Chronic hepatitis B virus infection in Eastern Ethiopia: Clinical characteristics and determinants of cirrhosis.

BACKGROUND: Chronic hepatitis B (CHB) virus infection is a major cause of liver-associated morbidity and mortality, particularly in low-income countries. A better understanding of the epidemiological, clinical, and virological characteristics of CHB will guide appropriate treatment strategies and improve the control and management of CHB in Ethiopia. AIM: To investigate the characteristics of CHB in Eastern Ethiopia and assess the efficacy and safety of antiviral treatment. METHODS: This cohort study included 193 adults who were human immunodeficiency virus-negative with CHB between June 2016 and December 2019. Baseline assessments included chemistry, serologic, and viral markers. χ 2 tests, Mann-Whitney U tests, and logistic regression analyses were used to identify the determinants of cirrhosis. Tenofovir disoproxil fumarate (TDF) was initiated using treatment criteria from the Ethiopian CHB pilot program. RESULTS: A total of 132 patients (68.4%) were men, with a median age of 30 years [interquartile range (IQR): 24-38]. At enrollment, 60 (31.1%) patients had cirrhosis, of whom 35 (58.3%) had decompensated cirrhosis. Khat use, hepatitis B envelope antigen positivity, and a high viral load were independently associated with cirrhosis. Additionally, 66 patients (33.4%) fulfilled the treatment criteria and 59 (30.6%) started TDF. Among 29 patients who completed 24 months of treatment, the median aspartate aminotransferase to platelet ratio index declined from 1.54 (IQR: 0.66-2.91) to 1.10 (IQR: 0.75-2.53) (P = 0.002), and viral suppression was achieved in 80.9% and 100% of patients after 12 months and 24 months of treatment, respectively. Among the treated patients, 12 (20.3%) died within the first 6 months of treatment, of whom 8 had decompensated cirrhosis. CONCLUSION: This study highlights the high prevalence of cirrhosis, initial mortality, and the efficacy of TDF treatment. Scaling up measures to prevent and control CHB infections in Ethiopia is crucial.

Insights into the role of IL-12B and IFN-gamma cytokine gene polymorphisms in HIV-1/AIDS infection.

One of the main characteristics of HIV-1 infection is persistent systemic immune activation. This immune activation and dysregulation is characterized by a specific pattern of cytokine production, expression of membrane activation molecules on the cells of the immune system, and changes in the levels of several immune parameters in blood. Therefore, the aim of the present work was to evaluate the effect of a Taq1 polymorphism in the 3'UTR of the IL-12B gene at position -1188 (A/C) and the biallelic polymorphism in the first intron of IFN-gamma at position +874 (T/A) on HIV-1/AIDS among north Indian population. IL-12B and IFN-gamma gene polymorphisms were studied in 300 patients with HIV-1/AIDS and an equal number of negatively diagnosed controls of the matched age, using DNA-based polymerase chain reaction with sequence-specific primers and restriction digestion. The allelic as well as genotypic frequencies of interleukin-12B gene polymorphisms did not significantly differ between HIV-1/AIDS patients and negative healthy controls. A statistically significant correlation was found between IFN-gamma polymorphism and the risk of the disease. The present study suggested that individuals with mutant homozygous IFN-gamma AA genotype were at risk of HIV-1/AIDS (OR = 1.88, 95% CI 1.14-3.10, P = 0.008).

Truncal Vagotomy for Peptic Pyloric Stenosis and Assessment of Completeness by Acid Tests

Background: Several types of operations are used for Peptic pyloric stenosis (PPS) which includes Vagotomy with antrectomy or drainage procedures. This study was done primarily to analyze the completeness of Truncal vagotomy (TV) by gastric acid secretion tests. The secondary analyses included demographic; clinical profile and out come of the operation.Methods: From December 27/2004 to June 26/2006; 32 consecutive patients; aged 10 to 65 yearsunderwent trans-abdominal (TV) and Posterior Gastrojejunostomy for PPS at Glen C. Olsenmemorial hospital. TV without mobilizing and encircling the esophagus. Prospectivelongitudinal case serial analysis was done to assess the completeness of TV. Outcome measuresused for assessment were the pre-operative basal acid output (BAO); Post-operative BAO; Postoperativesham feeding acid out put (SAO) and other relevant clinical characteristics.Results: After surgery; the average pre-operative BAO had decreased from 6.07+/-2.7mmol/hour to 0.42+/-0.29mmol/hour. The BAO was decreased by 91.3. Mean peak acid response after TV to SAO was 0.83+/- 0.45mmol/hour. The difference between the peak 15minutes out put of SAO and lowest 15 minutes out put of post-operative BAO did not exceed 0.6mmol in 30/32 patients. This shows that TV was complete in 93.7.There was no operative mortality and clinically significant post-operative complication developed in only three patients.Conclusion: Trans-abdominal TV done without mobilizing and encircling the esophagus wasfound safe and effective means of reducing acid secretion for patients with long standing peptic pyloric stenosis