I. Loperto

Hepatitis B and C virus reactivation in immunosuppressed patients with inflammatory bowel disease.

In recent years, a number of case reports and clinical studies have highlighted the risk of hepatitis B and C virus reactivation in patients with inflammatory bowel disease who are treated with immunosuppressive drugs. The cases of viral hepatitis reactivation that have been reported are characterized by a wide range of clinical manifestations, from viremia without clinically relevant manifestations to fulminant life-threatening hepatitis. The development and dissemination of biological immunosuppressive drugs have led to a significant increase in the number of reports of interest to physicians in a variety of clinical settings. On this topic, there have been a number of published guidelines and reviews that have collected the available evidence, providing recommendations on prophylactic and therapeutic strategies and methods for monitoring patients at risk. However, it should be noted that, to date, very few clinical studies have been published, and most of the recommendations have been borrowed from other clinical settings. The published studies are mostly retrospective and are based on very heterogeneous populations, using different therapeutic and prophylactic regimens and obtaining conflicting results. Thus, it seems clear that it is desirable to concentrate our efforts on prospective studies, not conducting further reviews of the literature in the continued absence of new evidence.

Prevalence and risk factors of HCV infection in a metropolitan area in southern Italy: Tail of a cohort infected in past decades.

Data on the prevalence of HCV infection in Italy are often outdated and from non‐urban populations. This study assessed the prevalence and risk factors for HCV infection in a large metropolitan area in southern Italy. A random 1:3 systematic sample of the adult general population of Naples was selected from three general practitioner patient registers in three different city districts. Socioeconomic indicators and risk factors for HCV infection were collected. Anti‐HCV and HCV‐RNA assays were performed. Logistic regression analysis was used to identify independent predictors of HCV infection. Of 1,500 randomly selected subjects, 1,315 (87.7%) participated in the study. Forty subjects (3.0%; 95%CI: 2.1–4.0) were anti‐HCV‐positive, with HCV‐RNA detected by PCR in 31 (77.5%) of these. Anti‐HCV prevalence increased with age, peaking (8.2%) in people born during the years 1945–1955. It was 1.7% in people residing in the better socioeconomic districts; but 5.7% in those residing in the district with lower socioeconomic status (P < 0.01). In multivariate analysis, age ≥60 years (OR 2.8, 95%CI: 1.3–6.1) and lower educational level (OR 3.6; 95%CI: 1.4–9.3), which is a proxy of low socioeconomic status, were the only independent predictors of the likelihood of anti‐HCV positivity. Overall, 22.5% of anti‐HCV positive subjects were previously unaware of their status. In the large city of Naples, infection with HCV is most common in people aged older than 60 years. Differences in socioeconomic conditions have played an important role in the spread of this infection. HCV positive subjects born during the years 1945–1955 are those who may benefit, to a greater extent, to be identified in order to receive the new effective therapy. J. Med. Virol. 89:291–297, 2017.

Prevalence of and risk factors for HBV infection in a metropolitan Southern Italian area: Evidence for the effectiveness of universal Hepatitis B vaccination

BACKGROUND Available data on HBV prevalence in Italy are outdated and assessed with studies conducted in small towns. We aimed to evaluate prevalence of and risk factors for HBV infection in the metropolitan area of Naples, 24 years after the introduction of mass vaccination campaign against Hepatitis B in Italy. METHODS A random systematic sample of the adult general population of Naples was selected from the register of 3 general practitioners in 3 different socio-economic districts. Independent predictors of the likelihood of HBV infection were identified by logistic regression analysis. RESULTS Among 900 selected subjects, 772 (85.8%) participated in the study. The overall HBsAg and anti-HBc prevalences were 1.7% and 14.4%, respectively. Both markers were more likely detected in the district at low socioeconomic status than in those at medium-high status (p<0.01). Anti-HBc prevalence linearly increased from 0% in subjects 30 years old or younger to 28.0% in those older than 60 years of age (p<0.01). At multivariate analysis, age >60 years (OR3.38; 95%CI:1.98-5.74), low socioeconomic district of residence (OR3.26; 95%CI:1.72-6.18), and low educational qualification (OR2.73; 95%CI:1.45-5.16) were independent predictors of anti-HBc positivity. CONCLUSION Differences in socioeconomic conditions have played a major role in the past spread of HBV infection in Naples. Hepatitis B vaccination has resulted very effectively in preventing HBV infection, regardless of the district of residence, as none of the subjects in the vaccinated cohorts was exposed to the infection.

