Autoimmune HEPATITIS (AIH) is one of causes of chronic liver diseases. It is an unresolving inflammation of liver tissue and characterized by elevated transaminases, hypergammaglobulinemia, and circulating autoantibodies. The disorder occurs mostly in females (F:M ratio is 3.6 to 1) and is a relatively uncommon disorder with point prevalence of 8-16.8 per 100 000 population in western countries. Hiostologic hallmarks are interface HEPATITIS (also called piecemeal necrosis), and portallymphoplasmacytic infiltration.Dignostic criteria are based on excluding other etiologies of chronic liver disease,such as viral hepatic (A, B, C), metabolic disorders eg Wilson disese,drug induced HEPATITIS and alcoholic liver disease. Conventional autoantibodies are Antinuclear antibody (ANA), Smooth muscle antibody (SMA) and Anti liver kidney microsomal 1 (Anti LKM1).Some cases have combined clinical, laboratory or histologic features of Primary Biliary Cirrhosis (PBC) or Primary Sclerosing Cholangitis (PSC) with AIH and are known as overlap syndrome. Standard treatments of AIH as the most successful treated form of chronic HEPATITIS are based on immunosuppression with corticosteroids alone or in combination with azathioprine.

Background: A higher prevalence of HEPATITIS B virus (HBV) infection has been reported in persons with intellectual disability as well as the nurses working in closed institutions compared to the general population. Objectives: In the present study, the serological and molecular markers of HBV infection in individuals with intellectual disability of closed institutions were investigated. Methods: Blood samples were derived from 400 persons with intellectual disability living in six institutions in Tehran and tested for HBsAg and HBcAb. Nested PCR, direct sequencing, and phylogenetic analysis were performed to determine the HBV genotypes and mutational patterns of HBsAg. Also, HBsAb was tested for HBV DNA positive cases. Results: Twenty-eight (7. 0%) patients were positive for the HBsAg serological test. Furthermore, six HBV OCCULT cases were identified. In total, out of 41 patients with HBV infection markers, 26 cases were positive for HBV DNA. Of these patients, 15 full-length HBsAg were successfully amplified and sequenced. All strains belonged to genotypeDand subtypes ayw2 and ayw3. These 15 isolated strains carried several immune escape mutants in the S genes. Surprisingly, mutations related to antiviral resistance were detected in the overlapped pol genes of strains isolated from naï ve-treatment patients. Conclusions: The observed frequency of HBV infection in individuals with intellectual disability was higher than the reported estimation of HBV infection in Iranian blood donors and the general population. All HBV isolates from these patients represented a homogenous genotype and corresponded with other reported strains from Mediterranean countries. The high frequency of immune escape strains, despite vaccination and detection of identical mutational patterns in different genes, might indicate that persons with intellectual disability have shared vaccine-escape and drug-resistant HBV strains.

Background and Aims: To initially explore the underlying pathogenesis of the relationship between genotypes of HEPATITIS B virus (HBV) and its clinical manifestations. Methods: The S and C genes of HBV from 60 serum samples, infected by HBV of genotypes B or C were amplified by PCR. The products were recombined with vector pEGFP-C1, which is an internal reference for transfection, to construct the eukaryotic expression recombinant plasmids, followed by cloning and subcloning. Then they were transfected into hepatocarcinoma cell HepG2. The increment rates and apoptosis rates of these transfected cells were determinated by MTT and flow cytometer, respectively. Results: The 120 eukaryotic expression recombinant plasmids were all constructed successfully. As an internal reference for transfection, EGFP confirmed that large S protein and C protein of HBV had been expressed in all HepG2 cells. It was found by flow cytometer that the apoptosis rates of HepG2 cells transfected by pEGFP-C1/HBs or pEGFPC1/HBc from HBV-genotype C samples were all significantly higher than that from HBV-genotype B samples (P=0.009 & P=0.001, respectively).Conclusions: HBV of genotype C can induce more serious cell apoptosis than HBV of genotype B. Difference in apoptosis may be an important reason that HBV of genotype C can induce more severe liver injury than HBV of genotype B.

Background: Via hemodialysis, viral infections can be transmitted in patients a new definition of this infection with no increase in liver enzymes, negative HCV-PCR in serum and presence of virus in the liver and peripheral blood mononuclear cell (PBMC) called OCCULT HEPATITIS C virus (HCV) infection (OCI). We decided to examine the prevalence of OCCULT HEPATITIS C infection on hemodialysis cases. Methods: The current research is a cross-sectional study on patients with end-stage renal disease (ESRD) who were at three hemodialysis centers in Mazandaran province in Iran during 2012-2014. In this study of 356 patients who were undergoing hemodialysis, 54 patients were excluded due to positive HCV Ab, and the remaining 302 patients were enrolled. The test of all serum samples for HCV-RNA detection of plasma and PBMCs was done by real-time polymerase chain reaction (real-time PCR). Results: There was a significant association between the duration of dialysis with the prevalence of OCCULT HCV infection (P=0. 017). Eight (2. 65%) patients were positive for HBs Ag and with OCI, but none of them was infected with both HEPATITIS C and B obviously. Also among the total number of patients, nine patients tested positive for HCV RT-PCR in PBMC in which one of them was positive for serum HCV RNA PCR and was excluded from the study. Conclusion: The results showed that eight patients had an OCI. There was not any association found between age and sex with OCI, but there was a significant relationship between the duration of dialysis with the prevalence of OCI.

