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    Acute Hepatitis C Infection Developing in the Offspring Born to an Anti-HCV- Positive Mother: A Case Report
    (Aves, 2009) Sirmatel, Fatma; Midikli, Durdane; Sirmatel, Ocal; Gursoy, Bensu; Duygu, Fazilet
    Acute hepatitis C developed one month after delivery in a child whose mother was an inactive carrier of HCV and had given birth by normal vaginal delivery. Acute hepatitis C was diagnosed after one month in the child by serological, biochemical and ultrasonographic tests. Although the patient had high liver enzyme levels (ALT 245 IU/L, AST 123 IU/L), and positivity for both anti HCV (by ELISA) and HCV-RNA viral load (by PCR), the mother was an inactive HCV carrier. The patient was breasfed by the mother and showed spontaneous clearence without antiviral treatment after two years. Women should be examined for HCV before pregnancy in regions with medium HCV risk levels, and need to be enlightened regarding this issue. Also, considering that 20-25% of acute hepatitis C cases show spontanous clearance within 6-12 months on follow up, unnecessary treatment can be prevented.
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    Analysis of Holo-Transcobalamin (Active Vitamin B12) in the Sera of Patients with Chronic Viral Hepatitis
    (Galenos Yayincilik, 2010) Sirmatel, Fatma; Sirmatel, Ocal; Bugdayci, Guler; Eris, Fatma Nur; Dincer, Sevim
    In chronic viral hepatitis, when early hepatic necrosis and viral replication are defined, progression of hepatic necroinflammation can be terminated and cirrhosis can be prevented by therapy. In chronic hepatic failure, an increase in the blood levels of vitamin B12 is observed as a result of vascular leakage. From this perspective, in cases with chronic viral hepatitis B (HBV) and chronic viral hepatitis C (HCV), the indicator of serum active vitamin B12, namely holo-transcobalamin II (Holo-TCII), is interpreted as an indicator of hepatocellular damage prior to treatment. The aim of this study is to evaluate the value of serum Holo-TCII in the diagnosis of hepatic failure and hepatocellulardamage in chronic viral hepatitis. In a university hospital, Holo-TCII, the best indicator of serum vitamin B12, was analyzed in the sera of 127 healthy blood donors and in 274 patients with chronic viral hepatitis (127 HBV patients and 17 HCV patients), who were clinically, serologically and histologically diagnosed. Age distribution of the patients ranged between 18 and 70 years. Serum samples of the patients with chronic viral hepatitis were collected before therapy and kept at -20 degrees C until use. When determining the study group, the patients with decompensated cirrhosis, any cardiac, metabolic, hematologic, gastrointestinal and autoimmune disorderswere excluded. As the control group, healthy blood donors without metabolic, cardiovascular, gastrointestinal and hematologic diseases were chosen; age and gender distributions were also considered to be parallel with the patient group. Analyses were performed with commercially available Holo-TCII kits according to the prospectus, using macro enzyme immunoassay method (EIA) method. Results were statistically compared between the groups. In our study, no difference was determined in terms of holo-TCII levels between chronic HBV (42.07 pmol/L) and HCV patients (42.8 pmol/L), whereas the results of the HBV and HCV patients were found to be significantly higher compared to the control group (25.7 pmol/L, p< 0.017). Holo-TCII can be used as the earliest symptom of cellular damage, particularly in patients with chronic viral hepatitis. Further studies on chronic hepatic failure and cellular damage may also provide information that Holo-TCII can be used as a diagnostic criterion.
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    Evaluation of Total Oxidative Level and Total Antioxidant Capacity in Cases with Chronic Viral Hepatitis
    (Aves, 2009) Sirmatel, Fatma; Duygu, Fazilet; Celik, Hakim; Selek, Sahabettin; Sirmatel, Ocal; Gursoy, Bensu; Eris, Fatma Nur
    Objective: Oxidative stress is described as an instability between production of free radicals from cells and antioxidant defence of the body. The aim of the study was to investigate the correlation of total antioxidant capacity (TAC) and total oxidative level (TOL) with the severity of the disease and reliability of these parameters in the follow up of response to treatment in cases with chronic viral hepatitis (CVH). Methods: Between January 2004-March 2006, 73 cases with CVH were included in the study. The ages of the patients ranged from 15 to 70 years. Diagnosis of CVH was confirmed by clinical serological, and biochemical markers. The cases were divided into two groups: Group 1 as HBsAg-positive or anti-HCV-positive but HBV DNA or HCV RNA-negative and Group 2 as proven CVH. TAC, lipid hydroperoxide (LOOH), and TOL of the sera were studied according to Erel method, and statistically evaluated by 2 test in all the cases. Results: TAC, LOOH and TOL were found statistically significantly different between two groups. Average values of TAC were 1.8 +/- 0.5 mmol Trolox-Eqv./L and 1.0 +/- 0.15 mmol Trolox-Eqv./L in Group 1 and Group 2 (p=0.0001) respectively. Average values of LOOH were 5.3 +/- 2.8 mu mol H2O2 in Group 1 and 10.6 +/- 10.1 mu mol H2O2 in Group 2 (p=0.002). Average values of TOL were 10.2 +/- 5.9 mu mol H2O2 Eqv./L in Group 1 and 18.5 +/- 16.6 mu mol H2O2 Eqv./L in Group 2 (p=0.004). Conclusions: TAC was found higher, and TOL and LOOH were found lower in Group 1 than Group 2. The evaluation of plasma TAC, TOS ve LOOH levels may be important activation markers for the follow up of CVH.