The findings obtained in the current study support the hypotheses that non-viral factors, such as lifestyle factors, reproductive factors, and a history of diabetes, might be involved in the etiology of hepatocellular carcinoma.

Understanding the prevalence and diversity of HBsAg variants in a population is fundamental to assay design and planning vaccination programs. It has been shown that mutations within the S gene, caused by selection or natural variation, can lead to false-negative results in assays for HBsAg, or have clinical implications, such as evading anti-HBV immunoglobulin therapy or vaccine-induced immunity. The region of HBsAg where most of these mutations occur is known as the major hydrophilic region (MHR). The aim of this study was to determine the prevalence and mutational patterns of MHR mutations in patients with chronic hepatitis B, and their correlation with patient characteristics, viral factors and antiviral therapy. The study comprised 164 plasma samples from patients with chronic hepatitis B, of which, 34.8% were on long-term lamivudine monotherapy. Direct sequencing of part of the S/pol gene was used for identification of HBsAg mutations, HBV genotypes, subgenotypes and HBsAg subtypes. The overall frequency of MHR mutations was 22.6%, but it varied significantly between untreated and treated patients (16.8% vs. 33.3%). The most frequent substitution was at position 120 (9.1%) whereas the most common vaccine-escape position, 145, was affected in 1.8% of isolates. The presence of MHR mutations was correlated with genotype D, subgenotype D3, and ayw2/ayw3 HBsAg subtypes and to older age (>40 years). It is concluded that natural viral variability present in a geographical region, duration of infection, and antiviral therapy are among the major factors associated with the occurrence of MHR mutations.

Hepatitis B virus (HBV) has been classified into eight genotypes (some of them further divided into two or more subgenotypes) and nine HBsAg subtypes, distinctly distributed geographically. The aim of this study was to gain insight into the distribution of HBV genotypes, subgenotypes and HBsAg subtypes among HBV chronically infected patients in Serbia, since there were no previously published data on this subject. Eighty-nine plasma samples that gave a positive result in a nested PCR were included for genotype identification. Genotyping was performed by direct sequencing of the part of the S/pol gene, and the HBsAg subtype was deduced from the HBsAg sequence. Two HBV genotypes, A and D, were encountered in Serbia, with genotype D (D - 82%, A - 18%) and subgenotype D3 (47.9%) being prevalent. Genotype D isolates had three assigned subtypes (ayw2, ayw3, ayw4), with ayw2 found to be the most prevalent (ayw2 - 53.4%, ayw3 - 43.8%, ayw4 - 1.4%). Genotype A isolates belonged to the A2 subgenotype and the HBsAg subtype adw2, as expected for samples from European population. The results correspond to country's geographical position, being in close proximity to the Mediterranean basin and on the main route between the Middle East and Central Europe.

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The scoring system can reliably identify treatment-naive HCV genotype 1 mono-infected Caucasian patients who have a high probability of achieving an SVR with peginterferon alfa-2a/ribavirin and will be particularly useful where protease inhibitors are not readily available.

The results showed that pegylated interferon alfa-2a plus ribavirin given once a week was well tolerated among prisoners and the regimen had the same adherence and effectiveness as in general population.

Introduction: Current standard treatment of chronic hepatitis C (CHC) consists of pegylated recombinant interferon alpha (PEG-IFN-α) combined with oral ribavirin (RBV). Interferon treatment is associated with depressive simptomatology. Risk factors such as duration of CHC, former drug addiction, lifetime psychiatric disorder, sex, duration of therapy, dose of PEG-IFN-α have been shown to be associated with depression in patients with CHC. Objective: To prospectively evaluate association of depression and specific risk factors in patients with CHC treated with PEG-IFN-α. Methods: The Hamilton Depression Rating Scale was used to asses depressive symptoms in 74 subjects with CHC before PEG-IFN-α (mean dose 152.6± 25.6 mcg), and in the follow-up visits (4, 12 and 24 week). The sociodemographic and hepatitis C related history of the patients were examined on the basis of medical chart review. Results: After controlling for baseline HAMD scores, only female sex was confirmed as a risk factor for depression (p=0.008) at fourth week after baseline. No association was found with any of three groups of risk factors: 1) subject related risk factors (age (p=0.955), sex (p=0.008), lifetime psychiatric disorder (p=0.656)), 2) illness related risk factors (duration of CHC (p=0.267), i.v drug aplication as way of transmission (p=0.292)) and 3) therapy-related risk factors (recommended duration of PEG-IFN-α (p=0.993) and dose of PEG-IFN-α (p=0.841)). Conclusions: Common risk factors were not found to correlate with depressive simptomatology in CHC on PEG-IFN-α. Hepathologists are encouraged to use self-assessment depression scale instead of relying on any of the routinely assesed risk-factors.

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