The role of mutations in core protein of hepatitis B virus in liver fibrosis

The core protein of hepatitis B virus encompasses B- and T-cell immunodominant epitopes and subdivided into two domains: the N-terminal and the functional C-terminal consisted phosphorylation sites. Mutations of the core gene may change the conformation of the core protein or cause alteration of important epitopes in the host immune response. In this study twenty nine men (mean age 40 ± 9 years old) with chronic hepatitis B were recruited for direct sequencing of the core gene. Serum ALT and HBV DNA level were measured at the time of liver biopsy. The effects of core protein mutations on patients' characteristics and subsequently mutations in B cell, T helper and cytotoxic T lymphocyte (CTL) epitopes and also C-terminal domain of core protein on the activity of liver disease was evaluated. Liver fibrosis was significantly increased in patients with core protein mutation (1.0 ± 0.8 vs 1.9 ± 1.4 for mean stage of fibrosis P = 0.05). Mutations in CTL epitopes and in phosphorylation sites of C-terminal domain of core protein also were associated with higher liver fibrosis (P = 0.003 and P = 0.04; Fisher's exact test for both). Patients with mutation in C-terminal domain had higher serum ALT (62 ± 17 vs 36 ± 12 IU/l, p = 0.02). Patients with mutations in B cell and T helper epitopes did not show significant difference in the clinical features. Our data suggests that core protein mutations in CTL epitopes and C-terminal domain accompanied with higher stage of liver fibrosis may be due to alterations in the function of core protein

Willingness-to-Pay for One Quality-Adjusted Life-Year: A Population-Based Study from Iran

OBJECTIVE: This study was aimed at estimating the value of the general population's willingness-to-pay (WTP) for one quality-adjusted life-year (QALY) in Iran. METHODS: Using multistage randomized cluster sampling, we recruited and interviewed 651 adult residents of Shiraz, south Iran. The mean age of the interviewees was 43.9 ± 16.3 years, and 326 (50.1%) of them were male. To each interviewee, we presented one of the hypothetical health scenarios that were used in the European value of a QALY project. Questionnaires, which were validated for the Persian language, were administered in digitally-assisted format, and a gray block questionnaire was used for special cases. The data were then analyzed using STATA and SPSS. RESULTS: The overall mean value of payment for one QALY of respondents who expressed WTP was US$2847, which is equal to 0.57 of the GDP per capita of Iran's population. Under the end-of-life (terminal illness) scenario, this value was 13% higher than health-gain scenarios. WTP was also associated with high educational level, household income, and household expenditure. CONCLUSION: Our results provided a threshold range of WTP and insights into rigorous scientific decision making about healthcare technology for the future

Promoter polymorphism of transforming growth factor-β1 gene and ulcerative colitis

AIM: To elucidate the possible difference in two promoter polymorphisms of the transforming growth factor-β1 (TGF-β1) gene (-800G > A, -509C > T) between ulcerative colitis (UC) patients and normal subjects

Iran’s Health Innovation and Science Development Plan by 2025

"nBackground: Iran has made significant development in health and its scientific productivity, but a cohesive approach through a long-term plan is required to utilize knowledge for the country's health and development of health science and technology. As a part of a national agenda for development of "Comprehensive Scientific Map of the Country", the draft of the plan in the health-sector has been prepared."nMethods: A combination of two normative and exploratory approaches has been adopted to prepare the plan. For each part of the plan, a project defined. The group-projects developed their parts and consequently the draft of the plan developed. In the normative approach, the Islamic-Iranian values besides the country's vision for the year 2025 were assumed. National Innovation System concept used to analyze the related environment. Expert panels, using foresight methods, mainly pre­pared the information required for developing the plan. To finalize the plan, the draft was disseminated and receiving feed­backs, the document was polished appropriately."nResults: The long-term plan in the health sector has been prepared with the participation of around three-hundred experts. This plan includes vision, goals, monitoring and evaluation indicators, priorities, scenarios, policies, strategies, and requi­sites."nConclusion: The main challenges were as follows: considering equity in health, balance in choosing priorities (primordial and primary prevention against advanced technologies), and the role of the government in knowledge management