected to the selected interview sheet and biological monitoring of urinary 1-hydroxy pyrene as a biomarker for PAHs exposure.Results: 73% of cases of HCC had increased level of 1-hydroxy pyrene in urine with statistical significance difference when compared to controls. There was a significant positive association between exposure to PAHs and development of HCC among case group (OR = 4.9). There was a significant association between smoking and abnormal high level of 1-hydroxy pyrene in urine (OR = 1.7) among the case group. There was a significant positive association between exposure to PAHs and development of HCC among males (OR = 1.6). There was neither statistical significance difference nor positive association between exposure to PAHs and development of HCC in urban areas (OR=0.8). There was a statistically significant positive association between exposure to PAHs and development of HCC among smoker (OR=1.7). There was neither statistical significance nor positive association between exposure to PAHs and development of HCC among patients with chronic active hepatitis C (OR=0.6). There was a highly positive correlation between 1-hydroxy pyrene and Alfa Feto Protein (AFP) among positive cases of 1-hydroxy pyrene in case group (OR=316.25). RAED M ALAZAB et al., 102Conclusion: Exposure to PAHs is considered as a risk factor of HCC among cases of hepatitis B and C. HCC cases had increased level of 1-hydroxy pyrene in urine with statistical significance difference when compared to controls. A significant positive association between exposure to PAHs and development of HCC among males and smokers were also detected.
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