Open Journal of Gastroenterology

Journal Information
ISSN / EISSN : 21639450 / 21639469
Current Publisher: Scientific Research Publishing, Inc. (10.4236)
Total articles ≅ 356
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Antonin Wilson Ndjitoyap Ndam, Ousmanou Nsangou Mbombo Njoya, Richard Njouom, Mathurin Kowo, Serge Clotaire Billong, Firmin Ankouane, Oudou Njoya, Elie Claude Ndjitoyap Ndam
Open Journal of Gastroenterology, Volume 10, pp 181-186; doi:10.4236/ojgas.2020.107018

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Bilal Khan, Bilquis Nawabi, Daniya Sivakumar, Said Maisam Shuoa, Ruihua Shi
Open Journal of Gastroenterology, Volume 10, pp 166-179; doi:10.4236/ojgas.2020.106017

Serges Magloire Camengo Police, Nathalie Philomène Boua-Akélélo, Georges Service, Eveline Mofini, Benoît Elowa, Armelo Thibaut Yangba Kalebanga, Bernard Bessanguem, Marcel Mbeko Simaléko, Peggy Guérendo, Henri Diemer, et al.
Open Journal of Gastroenterology, Volume 10, pp 144-150; doi:10.4236/ojgas.2020.106015

Abstract:
Introduction: Hepatitis B virus (HBV) and Hepatitis C Virus (HCV) infection is a public health problem. Sex workers remain a vulnerable group. Objective: To determine the prevalence of HBsAg and hepatitis C virus (HCV) antibody transport among female sex workers (FSW) in Bangui. Patients and Methods: All FSW carriers of HBsAg and/or anti-HCV Antibodies were collected in a 6-month cross-sectional analytical study. The HBsAg research used the Monolisa HBsAg® (BioMérieux®) technique, sandwich ELISA. HCV serology consisted of the search for anti HCV antibodies by monolisa HCV (BioMérieux®), Elisa of the sandwich type. HIV serology used two Elisa tests (Genscreen® and Vironostika®). Data analysis was done using Epi Info 3.5.1 software. The Chi2 test was used for comparison with a significance level p Results: Among the 345 FSW enrolled, 41 (11.9%) were carriers of HBsAg and 3 (0.8%) had anti HCV antibodies. The mean age was 21.3 years in HBsAg-positive FSW and 25 years in FSW with anti-HCV antibodies. FSW with HBsAg engaged in informal trade (n = 17), prostitution in bars or on the street (n = 15) and prostitution in the city (n = 9). On the other hand, the 3 FSW carrying anti-HCV antibodies were engaged in prostitution in the city. The 41 FSW HBsAg positive and 304 FSW HBsAg negative had at least 3 sexual partners. Anal penetration during sexual intercourse was acknowledged by 20 FSW carrying HBsAg and 101 FSW HBsAg negative (p = 0.0518). Among the 3 FSW (0.8%) carrying anti-HCV antibodies, 2 were carrying HBsAg. HIV serology was positive in 66FSW (19.13%) including 15 FSW coinfected with HIV/HBV (p = 0.0025). Conclusion: The prevalence of hepatitis B is high among FSW. Awareness and prevention action must be taken in favor of this key population.
Noboru Hirashima, Masaaki Shimada, Noboru Urata, Takuya Tsunekawa, Satoshi Unita, Takashi Kondo, Daiki Tanaka, Hisashi Kondo, Masashi Saito, Hiroaki Iwase, et al.
Open Journal of Gastroenterology, Volume 10, pp 1-13; doi:10.4236/ojgas.2020.101001

