Purpose Hepatitis C virus infection is a major health problem in hemodialysis patients. Occult HCV infection is defined as the presence of HCV-RNA in hepatocytes or peripheral blood mononuclear cells without the detection of HCV-RNA in the serum. We aimed to evaluate the prevalence and predictors of occult HCV infection among hemodialysis patients after treatment with direct-acting antiviral agents. Methods This research is a cross-sectional study that included 60 HCV patients maintained on regular HD patients who achieved 24 weeks of sustained virological response after treatment with direct-acting antiviral agents. Real-time PCR was performed to detect HCV-RNA in peripheral blood mononuclear cells. Results HCV-RNA was detected in peripheral blood mononuclear cells of three patients (5%). Occult HCV infection cases were treated by Interferon/ribavirin before direct-acting antiviral agents and two of them had raised pre-treatment alanine aminotransferase levels. Logistic regression analyses revealed that high pre-treatment viral load and raised pre-treatment alanine aminotransferase were associated with an increased risk of occult HCV infection with p value of 0.041 and 0.029, respectively. Conclusions Occult HCV infection in hemodialysis patients who achieved sustained virological response after treatment with direct-acting antiviral agents may occur, and this may necessitate dual testing for HCV in both serum and peripheral blood mononuclear cells to ensure viral clearance. Clinical trials registration ClinicalTrials.gov NCT04719338.
This study aimed to assess some inflammatory markers and hormone profile among patients with erectile dysfunction. NLR, PLR but not CRP inflammatory biomarkers of inflammation were statistically significantly elevated in patients with ED compared to controls. Hormonal changes were comparable in the study and control groups. Venogenic ED was the major type of ED. Patients with ED may have heightened subclinical inflammatory burden and these low cost readily available inflammatory markers can help in diagnosing ED. The appropriate screening for associated co-morbidities including increased risk of cardiovascular diseases and multidisciplinary management of patients with ED may contribute to improved sexual health of the patients.
Karef (2) , Shady Abouelnaga (3) and Islam Erfan (4) .
Aim of the study:To estimate the prevalence of adrenal insufficiency (AI) in hemodynamically stable cirrhotic patients and to evaluate the potential association with patients' clinical characteristics, cirrhosis etiology and liver disease severity. Material and methods:The cross-sectional study included 132 stable liver cirrhosis patients. Severity of liver disease was graded using the Child-Pugh classification and Model for End-stage Liver Disease (MELD) score. The adrenal function was evaluated by measuring basal and peak cortisol after 60 minutes following the short Synacthen test (SST). Differences in terms of demographic data, clinical information and liver disease severity were compared between cirrhotic patients with and without AI. Results: Out of 132 cirrhotic patients, 86 patients had evidence of AI based on the peak serum cortisol value while the prevalence was lower (67 patients out of 132) when basal cortisol level was taken as the basis. A total of 82 patients were classified as Child-Pugh class C, with an average MELD score of 20 ±7.1. Most patients with AI had Child-Pugh class C. Patients with AI had a higher prevalence of ascites, gastrointestinal hemorrhage, and hepatic encephalopathy, a higher MELD score and a lower serum sodium level compared to patients with normal adrenal function. AI was not related to the etiology of cirrhosis but was related to the severity of liver disease and the degree of hyponatremia. Conclusions: Adrenal insufficiency is common among hemodynamically stable patients with cirrhosis. It is related to the severity of liver disease and the degree of hyponatremia.
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