Hepatitis C and hepatitis B virus infections constitute an important public health problem in prisons. Public health strategies to prevent morbidity and mortality from these infections should include hepatitis B vaccination, HCV testing, counseling and medical management of infected prisoners.

Background and Aims: To eliminate the anti-definition of non-alcoholic fatty liver disease (NAFLD), positive clinical criteria for metabolic associated fatty liver disease are recently proposed. In this study, we examine the validation and utilization of these criteria. METHODS: Two cohorts of 316 consecutive patients were recruited, including 242 patients previously diagnosed to have NAFLD and 74 patients with concomitant NAFLD and chronic hepatitis C (CHC) The validity of the proposed criteria for MAFLD, namely presence of hepatic steatosis with one of three criteria, overweight/obesity, diabetes or evidence of metabolic dysregulation was assessed. Fibrosis was assessed using, fibrosis-4 (FIB-4) and NAFLD fibrosis score (NFS). The impact of MAFLD on the clinical outcomes in CHC patients was also investigated. Results: The clinical criteria captured 240 patients (99.2%). 215 (88.8%) met either overweight or diabetes and 25 (10.3%) met the presence of 2 criteria of metabolic dysfunction. In patients, with dual etiologies, in the multivariable analysis adjusting for age, sex, BMI, ALT, AST and diabetes, the presence of MAFLD were significantly associated with increase high FIB-4 score of fibrosis (Odds ratio [95% confidence interval], 3.77 [1.49-9.48], P < 0.005) when compared to those with MAFLD only. CONCLUSION: The proposed criteria for diagnosis of MAFLD is well validated and easily applicable to the entire spectrum of disease including non-obese subjects. Patients with lean MAFLD have favorable metabolic and fibrosis characteristics compared to their obese counterpart, while patients with concomitant MAFLD and CHC had severe metabolic and fibrosis characteristics compared to patients with MAFLD alone.

BackgroundHepatocellular carcinoma (HCC) is one of the most common cancers worldwide. It has been widely established that the early detection of HCC enables more treatment options with improvements in prognosis and survival.ObjectivesThe aim of this study was to assess the diagnostic accuracy of both circulating miR-215 and squamous cell carcinoma antigen-IgM (SCCA-IgM) as serum biomarkers for HCC by examining their diagnostic sensitivity, specificity, accuracy, and predictive values in hepatitis C virus (HCV)-induced HCC patients.Subjects and methodsThis study included 60 patients with HCV-related HCC. In addition, 60 patients with HCV-related liver cirrhosis (LC) and 60 apparently healthy subjects were involved, and served as diseased and healthy control groups, respectively. The relative expression levels of miR-215 were detected using quantitative real-time PCR. SCCA-IgM levels in serum were measured by enzyme immunoassay. We used receiver operating characteristic (ROC) curve to calculate the diagnostic accuracy against alpha-fetoprotein (AFP).ResultsRelative miR-215 expression levels increased the most in HCC patients compared to that in healthy or diseased controls (P<0.001). Serum concentration of SCCA-IgM was significantly higher in HCC group than that in the two control groups. We performed multivariate analysis using AFP level, focal lesion size, and portal vein thrombosis as independent variables. ROC curves showed that the optimum diagnostic miR-215 cutoff value for identifying HCC patients from cirrhotic ones was 417 (sensitivity, 97%; specificity, 91%) and for SCCA-IgM was 95 AU/mL (sensitivity, 92%; specificity, 98%). Moreover, the superiority of both miR-215 and SCCA-IgM to AFP is obvious in our study and this superiority is more evident in distinguishing HCC with AFP levels <200 ng/mL and HCC patients with small-sized focal lesions from cirrhotic patients.ConclusionCell-free miR-215 and serum SCCA-IgM could be used for early diagnosis of HCC either each one as a single marker or with AFP complement measurement.

Background: Hepatocellular carcinoma (HCC) is one of the most prevalent cancer worldwide. Early detection of HCC is crucial to improve prognosis and survival. Nearly 30 % of HCC patients present with normal serum alpha fetoprotein (AFP), which highlights the need for new biomarkers for HCC. Annexin A4 (ANXA 4) is one of the annexin family with high expressions found in gastric, liver, lung, colorectal and ovarian cancers. Aim : to evaluate the clinical significance of ANXA 4 in the early diagnosis of HCC. Methods: Thirty patients with hepatitis C virus (HCV) related HCC were enrolled in this study. They were stage A according to Barcelona Clinic Liver Cancer (BCLC) staging and they were grade A or B according to Child Pugh Classification. Twenty patients with HCV-related liver cirrhosis and 20 healthy persons seronegative for both HCV and HBV served as control group. ANXA 4 and AFP were measured in serum of all cases. Results: Serum ANXA 4 level was significantly higher in HCC patients compared to patients with liver cirrhosis and healthy controls (188, IQR 42-428 and 23, IQR 24-33 and and 21, IQR 22-24 ng ̷ ml, respectively). By using the ROC curve, the area under the curve of ANXA 4 was 0.972 and the best cutoff value was115 ng/ml, with sensitivity 95% and specificity 80%. Conclusion: The serum level of ANXA 4 might be a good biomarker for the early detection of HCC.

BackgroundHepatitis C virus (HCV) is a common chronic infection that is widely associated with symptoms of fatigue and abdominal pain. The aim of the present study was to determine the prevalence of functional dyspepsia (FD) among patients with hepatitis C.MethodsThis study included 252 patients with chronic hepatitis C and 150 healthy volunteers. Clinical and laboratory data were recorded for every patient. All patients and controls were administered a questionnaire of FD according to Rome III criteria.ResultsThe percentage of patients with FD was significantly higher in patients with chronic HCV than normal controls (65.9 % vs 28.7 %, respectively). In chronic HCV patients, post prandial distention syndrome (PDS) subtype was the predominant type (86.1 %). The percentage of patients with a high fibrosis score (F2–3) and raised ALT were significantly higher in patients with FD than in patients without FD (P < 0.001; P < 0.04; respectively). A multivariate regression analysis revealed a significant association between fibrosis score, BMI and FDConclusionFD is more prevalent in patients with chronic hepatitis C. Obese chronic HCV and those with higher fibrosis scores are more likely to have FD.