Generation Enzyme-linked Immunosorbent Assay Research Articles

Molecular and Immunological Detection of Hepatitis C Virus in Patients with Chronic Renal Failure

Due to its association with hepatocellular carcinoma and being one of the ten most common malignancies worldwide, hepatitis C viral infection has become a severe public health concern. Therefore, establishing an accurate, reliable and sensitive diagnostic test for this infection is strongly advised. Real-time polymerase chain reaction (PCR) has been created to achieve this purpose. The current study was established to investigate the hepatitis C virus among Iraqi patients with chronic renal failure and to detect the virus immunologically by the fourth generation enzyme-linked immunosorbent assay technique and molecularly by real-time PCR. As a result, out of 50 patients with chronic renal failure undergoing dialysis, 39 patients tested positive for anti-HCV IgG by ELISA test and only 9 patients of the total count tested positive and showed growth curves with copy numbers of 1×102, 2.5×102, 3×102, 2.7×103, 2.7×103, 3.5×103, 8.7×104, 3.5×105 and 5.5×106 copies/ml respectively detected for HCV only by real-time PCR. Therefore, real-time PCR is beneficial for precise viral load determination and detection of viral hepatitis in chronic renal failure patients.

Hepatitis B & C Among Patients of Non-Hodgkin’s Lymphoma and its Association with Pathological Factors

Objective: To see the frequency of hepatitis B and C virus among patients presenting with non-Hodgkin’s lymphoma and to see its association with pathological factors in Pakistani population. Study Design: Cross sectional study. Place and Duration of the study: Department of Medical oncology, Jinnah Postgraduate Medical Center, Karachi Pakistan, from Jan 2019 to Jan 2020. Methodology: Total 251 patients of age more than 15 years of either gender with proven diagnosis of non-Hodgkin’s Lymphoma were enrolled in the study. The sample of blood (15 ml) of each participants was taken and sent to laboratory for detection of virus. The HBsAg and HCV antibodies were detected using 3rd generation Enzyme-Linked Immunosorbent Assay (ELISA). The cut-off set for HBsAg as 2.0 and for HCV as 1.0 in the laboratory, respectively. The information regarding socio-demographics, comorbidities, risk factors and clinicopathological features were noted on pre-designed proforma. Results: Out of 251 patients with non-Hodgkin’s Lymphoma, 8.8% had hepatitis and 4% had hepatitis B No statistically significant association was found for prevalence of hepatitis B and C with respect to stage (p=0.791 and 0.299), histological type (p=0.165 and 0.398), bone marrow involvement (p=0.692 and 0.163) and site of tumor (p=0.067 and 0.116). Conclusion: The substantial proportion of hepatitis B and C in the current study provides epidemiological evidence that such infection may play a role in NHL growth.

Mortality prediction by prognostic scoring in Hepatitis C- associated or non- associated cirrhotic patients

Objectives: Hepatitis C virus (HCV) is a hepatotropic virus that is one of the most common causes of liver disease and a potential cause of substantial morbidity and mortality worldwide. There is a paucity of data on the etiological profile of cirrhosis with HCV association in western Uttar Pradesh. Methodology: The observational type of study was carried out from June 2021 to May 2022 on patients attending in Medicine department at Lala Lajpat Rai Memorable Medical College, Meerut in collaboration with the Microbiology Department at National Capital Region Institute of Medical Sciences, Meerut, Uttar Pradesh, India. We included 247 patients who were diagnosed with cirrhosis, informed consent was taken with a 5 ml blood sample collected from each patient. The sample was screened for the qualitative detection of HCV-specific antibodies using 3rd generation Enzyme-linked immunosorbent assay (ELISA) from all the participants and Scored by the MELD score system. Result: A total of 247 confirmed cirrhosis patient’s, 52 (21%), patients were positive with the association of HCV in the age group of 41-60 and the mean age was 50 years. The 31 (59.6%) were males, and 21 (40.3%) were females positive for HCV in the low-status family.

