Is lower low-density lipoprotein cholesterol associated with lower androgen and erectile dysfunction in men?

Background and aims

Therapeutic possibilities now exist to lower low-density lipoprotein cholesterol (LDL-C) to very low levels. However, substantial controversy remains in clinical practice with regard to its safety, and the question of whether low LDL-C levels per se may provoke adverse effects in humans arises. We aimed to explore the association of LDL-C with androgen and erectile dysfunction (ED) in a general population of men.

Hepatitis C virus RNA detection in serum and peripheral blood mononuclear cells of patients with hepatitis C

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Hepatitis C virus induces interferon-λ and interferon-stimulated genes in primary liver cultures

Hepatitis C virus (HCV) replication in primary liver cells is less robust than that in hepatoma cell lines, suggesting that innate antiviral mechanisms in primary cells may limit HCV replication or spread. Here we analyzed the expression of 47 genes associated with interferon (IFN) induction and signaling following HCV infection of primary human fetal liver cell (HFLC) cultures from 18 different donors. We report that cell culture-produced HCV (HCVcc) induced expression of Type III (λ) IFNs and of IFN-stimulated genes (ISGs). Little expression of Type I IFNs was detected. Levels of IFNλ and ISG induction varied among donors and, often, between adapted and nonadapted HCV chimeric constructs. Higher levels of viral replication were associated with greater induction of ISGs and of λ IFNs. Gene induction was dependent on HCV replication, as ultraviolet light-inactivated virus was not stimulatory and an antiviral drug, 2'-C-methyladenosine, reduced induction of λ IFNs and ISGs. The level of IFNλ protein induced was sufficient to inhibit HCVcc infection of na?ve cultures. Conclusion: Together, these results indicate that despite its reported abilities to blunt the induction of an IFN response, HCV infection is capable of inducing antiviral cytokines and pathways in primary liver cell cultures. Induction of ISGs and λ IFNs may limit the growth and spread of HCV in primary cell cultures and in the infected liver. HCV infection of HFLC may provide a useful model for the study of gene induction by HCV in vivo.     

Hepatitis B virus and hepatitis C virus co-infection: additive players in chronic liver disease?

Hepatitis B virus (HBV) and hepatitis C virus (HCV) share modes of transmission and their combined infection is a fairly frequent occurrence particularly in areas where the two viruses are endemic and among subjects with a high risk of parenteral infections. Moreover, the number of coinfected patients is likely higher than is usually thought. In fact, many studies have shown that HBV genomes may also be present in HBsAg-negative patients, particularly in those with HCV-related chronic hepatitis. This condition is commonly called "occult HBV infection". Much evidence suggests that coinfection by HBV and HCV may have considerable clinical relevance. In particular, this condition is generally believed to be a factor favouring the progression of liver fibrosis toward cirrhosis and the development of liver cancer, and in case of both overt and occult HBV infection. In spite of its potential clinical impact, however, there is few information about the possible interplay between the two viruses. Here, we concisely reviewed the available data on the virological and clinical features of the dual HBV/HCV infection prospecting the aspects that should be highlighted in the nearest future for improving the knowledge on this important field of the hepatology.     

Hepatitis C virus infection among patients with non-Hodgkin’s lymphoma in northern India

Background and aim  

Hepatitis C virus (HCV) has been postulated to be an etiological agent for lymphoid malignancies. Whereas a high prevalence of HCV infection in non-Hodgkin’s lymphoma (NHL) patients has been shown to exist in many geographical areas of high HCV prevalence, studies from other parts have not established any form of association. In India, there is a scarcity of data to show either a positive or a negative association between NHL and HCV infection. Therefore, we determined the prevalence of HCV infection in patients with NHL.     

Early-life educational attainment,APOE ε4 alleles,and incident dementia risk in late life

GeroScience - We examined the interactions between educational attainment and genetic susceptibility on dementia risk among adults over 60 years old. A total of 174,161 participants were...     

