1, 9, 36 Recently a randomized study that included patients with low ascites protein concentrations37 and a meta-analysis38 have indicated that antibiotic prophylaxis reduces SBP occurrence and improves short-term survival in see more high-risk patients with cirrhosis and ascites. Reducing the bacterial load in the gut by selective intestinal decontamination decreases the frequency of SBP, but increases the risks for infections with antibiotic-resistant bacteria39, 40 or posttransplant fungal infections41; thus, prophylaxis is currently restricted to patients at highest risk of SBP, as defined above.9 Now that we might

have identified a new subpopulation of patients with cirrhosis at high risk for both SBP and death, this clearly sets the stage for a prospective study of primary prophylaxis FK506 of SBP to see whether long-term survival can be further improved in genetically defined at-risk patients. The authors thank all patients for participating in this study and providing blood samples, and Stephanie Schwartz and Hildegard Keppeler for excellent technical

assistance. Contributions: B.A. and F.G. contributed equally to data acquisition and analysis. M.G. and L.T. helped in study design, collected data and recruited patients as part of their doctoral theses. T.S. and F.L. were responsible for study concept, design, and supervision. B.A. and F.G. drafted the article, which was edited by T.S. and F.L. This study was presented in part as Presidential Poster of Distinction at the Annual Meeting of the American Association for the Study of Liver Diseases (AASLD), San Francisco, November 4, 2008, and published in abstract form (HEPATOLOGY 2008;48:A1676). Additional Supporting Information may be found in the online version of this article. “
“Background and Aim:  Data on prevalence, human MCE leukocyte antigen (HLA) typing and small bowel histology among first-degree relatives of subjects with celiac disease (CD) is scarce. This prospective study evaluated the

prevalence and role of HLA DQ2/8 testing in screening of first-degree relatives of children with CD. Methods:  Thirty confirmed children with CD and 91/94 first-degree relatives (parents and siblings) were enrolled. HLA DQ2/8 testing was carried out in all index CD cases. Clinical evaluation with a questionnaire, total serum immunoglobulin A (IgA), human IgA-tissue transglutaminase (IgA-tTGA) and HLA DQ2/8 testing was carried out in all first-degree relatives. Subjects who were positive for IgA-tTGA were recommended endoscopic duodenal biopsy to document histological changes of CD. Results:  Nine first-degree relatives were positive for IgA-tTGA, seven underwent duodenal biopsy and four subjects had Marsh IIIa changes suggestive of CD.