Anti-hepatitis a virus seroprev alence among chronic viral hepatitis band c liver disease in husm and its association with cyp3a4*18 polymorphism.

dc.contributor.authorFazlina, Ahmad
dc.date.accessioned2022-12-28T07:07:14Z
dc.date.available2022-12-28T07:07:14Z
dc.date.issued2010
dc.description.abstractVaccination against hepatitis A virus is recommended in patients with chronic liver disease to prevent hepatic decompensation due to superinfection. CYP3A4 is the major cytochrome in humans and its activity is reduced in chronic liver disease as well as hepatic cirrhosis. Detection of CYP3A4 polymorphism may predict detrimental effects on patients with chronic viral hepatitis with superimposed Hepatitis A infection due to reduced hepatic activity to eliminate drugs and harmful environmental toxin. Therefore, the need for vaccination is augmented. The aim of this study is to find out the seroprevalence of anti-HAY antibodies in patients with chronic viral hepatitis B and C liver disease and its association with CYP3A4 polymorphism as well as to justify the need for vaccination against hepatitis A in these patients. From July to September 2009, 120 patients attending the Gastroenterology Clinic, Hospital Universiti Sains Malaysia were enrolled into this case control study. The diagnosis of chronic viral hepatitis B and C liver disease was based on presence of viral markers of more than 6 months and the diagnosis of liver cirrhosis was based on clinical, biochemical, radiological profiles. Serum from all patients were tested for anti-HA VlgG using a commercially available kit and blood was sent for CYP3A4 polymorphism analysis. The overall anti-HA V seroprevalence was 88.2%. The aetiology of chronic viral liver disease was hepatitis B in 96 patients (80.7%) and hepatitis C in 23 patients (19.3%). The mean age was 44.4 ±14. Patients were categorized by decades of age as follows: 24 (20.2%) patients in the 21-30 age group, 22(18.5%) in the 31-40 age group, 31 (26.1 %) in the 41-50 age group, 23 (19.3%) in the 51-60 age group and 19 ( 16.0%) patients aged more than 60 years. The seroprevalence according to age group was 66. 7%, 95.5%, 93.5%, 91.3% and 94.7% respectively. There was marked increase of prevalence in age group after 30 years (p=0.008). Seventeen patients were cirrhotics and the anti-HA V seroprevalence was I 00% compared to non-cirrhotic group which was only 86.3%(p=0.216). CYP 3A4* 18 polymorphism was detected in 3 of our chronic viral liver disease patients, with the frequency of 2.5% . All patients with the CYP3A4*18 mutations were found to be heterozygous. Our study demonstrated that the overall seroprevalence was 88.2% and age was the most important factor in determining anti-HA V positivity. Most patient aged more than 30 are likely to have natural immunity towards hepatitis A. There was no significant association between CP3A4* 18 mutation and anti-HA V serology. Since the prevalence of anti-HA VlgG is high, the hepatitis A vaccination may not be routinely required in this region especially in individual who are older than 30 years of age.en_US
dc.identifier.urihttp://hdl.handle.net/123456789/16996
dc.publisherPusat Pengajian Sain Perubatan, Universiti Sains Malaysiaen_US
dc.subjectVaccination against hepatitis A virus is recommended in patients with chronic liver disease to prevent hepatic decompensation due to superinfectionen_US
dc.titleAnti-hepatitis a virus seroprev alence among chronic viral hepatitis band c liver disease in husm and its association with cyp3a4*18 polymorphism.en_US
dc.typeThesisen_US
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