Vol. 3 Issue 2
On the cover: Official Journal of the Mexican Association of Hepatology
Over three decades of research in experimental animals and several clinical trials have brought us to the threshold of hepatocyte transplantation for the treatment of acute and chronic liver failure, and inherited metabolic disorders. However, more extensive clinical studies and routine clinical application are hampered by the shortage of good quality of donor cells. To overcome these hurdles, current research has focused on the search for alternatives to adult primary hepatocytes, such as liver cell progenitors, fetal hepatoblasts, embryonic, bone marrow or umbilical cord blood stem cells and conditionally immortalized hepatocytes. Cross-species hepatocyte transplantation is also being explored. It is hoped that ongoing research will permit the application of hepatocyte transplantation to the treatment of a wide array of liver diseases.
Infection with hepatitis C virus (HCV) is a global public health issue. More than 200 million people in the world are infected with HCV. Hepatitis C is considered one of the main causes of chronic hepatitis, cirrhosis, hepatocellular carcinoma and liver transplantation. The identification of the viral genome quickly allowed delineation of genomic organization, and the structure and biochemical characterization of the proteins of HCV. However, it has been difficult to study its life cycle, as well as the development of antiviral agents due to the lack of a system of permissible culture. Numerous attempts have been reported to establish an in vitro system for the study of HCV. Recently, a system of efficient culture was established that allows replication of subgenomic molecules of HCV in a cell line of human hepatoma. In this revision, after a brief description of the molecular biology, means of transmission and clinical characteristics of hepatitis C, some of the experimental models are described that have been developed to date, focusing mainly on the subgenomic replicon system and their use in the development of new antiviral treatments.
There is increasing evidence that fatty liver may be the most frequent liver disorder in Western countries. However, the epidemiology of fatty liver is still not fully understood and there is a clear need of better assessing and defining the potential role of the risk factors identified by clinical series in the general population. This article reviews the available data on the epidemiology of fatty liver and addresses some important questions that should be answered in much needed future research.
Background & Aim: Liver cirrhosis continues to be an important cause of death in Mexico. Some data suggest that being overweight is a risk factor for chronic liver disease. The aim of this study was to assess the link between the incidences of being overweight or obese and mortality from liver cirrhosis in Mexico during the period 1990-2001. Methods: We designed and conducted an ecological study of trends with multiple comparisons of regions of Mexico (North, Central, Mexico City, and South). We built the time trends according to the mortality rates of liver cirrhosis reported by the System of Vital Statistics (Health Ministry) in each state for each year from 1990 to 2001. The information on prevalences of overweight (body mass index (BMI) = 25-29.9) and obesity (BMI • 30) was from two national surveys (1993 and 2000). Results: The analysis of mortality trends in liver cirrhosis by region showed an increase in the risk of death across time. This risk was considerably higher for the South Region (β = 1.03, p <0.0001). The mortality rates remained higher than 30 per 100,000 inhabitants. When we selected the three states with the highest mortality rates for each region, the most significant changes in the trends were in the North and South regions (β = 0.75, p <0.0001 and β = 1.29, p <0.0001, respectively). In addition, the prevalence of overweight in the four regions increased from 1993 to 2000 (percentage change, 10.2-48.2). Obesity was most prevalent in the North and South regions in 1993. Conclusion: Our observations support the hypothesis that obesity might play an important role in the risk of developing liver cirrhosis.
In the performance of a transvascular liver biopsy, the Trucut-type transjugular liver biopsy set is advance over a multipurpose catheter place in the suprahepatic vein. Occasionally there is a sharp bend between the suprahepatic veins and the inferior vein cava and the multipurpose catheter does not provide sufficient support to track the biopsy access set. To deal with this problem we describe the use of a stiff guidewire for an easy introduction of the biopsy set.
46-year-old Mexican-born who lived in Mexico City was admitted to the hospital for evaluation with a twoweek history of fever, jaundice, and malaise. Physical examination he had cardiac murmurs. The liver was palpable 2 cm below the costal margins. Liver-function tests showed hypertransaminasemia. The patient had a high titer of anti-EBV IgM antibodies, but tests for all other antiviral antibodies were negative. The liver biopsy shows EBV latent membrane protein.