Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Hepatitis B virus markers in primary hepatocellular carcinoma(Faculty of Medicine, University of Peradeniya, Sri lanka, 1994) de Silva, H.J.; Ratnatunga, N.; Ramadasa, S.Based on serological studies, Sri Lanka has a relatively low Hepatitis B virus (HB V) [hepatitis B surface antigen (HBsAg)] carrier rate of 0.9% and a low prevalence of HBV (5-10%) among patients with primary hepatocellular carcinoma (PHC). To investigate this further we looked for HBV markers in PHC using more sensitive immunoliistochemical methods. Formalin fixed paraffin embedded tissue obtained from 18 PHCs were studied. Only 7 of the specimens contained non-tumour liver tis¬sue around the PHC, and evidence of cirrhosis was seen in 5 of them. Four micron thick sections of tissue were stained, with polyclonai antibod¬ies directed against HBsAg and hepatitis B core antigen (HBcAg) using a three stage immunoperoxidase technique (peroxidase-anti peroxidase). Positive control liver tissue was used in all experiments. HBsAg was detected in6(33.3%)of the 18 specimens (in the tumour tissue only in 3 speci¬mens, tumour tissue and surrounding cirrhotic liver tissue in 1. and surrounding cirrhotic liver tissue only and not in tumour tissue in 2 speci¬mens). The staining was cytoplasrnic. HBcAg was not detected in any of the tissue specimens tested. Nodatareg;irding serum alphafetoprotein levels were available from the patients medical records. From the preliminary results of this on going study, HBsAg markers appear to be more frequently associated with PHC than serological studies from Sri Lanka have indicated. HBV may, therefore, have arnore important aetiologi-cal role in PHC in this country than was previ¬ously believed.Item Lamivudine for hepatitis B infection in post-renal transplant patients: 36 month follow-up(Wiley Blackwell Scientific Publications, 2004) de Silva, H.J.; Herath, C.A.; Sheriff, M.H.R.INTRODUCTION: Therapy with interferon-alpha is inappropriate for post-renal transplant Hepatitis B infection, as it may result in graft rejection. We assessed the efficacy of lamivudine in HBV infection among post-renal transplant patients after 36 months of treatment. METHODS: From April 1999, post-renal transplant patients with chronic HBV infection were offered treatment with lamivudine 100 mg/day. Their liver function and HBV serology were assessed 3 monthly, and HBV-DNA annually or when otherwise indicated. Post-transplant immunosuppressive therapy was not altered. RESULTS: Lamivudine treatment was started in 43 patients [M:F = 28:15; median age 41 yrs (range 28–76)]. At recruitment, all were HBsAg (+), HBV-DNA (+) and anti-Hbe (-); 35 were HBeAg (+). Serum ALT was 24–768 IU/L (median 113). 6 had hepatic decompensation and 4 died (3 from renal causes) within one month of starting lamivudine. After 12 months of treatment HBV-DNA became undetectable and ALT normalised in 30/39 (76.9%). 16/30 discontinued treatment, but all 16 became HBV-DNA (+) 3 months later; lamivudine was restarted. 32 patients completed 36 months of treatment (7 lost to follow-up). All were HBsAg (+); 23 were HBVDNA (+) - 18/23 had earlier become DNA (-) with treatment but had breakthrough HBV-DNA (+), 5/23 were HBV-DNA(+) throughout follow-up; 4 patients were HBV-DNA (-), HBeAg (-), anti-Hbe (+); and 5 were HBV-DNA (-), HBeAg (-), anti-Hbe (-). There were no side-effects attributable to lamivudine. CONCLUSIONS: Lamivudine therapy suppressed HBV-DNA in postrenal transplant patients with HBV infection on immunosuppressive therapy, but suppression was dependant on continued therapy. After 36 months of treatment few patients showed HBe seroconversion, but not eradication of infection. Breakthrough HBV-DNA (+) occurred in a significant proportion during continued treatmentItem Prevalence of hepatitis B and hepatitis C infections and their relationship to injectable drug use in a cohort of Sri Lankan prison inmates(Sri Lanka Medical Association, 2015) Niriella, M.A.; Hapangama, A.; Luke, H.P.D.P.; Pathmeswaran, A.; Kuruppuarachchi, K.A.L.A.; de Silva, H.J.INTRODUCTION: Prisoners are considered to be at high risk for Hepatitis B (HBV) and Hepatitis C (HCV) virus infections. This is attributed to intravenous drug use and high-risk sexual behaviour. There are no published studies on HBV and HCV among prison inmates or injecting drug users in Sri Lanka. OBJECTIVES: To determine prevalence of HBV and HCV infections, and their relationship to injectable drug use among Sri Lankan prisoners. METHODS: We investigated 393 (median age 42 years (range 16 to 93); 82% males) randomly selected inmates of Mahara and Welikada prisons. RESULTS: Though 167 (42.5%) admitted drug abuse, only 17 (4.3%) had ever used intravenous drugs. Twelve (70.6%) of them reported sharing needles. One inmate was positive for HBsAg but was negative for HBV-DNA. Twenty seven (6.9%) were positive for anti-HCV antibodies, of whom only 2 (0.5%) were positive for HCV-RNA. None of the injecting drug users were positive for HBV-DNA or HCV-RNA. CONCLUSIONS: The prevalence of HBV and HCV infections as well as injecting drug use was very low among this cohort of Sri Lankan prisoninmatesItem Hepatitis B, C, and HIV infections in Sri Lanka(Ceylon College of Physicians, 2006) de Silva, H.J.; Abeywickrema, I.No Abstract AvailableItem Item Lamivudine therapy for hepatitis B infection in post-renal transplant patients: results after 36 months follow-up(Wiley-Blackwell, 2005) de Silva, H.J.; Herath, C.A.; Sheriff, M.H.No Abstract Available