The transmission rate of intra-familial hepatitis B virus (HBV) and mode of transmission were investigated in north eastern Egypt. HBV infection was investigated serologically and confirmed by molecular evolutionary analysis in family members (N = 230) of 55 chronic hepatitis B carriers (index cases). Hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (anti-HBc) prevalence was 12.2% and 23% among family members, respectively. HBsAg carriers were prevalent in the age groups; <10 (16.2%) and 21-30 years (23.3%). The prevalence of HBsAg was significantly higher in the family members of females (19.2%) than males (8.6%) index cases (P = 0.031). HBsAg and anti-HBc seropositive rates were higher significantly in the offspring of females (23%, 29.8%) than those of the males index cases (4.3%, 9.8%) (P = 0.001, 0.003), as well as higher in the offspring of an infected mother (26.5, 31.8%) than those of an infected father (4.7%, 10.5%) (P = 0.0006, 0.009). No significant difference was found in HBsAg seropositive rates between vaccinated (10.6%) and unvaccinated family members (14.8%). Phylogenetic analysis of the preS2 and S regions of HBV genome showed that the HBV isolates were of subgenotype D1 in nine index cases and 14 family members. HBV familial transmission was confirmed in five of six families with three transmission patterns; maternal, paternal, and sexual. It is concluded that multiple intra-familial transmission routes of HBV genotype D were determined; including maternal, paternal and horizontal. Universal HBV vaccination should be modified by including the first dose at birth with (HBIG) administration to the newborn of mothers infected with HBV.

Background and ObjectiveIrritable Bowel Syndrome (IBS) has a substantial impact on health-related quality of life (HR-QoL) but high-quality data pre- and post-treatment using the IBS–Quality of Life (IBS-QOL) measure are limited. The objective of this study was to evaluate the changes from baseline of the IBS-QOL scores, symptom scores and health economic data in IBS patients, after 4 and 8 weeks of treatment with mebeverine hydrochloride or pinaverium bromide.MethodsThis was a prospective observational cohort study in patients with IBS, diagnosed using the Rome III criteria in four countries (Poland, Egypt, Mexico and China).ResultsA total of 607 patients were enrolled. At baseline, the IBS-QOL total scores were 52.0 in Poland, 48.9 in Egypt, 51.9 in Mexico, 76.4 in China and 56.4 overall. Increases in IBS-QOL total score were statistically significant at Weeks 4 and 8 overall and in each country (overall: 11.8 at Week 4, 24.3 at Week 8; p < 0.001). Improvements were shown in all IBS-QOL subscales and scores. Symptoms and health economic outcomes were improved. Furthermore, the favourable safety profile of these treatments was confirmed in this study.ConclusionsThis study demonstrated that IBS patients have a substantially reduced HR-QoL and that treatment with mebeverine hydrochloride or pinaverium bromide improved HR-QoL.

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BackgroundMajor hydrophilic region in genomic HBV extending from aa99 to aa169, clustered with a highly conformational epitope, is critical to the antigenicity of hepatitis B surface antigen (HBsAg) and may affect the diagnosis of HBV in HBV screening test. So, this study aimed to characterize variants of S gene product of hepatitis B virus (HBV) isolated from patients with overt or occult HBV infection in north-eastern Egypt.MethodsThe study included sera of two different groups of volunteer blood donors (VBDs), 82 with overt HBV that were positive for HBsAg and anti-HBc and 343 donors negative for HBsAg eligible for donation. Of the latter group, only 44 were positive for anti-HBc. All anti-HBc positive sera were subjected to HBV DNA detection and partial sequence analysis targeting the HBV S gene.ResultsHBV DNA was detected in 22.7 % of HBsAg-/anti-HBc + (10/44 patients) and in 90 % of HBsAg + donors (74/82 patients) with significant statistical difference (P = 0.0001). Phylogenetic analysis showed that HBV strains retrieved from both groups were of genotype D. Amino acid escape mutation T125M was detected in only 2 samples of the occult infection group and in none of the overt group (P = 0.01). Different amino acid substitutions were identified in overt infection group: S143L/T (16.2 %, 12/74) and P120T/S (2.7 %, 2/74). Q129R was significantly more frequent in cases with occult HBV infection (40 %, 4/10) than overt group (6.8 %, 5/74) (P = 0.01).ConclusionsHBV genotype D predominated both in patients with overt and occult HBV infection. Different profiles of amino acid substitutions in the major hydrophilic region were seen in these two groups in Egypt.

Background: Helicobacter pylori (H. pylori) proved to be highly prevalent all over the world. H. pylori may modify the absorption of many nutrients. Studies have suggested that, beyond iron, H. pylori infection may affect the homeostasis of other micronutrients such as vitamins and trace elements. Our study's aim was to assess the effect of H. pylori infection on some blood micronutrient level including zinc, selenium, vitamin C, and vitamin B 12 in children with chronic or recurrent unexplained dyspeptic symptoms and/or non-variceal hematemesis. Results: A cross-sectional case-control study was carried out in 32 children (4-18 years) with chronic or recurrent unexplained dyspeptic symptoms and/or non-variceal hematemesis. Patients were divided according to the results histopathology and rapid urease test into two groups, H. pylori-positive patients (18 patients) and H. pylori-negative patients (14 patients). Another control group of 18 children was included. Serum levels of zinc, selenium, vitamin C, and vitamin B 12 were measured in all children. Prevalence of H. pylori infection was 56.2%. The mean serum zinc levels were significantly lower in H. pylori-positive cases than in control group (84.2 ± 13.85 versus 94.6 ± 6.52 with P = 0.009) and lower than in H. pylori-negative cases but not statistically significant (84.2 ± 13.85 versus 92.2 ± 8.53 with P = 0.054). The mean serum vitamin C levels were significantly lower in H. pylori-positive cases than in negative cases and control group (220.7 ± 46.16 versus 305.1 ± 28.83 and 313.1 ± 31.43 with P < 0.0001). The mean serum vitamin B 12 levels were significantly lower in H. pylori-positive cases than in negative cases and control group (167.8 ± 76.98 versus 290.1 ± 69.92 and 326.1 ± 38.67 with P < 0.0001). The mean serum selenium level was slightly higher in H. pylori-positive patients than in H. pylori-negative patients and control group but not statistically significant (118.2 ± 11.13 versus 112.1 ± 8.69 and 113.1 ± 13.76 with P = 0.096, 0.243 respectively). Conclusion: Helicobacter pylori infection in children has a significant negative effect on the serum levels of zinc, vitamin C, and vitamin B 12 .