Abstract:
Background: Interferon-free direct-acting antivirals (DAA) have markedly increased the sustained virological response (SVR) rate among patients with hepatitis C. Although DAA inhibit the development of hepatocellular carcinoma (HCC), predictive factors remain unclear. The aims of the present study were to investigate predictive factors for HCC occurrence and recurrence after SVR by DAA in prospectively followed patients with hepatitis C (HCV). Methods: One hundred and eighty-three HCV-infected patients treated with DAA and achieving SVR were prospectively followed up for more than one year. Among these patients, 166 had no history of HCC before DAA therapy, while 17 had a history of being treated for HCC by radiofrequency ablation or resection before the initiation of DAA. Liver stiffness (LS) measurements were conducted using transient elastography, and LS was assessed at the initiation of DAA (LS0), 24 weeks after the initiation of DAA (LS24), 48 weeks after (LS48), and every year after that. Results: HCC occurred in 7 out of 166 patients without a history of HCC (4.2%), and recurred in 9 out of 17 with a history of HCC (52.9%). Patients with a history of HCC were significantly older, mainly males, had higher alpha-fetoprotein (AFP) levels before DAA and at SVR24, higher Fib-4 levels, and higher LS0, 24, and 48 than those without a history of HCC. Age (p = 0.013) and AFP at SVR24 (p = 0.036) correlated with occurrence. LS48 (p = 0.043) correlated with recurrence. Conclusions: Predictive factors differed between HCC occurrence and recurrence after SVR by DAA in HCV patients. High recurrence rates were due to fibrosis in the liver being more advanced in patients with than in those without a history of HCC. Age and AFP at SVR24 were identified as predictive factors of HCC occurrence and LS48 of HCC recurrence.
Aboudou Raïmi Kpossou, Frédéric Sogbo, Alexandra Marilyn Oloukèmi Zomahoun, Khadidjatou Saké Alassan, Rodolph Koffi Vignon, Comlan N’Déhougbèa Martin Sokpon, Fadel Sourokou, Jean Séhonou, Nicolas Kodjoh, Dissou Affolabi
Open Journal of Gastroenterology, Volume 10, pp 31-44; doi:10.4236/ojgas.2020.102004

Abstract:
Introduction: Hepatitis D virus (HDV) is a satellite virus of hepatitis B virus (HBV). The purpose of this work was to describe the epidemiological, clinical and biological characteristics of HBV/HDV co-infection and the factors associated with this co-infection in Cotonou. Methods: This was a cross-sectional, descriptive study with prospective data collection. It took place from June to October 2016 at CNHU/HKM and the Atinkanmey Polyclinic in Cotonou. Subjects over 15 years of age with HBsAg and untreated for hepatitis were included consecutively. Sociodemographic, clinical and biological characteristics were collected for each patient using only a standardized questionnaire. Then, a blood sample was taken for the determination of anti-HDV antibodies as well as the viral load of HBV. Results: A total of 156 subjects were included, predominantly male (sex-ratio = 2), and of median age 36 years. The majority were monogamous married (50%) or single (41.7%), and were from south of Benin (84.6%). Most subjects were asymptomatic (49.4%). The prevalence of total HDV antibodies was 3.9% (6/156). In subjects with total HDV antibodies, the prevalence of HDV IgM was 33.3%. Origin in northern Benin appears to be a risk factor for HDV infection (p = 0.042). Similarly, married subjects were statistically more infected with HDV than unmarried subjects (p = 0.002). Conclusion: The prevalence of HDV infection varies according to the origin of the patients and their marital status.
Jile Florient Mimiesse, Ngalessami Mouakosso Marlyse, Ahoui Apendi Clausina, Mongo Onkouo Arnaud, Atipo-Ibara Ollandzobo Lucie, Firmin Bossali, Akoa Ngala Itoua-Ngaporo, Rody Stéphane Ngami, Mahoungou Gael Honal, Deby Gassaye, et al.
Open Journal of Gastroenterology, Volume 10, pp 23-29; doi:10.4236/ojgas.2020.101003

Abstract:
Introduction: cirrhosis is a serious pathology that leads to complications whose management remains difficult in our country. This study aimed to evaluate the evolutionary aspects of cirrhosis at the Brazzaville University Hospital. Patients and methods: this was a retrospective study over a period of 18 months (from January 2015 to July 2016), performed in the Gastroenterology Department of the Brazzaville University Hospital. All patients regularly followed for decompensated cirrhosis were included. The studied variables were the epidemiological, clinical and paraclinical characteristics, the occurrence of complications, the survival, and the causes of death. Univariate analysis was used to determine prognostic factors based on the Child Pugh score. Results: There were 43 patients, including 32 men and 11 women, with a mean age of 52 ± 9.5 years. Viral hepatitis B was the most common etiology (39.5%). Child Pugh stage C was found in 60.5%. Oesophageal varices were present in 93% of cases. Survival at 18 months was 72%. In univariate analysis, two variables were significantly associated with decreased survival, including Child Pugh stage C and esophageal varices (grade II and III). Conclusion: cirrhosis remains a worrying pathology because the diagnosis is often made at the stage of often serious complications putting at risk of vital prognosis.
Virukalpatti Gopalratnam Mohan Prasad, Prashant Rahate, Husain Bohri, Jyoti Ranjan Mahapatra, Ashish Mungantiwar, Priyanka Srivastava, Nirali Bhatt, Dhavalkumar Patel, Soumen Roy, Amit Qamra
Open Journal of Gastroenterology, Volume 10, pp 14-22; doi:10.4236/ojgas.2020.101002