Introduction: There are multiple reports of Acute HEPATITIS B after blood transfusion inspite of good screening for HEPATITIS B before transfusion. Therefore, OCCULT HEPATITIS B is a serious concern for Blood transfusion. There is a lot of evidence that positive HBCAb in seronegative HBSAg blood donors is associated with OCCULT HEPATITIS B. Aim: Evaluation of the prevalence of HBCAb in seronegative HBSAg blood donors. Method: In a cross sectional descriptive study, we evaluated the serum of 1230 Blood donors for HBCAb, HCVAb and Aminotranferase levels. HBSAg or AntiHIV Ab positive cases were excluded from the study. Detection of Anti HBSAb was done in HBCAb positive patients and liver biopsy was performed in all HCVAb positive cases. Results: 15.1% of blood donors were positive for HBCAb and 51.6% of them had Anti HBSAb. Aminotranferase levels were normal in all people who were positive for HBCAb ,but about 50% of HCVAb positive persons had elevated aminotransferase levels and liver biopsy of all these patients showed inflammation Conclusion: Prevalence of HBCAb is high in our seronegative HBSAg Blood donors and biomolecular studies such as PCR for HBV DNA is indicated in HBCAb positive people, especially in people with isolated HBCAb .

Background and Objectives: The prevalence of HEPATITIS B virus (HBV) infection among haemodialysis (HD) patients has been well documented. In addition to overt infection, OCCULT HEPATITIS B infection exists in which a patient who is diagnosed seronegative for HEPATITIS B surface antigen (HBsAg) shows positive HBV-DNA on using more accurate molecular methods. This study aims to determine the prevalence of overt and OCCULT HBV infection among the HD patients who had attended Al-Nasiriyah dialysis centre during a two-month period. Materials and Methods: Serological qualitative detection of HBsAg by rapid test (strips), enzyme immunoassay (EIA, HBsAg) and molecular (real-time polymerase chain reaction (real-time PCR)) was conducted for quantitative detection of HBV in HD patients’ serum. Results: The prevalence of overt HBV infection among HD patients was 3. 7%. The viral load of HBV positive patients was ranging from 5. 85 × 101 to 2. 16 × 106 copies/ml of serum with median (7. 4 × 105 copies/ml). OCCULT HEPATITIS B was not detected in any of the seronegative HD patients (0%). Overt infection was found more in males (80%) than females (20%) (P<0. 05). Similarly, infection was found to be higher among patients who had blood transfusions (80%) than those who had not (20%) with statistical significant p<0. 05. Although not statistically significant, the mean duration of HD was higher among HBV positive HD patients (17. 6) than HBV negative HD patients (14. 3). A dual infection of HBV and HCV was not detected in this study. Conclusion: Nosocomial transmissions at HD centres and blood transfusion are important risk factors. Besides serological screening, real-time PCR offers a safeguard against the spread of overt and OCCULT HBV infection and determines the viral load of the positive patients.

Background and purpose: OCCULT HEPATITIS B infection (OBI) is defined as a form of HEPATITIS B that despite absence of detectable HBsAg, HBV-DNA is present in patient’s peripheral blood. Genetic and immunological differences appear to play important roles in producing OBI. Therefore, this project was aimed to examine the expression of a chemokine receptor (CCR5) on CD8+ T cells of OBI patients.Materials and methods: In this experimental study, 3,700 HBsAg- plasma samples were collected. Samples were tested for anti-HBc antibody and all of HBsAg-/anti-HBc+ samples were screened for HBV-DNA by PCR. HBV-DNA positive samples were assigned as OBI cases. Also, flow cytometry analysis was performed to examine the expression of CCR5 on CD8+ T cells of OBI patients.Results: Results of current study showed that 352 (9.5%) cases of samples were positive for anti-HBc+. Examination of HBsAg-/anti-HBc+ samples for HBV-DNA by PCR showed that 57 (16.1%) cases had HBV-DNA. Flow cytometric studies indicated lymphocytosis in these patients; however, the number of cells which expressed CD8+ and CCR5 is decreased significantly in patients, compared to healthy control. In addition to CD8+ T cells, the expression of CCR5 is also decreased on all immune cells.Conclusion: One of the chemokine receptors which are expressed by CD8+ T cells is CCR5 and these cells are recruited to infected tissues, including liver by CCR5. Therefore, based on results of this investigation, one may conclude that due to the decreased expression of CCR5, the CD8+ T cells are unable to respond to the chemokines (CCR5 ligands) and, hence, cannot immigrate to the infected liver and incorporate in clearance of HEPATITIS B virus.