Search

Objective: In this study, it was aimed to determine the HCV prevalence and the occult HBV prevalence by HBV DNA analysis in serum samples of HBsAg patients undergoing routine hemodialysis. It was also aimed to determine the liver fibrosis level with fibrometer, which is a non-invasive method. Methods: The study included 100 patients who applied for routine hemodialysis and were negative for HBsAg in screening tests. In samples from the patient, ALT, HBsAg, Anti-HBc IgG, HBV DNA, Anti HCV, HCV RNA and fibrometer were studied from serum samples from the same system. HBsAg negative and HBV DNA positive occult hepatitis B were accepted. Results: HBV DNA was found positive in 100 positive 4 (4%). Viral load was <10 IU/ml in two of the HBV DNA positive cases, and 17 and 16 IU/ml in the other two cases. While Anti HCV positive was detected in one patient; HCV RNA could not be detected in any patient. While there was a significant difference in scores compared to those who did not have occult B; The score of histological activity and necrosis were not significantly different. Conclusion: Since antigen asntibody-based serology tests may be insufficient in the diagnosis of occult HBV, determination of HBV DNA level in special groups such as hemodialysis patients is important in terms of early recognition of occult HBV and preventing important complications such as cirrhosis and hepatocellular cancer. The absence of a previous study on occult hepatitis B and fibrometer in the literature has increased the importance of this study. [ABSTRACT FROM AUTHOR]

Background: Familial Mediterranean fever (FMF) is a monogenic autoinflammatory disease, and colchicine is the mainstay of treatment. Approximately 5%-10% of patients may respond inadequately to colchicine, and anti-interleukin-1 (anti-IL-1) agents are important treatment options in these patients. The aim of this study was to see whether there is any factor associated with the withdrawal of these anti-IL-1 agents and to investigate the characteristics of colchicine-resistant FMF patients who needed biological therapy., Methods: Demographic, clinical characteristics, and disease severity of patients, at 2 referral centers, between 2012 and 2022, in whom anti-IL-1 treatment was continued and discontinued, were compared in this study. The international severity scoring system for FMF (ISSF) was used for disease severity assessment., Results: In 64 colchicine-resistant FMF patients, the median (interquartile range) duration of biological treatment was 39 (45) months. Treatment of 26 patients (40.6%) was started with anakinra and 38 (59.4%) with canakinumab. During follow-up, anti-IL-1 treatment was discontinued in 23 patients (35.9%). High ISSF scores before biological treatment, presence of exertional leg pain, subclinical inflammation, and comorbidity were found to be statistically more frequent in the group whose biological therapy could not be discontinued (p = 0.009, p = 0.006, p = 0.026, p = 0.001, respectively)., Conclusions: Low ISSF scores before biological treatment with no accompanying exertional leg pain, subclinical inflammation, and comorbidities may be stated as an associated factors in terms of the discontinuation of biological agents in colchicine-resistant pediatric FMF patients., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)