HBsAg Test Research Articles

Analysis on Reentry Situation of HBsAg Single Reagent Reactive Blood Donors in Anhui Province

To analyze the reentry situation of HBsAg single reagent reactive blood donors in Anhui province, and to verify the rationality and effectiveness of reentry strategy of blood donors in Anhui province. Shielded blood donors who were HBsAg single reagent reactive might voluntarily apply for returning to the team of blood donors after the shield of 6 months. Blood bankstaff that shielded those donors should draw blood and conduct screening tests. Samples from donors who were HBsAg negative should be delivered to Anhui Blood Center to conduct the reentry detections. Shielded blood donors were allowed to return to the team if the results of HBsAg test, neutralization test, HBcAb test and nucleic acid test were negative. 109 person-portions of samples for returning to team from September 2013 to December 2016 were delivered to Anhui Blood Center. After reentry tests, 60 of them were negative, 8 cases were positive, while 41 cases were undetermined, and the qualified rate was 55.05%.25 negative donors were from Hefei, 20 of them donated blood again and were negative. The shielding and reentry strategy of blood donors with HBsAg single reagent reactive in Anhui province is rational and effective. However, there are still some deficiencies in trace of donors and information transmission, which needs to be further improved.

Prevalence of Hepatitis B and C Infection Among Street Children Community in Malang City

Background: World Health Organization (WHO) announced that during 2017, 325 million people worldwide were infected with the hepatitis B virus (HBV) or hepatitis C virus (HCV). Street children community is a part of society that is susceptible to HBV and HCV transmission, yet no data available about the prevalence. The purpose of this study was to determine the prevalence of hepatitis B and hepatitis C infections in street children community of Malang during 2017.Method: This cross-sectional study was conducted in September 2017 with subjects of street children who were members of the East Java Humanitarian Network (EJHN) group. They were interviewed, got vital signs examined, and performed HBsAg and anti HCV tests using the ECLIA method.Results: There were 90 subjects, with more male than female (60%). The most frequent age range was between 21 to 30 years (35.6%). Most of them do not have permanent jobs (37.8%). The level of education varied, with 30% were at the level of primary education and 56.7% were married. There were 4.4% hepatitis B positive and 1.1% of hepatitis C positive among the subjects. Subjects with positive results had history of free sex, tattoos, and intravenous drugs abuse as the risk factors of HBV and HCV transmission.Conclusion: The prevalence of Hepatitis B and Hepatitis C in the population of street children in Malang city, East Java, were 1.1% and 4.4%, respectively. The most common risk factors were free sex and tattoos.

Identifying gaps across the cascade of care for the prevention of HBV mother-to-child transmission in Burkina Faso: Findings from the real world.

Prevention of mother-to-child transmission (PMTCT) is a challenge for controlling the hepatitis B epidemic. In Sub-Saharan countries, pilot interventions including the screening of pregnant women for HBsAg, implementation of anti-HBV therapy and infant immunization within 24 hours of life are initiated and need to be evaluated. This pilot study aimed to describe the cascade of care for hepatitis B PMTCT in a real life situation, and to identify sociodemographic factors associated with adequate management of pregnant women and infants. The study was conducted from October 1st, 2014 to February 28th, 2016 in the antenatal clinics (ANCV) of Baskuy district which comprises nine first-level public health centres. Univariate and multivariate logistic regression analysis were used to identify sociodemographic factors associated with the likelihood of retention in the cohort, HBV DNA testing, birth dose delivery and HBsAg testing of the children at 6 months of age; P ˂ .05 was selected as cut off for significance. In this prospective cohort study, of 5200 pregnant women consulting for the antenatal visit, 2261 (43.5%) were proposed pre-test counselling and HBsAg screening and 2220 (98.2%) have agreed to screening. Among 1580 (71.2%) women that came back for the post-counselling interview, 75 were positive for HBsAg (4.8%), 73 (97.3% of the women provided HBsAg result) consented to medical consultation with hepatogastroenterologists and 53 (72.6%); performed the HBV DNA testing. Forty-seven out of 60 (78.3%; 65.8-87.9) children born alive were immunized for HBV within 24 hours of life. Retention in care was associated with the level of education of the infant's father, secondary school or higher was associated with a better retention in care of the women (OR: 6.6; P = .03). Our study shows large gaps in HBV PMTCT. Resources for hepatitis B screening, care and prevention including universal access to the vaccine birth dose should be allocated to reduce infection in HBV exposed infants born in Burkina Faso.

