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The Incidence and the Clinical Significance of the Gray Zone in the Clinical Phases of Chronic Hepatitis B Virus Infection

Background: five clinical phases were described in patients with chronic (HBV) infection: HBeAg- positive HBV infection, HBeAg- positive chronic HB, HBeAg negative HBV infection, HBeAg-negative CHB and occult HBV infection.

Aim: This study aimed to determine the incidence of the unclassified phase (gray zone) in chronic hepatitis B patients and its significant in the clinical practice. 

Patients and methods: The study was conducted retrospectively on 109 patients' who have HBsAg positive for more than 6 months. The data recorded include; HbeAg and anti-HBe Ab, ultrasound of the abdomen, HBV DNA load and alanine aminotransferase (ALT), accordingly; we classify the patients to known clinical phases. Patients who were unfit one of these phases considered to be in the gray zone and subsequently sent for liver fibroscan to determine the fibrosis stage. 

Results: The mean age of our patients was 34.25 (±13.93) years with 54.12% being males. The mean viral load was 5,885,490 IU/ml and mean ALT was 56.22 (±89.88) U/L. eight  patients (7.3%) were in the HBeAg+ve HBV infection, 13 patients (11.9%) were in HBeAg+ve CHB . Thirty four patients (31.1%) were in the HBeAg-ve HBV infection and 23 (21.1%) were in HBeAg-ve CHB phase, both were showed a higher occurrence with age> 35 years. Thirty one (28.4%) further patients failed to identify with any of the four phases (normal ALT with HBV load > 2000 IU/ml), this group also showed significant relation to age above 35 years and 12 patients (38.8%) had significant fibrosis on fibroscan.

Conclusions: A considerable number of patients with chronic HBV infection have persistently normal ALT levels, despite elevated levels of viral load; this is known as the "grey zone" phase. These patients merit close follow up with short-interval measurement of liver enzymes, liver fibroscan and biopsy may be considered.

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Publication Date
Wed Jan 02 2013
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Serum interleukin 1 and interleukin 10 levels in Iraqi leukemic patients with hepatitis G virus infection.

Background:

Objectives : This prospective   study aimed to  estimate interleukins 1 and 10  levels in acute  hepatitis (G) in Iraqi patients with leukemiaHepatitis G virus and GB virus C (GBV-C)  RNA viruses that were independently identified in 1995, and were subsequently found to be two isolates of the same virus. Blood transfusion is the main risk factor for HGV transmission Immune-mediated mechanisms are believed to play an important pathogenic role in  hepatitis G virus infection. Interleukin-1 (IL-1) plays an important role in the inflammatory process. implying that IL-1 may play a role in viral clearance and  suggesting that IL-1 has direct antiviral

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Publication Date
Fri Feb 01 2013
Journal Name
Ijbpas
ALTERATION OF IMMUNE MEDIATORS IN PATIENTS WITH HEPATITIS B AND C VIRUS INFECTION

HBV and HCV are the major causes of chronic liver diseases throughout the world, and constitute a major global health risk. There is accumulated evidence that the imbalance of proinflammatory and anti-inflammatory cytokine production may play an important role in the pathogenesis of viral hepatic infections and may influence the clinical outcome and disease progression. This study was undertaken to analyze the circulating levels of Tumor Necrotic Factor (TNF-α) and Th2 cytokine IL-10 in patients infected with Hepatitis B and C virus. The study population consisted of 30 patients with chronic HBV, in addition to other 30 patients with chronic HCV infection were recruited on their first examination at the Al-Kindy General Hospital in Baghdad

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Publication Date
Tue Apr 01 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Hepatitis G virus infection among Iraqi patients on maintenance hemodialysis

Background: Patients on maintenance hemodialysis are at increased risk of infection with parentally transmitted viral agents. In recent years a high prevalence of hepatitis G virus infection among end stage renal diseases and chronic hemodialysis patients has been well documented.
Objectives: To assess the percentage and risk factors of HGV in hemodialysis patients, and to evaluate the clinical consequences of HGV in this population.
Patients and methods: Fifty (50) patients with chronic renal failure who underwent maintenance hemodialysis. Patients were currently attending hemodialysis department of Baghdad teaching hospital during the period of October 2011 to January 2012, compared to forty one (41) healthy blood donors who unde

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Publication Date
Thu Jan 01 2026
Journal Name
Open Journal Of Medicinal Chemistry
Publication Date
Mon Apr 01 2013
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Triplex ultrasound findings of chronic leg ischemia with clinical correlation

Background: Chronic leg ischemia commonly affects the arteries supplying the leg and mostly caused by atherosclerosis. Triplex ultrasound scanning is useful for delineating the anatomic site of disease in the lower limb in addition to the grading of the stenosis and evaluation of post-stenotic flow.