Autoantibodies against oxidized low-density lipoprotein and lipid profile in patients with chronic periaortitis: case�Ccontrol study

Chronic periaortitis is thought to result from an autoallergic reaction to oxidized low-density lipoprotein (OxLDL). No data exist on lipid profile and atherosclerotic biomarkers. We investigated circulating levels of OxLDL and of anti-OxLDL (aOxLDL) antibodies in patients with chronic periaortitis using the cross-sectional case–control study on 20 patients with chronic periaortitis. Patients were compared to 20 age- and sex-matched controls. aOxLDL antibodies were measured by ELISA and expressed as mean optical density values at 450 nm from duplicate measurements (OD₄₅₀). aOxLDL antibody titers (median [interquartile range]) did not differ significantly between patients and controls (aOxLDL-IgM: 0.70 [0.24–1.08] vs. 0.54 [0.25–0.73] OD₄₅₀; aOxLDL-IgG: 0.59 [0.38–0.75] vs. 0.41[0.33–0.63]OD₄₅₀). Female patients had higher aOxLDL-IgM levels than male patients (1.02 [0.46–1.38] vs. 0.29 [0.22–0.84] OD₄₅₀; P = 0.05). aOxLDL-IgM titers were lower in patients with cardiovascular disease (CVD) than in patients without CVD (0.22 [0.16–0.37] vs. 0.92 [0.70–1.30] OD₄₅₀; P = 0.003) and correlated positively with HDL-cholesterol (r = 0.47, 95% CI 0.02–0.69; P = 0.03) and inversely with diastolic blood pressure (r = −0.46, 95% CI −0.75 to −0.01; P = 0.03) and OxLDL/apoB ratio (r = −0.41, 95% CI −0.73 to 0.04; P = 0.06). No differences or associations were found between aOxLDL-IgG titers and other variables between or within patients and/or controls. In patients OxLDL levels correlated with smoking pack-years (r = 0.58, 95% CI 0.17–0.81; P = 0.007). Data suggest a differing innate immune response to OxLDL in patients with chronic periaortitis compared to controls. Whether this response is causally related to chronic periaortitis development remains to be clarified.     

Hepatitis B virus genotypes,phylogeny and occult infection in a region with a high incidence of hepatocellular carcinoma in China

AIM:To determine the genotypes and phylogeny of hepatitis B viruses(HBVs)in asymptomatic HBV carriers,and the prevalence of occult HBV infection in Long An County,Guangxi Zhuang Autonomous Region,an area with a high incidence of hepatocellular carcinoma. METHODS:A nested polymerase chain reaction(nPCR) was used for detection of HBV DNA in serum samples from 36 blood donors with asympmatic HBV infection,and in serum samples from 52 HBsAg negative family members of the children who did not receive hepatitis B vaccination in Long An County.PCR products were sequenced,and the genotype of each HBV sequence was determined by comparison with sequences of known genotypes in the GenBank and EMBL nucleotide databases using the BLAST programme.Phylogenetic trees were constructed by the quartet maximum likelihood analysis using the TreePuzzle software. RESULTS:Twenty(55.56%)of 36 HBV asymptomatic carriers were positive for HBV DNA.They were all genotype C by comparison with sequences of known genotypes in the GenBank and EMBL nucleotide databases.The full-length HBV DNA sequence isolated from the sample No.624 contained 3 215 bases.No interesting mutations were found in this isolate.The homology analysis showed that this strain was closer to the Vietnamese HBV genotype C strain,with a homology of 97%,compared its relation to the same genotype of HBV isolated in Shanghai.Six(11.5%) of the 52 HBsAg negative family members were positive for HBV DNA.A point mutation was found in the sample No.37,resulting in the substitution of amino acid glycine to arginine in the"a"determinant.Other samples with positive HBV DNA did not have any unusual amino acid substitutions in or around the"a"determinant,and were attributed to the wild-type HBV. CONCLUSION:The HBVs isolated from asymptomatic carriers of Long An County were all identified as genotype C,and the prevalence of occult HBV infection in the population of the county is as high as 11.5%.It is suggested that genotype C and persistent occult HBV infection may play an important role in the development of HCC in the county.     