Nucleic Acid Test versus Enzyme Linked Section Immunosorbent Assay for Screening of Human Immunodeficiency Virus in Donated Blood Units: A Comparative Study at a Blood Centre in Western Rajasthan, India

Introduction: With a population of 1.3 billion people and a frequency of Human Immunodeficiency Virus (HIV) (0.17-0.29%), Hepatitis B Virus (3-4%), and Hepatitis C Virus (0.09-15%) in the general population, maintaining blood safety is a difficult undertaking in India. The fourth-generation Enzyme Linked Immunosorbent Assay (ELISA), which can be used in place of Nucleic Acid Amplification Test (NAT) testing in situations with limited resources, has been recommended as the minimal HIV test to increase the safety of blood transfusions. Aim: To compare the fourth generation ELISA with NAT in the screening of transfusion transmissible HIV infection in blood donors. Materials and Methods: A cross-sectional study was carried out at the Blood Centre, Department of Immuno-Haematology and Transfusion Medicine, Sardar Patel Medical College and Associated Groups of Hospitals, in Bikaner, Rajasthan, India. A total of 2000 voluntary and replacement blood donors were recruited consecutively between January 2020 to December 2021 (two years), and their samples were screened using fourthgeneration ELISA. All of these samples were sent to AIIMS in Jodhpur for NAT to identify HIV RNA, HCV RNA and HBV DNA. Results: In this study, when the fourth generation ELISA negative samples were subjected to NAT, no sample was found to be reactive for HIV in NAT, i.e. there was no NAT yield for HIV. Conclusion: As a bare minimum, the fourth-generation ELISA test should be used for blood donor screening and can be considered a cost-effective and reliable test in a resource limited setting. However, additional tests can be advocated for an additional layer of blood safety.

Comparative Evaluation of Three Diagnostic Tools for the Detection of Hepatitis C Virus among High-risk Individuals in a Tertiary Care Centre of Northeast India

Introduction: Hepatitis C virus (HCV) has posed a major public health problem globally. Since majority of HCV infected patients are asymptomatic, diagnosis of HCV infection is mainly based on the detection of anti-HCV antibodies by the Enzyme Linked Immunosorbent Assay (ELISA) or Rapid Diagnostic Tests (RDTs) and HCV Ribonucleic Acid (RNA) by real time Polymerase Chain Reaction (PCR) of serum or plasma samples. Aim: To assess the performance of RDT and 4th generation ELISA against real time reverse transcriptase PCR for the detection of HCV. Materials and Methods: A hospital-based cross-sectional study was carried out in the Virology Section, Department of Microbiology, Jawaharlal Nehru Institute of Medical Sciences (JNIMS), Imphal, Manipur, India, for a period of two years from June 2019 to May 2021. The study included 3,254 plasma samples from suspected cases of HCV monoinfection, and HCV/HIV co-infection. The plasma samples were subjected to anti-HCV antibodies by RDT (SD BIOLINE, South Korea) and 4th generation ELISA (Monolisa™ HCV Ag-Ab ULTRA, BioRad, France), and HCV RNA by real time PCR. Data analysis was done using descriptive statistics, and performance of the assays was evaluated by using Cohen kappa test (κ) and Receiver Operating Characteristic (ROC) curve. Results: PCR is considered as the gold standard test. HCV was detected by RDT in 453 (13.92%), ELISA in 413 (12.69%) and RT-PCR in 367 (11.28%) samples. The present study demonstrated sensitivity of 97.55% and specificity of 96.71% with Positive Predictive Value (PPV) of 79.03% by HCV-RDT. The 4th generation ELISA showed high sensitivity of 99.46% and specificity of 98.34%. Using ROC curve, the area under the curve was 81% for ELISA with diagnostic accuracy of 98.46%. Conclusion: 4th generation ELISA is more sensitive and specific than RDT for the detection of HCV infection. Confirmatory HCV-RNA assay could be performed to clear doubts related to false-positive and false-negative findings of the primary screening assays.