Abstract:
Introduction: Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease ranging from liver steatosis to nonalcoholic steatohepatitis (NASH). Besides lifestyle modifications, Vitamin E (800 IU/day) is generally recommended for NASH. Vitamin E monotherapy is not sufficient for the multifaceted disease like NALFD. The combination of Vitamin E 400IU and Fraxinus excelsior 500 mg twice daily was found to be better than vitamin E 400 IU twice daily in improving the lipid profile and liver function parameters in patients with NAFLD. We conducted a study to assess safety and effectiveness of Vitamin E plus Fraxinus excelsior in Indian patients with NAFLD in real-world settings. Patients and Methods: This was a non-interventional study in NAFLD patients with varying grades of steatosis conducted by 234 physicians across India from January 2018 to August 2018. Patients received combination of Vitamin E (400 IU) and Fraxinus excelsior (500 mg) soft gelatin capsules twice daily after meals for 12 weeks. Effectiveness of the treatment was assessed at visit 2 (6 weeks) and visit 3 (12 weeks, end of study) from baseline. The parameters for assessment included severity of liver steatosis, liver function parameters and the global assessment of safety and effectiveness. Results: A total of 1114 patients were included in the study. At baseline, majority of the patients (71.18%) had Grade II liver steatosis followed by 21.01% and 7.81% patients who had Grade III and Grade I liver steatosis, respectively. After 12 weeks of treatment with vitamin E and Fraxinus excelsior combination, 21% patients had no steatosis, 58.79% patients were in Grade 1 steatosis, 19.57% in grade II steatosis and only 0.63% patients in Grade III steatosis. The mean percentage reduction in aspartate aminotransferase (AST) level at week 6 and week 12 from baseline was 24.92% and 43.79%, respectively. Similarly, the mean percentage reduction in alanine aminotransferase (ALT) level at week 6 and week 12 from baseline was 24.37% and 44.05% respectively. The mean reductions in AST and ALT were significant at week 6 and week 12. More than 50% of the investigators rated treatment as excellent for the safety and effectiveness. Conclusion: Evidence from this Indian real-life study suggests that Vitamin E (400 IU) and Fraxinus excelsior (500 mg) is safe and effective for the treatment of NAFLD in routine clinical practice. Its consumption is associated with improvement in hepatic steatosis and liver function parameters (AST and ALT). Given the limited therapeutic options in NAFLD, this combination has the potential to bridge the therapeutic gap in management of NAFLD.
Serges Magloire Camengo Police, Georges Service, Nathalie Philomène Boua-Akelelo, Diane N’Guilé, Benoît Elowa, Timothée Mobima, Francky Kouandogui Bangué, Eveline Mofini, Yangba Kalebanga Armelo Thibaut, Bessanguem Bernard, et al.
Open Journal of Gastroenterology, Volume 10, pp 97-105; doi:10.4236/ojgas.2020.104010

Abstract:
Objective: To describe the epidemiological, clinical, biological and morphological aspects of primary liver cancer (PLC). Patients and Methods: We conducted a 38-month cross-sectional study in the Department of hepatogas-troenterology and Internal Medicine “Amitié Sino-Centrafraine” University Hospital Center in Bangui. Included in the study were all patients with a diagnosis of PLC. The PLC’s diagnostic arguments were the large tumor liver associated or not with the elevation of alpha-fetoprotein, the heteronodular liver hypervascularized on abdominal ultrasound. Data analysis was done using Epi Info 3.5.1 software. Results: We collected 115 cases of CPF among 2410 hospitalized patients (4.7%). There were 86 men and 29 women (sex ratio: 2.9). The average age was 50 years old. The main risk factors were alcohol consumption (72.2%) and chronic hepatitis B infection (67.4%). Frequent clinical signs were pain in the right hypochondrium and/or epigastric (93.86%), large tumor liver under examination (91.3%), weight loss (74.78%). The serum alpha-fetoprotein concentration was ≥ 400 ng/ml in 73% of the cases. The abdominal ultrasound found a heteronodular liver in all patients. The nodules were multiple hyperechoic in 66.1% of the cases. According to the Child-Pugh classification, the patients were classified as B (49.5%) and C (33.9%). The Okuda Classification ranked patients at stage 1 in 16.5% cases, stage 2 in 52.1% cases and stage 3 in 31.3% cases. According to the BCLC classification, 5.2% of patients were in stage A, 12.2% in stage B, 52.2 in stage C and 30.4% in stage D. Death was recorded during hospitalization in 89 cases (77.4%). Conclusion: CPF is a frequent and serious pathology in Bangui. Its diagnosis is often late, preventing curative treatment. The main causes are alcohol consumption and the hepatitis B virus. The population should be educated to reduce the incidence of this disease.
Mohammed Ahmed Nagah
Open Journal of Gastroenterology, Volume 10, pp 72-87; doi:10.4236/ojgas.2020.104008

