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Does High Viral Load of Hepatitis E Virus Influence the Severity and Prognosis of Acute Liver Failure During Pregnancy?
ABSTRACTS
Results: Significant distribution of Major allele A with higher level of expression of mRNA transcripts was observed in the SNP rs 41309790. Conclusion: the significant distribution of Major allele A with higher level of expression of mRNA transcripts which was observed in the SNP rs 41309790 raises the possibility of association of this SNP with more susceptibility for progression to HCC in persistent HCV infection. However, further studies are mandatory to elucidate whether this SNP variant represents an appropriate scheme to positively influence the outcome of HCV patients in larger samples. Corresponding author: Premashish Kar. E-mail: [email protected]
DOES HIGH VIRAL LOAD OF HEPATITIS E VIRUS INFLUENCE THE SEVERITY AND PROGNOSIS OF ACUTE LIVER FAILURE DURING PREGNANCY? Premashis Kar,1 Jayanta Borkakoti,1 Rajib Kishore Hazam,1 Mohammad Asim,1 Ashok Kumar2
Plenary Session Abstracts
1 PCR Hepatitis Laboratory, Department of Medicine, Maulana Azad Medical College and Associated Lok Nayak Hospital, University of Delhi, India, 2Department of Gynaecology, Maulana Azad Medical College and Associated Lok Nayak Hospital, University of Delhi, New Delhi, India
PLENARY SESSION Background and Aims: The incidence and mortality in pregnant women with acute liver failure caused by hepati-
21ST ANNUAL CONFERENCE—2013
tis E virus (HEV) is high. Data on the viral load of HEV during pregnancy is limited. The study was designed to determine the viral load of HEV and its association with the disease severity in patients with acute liver failure. Methods: A total of HEV related 163 patients with acute liver failure which included 105 pregnant, 46 non-pregnant women and girls and 12 men, and 730 patients with acute viral hepatitis which comprised of 220 pregnant women; 282 non-pregnant women and girls and 228 men were included in the study. Viral load was measured by realtime PCR. Comparison was made between the pregnant and non-pregnant women. Results: HEV RNA was detectable in 265 patients (142 pregnant; 75 non-pregnant and 48 men) and 104 patients with acute liver failure (64 pregnant, 34 non-pregnant and 6 men). The viral load of HEV in pregnant women with acute liver failure and acute viral hepatitis was significantly higher 129984.0 103104.17 copies/ ml and 768.921105.40 copies/ml respectively compared to the non-pregnant women which was 189.2 225 copies/ ml and 12.73 7.8 copies/ ml (P <0.0001). The viral load of HEV was also significantly higher in the pregnant patients with acute liver failure compared to the pregnant women with acute viral hepatitis and also men (P <0.0001). Conclusion: High viral load of HEV during pregnancy could be one of the factors responsible for the severity of the infection during pregnancy. Corresponding author: Premashish Kar. E-mail: [email protected]
LIVER TRANSPLANTATION
HIGH TITRE ANTI HBS HUMAN PLASMA (OR) HYPER IMMUNE PLASMA (HIP): A COST EFFECTIVE MANAGEMENT OF HBV RECURRENCE IN POST LIVER TRANSPLANT RECIPIENTS: A PRELIMINARY OBSERVATION Joy Varghese,1 Deepti Sachan,2 Srinivasa Reddy,1,2,3 Thomas Cherian,1,2,3 K. Venugopal,3 Rajasekar Perumalla,3 N. Gomathy,3 A. Olithselvan,3 S. Vivekananthan,3 S. Vijaya,1 V. Jayanthi,1 M. Rela1,2 1 Department of Hepatology & Liver Transplantation, Global Hospitals & Health City, Chennai, India, 2Department of Transfusion Medicine, Global Hospitals & Health City, Chennai, India, 3Institute of HPB & Transplantation, Global Hospitals & Health City, Chennai, India
Background: Prophylaxis with long-term hepatitis B immunoglobulin (HBIG) and nucleoside analogous can preS2
vent HBV recurrence in liver transplant (LT) recipients. HBIG dose is adjusted to maintain anti HBsAb level to >100 IU/mL. A single dose of HBIG (1000 IU) per month costs Rs 50,000/-. Aim: To study the efficacy of high titre anti HBs human plasma (> 5000 IU/L) (or) hyper immune plasma (HIP) in preventing HBV recurrence in post LT period. Method: Pre-transplant HBV DNA levels were noted. HIP obtained from relatives of LT recipients was given in a dose of 2000 IU to 2 recipients with low anti HBs titre. In 2 other recipients, HIP was given during anhepatic phase and maintained on this alone. The cost, number of transfusions and outcome between HBIG and HIP was assessed at end of 3 months. Results: In the non-compliant group, HIP when given at low anti Hbs titre, the titre increased and remained high at 172+ 82 IU/L for 3 months; those on HBIG with similar low titre, despite receiving a monthly dose, failed to achieve the target of 100 U/L. The cost of HIP for 3 months was Rs 4000/- as © 2013, INASL