Prevalence and Risk Factors of Hepatitis C Virus Infection Among High-risk Egyptian Children

Objective: The present study aimed to evaluate the prevalence of HCV among high-risk Egyptian children. Background: Hepatitis C virus (HCV) infection is a global health problem. Children with certain risk factors are at high risk of infection. Methods: The study included 1357 children. aged 3-15 years with risk factors of HCV including receiving blood products, hemodialysis, previous surgical intervention, insulin therapy and positive family history. They were subjected to careful history taking, thorough clinical examination and routine laboratory investigations. All children were tested for HCV antibodies using commercial 4th generation enzyme-linked immunosorbent assay (ELISA) kits. Those with positive results were further assessed using polymerase chain reaction (PCR). Results: Among the studied patients, there were 89 children (6.6 %) with positive HCV Ab and 73 children (5.4 %) with positive PCR test for HCV. Using multivariate logistic regression, significant predictors of HCV infection in the studied children were blood transfusion (OR:1.23, CI: 0.019-13.4), IV injection (OR:10.962, CI: 1.937-62.026) and previous operation (OR: 3.12, CI:1.046-31.6). Conclusion: HCV infection is highly prevalent among high-risk children. Blood transfusion, IV injection and exposure to surgery are independent risk factors for infection in this population

Seroepidemiology and associated risk factors of hepatitis B and C virus infections among pregnant women attending maternity wards at two hospitals in Swabi, Khyber Pakhtunkhwa, Pakistan.

Hepatitis B and C infections are global issues that are associated with a massive financial burden in developing countries where vertical transmission is the major mode and remains high. This cross-sectional study was designed to investigate the seroepidemiology and associated risk factors of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among 375 pregnant women attending antenatal care health facilities at Bacha Khan Medical Complex (BKMC) Shahmansoor and District Head Quarter (DHQ) Hospital Swabi, Khyber Pakhtunkhwa, Pakistan. From a total of 375 pregnant women selected using systematic random sampling from both hospitals, 10 ml of blood samples were collected and alienated serum was examined for indicators identification through the Immuno-Chromatographic Test (ICT) and 3rd Generation Enzyme-Linked Immunosorbent Assay (ELISA). A pre-structured questionnaire was used to collect the socio-demographic data and possible risk factors. The data was analyzed via SPSS 23.0 statistical software. A chi-square analysis was performed to determine the association between variables. P-value < 0.05 was set statistically significant. The overall frequency of HBV and HCV among 375 pregnant women involved in the study was 3.7% and 2.1% respectively. None of the pregnant women were co-infected with HBV and HCV. Dental extraction (P = 0.001) and blood transfusion (P = 0.0005) were significantly allied with HBV infection while surgical procedure (P = 0.0001) was significantly associated with HCV infection. Moreover the sociodemographic characteristics: residential status (P = 0.017) and educational level (P = 0.048) were found significant risk factors of HBsAg and maternal age (P = 0.033) of anti-HCV, respectively. HBV and HCV infections are intermediary endemic in the study area. A higher prevalence of HBV was detected among pregnant mothers with a history of dental extraction, history of blood transfusion, resident to the urban area and low educational level. The age and surgical procedures were the potential risk factors found significantly associated with HCV positivity among pregnant mothers in our setup. Future negotiations to control vertical transmission should include routine antenatal screening for these infections early in pregnancy and the requirement of efficient preventive tools including the birth dose of the hepatitis B vaccine in combination with hepatitis B immune globulins to the neonate.

