NEW YORK (Reuters Health) Apr 29 - Serum antibodies to hepatitis B virus (HBV) core antigen (anti-HBc) in isolation may serve as a marker of occult infection with HBV, according to a report in the April issue of the Journal of Medical Virology.
Occult HBV infection is defined as the presence of HBV DNA in blood or liver in the absence of detectable HBV surface antigen (HBsAg) in serum, the authors explain, and previous studies have associated occult HBV infection with the progression of chronic liver disease in patients infected with hepatitis C (HCV).
Dr. Francesco Vitale from Universita degli Studi di Palermo, Italy and colleagues evaluated the prevalence of isolated anti-HBc and its possible value as a serologic marker for detection of HBV DNA in HBsAg-negative/anti-HBc-positive patients with or without HCV infection.
The prevalence of "anti-HBc alone" was 1.8% among asymptomatic subjects, 10.2% among drug users, and 21.5% among patients with hepatocellular carcinoma, the authors report.
More than half the individuals with anti-HBc in isolation (57.4%) were anti-HCV positive, including more than 85% of drug users and hepatocellular carcinoma patients with isolated anti-HBc.
Four percent of the sera with anti-HBc alone contained HBV genomes, the researchers note, including 5.9% of those without HCV antibodies, 3.2% of drug users, and 4.8% of hepatocellular carcinoma patients.
"This serologic pattern could be useful for further clinical investigations," Dr. Vitale and colleagues conclude. "Surely, a definitive assessment of this serological pattern as a sentinel marker for 'occult HBV' would require molecular investigation of individuals without, as well as with, 'anti-HBc alone'."
"The ultimate goal is to define the infectivity and clinical consequences of persons with these atypical serologic and molecular patterns of HBV infection," they add.
J Med Virol 2008;80:577-582.
(Source: Medscape)
Friday, May 09, 2008
Neutrophil-To-Lymphocyte Ratio Prognostic in MI Patients by Megan Rauscher
NEW YORK (Reuters Health) Apr 29 - Results of a study establish that neutrophilia and lymphopenia, expressed as a high neutrophil-to-lymphocyte ratio (N/L), are strongly related to long-term mortality in patients with ST-segment elevation myocardial infarction (STEMI).
"This ratio showed higher discriminative ability than total white blood cell count," Dr. Julio Nunez from the University of Valencia, Spain, noted in comments to Reuters Health.
Dr. Nunez and colleagues determined the association of N/L maximum value with mortality and compared its predictive ability with total white blood cell maximum count (WBC) in 470 STEMI patients admitted to a single university hospital. Measurements were obtained at admission and daily for the first 96 hours after admission. During a median follow up of 3 years, 106 patients died (22.6%).
"In this study, we showed that N/L-max measured within the first 96 hours after onset of STEMI symptoms carried significant prognostic value for subsequent mortality," the authors report in the March 15 issue of the American Journal of Cardiology.
The mortality rate during follow up in the first quintile of N/L-max was 6.4%. The highest mortality rates were seen in patients in the fourth and fifth quintiles -- 34% and 47.9%, respectively -- which translated to hazard ratios of 2.58 and 4.20, respectively.
"This association remained significant after adjusting for key predictors including age, reperfusion criteria, renal function, and surrogates of myocardial extensions, such as left ventricular dysfunction, systolic blood pressure and Killip's classification," the investigators note.
The overall discriminatory ability of N/L-max was superior to that of WBC-max, they also report.
These findings were not unexpected, Dr. Nunez told Reuters Health, "because inflammation response is associated with adverse prognosis in the setting of acute coronary syndromes, and commonly this response is characterized by neutrophilia and lymphopenia, so N/L seems a better inflammation marker than total white blood cells."
His group hypothesizes that "patients with high N/L ratio during the acute phase of myocardial infarction could be a subgroup with higher benefit from an aggressive treatment."
"Further studies are needed to clarify this point," Dr. Nunez said.
Am J Cardiol 2008;101:747-752.
(Source: Medscape)
"This ratio showed higher discriminative ability than total white blood cell count," Dr. Julio Nunez from the University of Valencia, Spain, noted in comments to Reuters Health.
Dr. Nunez and colleagues determined the association of N/L maximum value with mortality and compared its predictive ability with total white blood cell maximum count (WBC) in 470 STEMI patients admitted to a single university hospital. Measurements were obtained at admission and daily for the first 96 hours after admission. During a median follow up of 3 years, 106 patients died (22.6%).
"In this study, we showed that N/L-max measured within the first 96 hours after onset of STEMI symptoms carried significant prognostic value for subsequent mortality," the authors report in the March 15 issue of the American Journal of Cardiology.
The mortality rate during follow up in the first quintile of N/L-max was 6.4%. The highest mortality rates were seen in patients in the fourth and fifth quintiles -- 34% and 47.9%, respectively -- which translated to hazard ratios of 2.58 and 4.20, respectively.
"This association remained significant after adjusting for key predictors including age, reperfusion criteria, renal function, and surrogates of myocardial extensions, such as left ventricular dysfunction, systolic blood pressure and Killip's classification," the investigators note.
The overall discriminatory ability of N/L-max was superior to that of WBC-max, they also report.
These findings were not unexpected, Dr. Nunez told Reuters Health, "because inflammation response is associated with adverse prognosis in the setting of acute coronary syndromes, and commonly this response is characterized by neutrophilia and lymphopenia, so N/L seems a better inflammation marker than total white blood cells."
His group hypothesizes that "patients with high N/L ratio during the acute phase of myocardial infarction could be a subgroup with higher benefit from an aggressive treatment."
"Further studies are needed to clarify this point," Dr. Nunez said.
Am J Cardiol 2008;101:747-752.
(Source: Medscape)
Subscribe to:
Posts (Atom)