Results: Significant distribution of Major allele A with higher level of expression of mRNA transcripts was observed in the SNP rs 41309790. Conclusion: the significant distribution of Major allele A with higher level of expression of mRNA transcripts which was observed in the SNP rs 41309790 raises the possibility of association of this SNP with more susceptibility for progression to HCC in persistent HCV infection. However, further studies are mandatory to elucidate whether this SNP variant represents an appropriate scheme to positively influence the outcome of HCV patients in larger samples. Corresponding author: Premashish Kar. E-mail: [email protected]
DOES HIGH VIRAL LOAD OF HEPATITIS E VIRUS INFLUENCE THE SEVERITY AND PROGNOSIS OF ACUTE LIVER FAILURE DURING PREGNANCY? Premashis Kar,1 Jayanta Borkakoti,1 Rajib Kishore Hazam,1 Mohammad Asim,1 Ashok Kumar2
Plenary Session Abstracts
1 PCR Hepatitis Laboratory, Department of Medicine, Maulana Azad Medical College and Associated Lok Nayak Hospital, University of Delhi, India, 2Department of Gynaecology, Maulana Azad Medical College and Associated Lok Nayak Hospital, University of Delhi, New Delhi, India
PLENARY SESSION Background and Aims: The incidence and mortality in pregnant women with acute liver failure caused by hepati-
21ST ANNUAL CONFERENCE—2013
tis E virus (HEV) is high. Data on the viral load of HEV during pregnancy is limited. The study was designed to determine the viral load of HEV and its association with the disease severity in patients with acute liver failure. Methods: A total of HEV related 163 patients with acute liver failure which included 105 pregnant, 46 non-pregnant women and girls and 12 men, and 730 patients with acute viral hepatitis which comprised of 220 pregnant women; 282 non-pregnant women and girls and 228 men were included in the study. Viral load was measured by realtime PCR. Comparison was made between the pregnant and non-pregnant women. Results: HEV RNA was detectable in 265 patients (142 pregnant; 75 non-pregnant and 48 men) and 104 patients with acute liver failure (64 pregnant, 34 non-pregnant and 6 men). The viral load of HEV in pregnant women with acute liver failure and acute viral hepatitis was significantly higher 129984.0 103104.17 copies/ ml and 768.921105.40 copies/ml respectively compared to the non-pregnant women which was 189.2 225 copies/ ml and 12.73 7.8 copies/ ml (P <0.0001). The viral load of HEV was also significantly higher in the pregnant patients with acute liver failure compared to the pregnant women with acute viral hepatitis and also men (P <0.0001). Conclusion: High viral load of HEV during pregnancy could be one of the factors responsible for the severity of the infection during pregnancy. Corresponding author: Premashish Kar. E-mail: [email protected]
LIVER TRANSPLANTATION
HIGH TITRE ANTI HBS HUMAN PLASMA (OR) HYPER IMMUNE PLASMA (HIP): A COST EFFECTIVE MANAGEMENT OF HBV RECURRENCE IN POST LIVER TRANSPLANT RECIPIENTS: A PRELIMINARY OBSERVATION Joy Varghese,1 Deepti Sachan,2 Srinivasa Reddy,1,2,3 Thomas Cherian,1,2,3 K. Venugopal,3 Rajasekar Perumalla,3 N. Gomathy,3 A. Olithselvan,3 S. Vivekananthan,3 S. Vijaya,1 V. Jayanthi,1 M. Rela1,2 1 Department of Hepatology & Liver Transplantation, Global Hospitals & Health City, Chennai, India, 2Department of Transfusion Medicine, Global Hospitals & Health City, Chennai, India, 3Institute of HPB & Transplantation, Global Hospitals & Health City, Chennai, India
Background: Prophylaxis with long-term hepatitis B immunoglobulin (HBIG) and nucleoside analogous can preS2
vent HBV recurrence in liver transplant (LT) recipients. HBIG dose is adjusted to maintain anti HBsAb level to >100 IU/mL. A single dose of HBIG (1000 IU) per month costs Rs 50,000/-. Aim: To study the efficacy of high titre anti HBs human plasma (> 5000 IU/L) (or) hyper immune plasma (HIP) in preventing HBV recurrence in post LT period. Method: Pre-transplant HBV DNA levels were noted. HIP obtained from relatives of LT recipients was given in a dose of 2000 IU to 2 recipients with low anti HBs titre. In 2 other recipients, HIP was given during anhepatic phase and maintained on this alone. The cost, number of transfusions and outcome between HBIG and HIP was assessed at end of 3 months. Results: In the non-compliant group, HIP when given at low anti Hbs titre, the titre increased and remained high at 172+ 82 IU/L for 3 months; those on HBIG with similar low titre, despite receiving a monthly dose, failed to achieve the target of 100 U/L. The cost of HIP for 3 months was Rs 4000/- as © 2013, INASL