Background: The presence of anti-HBc IgG in the absence of HBsAg is usually indicative of a past self-limiting HBV infection. But it is frequently associated with co-infection with HCV which can worsen the existing status of chronic liver disease (CLD). Objectives: The present study was planned to evaluate the significance of isolated HBc IgG positivity in patients of CLD and look for the presence of HCV co-infection in such patients. Methods: Clinical profiles and biochemical tests were done for all the 77 CLD cases included in the study. Blood samples were taken from these patients and tested by the commercially available EIA for the presence of HBsAg, anti-HBc IgG, anti-HBs and anti-HCV. HBV DNA was detected by amplifying the surface region in all the cases. Results: Isolated anti-HBc IgG positivity defined as the presence of anti-HBc IgG in absence of any other serological markers of HBV infection was detected in 28 patients. Out of 64 patients positive for anti-HBc IgG 36 had the markers of HBV, either HBsAg, HBV DNA or anti-HBs alone or in combination. There was a significant association between isolated anti-HBc IgG positivity and HCV co-infection. Conclusion: Anti-HBc IgG should be tested in all patients with CLD as it is frequently the only marker of HBV infection in such patients and they should be monitored closely as such patients can develop CLD. Presence of co-infection with HCV should be actively searched for in such patients.
TT virus (TTV) is a newly discovered non-enveloped, single stranded DNA virus of high genotypic variability, found frequently in patients with acute or chronic hepatitis of non A-G aetiology. This study was carried out to look for the presence of TTV and its genotypes in patients with different types of liver diseases from northern India.A total of 262 serum samples from patients of acute viral hepatitis (AVH; n=72), fulminant hepatic failure (FHF; n=49), chronic active hepatitis (CAH; n=93) and liver cirrhosis (LC; n=48), were analyzed for hepatitis A-G viral markers. TTV DNA was detected in all cases by nested polymerase chain reaction (PCR) using the primers from N22 and untranslated (UTR) region. TTV-DNA was also tested in 150 volunteer blood donors. Direct nucleotide sequencing of N22 amplicons were carried out to look into the prevalent TTV genotypes.TTV-DNA was detected in 73.6, 59.2, 21.5 and 29.1 per cent cases with AVH, FHF, CAH and cirrhosis, respectively. In AVH and FHF groups, TTV showed co-infection with all A-G hepatitis cases whereas in CAH and cirrhosis groups, TTV co-infection observed with HBV, HCV and HGV. TTV-DNA was detected in 45.3 per cent volunteer blood donors. No statistically significant difference was observed amongst the mean liver function profile of UTR PCR positive and negative cases in different liver disease groups except AVH cases, in whom the various biochemical parameters between TTV positive and TTV negative patients were marginally significant. However, no significant evidence of biochemical or histological deterioration of the liver was observed in TTV positive cases amongst FHF, CAH and cirrhosis. Predominance of genotype 1a was observed in all the cases from north India.TTV is a frequent virus isolated from patients with various types of liver diseases as well as in healthy individuals from northern India. TTV has no effect on biochemical markers of associated liver diseases. Genotype 1a was the most predominant type in different liver disease groups. The occurrence of TTV did not further influence the course of the disease.
The most well-known primary liver cancer in the world is Hepatocellular Carcinoma (HCC). Its prevalence is alarmingly increasing and has drawn public attention on a global scale. With regard to regional variation, racial differences, and socioeconomic level, it occurs more frequently in underdeveloped countries than in industrialised ones. Aflatoxin use is one of the main risk factors for HCC. Aflatoxin B1, a genotoxic hepatocarcinogen, is thought to induce cancer by causing DNA adducts in target liver cells that result in genetic alterations. HCC may result from a mutational impact caused by DNA adducts at the codon 249 hotspot in exon 7 of the P53 tumour suppressor gene, which interacts with the guanine bases of liver cell DNA. Aflatoxin-contaminated food affects about 4.5 billion people worldwide, mostly in developing nations with poor incomes. Treatment of crops that are prone to fungal contamination, proper food handling techniques, and the use of chemopreventive intervention are all part of prevention. Additionally, in order to maintain efficient food regulation systems and reduce the risk of aflatoxins contaminating food, a networked collaboration of several sectors, including public health, agricultural departments, and the media, is needed.
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