English

BACKGROUND Blood transfusion is a common life-saving medical procedure, but it may cause acute and delayed complications. A transfusion transmissible infection (TTI) is any infection that is transmissible from person-to-person through parenteral administration of blood or blood products i.e. packed red blood cells (RBC), platelets, plasma and other blood products. This study was undertaken to assess the prevalence of transfusion transmissible infections among blood donors in blood bank connected to a tertiary care hospital in Kerala and evaluate the safety of the blood donations. METHODS Samples of 13,262 donors from January to June 2018 were taken. All the donors who were accepted for donation as per criteria by national acquired immunodeficiency syndrome (AIDS) control society were included in the study. Consent was obtained from blood donors to conduct testing for transfusion transmitted diseases. Donors were screened by 4th generation enzyme linked immuno sorbent assay (ELISA) test kits for HIV-1/2, 3rd generation ELISA test kits for HBsAg and hepatitis C virus (HCV), rapid immunochromatographic test for malaria and rapid plasma reagin (RPR) test for syphilis. Tests were performed as per manufacturer instructions. All the reactive samples were discarded as per the guidelines. RESULTS Among 13,262 donors, 13,014 (98.12 %) were males and 248 (1.8%) were females within the age group of 18 - 60 years. Out of these, 7 (0.052%) donors were HBsAg positive and 3 (0.02%) were HIV positive. RPR reactivity was seen in 2 donors (0.01%) only. None of the blood donors tested showed positivity for HCV or malarial parasite. In this study, prevalence of hepatitis B was highest (0.052) followed by HIV (0.02%) and syphilis (0.02%). CONCLUSIONS Hepatitis B virus (HBV) is the most common transfusion transmissible infection among apparently healthy donors, followed by HIV and syphilis. TTI’s can be eliminated or reduced by implementing an integrated strategy for blood safety, like effective selection of blood donors, avoiding unnecessary transfusions, and early detection of TTIs. KEYWORDS Transfusion-Transmitted Infections, HIV, HBV, HCV

Screening of Human Immunodeficiency Virus (HIV) among Newly Diagnosed Tuberculosis Patients in Eastern Sudan.

Tuberculosis (TB) is a leading cause of death in patients infected with Human Immunodeficiency Virus (HIV), and HIV infection is the most potent risk factor for the development of active TB disease from a latent TB infection. This study aims to determine the seroprevalence of HIV among newly diagnosed TB patients in Kassala state eastern Sudan. This was a descriptive, hospital-based, cross-sectional study of 251 active and newly diagnosed TB patients, selected by simple random sampling. Blood samples and demographic data were collected from each patient. TB was diagnosed by direct ZN smear and molecular detection by Xpert MTB/RIF. The serum samples were tested for HIV using 4th generation enzyme-linked immunosorbent assay (ELISA). The prevalence of HIV was 13.9% (35/251), the infection rate among pulmonary TB was 17%, whereas that in extrapulmonary TB was 4.8%, the prevalence was (18.2%) in the males, and (7.2%) in the females. In conclusion: TB/HIV co-infection in the Eastern part of Sudan was high compared with the global prevalence, all TB patients should therefore be assessed for HIV risk factors and advised to undergo HIV testing.

Anti-HIV-1 antibodies based confirmatory results in Wuhan, China, 2012-2018.

The number, intensity and order of emergence of HIV-1 specific antibodies in serum or plasma were associated with the stage of HIV-1 infection. In this study, we retrospectively analyzed the HIV-1 confirmatory results tested by western blot (WB) or recombination immunoblot assay (RIBA) in Wuhan, 2012–2018, to access the profiles of HIV-1 specific antibodies. A total of 14432 HIV-suspected serum or plasma samples collected from local hospitals and other HIV screening laboratories were further screened by two 4th generation enzyme-linked immunosorbent assay (ELISA) kits in our laboratory, of which 11068 specimens (76.69%) had at least one positive ELISA result and thereby were finally confirmed with WB or RIBA. RIBA had identified 652 (81.09%) positive and 13 (1.62%) indeterminate cases from July 1, 2014 to January 7, 2015, while WB had identified 8358 (81.43%) positive and 643 (6.26%) indeterminate cases in the other times during 2012–2018. The indeterminate rate of WB was significant higher than that of RIBA (p<0.001). Although the number of HIV-1 infected subjects increased significantly from 2012 (n = 911) to 2018 (n = 1578), the positive rate of HIV-1 antibodies decreased markedly from 70.08% in 2012 to 58.79% in 2018 (p<0.001). The most commonly observed antibody profile was gp160+gp120+p66+(p55+)p51+gp41+p31+p24+p17+ (4131, 49.43%) for WB-MP and gp160+gp120+gp41+p31+p24+p17+ (382, 58.59%) for RIBA-WANTAI, and the absence of reactivity to three possible serologic markers for recent HIV-1 infection, p31, p66, and p51, increased significantly from 2012 to 2018, with the overall rate of 17.03%, 9.40%, and 15.15%, respectively. The suspected acute HIV-1 infection was also observed to be increased in recent years, with an overall rate of 1.00%. Our results indicated the detection rate had decreased for HIV-1 infection, but increased for suspected recent and acute HIV-1 infection during 2012–2018, reflecting the efforts of intervention among high risk population.

