Celiac disease is characterized by a gluten-induced damage of the small bowel in sensitive individuals that may cause malabsorption. Non-intestinal inflammatory diseases may trigger immunologic gluten intolerance in susceptible people and the HCV virus may be considered as a suitable candidate. Interferon therapy could precipitate symptom onset in subjects with silent celiac disease. In fact, symptoms such as diarrhea, anemia, and weight loss may occur during interferon therapy and are associated with serological positivity of anti-tranglutaminase antibodies. To date, considering the available literature data, it is very difficult to support a firm association between HCV CHRONIC HEPATITIS and celiac disease. Thus, such a serological screening in HCV patients before starting interferon therapy should not be recommended. However, serology for celiac disease must be considered in patients who develop diarrhea and/or weight loss during such therapy.

Background and Aims: The aim of this study was to detect the substitutions Ser128Arg (A128C) and Leu554Phe (T554C) which are responsible for E-selectin polymorphisms in patients with CHRONIC HEPATITIS B and healthy controls. We investigated possible association of the Ser128Arg and Leu554Phe gene polymorphisms in the E-selectin gene with susceptibility to CHRONIC HEPATITIS B.Methods: Sixty-three patients with CHRONIC HEPATITIS B virus infection and 150 healthy subjects were recruited sequentially as they presented to clinic. Classification of CHRONIC HEPATITIS B virus (HBV)-infected patients was as asymptomatic carrier state (34 patients) and CHRONIC HEPATITIS B (29 patients). Genomic DNA was isolated from anticoagulated peripheral blood Buffy coat using Miller's salting-out method. The presence of the E-selectin gene polymorphisms was determined by using polymerase chain reaction amplification refractory mutation system (ARMS).Results: Distribution of E-selectin 128 (A+C-, A+C+, A-C+) genotypes and E-selectin 554 (C+T-, T+C-, C+T+) genotypes were not statistically different in CHRONIC HEPATITIS B patients and controls (P=0.41 and 0.96, respectively). Also, two groups had no significant difference in distribution of frequencies of allele 128A (P=0.41), 128C (P=0.15), allele 554C (P=0.85), and allele 554T (P=0.76). Carrying of allele 128A (OR=0.58, 95% CI=0.16-2.12), 128C (OR=1.52, 95% CI=0.84-2.74), 554C (OR=1.24, 95% CI=0.12-12.08), and allele 554T (OR=0.88, 95% CI=0.38-2.01) were not risk factors for susceptibility to CHRONIC HEPATITIS B infection.Conclusions: Carrying E-selectin gene polymorphisms of Ser128Arg and Leu554Phe is not considered risk factor for susceptibility to CHRONIC HEPATITIS B infection.

BACKGROUND: Silymarin derived from silybum marianum (milk thistle), a flowering member of the daisy family, may benefit liver function in people infected with the HEPATITIS C virus. The aims of this pilot study were to assess the efficacy and safety of silymarin on serum HEPATITIS C virus (HCV) RNA, serum aminotransferases (ALT, AST) levels, liver fibrosis and well-being in patients with CHRONIC HEPATITIS C (CHC).METHODS: This prospective self-controlled trial study was conducted from March to September 2006 at Department of Gastroenterology, Isfahan University of Medical Sciences, Isfahan, Iran.55 patients with HCV (10 female and 45 male) with a mean age of 31.8±6.4 years (10-67 years) were participated in the study. Patients received 24 weeks of silymarin (630 mg/day). Baseline virological biochemical, liver fibrosis (by a serum fibrosis markers, including YKL–40 and Hyaluronic acid), and SF-36 questionnaire were performed with biochemical tests repeated at the end of the treatment period.RESULTS: There was statistically difference in mean of ALT (108.7±86.6 vs 70.3±57.7) before and after the treatment (p<0.001). The means of AST were 99.4±139.7 and 59.7±64.32 before and after the treatment with statistically differences (p=0.004). After the treatment, nine patients were found with negative HCV-RNA (p=0.004) and statistically significant improvement in results of liver fibrosis markers were found only in fibrosis group (p=0.015). Quality of life was improved significantly (p<0.001).CONCLUSIONS: This study indicated that in patients with CHC performing silymarin (650 mg/day) for 6 months, improved serum HCV-RNA titer, serum aminotransferases (ALT, AST), hepatic fibrosis and patient’s quality of life. More future studies are warranted.

Background: CHRONIC delta HEPATITIS is the most severe form of viral HEPATITIS, for which interferon administration is the only available treatment. However, the efficacy of interferon treatment is affected by the dose and duration of treatment, and relapse rates are high.Objectives: In this study, we sought to evaluate the efficacy of treatment with pegylated interferon and observe the relapse rates of delta HEPATITIS after treatment.Patients and Methods: Forty-six patients with CHRONIC delta HEPATITIS were retrospectively studied between January 2002 and December 2010. Patients were evaluated for biochemical, virological, and histological responses. They were then followed-up for at least 1 year after discontinuation of the treatment.Results: All the 46 patients in the study received PEG-IFN therapy. Of the 46 patients, 25 were treated with PEG-IFN for 1 year and 21 were treated for 2 years. Sixteen patients (34.7%) showed a biochemical response, 27 (58.6%) showed a virological response, and 39 (84.7%) showed a histological response. Sustained virological and biochemical responses were achieved in 41% and 47.8% of the patients, respectively. Sixteen (84.2%) patients of the 19 with high levels of HEPATITIS delta virus RNA (HDV RNA) (HDV RNA level>1 × 105) and 10 (71.4%) of the 14 patients with high titers of HEPATITIS B surface antigen (HbsAg) (HbsAg>102 IU/mL) at the beginning of the treatment showed relapse after treatment.Conclusions: We found no significant differences between 1-year and 2-year treatments.However, the relapse rate was lower in the 2-year treatment group. Higher HDV RNA and HbsAg levels before treatment were associated with higher relapse rates. Younger age was a significant factor in predicting response.

Background and Aims: CHRONIC HEPATITIS B and C are prevalent diseases, especially in developing countries. In many of the patients they cause limitations in physical and mental functions and finally cause reduction in their life quality. We wanted to assess the quality of life in these patients.Methods: This research was done on 74 CHRONIC HEPATITIS B and C patients of Rasht which their diseases were confirmed by serologic and histologic methods and their hepatic enzymes including AST & ALT was two times more than normal range for at least 6 months. Cross-sectional questionnaire survey performed in October 2003 till July 2004 in Gastrointestinal & Liver Diseases Research Center of Rasht (north city of Iran), Razi hospital. The questionnaires consisted of 29 questions that were given to the patients and they were let free to complete it.Results: The individuals under survey consisted of 15 (20.27%) CHRONIC HEPATITIS B patients and 59 (79.72%) CHRONIC HEPATITIS C patients. 54 (72.79%) ones were male and 20 (27.02%) were female. Total adjusted score (up to 100 points) of life quality was 54.4 ± 22.5. No meaningful difference was seen between two sexes based on total score of life quality. Also, in different fields of life quality no significant difference was seen between two genders, except the systemic signs that the average of adjusted score of females (43±28) was less than males (63±27) that means meaningful statistical difference (P<0.007).Conclusions: Generally, it seems that CHRONIC HEPATITIS B and C have untoward life qualities which could result from concern of decrease of social support or fear of society or decrease in patronage of the family or friends and it is mandate to be concerned when furnishing services to these patients.