Polymorphisms at cholesterol 7α-hydroxylase,apolipoproteins B and E and low density lipoprotein receptor genes in patients with gallbladder stone disease

AIM: To investigate the relationship between gallbladderstone disease (GSD) and single nucleotide polymorphismsof cholesterol 7α-hydroxylase (CYP7A) gene promoter,apolipoprotein (APO) B gene exon 26,APOEgene exon 4 ormicrosatellite polymorphism of low density lipoproteinreceptor (LDLR) gene exon 18.METHODS: Genotypes of CYP7A,APOB,APOE and LDLRgenes were determined in 105 patients with GSD diagnosedby B-mode ultrasonography and 274 control subjects.Serum lipids were analyzed with HITACHI 7060 automaicbiochemical analyzer.RESULTS: Body mass index (BMI) was significantly higher inpatients with GSD (24.47±3.09) than in controls (23.50±2.16).Plasma total cholesterol was lower in patients with GSD(4.66±0.92 mmol/L) than in controls (4.91±0.96 mmol/L),P<0.01 after adjusted for age,sex and BMI.The significantlyhigher frequency of A allele of CYP7A gene polymorphismand X allele of APOBgene polymorphism was seen in GSDpatients.Percentages of A allele in patients and controlswere 62.86% and 54.38% (P<0.05) and those of X allele8.57% and 4.01% (P<0.01).Subjects with A allele hadsignificantly lower plasma total cholesterol and LDLcholesterol than subjects with CC homozygote.In a multiplevariable logistic regression model,the BMI (OR=1.13,95%CI: 1.05-1.22),A allele (OR=1.48,95% CI: 1.05-2.09) andX allele (OR=2.28,95% CI: 1.14-4.59) were positivelyassociated with GSD (P<0.05).Plasma total cholesterol(OR=0.69,95% CI: 0.64-0.74) was negatively related toGSD (P<0.05).CONCLUSION: With an association analysis,it was determinedthat A allele of CYP7A gene and X allele of APOB genemight be considered as risk genes for GSD.These allelesare related with differences of serum lipids among subjects.Multiple-variable logistic regression model analysis showedthat besides BMI,GSD was affected by polygenetic factors.But the mechanism for these two alleles responsible for GSDrequires further investigations.     

Polymorphisms at cholesterol 7α-hydroxylase, apolipoproteins B and E and low density lipoprotein receptor genes in patients with gallbladder stone disease

AIM: To investigate the relationship between gallbladder stone disease (GSD) and single nucleotide polymorphisms of cholesterol 7α-hydroxylase (CYP7A) gene promoter,apolipoprotein (APO) B gene exon 26, APOEgene exon 4 or microsatellite polymorphism of low density lipoprotein receptor (LDLR) gene exon 18.METHODS: Genotypes of CYP7A, APOB, APOE and LDLR genes were determined in 105 patients with GSD diagnosed by B-mode ultrasonography and 274 control subjects.Serum lipids were analyzed with HITACHI 7060 automaic biochemical analyzer.RESULTS: Body mass index (BMI) was significantly higher in patients with GSD (24.47&#177;3.09) than in controls (23.50&#177;2.16).Plasma total cholesterol was lower in patients with GSD (4.66&#177;0.92 mmol/L) than in controls (4.91&#177;0.96 mmol/L),P&lt;0.01 after adjusted for age, sex and BMI. The significantly higher frequency of A allele of CYP7A gene polymorphism and X+ allele of APOBgene polymorphism was seen in GSD patients. Percentages of A allele in patients and controls were 62.86% and 54.38% (P &lt;0.05) and those of X+ allele 8.57% and 4.01% (P&lt;0.01). Subjects with A allele had significantly lower plasma total cholesterol and LDL cholesterol than subjects with CC homozygote. In a multiple variable logistic regression model, the BMI (OR=1.13, 95% CI: 1.05-1.22), A allele (OR=1.48, 95% CI: 1.05-2.09) and X+ allele (OR=2.28, 95% CI: 1.14-4.59) were positively associated with GSD (P &lt;0.05). Plasma total cholesterol (OR=0.69, 95% CI: 0.64-0.74) was negatively related to GSD (P&lt;0.05).CONCLUSION: With an association analysis, it was determined that A allele of CYP7A gene and X+ allele of APOB gene might be considered as risk genes for GSD. These alleles are related with differences of serum lipids among subjects.Multiple-variable logistic regression model analysis showed that besides BMI, GSD was affected by polygenetic factors.But the mechanism for these two alleles responsible for GSD requires further investigations.     

