Dear Editor, Hepatocellular carcinoma (HCC) is a common primary liver malignancy worldwide with a poor prognosis (1) and is the third leading cause of cancer-related deaths (2). Chronic hepatitis B (HBV) infection, which can cause liver inflammation, has been seen in many individuals with HCC. In addition, fibrosis and cirrhosis are inevitable complications of the infection, which leads to the death of a patient (3, 4)...

Background: Chronic infection with hepatitis B virus (HBV) is related to more than 50% of all cases of hepatocellular carcinoma (HCC). The HBx protein of the virus plays an important role in carcinogenesis through different mechanisms, including interaction with the Notch1 signaling pathway. Several microRNAs have also been shown to play essential roles in the carcinogenesis of HCC, and the molecules can be considered the novel biomarkers for the DIAGNOSIS of different types of cancer. Methods: In the present study, the expression levels of four bioinformatically predicted microRNAs, including miR-214, miR-6510, miR-5193, and miR-34a, were compared in individuals with HBV-associated HCC and controls in order to assess the diagnostic utility of these microRNAs as noninvasive biomarkers. Seventy three plasma samples were subjected to RNA extraction, and the microRNA expression profiles were assessed by RT-qPCR. The expression of miR-103 was used as the endogenous reference for the normalization of quantitative data. Results: The plasma expression of all miRNAs was significantly lower in the HCC group, but the downregulation was most marked for the newly described molecule, miR-5193 (-18. 86 folds and-5. 71 folds compared to healthy individuals and chronic HBV patients). Another novel microRNA, miR-6510, was downregulated by-4. 23 folds (P = 0. 001). The results of the ROC curve analysis indicated that the differential expression of miR-5193 could distinguish HCC patients with high sensitivity and specificity. Conclusions: The study microRNAs may have a role in HCC development and progression. In addition, miR-5193 can be potentially used as a non-invasive biomarker for the detection of HBV-induced HCC.

Background and Objective: Infection with hepatitis B is one of the most common infectious diseases worldwide. The presence of HBeAg correlates with high infectivity in acute HBV infection. The presences of anti-HBe indicate suppression of viral replication and low infectivity of disease. But sometimes, the appearance of anti-HBe is followed by disappearing of HBeAg in the presence of detectable HBV-DNA in serum indicates active viral replication. This situation may be due to the presence of certain precore and core mutations in the HBV genome that alter the expression of HBeAg. The aim of this study was to detect HBV-DNA and viral load in HBeAb positive patients.Materials and methods: We studied 50 sera of hepatitis B infected patients. Hepatitis B serological markers including HBsAg, HBeAg, HBeAb and HBcAb were measured by Enzyme-Linked Immunosorbent Assay (ELISA). HBV-DNA was extracted from serum samples. Then, PCR was carried out on the extracted HBV-DNA using specific primer for C gene. HBV viral load in serum was detected by Real-Time PCR. In this study both methods PCR and Real-Time PCR were performed. Liver enzymes levels ALT& AST were measured in patients by using Pars Azmoon kit and based on kit instruction.Results: Of 50 HBV infected patients, all patients (100%) were positive HBsAg and anti-HBc and only 92 % of them were HBeAb positive. HBV-DNA was detected in 100% of patients. Of HBeAb positive patients, 36.7% of them had high viral load.Conclusion: The results of this study show that there is a spectrum of HBeAb positive patients had high viral load. Therefore, it is necessary that the possibility of the presence of precore and core mutations in these patients should be studied.

Background and Objectives Beta-2 microglobulin (β2MG) is the light chain of Histocompatibility–Class I human antigen and its normal range is <3mg/ml. β2MG level in sera of hepatitis B patients increases. In Hepatitis infection the presentation of the viral antigen on the hepatocyte in the presence of Class I HLA antigen plays a major role in the elimination of the virus. Materials and MethodsIn this descriptive study, sβ2MG, HBsAg (by ELISA), and HBV DNA (by PCR) were evaluated in sera of 49 patients with hepatitis B and 35 subjects in control group. ResultsOur results showed HbsAg was positive in all patients. 29 of patients were HBV-DNA-PCR positive and 20 HBV-DNA-PCR negative. β2MG in all subjects in control group was in normal range and in 34.7% of patients above normal limit. β2MG in HBV-DNA-PCR positive patients was higher than HBV DNA PCR negative patients. Such differences were significant (p<0.05). ConclusionsIt seems S β2MG is a good marker for HBV replication and its absence may exclude HBV replication. The role of β2MG in monitoring response to therapy needs to be further evaluated.

