Prevalence and Risk Factors of Hepatitis B Virus Infection in a Private Tertiary Care Hospital in Kashmir: A Cross-sectional Study

Mortality among hemodialysis patients in Europe, Japan, and the United States: Case-mix effects

The incidence of hepatitis B virus (HBV) infection in dialysis populations has declined over recent decades, largely because of improvements in infection control and widespread implementation of HBV vaccination. Regardless, outbreaks of infection continue to occur in dialysis units, and prevalence rates remain unacceptably high. For a variety of reasons, dialysis patients are at increased risk of acquiring HBV. They also demonstrate different disease manifestations compared with healthy individuals and are more likely to progress to chronic carriage. This paper will review the epidemiology, modes of transmission and diagnosis of HBV in this population. Prevention and treatment will be discussed, with a specific focus on strategies to improve vaccination response, new therapeutic options and selection of patients for therapy.

Epidemiology of hepatitis B in Europe and worldwide.

Introduction: Drug addiction one of the greatest challenges face across the glob. The parenterally transmitted viruses like Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) occur more frequently in this high-risk group of population as compared with the general population. Aim: To find the prevalence of HBV, HCV and HIV in People Who Inject Drugs (PWIDs) attending a tertiary care hospital in Kashmir valley, India. Materials and Methods: A prospective descriptional study was conducted from October 2017 to October 2020 in the Department of Microbiology of a tertiary care hospital in Kashmir. Subjects included 200 (PWIDs) who voluntarily presented themselves at the drug clinic. Participants were tested for HBV, HCV and HIV infections. For HBV, surface antigen was detected using Enzyme-linked Immunosorbent Assay (ELISA), HCV was detected by HCV antibody test using ELISA and HIV was detected using combination of three rapid kits, COMBAIDS-RS ADVANTAGE ST, MERISCREEN HIV 1-2 WB and TREDRO HIV 1-2 Ab. Demographic data was collected from all the PWIDs. Results: Among 200 PWIDs,138 (69%) were in the age group of 16-25 years and none of them was more than 35 years of age. The mean age of PWIDs was 22.9 years. Out of 200, 20(10%) PWIDS had HCV antibodies, 7 (3.5%) were positive for HBV, and 1 (0.5%) had anti-HIV antibodies. A 73.5% of PWIDs belonged to urban Kashmir and majority of them (62.5%) were college going students. Conclusion: From present study, authors report a high prevalence of hepatitis C and B in PWIDs of Kashmir. It is also the fact that these figures are just the tip of the iceberg. Targeted intervention programs should make HBV/HCV testing, prevention and care more accessible for PWIDs.

Background: Neonatal sepsis refers to generalized bacterial blood stream infection in first 28 days of life documented by positive blood cultures. It is one of leading causes of neonatal mortality. Objectives was to study clinicobacteriological, antibiotic sensitivity patterns and mortality of neonatal sepsis.Methods: This prospective study was conducted in the Department of Pediatrics of Government Medical College Srinagar in collaboration with Department of Microbiology of same medical college after ethical clearance from ethical committee of Government Medical College Srinagar. One hundred (100) neonates out of 731 neonates admitted between octomber2007 and September 2008 with signs and symptoms of neonatal sepsis were included in our study by random sampling method. After history, examination and laboratory investigation blood culture results were analyzed by standard statistical methods.Results: The blood culture was positive in 40% of neonates. Fifty one (51) neonates were males while as 49 were females. Sixty three (63) neonates had late onset of sepsis while as 37 had early onset sepsis. The positive blood culture was more common in males, late onset sepsis, babies born in rural areas, home born, vaginal births, preterm and other low birth weight neonates .The gram negative isolates were most common followed by positive ones .The best sensitivity of gram negative isolates was to ciprofloxacin followed by amikacin and cephalosporins while as gram positive isolates were sensitive to imipenum followed by vancomycin. Pseudomonas was most responsive to pipercillin +tazobactum combination. The neonatal mortality was 35% being higher in early onset sepsis and low birth weights.Conclusions: This study depicts a high rate of neonatal sepsis, mainly caused by gram negative organisms followed by gram positive organisms with rising drug resistance that could bear far reaching implications to the times to come, mandating the implementation of sepsis preventive measures and administration of specific antibiotics.

Background: Acute kidney injury (AKI) is a common entity in neonates admitted to the neonatal intensive care unit (NICU). Neonatal AKI is associated with increased morbidity and mortality and a greater risk of chronic kidney disease among the affected ones in future. Objectives: The objectives of this study were to study the incidence and outcome of neonatal AKI in our NICU. Materials and Methods: This single-center retrospective study included all infants who were admitted in a tertiary care hospital, J and K, from June 2013 to May 2014. Neonates, who had known congenital kidney diseases or if they did not survive beyond the first 48 h of life or had a hospital stay for <24 h, were excluded from the study. AKI was defined according to the kidney disease: Improving global outcomes criteria. Both AKI and non-AKI neonates were followed up until NICU discharge. Outcomes studied included mortality and length of NICU stay. Results: A total of 1439 neonates were studied among whom 72.89% (1049/1439) were normal weight, 11.46% (165/1439) were low birth weight, and 15.63% (225/1439) were very low birth weight. Of 1436 studied, 72% (1036) were term babies and 28% (403) were preterm babies. Perinatal asphyxia accounted for 43% (620/1439), seconded by neonatal sepsis 31.6% (455/1439) as a cause of NICU admission. Incidence of neonatal AKI in our study was 8.33% (120/1439). Mortality rate among the neonatal AKI patients was 34.1% (41/120). Conclusion: Our study shows an incidence of 8.3% among the NICU patients with a high mortality rate of 34.1%, implying a heightened awareness and very close monitoring of renal function during hospitalization and after discharge in such infants.