Abstract:
Background: Liver fibrosis is the presence of excess collagen due to new fibers formation. It is classified as a component of many forms of liver disease and injury rather than a disease by itself. To-date, there is no effective treatment for liver fibrosis. The only known way for patients suffering from advanced liver fibrosis is liver transplantation. Aim: The study was conducted to prove safety of Regehep (DAH04) as a novel treatment for treatment of advanced liver fibrosis in both of healthy adult volunteers. In addition, effectiveness and tolerability of Regehep (DAH04) in patients with advanced liver fibrosis. Method: Fourteen adult volunteers were enrolled for part A and B. Part A, twelve adult healthy volunteers were randomly assigned into four groups (n = 3) as section of safety. Part B, two patients were enrolled to asses tolerability and effectiveness of Regehep in case of advanced liver fibrosis. Single ascending dose was used to asses safety in part A while therapeutic dose was used to achieve primary and secondary end point in part B. Results: There were no serious side effects as well as no serious biochemical changes after administration of single ascending doses of Regehep (DAH04) up to 25 folds of therapeutic dose. While part B, two cases of advanced liver fibrosis showed improvement of biochemical profile and ultrasound images of the liver till curing of periportal fibrosis as secondary end point. Conclusion: Regehep (DAH04) appears to be safe in doses up to 25 folds of therapeutic dose as well as effective in treatment of periportal fibrosis in late stages.
Ali Hussein Mohammed, Ahmed Sedky, Hisham A. Alghany Algahlan, Amr M. Zaghloul
Open Journal of Gastroenterology, Volume 10, pp 61-71; doi:10.4236/ojgas.2020.104007

Abstract:
Nonalcoholic fatty liver disease (NAFLD) is a pathological condition seen as histological change ranging from simple steatosis to steatohepatitis, advanced fibrosis and liver disease among patients without significant alcohol consumption. Microalbuminuria which is defined as the urinary albumin excretion of 30 - 300 mg/24h has been reported to be a risk factor for renal and cardiovascular disorders. It also has independent correlation to high mortality in diabetic and hypertensive patients. NAFLD is affecting non obese non diabetic individuals; Microalbuminuria is correlated to visceral adipose tissue even in non diabetic non obese patients with limited studies in this aspect. Microalbuminuria is considered as a risk factor for cardiovascular and chronic kidney disease. Aim of the work: To assess urinary albumin creatinine ratio in non-obese non-diabetic patients with nonalcoholic fatty liver disease. Patients and methods: Total number of 80 patients with NAFLD that were non diabetic non obese patients. Abdominal ultrasonography and laboratory investigations were done. Results: Eighty non-obese, non-diabetic subjects (32 women, 48 men) with the mean age of 50.9 were included in this study. The population of the study was classified into four groups according to ultrasonographic degrees of steatosis. Control Group (A), (No. 25) 31.25% of total cases are reported as no fat accumulation in liver. Group B; No. 21 26.25% of total cases are reported as had mild steatosis (NAFLD 1). Group C; No. 18 (22.5%) of total cases and reported as had moderate fat accumulation (moderate steatosis). Group D; No. 16 (20%) of total cases reported had severe fat accumulation (severe steatosis). Urinary albumin creatinine ratio also shows increase in its values with increasing in the degree of steatosis among different groups which is highly statistically significant. Triglycerides, total cholesterol and LDL show also significant changes between groups as they are significantly increased in value as regard increasing in degree of steatosis, inversely noticed with HDL levels as it goes down with elevated degree of steatosis which is statistically significant. Discussion: The effects of fatty liver disease on renal functions have been evaluated in some studies; in this study we tried to evaluate the correlation between microalbuminuria and various degrees of steatosis in non-obese non diabetic patients; we found that NAFLD could be seen in non obese non diabetic individuals with special reference to other factors that may influence the progress of the disease such as hyperlipidemia with increased risk of microalbuminuria among those patients. Conclusion: After exclusion of type 2 DM and obesity, we conclude that the presence and the severity of microalbuminuria are more apparent among NAFLD patients.
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