Objectives: To determine the extent of vasculopathy in patients with chronic leg ischemia by using triplex ultrasound scanning and match the sonographic findings with the clinical signs and symptoms.

Patients and methods: A cross sectional study from October 2009 to September 2010 was performed on 56 patients with clinical suspicion of chronic leg ischemia referring to ultraso

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Role of Programmed Cell Death-1 and Programmed Cell Death Ligand-1 immune checkpoint biomarkers among chronic Hepatitis C virus patients under Hemodialysis

Background: Hepatitis C virus (HCV) infection is one of the most common infections associated with chronic kidney disease (CKD) patients undergoing hemodialysis (HD) in Iraq.

Aim of the study: To determine the prognostic factor value of Programmed Cell Death-1 (PD-1) and Programmed Cell Death Ligand-1 (PD-L1) immune checkpoint biomarkers among CKD patients with HCV infection under HD.

Methodology: ELISA technique was used for the measurement of the above-mentioned biomarkers in the serum of 90 Iraqi patients. The participants were divided into three groups; Group I included 30 patients infected with HCV without antiviral treatment, group II included 30 patients infected wit

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Publication Date
Sun Oct 02 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Serological Patterns of Hepstitis B Virus Among HBsAg Negative Blood Donors in Baghdad, Iraq by Using Architect System

Background: About 10-15% of population HBV infection becomes chronic, and 85-90% are resolved. In Iraq, HBs-Ag assay by ELISA is only mandatory test for detection of HBV infection in blood donors. Anti- HBc and anti-HBs were not detectable in their sera.
Objective: To investigate the distribution of serological patterns for HBV who were HBsAg negative.
Material and method: Between July 18, 2011 to December 25, 2011, 10ml of blood samples were collected from National blood Transfusion Center donors, Baghdad, for 25782 individuals (25294 male, 488 female), mean age (20-65)years. HbsAg positive sera excluded (185), and final number of donors included in the
study was 25597 HbsAg negative.
Result: The data sho

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Publication Date
Sun Oct 03 2010
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Hepatitis G virus infection among Iraqi patients with Chronic liver diseases.

Background: The hepatitis G virus( HGV), also called hepatitis GB virus, as a member of the Flaviviridae family distantly related to hepatitis C virus (HCV), Little is known about the frequency of HGV infection, the nature of the illness, or how to prevent it. What is known is that transfused blood containing HGV has caused some cases of hepatitis. They infect humans, but are not known to cause human disease. This virus can be transmitted efficiently by blood transfusion and by other parenteral mechanisms. Transient and long lasting infections with HGV have been documented in man.
Patients and methods: HBs Ag, Anti-HCV IgG and Anti-HGV IgG were detected by Enzyme-Linked Immunosorbent Assay (ELISA).HCV RNA

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Publication Date
Fri Jun 24 2022
Journal Name
Iraqi Journal Of Science
The Role of Toll Like Receptor -2 in Hepatitis B Infection

Hepatitis B virus (HBV) infection is a global public health problem. It is estimated that there are 240 million HBV carriers in the world, of whom roughly 600,000 die annually from HBV-related liver disease. A total of 150 individuals were included in this study, 130 individuals of them had hepatitis B infection (patients group); HBs-Ag was detected in their sera by enzyme linked immunosorbent assay (ELISA) technique and was confirmed by real time PCR analysis to detect the viral genetic material, the others were control. Most of HBV patients in this study were located within 20-40 years group with a percentage of 47.7% and within the 40-60 years group with a percentage of 38.5%. Acute infection was confirmed by detection of anti-HBc IgM

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Publication Date
Sun May 03 2020
Journal Name
Journal Of Advanced Laboratory Research In Biology
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