Background: Viral load has been used to diagnose and monitor patients who are being treated for chronic hepatitis B (CHB). The DIAGNOSIS methods are molecular-based and expensive. Quantitation of hepatitis B surface antigen (HBsAg) by automated chemiluminescent micro-particle immunoassay has been proposed to be a surrogate marker.Quantitating HBV DNA levels molecularly is expensive; thus, a cheaper laboratory test as a surrogate diagnostic marker might simplify our management.Objectives: We determined whether quantitative HBsAg levels correlate with HBV DNA levels in CHB.Patients and Methods: In this cross-sectional study, all CHB patients who were referred by a gastroenterologist to undergo quantitative HBV DNA assay in a qualified laboratory in Mashhad, Iran in 2009 were enrolled, and blood samples was obtained. Patients who were positive for antibodies to HCV and HDV were excluded. HBV DNA was measured by real-time polymerase chain reaction, and serum HBsAg was quantified byelectrochemiluminescence assay (Roche Diagnostic).Results: Of 97 patients, 70 were male (72%) and 27 were female (28%); the mean age was 39 ± 11 years. Eighty-seven percent wasHBeAg-negative. By Mann-Whitney test, HBSAg titer differed significantly between HBeAg-positive and -negative patients (P=0.001), as did HBV DNA levels (P=0.009). By Spearman test, there was no significant correlation between HBsAg and HBV DNA levels (P=0.606 and r=0.53).Conclusions: HBeAg-negative patients have higher levels of HBsAg and lower levels of HBV DNA. By electrochemiluminescence assay, HBsAg has no significant correlation with HBV DNA levels in CHB with predominant genotype D and HBeAg negativity in Iran.

BACKGROUND AND OBJECTIVE: One of the most important mutations, which occur in hepatitis B virus, is precore mutant. This mutation is associated with highly productive infection in anti HBe+ chronic HBV carriers. These chronic HBV carriers are predisposed to developing active hepatitis. The aim of this study was to determine the prevalence of HBV DNA in chronic anti HBe+ HBV carriers in Babol. METHODS: This cross-sectional study was conducted on patients with Anti HBe+ chronic HBV carriers in Babol during 2002. In all cases, HBV DNA was assayed by PCR. Prevalence of HBV DNA in males, females and different age groups were compared with X2 test.FINDINGS: Of 257 cases of anti HBe+ (mean age ± SD, 32.3 ± 11.2 years), HBV DNA was positive in 222 (86.4%) cases. HBV DNA was positive in 136 (87.2%) of 156 males and 86 (85.15%) of 101 female cases (p=0.7). There was no significant difference in prevalence of HBV DNA between age groups (p=0.07). CONCLUSION: These results show that the high prevalence of HBV precore mutants in this region. Follow up of these individuals are necessary.

Background: The aim of this study was to investigate the prevalence of hepatitis B virus (HBV) genotypes in Isparta, Southwest of Turkey, as well as the clinical features and transmission route for patients with HBV infections. Methods: Patients (n = 135) with HBV infection were included in the study. Epidemiological and clinical data were obtained. HBV genotypes were determined with a preS2 epitope ELISA kit. Results: Although the HBV transmission route remained unidentified in 51.1% of the patients, blood contact was determined as the most common probable transmission route (38.5%). One hundred twenty-four (91.8%) of 135 samples, could be genotyped. One hundred fifteen (85.1%) were genotyped as type D/E, six (4.4%) were genotyped as type A, two (1.4%) were genotyped as type C, and one (0.7%) were genotyped as type F. Conclusion: Genotype D/E is determined as the predominant HBV genotype circulating in Isparta, Southwest of Turkey. No relationship between genotypes and disease severity and transmission route has been detected.