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Epidemiology of hepatitis B virus infection in Albania

World Journal of Gastroenterology 2009年第7期15卷 849-852页

作者： Bashkim Resuli skerdi prifti Bledar Kraja Tatjana Nurka Mimoza Basho Edita Sadiku University Clinic of Gastrohepatology University Hospital Center "Mother Teresa"Dibra stnr 371TiranaAlbania Blood Bank Center QSU Mother TheresaDibra stnr 371TiranaAlbania Department of Infection Disease Public Health InstituteA Moisiu stnr 85TiranaAlbania University Clinic of Internal Medicine University Hospital Center "Mother Teresa"Dibra stnr 371TiranaAlbania

AIM： To assess the prevalence and socio-demographic distribution of hepatitis B virus （HBV） infection in Albania. METHODS： Blood samples from 410 unselected schoolboys, 666 students, 500 military personnel, 1286 casual blood donors, 378 voluntary blood donors and 640 pregnant women （total 3880 non-vaccinated residents of rural and metropolitan areas from all over Albania; 2354 （60.7%） male and 1526 （39.3%） female; mean age of 26.3 years） were tested during 2004-2006 for hepatitis B surface antigen （HBsAg） and antibodies to hepatitis B virus （anti-HBs） by ELISA. RESULTS： The HBsAg and anti-HBs prevalence were 9.5% and 28.7%, respectively. The highest HI3sAg prevalence was evident in the younger age group, such as in schoolchildren （11.8%） and the military （10.6%）. Consequently, the anti-HBs prevalence increased with age, from 21.2% in schoolchildren （mean age： 15.7 years）, to 36.3% in pregnant women （mean age： 26.3 years） and 29.7% in voluntary blood donors （mean age： 40.1 years）. There were no significant differences between males and females. CONCLUSION： Despite the estimated two-fold reduction of HBsAg prevalence in the general population from about 18%-19% to 9.5%, Albania remains a highly endemic country （i.e. over 8% of HBsAg prevalence rate）.

关键词： Albania Hepatitis B virus Blood donor Military Pregnant women Schoolchildren Student

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Predictors of esophageal varices and first variceal bleeding in liver cirrhosis patients

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World Journal of Gastroenterology 2017年第26期23卷 4806-4814页

作者： Bledar Kraja Iris Mone Ilir Akshija Adea Kocollari skerdi prifti Genc Burazeri Department of Biomedical Sciences Faculty of MedicineUniversity of Medicine University Clinic of Gastrohepatology University Hospital Center Mother Teresa Department of Laboratory University Hospital Center Mother Teresa Department of Statistics University Hospital Center Mother Teresa Department Department of International Health School CAPHRICare and Public Health Research InstituteMaastricht University

To assess “predictors” of esophageal varices (EV) and variceal bleeding using non-invasive markers in Albanian patients diagnosed with liver cirrhosis. METHODSOne hundred thirty-nine newly diagnosed cirrhotic patients without variceal bleeding were included in this analysis. Model for end-stage liver disease (MELD), aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT), AST to platelet ratio index (APRI), platelet count to spleen diameter (PC/SD), ﬁbrosis-4-index (FIB-4), fibrosis index (FI) and King’s Score were measured for all participants. All patients underwent endoscopic assessment within two days of hospitalization. The major end point was the first esophageal variceal bleeding (EVB) event. The diagnostic performance of “predictors” for the presence of EV and EVB were assessed by sensitivity and specificity values obtained from the receiver operating characteristics procedure. RESULTSFIB-4 was the only strong and significant “predictor” of esophageal varices (multivariable-adjusted OR = 1.57 for one unit increment; 95%CI: 1.15-2.14). Furthermore, a cut-off value of 3.23 for FIB-4 was a significant predictor of esophageal varices, with a sensitivity of 72%, a specificity of 58% and a proportion of area under the curve (AUC) of 66% (P = 0.01). During the follow-up (median: 31.5 mo; interquartile range: 11-59 mo), 34 patients (24%) experienced a first EVB. FIB-4 was a poor predictor of EVB (the AUC was only 51%) for a cut-off value of 5.02. Furthermore, the AUC of AST/ALT, APRI, PC/SD, FI, MELD and King’s Score ranged from 45% to 55%. None of the non-invasive markers turned out to be a useful predictor of EVB. CONCLUSIONDespite the low diagnostic accuracy, FIB-4 appears the most efficient non-invasive liver fibrosis marker which can be used as an initial screening tool for cirrhotic patients.

关键词： Albania Esophageal varices Liver cirrhosis Non-invasive biomarkers Variceal bleeding

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