Background: Coronavirus disease 2019 (COVID-19) emerged as a life-threatening respiratory condition, especially in immunocompromised patients, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Initially detected in China in December 2019, the first case in India was diagnosed on January 30, 2020. Here we report a nosocomial COVID-19 outbreak among cancer patients and healthcare workers (HCWs) in a medical oncology unit of a tertiary care hospital from our region.Materials and methods: This was a descriptive study of the nosocomial COVID-19 outbreak and was conducted in the month of January 2022 at the medical oncology unit of a tertiary care hospital in Srinagar, Jammu and Kashmir (J&K), India. The study included 25 COVID-19 cases, including patients and HC/non-HCWs (NHCWs). The confirmation of diagnosis was done through real-time polymerase chain reaction (RT-PCR) using nasopharyngeal/oropharyngeal swabs as the test sample.Results: Twenty-five COVID-19 cases, including 14 admitted patients, nine HCWs, and two NHCWs were confirmed by COVID-19 RT-PCR in a span of 11 days. The first case was a positive HCW. The patients were admitted for management of various hematological as well as solid organ malignancies. Of the 14 patients, eight were in the pediatric age group with a mean age of 6.9 years, and six were adults with a mean age of 55.2 years. Thirteen patients were on different chemotherapy protocols, and one was undergoing an autologous stem cell transplant. Of the 14 patients, four were asymptomatic for COVID-19 symptoms, eight had mild disease, and two had severe disease with respiratory failure. Two patients with severe diseases needed COVID-19-designated high-dependency unit (HDU) admission. There was one COVID-19-related death. Among the healthcare workers, the mean age was 33.8 years, of which six were males and three were females. All the HCWs and NHCWs had mild disease, and all of them recovered completely.Conclusion: Nosocomial COVID-19 illness is a new entity and is preventable. COVID-19 illness will remain in society after the pandemic is over, like the influenza B viral illness, and there can be seasonal flares in the future. Proper measures should be taken to prevent its clustering in hospital settings.

Natural history of chronic hepatitis B in Euro-Mediterranean and African Countries

Hepatitis B Virus (HBV) infection is one of the most infectious diseases globally. Nigeria is among the endemic countries for HBV, with a National prevalence of 11%. The Primary Healthcare Center (PHC) is critical for interrupting the transmission of HBV infection. Consequently, the baseline information concerning the prevalence, associated risk factors, and vaccination status of the health workers for HBV is required for the system strengthening, hence, the need for this study. To determine the prevalence of HBV among health workers in PHCs in AMAC, Abuja. 2. To identify the risk factors associated with HBV infection amongst this cohort. A hospital-based cross-sectional descriptive study involving 168 randomly selected PHC health workers. Data was collected with a structured questionnaire, and participants were screened for HBsAg. Data were analyzed using SPSS version 21.0 with results significant at p-value < 0.05. 168 respondents participated in the study, 65.5% were females, and the mean age was 34 +/- 9 years. The full vaccination rate was 44%, while the prevalence of HBV infection was 4.8%. The history of dental procedure was the only significant predictor of HBV infection, and those who had the dental procedure were thrice more likely to be infected with HBV than their counterparts (OR: 3.077). The prevalence of HBV in this study is low, per, National prevalence, but high for this cohort of health workers with a considerable Hepatitis B vaccination rate. There is a need to strengthen health workers' HBV screening and vaccination in addition to improving infection prevention and control in dental clinics/surgeries. Keywords: HBV Infection, Health-worker, Primary Healthcare Center, Prevalence, Risk Factors.