A comparative study on fourth generation ELISA and rapid assay for diagnosing HIV infection in the high risk group

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Enzyme linked immunosorbent assay (ELISA) is a widely employed method for detecting HIV. Following its successful detection of HIV, the fourth generation ELISA was approved by FDA. The advantage of the FDA approved fourth generation ELISA is it detects p24 antigen, HIV 1&amp;amp;2 antibodies simultaneously and that too 5-7 days prior to conventional tests so that it detects HIV seroconversion earlier reducing its further spread.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The study was conducted in a tertiary level medical centre after obtaining ethical approval. 200 patients from high risk group and their contacts were selected after a thorough physical examination and tests were done using fourth generation ELISA and rapid assay and these results were compared.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; As per our observations, the percentage of patients tested positive by fourth generation ELISA out of 200 subjects was 37% and negative was 63%. The detection rate of HIV positivity by rapid assay in high risk group was 11% and negative was 89%. The detection rate was also higher with fourth generation ELISA when various other parameters were compared.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; In this study, the percentage of HIV positivity detected by fourth generation ELISA was higher than that detected by rapid assay showing that fourth generation ELISA is a more sensitive test than rapid assay as well as a better diagnostic modality to opt for when coming to early detection in HIV. &lt;/p&gt;

Human papillomavirus in pregnant women at Bowen University Teaching Hospital, Ogbomoso, Nigeria

ABSTRACTBackground: Trans-placental transmission of human papillomavirus infection during pregnancy and burden of cervical cancer is increasing in Nigeria. However, studies on the prevalence of HPV among pregnant women are limited in Ogbomoso.Materials and Methods: A total of 93 pregnant women attending the antenatal clinic of Bowen University Teaching hospital in the age range 20–45 years consented for the study. All sera were tested for the presence of IgM antibodies against HPV using a third generation Enzyme-Linked Immunosorbent Assay. Chi-square test was used to assess the association between the socio-demographic variables and HPV status. Statistical significance was set at P ≤ 0.05.Results: The overall seroprevalence of HPV was 5.38% (5/93). The mean age of the study participants was 30.62 ± 5.03 years. The highest prevalence was recorded among the age group 26–35 (6.3%; 4/64) years while the least was recorded among the age group 20–25 (6.7%; 1/15) years. None of the socio-demographic characteristics and potential risk factor considered had statistically significant association with HPV infection (P ˃ 0.05).Conclusion: Awareness and screening of pregnant women should be strengthened among health stakeholders for proper management.

A ten-year trend of human immunodeficiency virus infection in voluntary blood donors in the South Backa district of Vojvodina

Introduction. The first cases of human immunodeficiency virus infection and the first transmission of human immunodeficiency virus infection through blood transfusion in Vojvodina were registered in 1985. The aims of this study were to determine the ten-year trend of human immunodeficiency virus infection among blood donors in South Backa District of Vojvodina, routes of transmission and risk factors. Material and Methods. A retrospective study was conducted at the Blood Transfusion Institute of Vojvodina during 2009 - 2018, and human immunodeficijenca antigens and antibodies were analyzed. A total of 300 936 blood donor samples were screened using combined antibody-antigen tests (fourth generation enzyme-linked immunosorbent assay and chemiluminescence). Further testing included confirmatory immunoblot assay and molecular assay. Results. The overall human immunodeficiency virus seroprevalence was 3.7 per 100 000 donations. The number of blood donors found to be human immunodeficiency virus positive has increased during the study period showing a positive trend. The highest number of human immunodeficiency virus positive results was reported among blood donors aged 26-35 (36%) and 46-55 years (27%). The infection was more frequent in males. The leading rout of transmission was through unprotected sexual intercourse. Higher human immunodeficiency virus prevalence was among regular blood donors (73%). Conclusion. This study points to the importance of careful selection of blood donors and their education about risk behavior in order to reduce the risk of human immunodeficiency virus transmission. Concomitant use of sensitive serological and molecular tests is crucial to increase the blood safety.

