Cellular immune responses in patients with dual infection of hepatitis B and C viruses: Dominant role of hepatitis C virus

Several lines of evidence have suggested that immune mechanisms are involved in the pathogenesis of hepatitis B virus (HBV)- and hepatitis C virus (HCV) -related hepatitis. Study of patients with dual HBV and HCV infection raises the question of which is etiologically more relevant in determining the liver cell damage. To address this issue, proliferation of peripheral blood mononuclear cells (PBMCs) in response to a panel of HBV and HCV antigens was assayed in 13 patients with chronic dual hepatitis B and C, 7 patients with chronic hepatitis B, 7 patients with chronic hepatitis C, and 6 patients with hepatitis B surface antigen (HBsAg) carrier state. Although HBV or HCV hepatitis patients had a significant response to HBV or HCV antigens, respectively, the patients with dual hepatitis B and C exclusively responded to HCV antigens, but not to HBV antigens. One patient who was seropositive for both HBV-DNA and HCV-RNA showed a low response to HBV antigens initially but lost the response 3 months later and became responsive to more HCV antigens. These findings suggest that HCV has a dominant role in the immune response of the patients with dual HBV and HCV infection.     

Post-polypectomy bleeding after colonoscopy on uninterrupted aspirin/non steroideal antiflammatory drugs: Systematic review and meta-analysis

Background and aimThe aim of this systematic review and meta-analysis was to assess the risk of post-polypectomy bleeding (PPB) in patients that underwent colorectal polypectomy and exposed to ASA/NSAIDs.MethodsRelevant publications were identified in MEDLINE/EMBASE for the period 1950–2016. Studies with specified ASA/NSAIDs exposure and bleeding rate were included. Study quality was ascertained according to Newcastle-Ottawa Scale. Forest plot was based on fixed or random effect models in relation to the heterogeneity.Results11 studies (4 prospective and 7 retrospective) including 9307 patients were included in the analyses. Overall, 344 patients (OR 1.8; 95% CI 1.2–2.7; p-value 0.001, I² 52%) experienced rectal bleeding after procedure. While the rate of immediate PPB on aspirin and/or NSAIDs was not increased (OR 1.1; CI 95% 0.6–2.1; d.f. = 1, p = 0.64, I² 0%), the risk of delayed PPB was augmented (OR 1.7; 95% CI 1.2–2.2; d.f. = 8, p = 0.127, I² 36%).ConclusionsASA/NSAIDs are not a risk factor for immediate PPB but the chance of delayed is increased.     

La tomographie par émission de positons au 18F-FDG en pathologie rénale non oncologique : indications actuelles et perspectives

Positron emission tomography combined with computed tomography (PET/CT) is a nuclear imaging technique which provides anatomical and functional information. PET/CT is increasingly used in non-oncological nephrology since conventional radiological approaches after injection of contrast agents are relatively contra-indicated in patients with chronic kidney disease (CKD). PET/CT after i.v. injection of ¹⁸F-fluoro-deoxy-glucose (FDG) is not toxic and is characterized by a high sensitivity. The level of irradiation (∼5 mSv) is acceptable. CKD does not significantly influence tissue uptake of ¹⁸F-FDG. The purpose of the present review aims at detailing the non-oncological indications of ¹⁸F-FDG PET/CT in general nephrology and after kidney transplantation. Particularly, ¹⁸F-FDG PET/CT appears useful in the diagnosis of cyst infection in patients with autosomal dominant polycystic kidney disease, as well as in the characterization of retroperitoneal fibrosis. In kidney transplant recipients, ¹⁸F-FDG PET/CT may help in the diagnostic work-up of suspected acute rejection, thereby eventually avoiding unnecessary kidney transplant biopsy. Perspectives in ¹⁸F-FDG PET/CT imaging are discussed, including innovative approaches of image analysis.