Lack of evidence that adherence to standard of care therapy improves survival in subjects with hepatocellular carcinoma in clinical practice

Currently, the BCLC classification, which links tumor stage with treatment option, is the standard system for clinical management of HCC. Thus far, this approach has been considered the standard of care worldwide. This study aimed to evaluate the survival of patients with HCC according to the BCLC Stage, surveillance, and adherence to standards of care. A 3‐year prospective study enrolled 92 consecutive patients with HCC in the Gastroenterology Unit of the University of Naples “Federico II”. Predictors of the likelihood of death were evaluated by the multivariate Cox model. Forty out of 92 (43%) subjects died during three years of follow up. The overall mortality rate per 100 person–years was 16.7, while the mortality rate for hepatic causes was only 14.2; it was lower in subjects under surveillance (11.4 vs. 28.2), in subjects adherent to standards of care (12.0 vs. 21.1), and in those who were in a better BCLC stage (10.6 vs. 45.8). The multivariate Cox model showed that advanced BCLC stage (HR 4.1, 95%C.I. = 1.8–9.4) was the sole independent predictor of the likelihood of mortality. In this regard, we observed lack of evidence that the adherence to the BCLC recommendations reduces the mortality of patients with HCC; and that the BCLC system cannot be accepted as a “commandment” to be invariably followed in everyday practice. Strategies to help improve adherence to international guidelines for HCC in clinical practice are required. J. Med. Virol. 87:1368–1376, 2015.

Su1001 Circulating Scca-IgM Complex Is an Useful Biomarker to Monitor HCC Therapy

Background and Aims: Using in vitro cell culture and in vivo xenograft mouse models, we have previously shown that the heparan sulfate-degrading endosulfatase SULF1 functions as a tumor suppressor in established hepatocellular carcinoma cell lines by abrogating receptor tyrosine kinase signaling. In contrast, whole genome gene expression analysis of resected human HCCs showed increased expression of SULF1 in 70% of primary HCCs; and SULF1 expression in primary HCCs has been associated with activation of the oncogenic Wnt/β-catenin pathway. Here we report for the first time the results of DEN-induced hepatocarcinogenesis in a hepatocyte-specific transgenic Sulf1 mouse model in which the Sulf1 gene is driven by the transthyretin promoter. The effect of Sulf1 transgenesis on Wnt/ β-catenin activation was assessed. Methods: Liver carcinogenesis was induced in wild-type or hepatocyte-specific Sulf1 transgenic mice by intraperitoneal injection of 15 mg/kg of the liver carcinogen diethylnitrosamine (DEN) at 14 days after birth. Mice were sacrificed at 8 months of age and the harvested livers were examined for weight, tumor size and number. Cell proliferation was assessed using the BrdU proliferation index and Wnt/ β-catenin activation was measured by assessment of β-catenin staining and cytoplasmic-nuclear translocation of β-catenin. Results: Consistent with the observation of increased SULF1 in primary human HCCs, Sulf1 transgenic mice showed increased liver tumorigenesis as demonstrated by tumor number, tumor volume, liver weight/body weight ratio, and BrdU proliferation index. To investigate the mechanism for this, we performed immunohistochemistry for β-catenin. Wnt-β-catenin signaling was increased in Sulf1 transgenic mice compared to wild-type mice, as assessed by both increased β-catenin immunostaining and increased cytoplasmic-nuclear translocation of β-catenin. Conclusions: In contrast to the tumor suppressor effects of SULF1 in established human cell lines, which are mediated by inhibition of the co-receptor function of heparan sulfate in receptor tyrosine kinase signaling, primary HCCs in an in vivo model of DEN-induced HCC in Sulf1 transgenic mice show increased liver tumorigenesis associated with activation ofWnt-β-catenin signaling. This suggests that the effect of Sulf1 in carcinogenesis is context-dependent, but appears to be mediated through oncogenic Wntβ-catenin signaling in the majority of HCCs.

Mo1045 Decaffeinated Coffee Reduces Intestinal Leakiness in Rats Fed With a Hfd by Modulating Occludin and Zonulin-1 Expression

2; p,.01), and LMMS restored liver triglyceride content to normal levels (db/db + LMMS vs. WT + SED, p=.13). LMMS training had no effect on fasting glucose, inguinal and interscapular fat pad weights, or plasma markers of lipid metabolism and hepatic injury (all p..05). Conclusion: LMMS was effective in improving insulin sensitivity and suppressing abdominal obesity and fatty liver. LMMS should be further explored in the prevention and treatment of type 2 diabetes and NASH.