Humoral response to John Cunningham virus during pregnancy in multiple sclerosis

BackgroundPregnancy induces an immunosuppressive state in the mother to ensure immunological acceptance of the foetus. Impairment of cell-mediated immune responses may render the mother susceptible to intracellular pathogens. It is not presently known whether pregnancy alters the immunosurveillance for John Cunningham virus (JCV), an opportunistic pathogen associated with natalizumab treatment for multiple sclerosis (MS). ObjectiveTo evaluate whether the humoral immune response to JCV is altered during pregnancy among MS patients and healthy controls to get insight to potential pregnancy-induced alterations related to immune response to JCV during pregnancy. MethodsSerum anti-JCV-antibody-indices (JCV-Ab-index) were determined by a two-step second–generation enzyme-linked immunosorbent assay in 49 MS patients during and after pregnancy and in 49 healthy controls during pregnancy. For comparison, total IgG levels and antibodies against Epstein-Barr, cytomegalo and measles viruses were similarly measured. ResultsThe JCV-Ab-indices of MS patients were not altered during the pregnancy (1st vs. 3rd trimester, 0.62 vs. 0.77, p = 0.99). Contrary to this, in the healthy controls JCV-Ab-indices (p = 0.005), antibody levels to the other viruses, and total IgG levels (p < 0.0001) decreased significantly during pregnancy. ConclusionsJCV-Ab levels remain unaltered during MS pregnancy, while the total IgG concentration is reduced/diluted due to increasing plasma volumes during the course of pregnancy. This may imply a biologically significant alteration in the immune response to JCV during MS pregnancy.

PREVALENCE OF HEPATITIS B VIRUS AND ASSOCIATED RISK FACTORS IN IRULA TRIBAL POPULATION

Objective: The study is to analyze the prevalence of infections caused by hepatitis B virus (HBV), and to analyze of risk factors for hepatitis B surface antigen (HBsAg) transmission among the Irula tribes of Tamil Nadu.Methods: Serum samples were collected from 350 participants of Irula tribes from 15 different locations of Tamil Nadu. All serum samples were tested for serological markers of HBV (HBsAg) by 3rd generation enzyme-linked immunosorbent assay kit, and the data were subjected to analyze using SPSS (version 17.0) and Chi-square test to determine the risk factors of HBV among Irula tribes.Results: In the study, HBsAg positivity was observed in a higher percentage in males 10 (8.47%) than females 9 (3.54%) and their all age groups indicate the high prevalence of HBV infection in Irula tribes. Analysis of risk factors showed that jaundice in family (JF), tattooing, series of injection, sexual promiscuity, and surgery with blood transfusion plays a major role in transmission in spread of HBV.Conclusion: Hepatitis B is a major health problem in Irula tribes and needs to design intervention strategies among Irula tribal population.

Seroprevalence and risk factors of hepatitis B virus among blood donors in district Charsadda Khyber Pakhtunkhwa Pakistan

Hepatitis B Virus (HBV) is a serious worldwide public health issue both in underdeveloped and developed countries. About two billion individuals were infected by HBV globally, of which 400 million were chronic HBV carrier. The aim of this retrospective study was to investigate the seroprevalence and some possible risk factors of hepatitis B virus infection among male blood donors in district Charsadda, Khyber Pakhtunkhwa Pakistan. A total of 460 male blood donors with age range 15-55 years were screened for HBsAg by Immunochromatographic technique (ICT) and 3rd generation enzyme-linked immunosorbent assay (ELISA). Out of 460 samples, 11(2.39%) were found positive for HBsAg by ICT, and 13(2.82%) were HBsAg positive by ELISA. The mean seroprevalence of HBV from both ICT and ELISA was 2.60%. The highest seroprevalence (46.15%) was observed among the donor groups with age range of 21-30 years followed by (30.76%) among 15-20 years, (15.38%) among 31-40 years and the lowest seroprevalence (7.69%) among 41-55 years. Blood transfusion (30.76%) was the most apparent influencing risk factor for HBV followed by dental treatment (23.07%), Sexual partner positive for HBV infection (15.38%), surgery and shave by the barbers (7.69%) for each and unknown reason (15.38%). Keywords: Hepatitis B virus; ELISA; ICT; Risk factors; Blood donors http://dx.doi.org/10.19045/bspab.2017.60070