Efficacy of reduction therapy of natural human β-interferon and ribavirin in elderly patients with chronic hepatitis C, genotype 2 and high virus load

Aim: To evaluate the efficacy of natural human interferon (IFN)‐β and ribavirin in elderly patients infected with hepatitis C virus (HCV) genotype 2 and high virus load. Methods: Inclusion criteria were age of 65 years or older, HCV genotype 2 and serum HCV RNA level of 5.0 logIU/mL or more. A total of 33 were enrolled in this retrospective cohort study. IFN‐β was administrated i.v. at a dose of 6 million units daily for 4 weeks initially, followed by three times a week for 20 weeks. Ribavirin was given daily for 24 weeks at the dose described based on bodyweight. Fifteen patients were given a standard dose of ribavirin (standard group). Eighteen patients were given a reduction dose of ribavirin that decreased by one tablet per day compared to the standard group (reduction group). Results: Of the 33 study patients, no patient stopped the treatment due to treatment‐related adverse events. The dose of IFN‐β was reduced in three patients: Two patients belonged to the standard group and one patient belonged to the reduction group. The dose of ribavirin was reduced in 11 patients during combination therapy: nine patients belonged to the standard group and two patients belonged to the reduction group. The sustained virological response (SVR) was 72.2% (13/18) in the reduction group and 80.0% (12/15) in the standard group. There was no significant difference in SVR rate between the reduction and standard groups (P = 0.699). Conclusion: The reduction therapy of IFN‐β and ribavirin in elderly chronic hepatitis C patients with genotype 2 and high virus load is one selection of treatment.     

Seroprevalence and factors associated with Human Immunodeficiency virus,Human T lymphotropic virus and Hepatitis B/C infections in parturient women of Salvador – Bahia,Brazil

BackgroundThe heterogeneity in detection rates of Human immunodeficiency virus, (HIV), Human T lymphotropic virus (HTLV) and Hepatitis B and C infections among pregnant women and the continuous exposure to risk factors limits the adoption of preventive and control actions.ObjectiveTo evaluate the HIV, HTLV, Hepatitis B and C seroprevalence rates, and associated risk factors in parturient women in Salvador, Brazil.MethodsThis was a cross-sectional study in 2099 parturient women attended in two public maternity hospitals in Salvador, Brazil. One blood sample was drawn for serological screening and socio-demographic, obstetric and clinical data were collected.ResultsHIV seroprevalence rate was 1.5% (of which 0.6% were new cases); seroprevalence rates for HTLV, HBV, and HCV were 0.4%, 0.4%, and 0.1%, respectively. Univariate analysis showed a significant association between socio-demographic and behavioral factors with retroviral infections, while viral hepatitis was mainly associated with parenteral exposure. In a multivariate analysis, multiple sexual partners (OR 3.3; 95% CI: 1.1–9.2), history of sexual/domestic violence (OR 2.8; 95% CI: 1.1–6.9), syphilis co-infection (OR 2.6; 95% CI: 1.0–6.9), use of alcohol or drugs (OR 2.5; 95% CI: 1.2–5.5), and low schooling level (OR 2.3; 95% CI: 1.1–4.9) were independent risk factors for HIV infection. History of stillbirth and low birth weight infants was significantly associated with HTLV positive status, showing a negative impact on gestation.ConclusionsThe seroprevalence rates for HIV, HCV, HBV, and HTLV were similar to that found in previous studies in other Brazilian regions. The high individual, socioeconomic, and social vulnerability detected in seropositive parturient women indicates the need to improve coverage and effectiveveness of STDs control with prevention, detection and monitoring strategies, focusing in pregnant women exposed to high biopsychosocial risk.     

TAVR in patients with severe aortic stenosis and less than high risk: Future or present reality?

• TAVR use is growing in patients with less than high surgical risk.
• Several registries, including this one, show excellent safety with TAVR in intermediate‐risk patients compared with similar patients undergoing SAVR.
• Long‐term data from ongoing randomized trials will answer definitively if we should routinely perform TAVR in intermediate‐risk patients.