Background and study aim:: Viral hepatitis is a serious global public health problem affecting billions of people globally, and both hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are rapidly spreading in the developing countries including Egypt due to the lack of health education, poverty, and and illiteracy. So this study was conducted to determine the prevalence of HCV antibodies and HBsAg and possible risk factors of transmission of these infections among workers of Zagazig Faculty of medicine and its hospitals. Patients and methods: This study was conducted on two hundred workers (non medicals) All were randomly selected from all clinical and academic Departments of Zagazig Faculty of Medicine and its Hospitals. Their age was above 18 years and up to 60 years. Possible associated factors with infections by the viruses were collected from patient using questionnaire Rapid diagnostic test kits were used to screen for Hepatitis B surface antigen (HBsAg) and anti-Hepatitis C virus (HCV) antibodies. Results :Out of two hundred 39 (19.5%)of workers had Hepatitis C virus (HCV) antibodies and 7 (3.5%) of workers had Hepatitis B surface antigen and one worker 1 ((0.5%). had dual hepatitis B and C virus coinfection . The prevalence of chronic HCV and HBV is higher among males (20.2% and 4% respectively ) than females (17.3% and 1.92% ) and both HBsAg and HCV Abs was ( 0.7)% in males and negative in females. The prevelance of HCV Abs was high among workers with past history of barbering (69.23%) while prevalence of HBV was high in workers with a history of blood transfusion (28.57%).Multivariate regression was used to estimate independent effects of risk factors on seropositivity of both virsus . A highly significant association was found between workers with history barbering (OR 4.58 ) and those with seroposiotivity of HCV abs. While there was no significant association between workers with a history of dental procedure(OR 1.44), operation (OR 1.2) and blood transfusion(OR 1.5) and those with acquired seropositivity of HCVAbs. And a highly significant association was found between workers with history of blood transfusion and those with acquired seropositivity of HBV ( OR 8.18), while there was no significant association between workers with a history of dental procedure(OR 0.2), barbering(OR 0.59) and operation (OR 0.63) and those with acquired seropositivity of HBs. Conclusion : We can conclude that he prevalence of HBV and HCV infections among workers of Zagazig Faculty of Medicine and its hospitals in this study is high . Barbering has 4 times risk of HCV infection and blood transfusion has 8 times HBV infection. and working in operation units was associated with increase the risk of HBV and HCV infections, but working in other units like surgical and non surgical , administration and ICU was associated with increase HCV transmission. For prevention the spread of HBV and HCV, people must be educated about these infections and modes of transmission , better infection control practices in hospitals, healthcare and barbering facilities.

Hepatitis B virus (HBV) is the leading cause of cirrhosis and hepatocellular carcinoma all over the world. Its prevalence varies greatly from one country to another and reaches 25% in certain parts of Africa and Asia and less than 1% in Europe and America. A variety of risk factors have been found to be responsible for the high prevalence of HBV. In Western societies parenteral drug abuse and homosexuality were found to be the main routes of spread throughout the community while in Oriental countries perinatal transmission from infected mothers is the main route. Other risk factors for HBV infection have been defined in the hospital setting. (excerpt)

High prevalences of hepatitis B and C virus infections among adults living in Binh Thuan province, Vietnam.

Low frequency of occult hepatitis B infection in anti-HBc seropositive blood donors: experience from a tertiary care centre in South India.

Hepatitis viruses and human immunodeficiency virus co-infection: pathogenisis and treatment

BackgroundPeople with severe mental disorders (SMDs) are associated with increased risk of infectious disease including human immunodeficiency virus infection (HIV) and hepatitis viruses, such as hepatitis B virus (HBV), hepatitis C virus (HCV), and other types of hepatitis viruses because of high-risk behaviors compared to the general population. The prevalence of HIV in people with SMDs is higher in females than in males. Unlike HIV, the prevalence of HBV and HCV is higher in males than in females. This study aimed to carry out a systematic review and meta-analysis to determine the prevalence and estimated gender difference in the risk of HIV, HBV, and HCV in people with SMD.MethodsLiterature search was performed using the electronic databases PubMed, EMBASE, and Scopus. Publications were screened according to predefined inclusion criteria. A qualitative and quantitative analysis was undertaken for this systematic review. Eighteen materials published from 1993 to 2017 were included in the qualitative and quantitative analysis. Random-effect model was used to calculate weighted prevalence, odds ratio (OR), and corresponding 95% confidence interval (CI).Results12,290 citations were identified and 18 articles including 11,175 participants were included. The results of our meta-analysis show that the prevalence of HIV, HBV, and HCV in people with SMD was 7.59% (95% CI 4.82–11.75), 15.63% (95% CI 7.19–30.69), and 7.21% (95% CI 4.44–11.50), respectively. The prevalence of HIV was higher in women (8.25%) than men (7.04%), but the prevalence of HBV and HCV was higher in men than women (18.91% versus 12.02% and 9.16% versus 5.43% for HBV and HCV in men versus women, respectively). A meta-analysis of included studies demonstrated a significantly increased risk of HBV (OR 1.72; 95% CI 1.17–2.53) and HCV (OR 2.01; 95% CI 1.16–3.20) infections in men compared to women in people with SMD. However, no significant association was observed between gender and HIV. The funnel plot and Egger’s regression tests provided no evidence of substantial publication bias in the prevalence and gender difference in association for HIV, HBV, and HCV in people with SMD.ConclusionsIn our review, the prevalence of HIV, HBV, and HCV was high. The prevalence of HBV is significantly higher than HIV and HCV. There was a significantly increased risk of HBV and HCV infections in men compared to women. No significant association was observed between gender and HIV. People with SMDs warrant greater emphasis in efforts to identify and treat HIV, HBV and HCV.