Seroprevalence and Risk Factors of Hepatitis E in Eastern Iran

Background: Hepatitis E infection is one of the most common causes of acute hepatitis. It is caused by the RNA virus of the hepatomegaly viridae family, which is transferred through stool in contaminated water. Cases of infection are most prevalent in developing countries. Objectives: This study was conducted to investigate the seroprevalence of hepatitis E among urban adults. The reason was the current lack of information on the hepatitis E prevalence among the general population in the city of Birjand in eastern Iran. This information is necessary because Southern Khorasan is in close proximity to Afghanistan. Methods: In this cross sectional study, 522 participants aged over 17 years were selected from the city of Birjand, eastern Iran, using the random cluster sampling. The participants completed a researcher-made questionnaire that included demographic characteristics, risk factors for infectious diseases such as records of blood transfusions, specific exposures, intravenous drug abuse, recent diagnosis or a history of liver disease, and other medical information. After selection, a blood sample was taken from each participant to a volume of 5 cc. Each blood sample was then measured for the title of IgG antivirus of hepatitis E by the enzyme-linked immunosorbent assay (ELISA) method using the third generation ELISA kit made by Delavara Company. Results: This study included 554 participants. The mean age of the participants was 41.4 years (age range, 17 - 72 years). From a total of 554 participants, 295 (53.2%) were females and the remainder were males. Results showed that the hepatitis E antibody title was positive in 139 (25.1%) participants and negative in the others. Comparison of the prevalence rates of positive HEV between men and women showed no statistically significant difference although it was significantly higher in married participants than in single ones (P < 0.001). Results also showed that the prevalence was less in participants with a tertiary education compared to those with a lower level education. Along with age, the prevalence of the positive antibody title increased significantly. The prevalence of HEV in participants who were smokers was significantly (P < 0.001) lower than in those who were nonsmokers. Conclusions: In this study, the seroprevalence of contact with HEV in urban adults in the city of Birjand was 25%. The results of this study showed that the prevalence of hepatitis E in the city of Birjand, eastern Iran, was higher than in other places compared with previous studies on communities in Iran. Also, the prevalence of HEV in single and educated people was significantly less than that in married and literate individuals.

Hepatitis C: an Overview of Various Laboratory Assays with their Mode of Diagnostic Cooperation.

This review describes in chronological order the different assays for hepatitis C virus (HCV) antibodies, for the core antigen and for the HCV-RNA. By ascending chronological order, the enzyme-linked immunosorbent assay (ELISA), rapid diagnostic tests (RDTs), HCV-Ab IgG avidity index (HCV AI), and Cy3-labeled microarray assay have been described for HCV antibodies in addition to ELISA for the total HCV core antigen (Ag). The recombinant immunoblot assay (RIBA) is a confirmatory test for HCV-Ab in blood, which is no longer needed due to the use of the sensitive third and fourth generation ELISA in addition to HCV-RNA detection by the Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR). ELISA and RIBA measure current and prior exposure to HCV infection, but cannot discriminate between the two. RT-PCR is performed after ELISA for the diagnosis of HCV infection whether acute, chronic, false positive or false negative ELISA. The cooperation between ELISA and RT-PCR in the diagnosis of HCV infection has been tabulated and discussed. HCV genotyping and subtyping testing is essential in pre-treatment evaluation of the patients for setting valuable treatment strategies and in understanding the epidemiology of the virus.

Characterization of differential antibody production against hepatitis C virus in different HCV infection status.

BackgroundThe Centers for Disease Control and Prevention (CDC) issued an update on hepatitis C virus (HCV) testing approach, in which it omitted the use of recombinant immunoblot assay (RIBA) in the diagnostic algorithm and recommended that future studies are needed to evaluate the performance of HCV testing without RIBA. As Egypt has the highest prevalence of HCV worldwide, we aimed to evaluate the value of RIBA in HCV testing in a high prevalence population. Our objective was to clarify whether enzyme linked immunosorbent assay (ELISA) anti-HCV signal-to-cutoff (S/CO) ratios were able to discriminate true positive from false positive anti-HCV antibody status and to evaluate the role of RIBA in solving this problem which may lead to a redefined strategy for diagnosis of HCV infection. Our second objective was to elucidate the effects of different HCV peptides of both structural and non-structural proteins on the humoral immune response to HCV infection. MethodsThe current study drew results from 167 individuals divided into three groups: Group I: included 77 HCV antibody positive (ELISA) high risk health care workers (HCW), Group II: included 56 presumably uninfected individuals who showed normal liver enzymes, negative HCV RNA and were asymptomatic. Their ELISA HCV antibody S/C ratio ranged from 0.9 to <5. Group III: included 34 patients enrolled from outpatient clinics of Ain Shams Hospital with persistent viral replication, elevated liver enzymes, and chronic HCV related liver disease. All study participants were assessed for the presence of anti-HCV antibodies by 3rd generation ELISA which was confirmed by RIBA.ResultsInterpreting the results of both ELISA and RIBA together, false positive results were highly significantly increased in HCW when compared with the other two groups. Indeterminate and false negative results were only found in the presumably uninfected group. For differentiated antibody responses by RIBA, chronic HCV cases had the highest frequency of positive antibody response to core peptides while the presumably uninfected group had the lowest. Antibody response to E2 was found less frequently in chronic cases than Core 1, Core 2 and NS3. The specific antibody response to the different HCV peptides showed the same distribution of frequencies in both chronic HCV cases and the presumably uninfected individuals with the chronic cases having the highest frequencies. This distribution was different from the HCW. The most evident difference was the reaction towards NS3 which was the highest antibody producing peptide in chronic HCV and presumably uninfected individuals whereas in HCW Core1 was the highest.ConclusionThe HCV antibody immunoblot assay (RIBA) is still necessary for the detection of false positive cases which can occur quite frequently in countries of high prevalence as Egypt. Indeterminate RIBA results indicate a waning antibody response in elderly individuals who recovered from previous or distant HCV infection.

Sero-prevalence of HBV and associated risk factors among HIV positive individuals attending ART clinic at Mekelle hospital, Tigray, Northern Ethiopia.

BackgroundBecause of the shared mean of transmission, hepatitis B virus (HBV) is one of an important cause of co-morbidity and mortality in peoples living with HIV/AIDS. Hence, the aim of this study was to determine the sero-prevalence of HBV infection and associated risk factors in HIV/AIDS positive individuals attending ART clinic at Mekelle hospital, Mekelle, Northern Ethiopia.MethodsA cross sectional study was conducted from August to October 2014 in HIV/AIDS positive adult individuals. Socio-demographic data and other explanatory variables were collected from 508 study participants using pre-tested and structured questionnaire-based interviews. Serum hepatitis B surface antigen (HBsAg) was detected using commercially available rapid test and third generation enzyme-linked immunosorbent assay (ELISA). Bivariate and multivariate analysis, using SPSS V.20.0, were performed to assess the variables associated with HBV infection and P value less than 0.05 was considered as statistically significant.ResultsA total of 508 study participants, 305 females and 203 males were included in this study with the mean (+SD) age of 37.8 + 9.6. The sero-prevalence of HBsAg was 5.9 %. Male gender (AOR = 2.6, 95 % CI 1.2–5.7), multiple sexual partners (AOR = 4.2, 95 % CI 1.3–13.1) and CD4 count <200 cells/μl (AOR = 3.5, 95 % CI 1.1–11.2) were significantly associated with HBsAg positivity.ConclusionThe prevalence of HBsAg was similar to the general population. However, HIV/AIDS positive individuals with reduced CD4 count, <200 cells/μl, showed a significant association with HBsAg seropositivity. Therefore, we recommended, all HIV/AIDS positive individuals should be screened for HBsAg during their follow for better treatment outcome and minimize risks of HBV transmission.