The Profiles of Hepatitis B and C Virus Infections in Prison-Assisted Citizens

Prison-assisted citizens or prisoners are one of the groups of people who are at high risk of Hepatitis B and C virus infections. The data on the prevalence of both viruses in prisoners in Indonesia are still limited. This study aims to determine the profiles of Hepatitis B and C virus infections in prison-assisted citizens in the Class IIA Narcotics Correctional Institution in Bandung Regency. A total of 30 prisoners were used as the samples in this study. All procedures performed in this study were following the applicable codes of ethics. The presence of surface antigens of Hepatitis B virus (HBsAg) in serums was detected using a qualitative sandwich Enzyme-Linked Immunosorbent Assay method. The existence of antibodies of the Hepatitis C virus (Anti-VHC) was detected using the immunochromatography method. The laboratory test results have shown five people (16.7%) were positive on the HBsAg test and one person (3.3%) was positive on the anti-VHC test. One case of Hepatitis B and C co-infection was also found in the prison-assisted citizens who were in the Class IIA Narcotics Correctional Institution in Bandung Regency. All the prisoners infected by the Hepatitis B and C viruses used injection drugs, had tattoos on their bodies and never received vaccinations.

Point-of-Care Tests for Hepatitis B Are Associated with A Higher Linkage to Care and Lower Cost Compared to Venepuncture Sampling During Outreach Screenings in an Asian Migrant Population.

Background:This study compares venepuncture versus point-of-care (POC) HBsAg tests on screening cost and linkage to care in prospective outreach screenings in an Asian population in three major cities in Belgium between 10/2014 and 5/2018.Methods:Two community outreach screening programs were organised between 10/2014 and 5/2018. The first screening program used venepuncture and serologic testing for HBsAg. In the second program, HBsAg was tested in finger stick blood POC tests. Positive results were confirmed during outpatient visits with serologic testing. Linkage to care was defined as having received specialist care follow-up with at least one abdominal ultrasound within three months of screening.Results:For 575 participating individuals, 571 valid results were obtained, 456 with venepuncture, and 115 using POC testing. Overall HBsAg seroprevalence was 6.8%. Linkage to care was higher when using POC testing compared to venepuncture (86% or n = 6/7 versus 34% or n = 11/32; p = 0.020). The POC screening program was economically more attractive with a total cost of € 1,461.8 or € 12.7 per person screened compared to € 24,819 or € 54.0 per person screened when using venepuncture testing. Results and an appointment for specialist care follow-up were given onsite with POC testing, while with venepuncture testing; results were sent within 20–45 days.Conclusion:In an Asian migrant population in Belgium with an HBsAg seroprevalence of 6.8%, HBV screening based on POC tests resulted in lower costs per person screened (76.5% lower), and higher linkage to care (2.5 times).

Evaluation of rapid diagnostic test compared with ELISA for detection of hepatitis B surface antigen

Hepatitis B is a serious type of viral infection affecting millions of people throughout the world. Some of those who become Chronic carriers may progress to develop hepatocellular carcinoma and end stage liver disease. Therefore, early diagnosis and management is the need of time. Present study was aimed to compare the relative sensitivity and specificity of rapid ICT with ELISA for the detection of HBsAg.: One step rapid test for detection of HBsAg was performed on samples by Meriscreen HBsAg test from Meril Diagnostics. HbsAg ELISA was done by using SD HBsAg ELISA 3.0 from SD Biostandard diagnostics Private Ltd. This is assay for qualitative detection of HBsAg from human serum and plasma. Total 526 samples were analysed. Out of 64 positive samples, 62 were positive by rapid card test, and 2 were negative. Out of 462 negative samples, 461 were negative by rapid card test, and one was positive. We found the sensitivity and specificity of rapid ICT was 96.8% and 99.7% as compared to ELISA. The results are very much similar to several previous studies done in India and other parts of world. It would be wise to validate this point of care tests with a standard ELISA or other specific tests whenever feasible.

An Economic Evaluation of the Cost-Effectiveness of Opt-Out Hepatitis B and Hepatitis C Testing in an Emergency Department Setting in the United Kingdom.

The prevalence of hepatitis is high in emergency department (ED) attendees in the United Kingdom, with a prevalence of up to 2% for hepatitis B (HBV) HBsAg, and 2.9% for hepatitis C (HCV) RNA. The aim of this paper is to perform an economic evaluation of opt-out ED-based HCV and HBV testing. A Markov model was developed to analyze the cost-effectiveness of opt-out HCV and HBV testing in EDs in the UK. The model used data from UK studies of ED testing to parameterize the HCV and HBV prevalence (1.4% HCV RNA, 0.84% HBsAg), test costs, and intervention effects (contact rates and linkage to care). For HCV, we used an antibody test cost of £3.64 and RNA test cost of £68.38, and assumed direct-acting antiviral treatment costs of £10 000. For HBV, we used a combined HBsAg and confirmatory test cost of £5.79. We also modeled the minimum prevalence of HCV (RNA-positive) and HBV (HBsAg) required to make ED testing cost-effective at a £20 000 willingness to pay per quality-adjusted life-year threshold. In the base case, ED testing was highly cost-effective, with HCV and HBV testing costing £8019 and £9858 per quality-adjusted life-year gained, respectively. HCV and HBV ED testing remained cost-effective at 0.25% HCV RNA or HBsAg prevalence or higher. Emergency department testing for HCV and HBV is highly likely to be cost-effective in many areas across the UK depending on their prevalence. Ongoing studies will help evaluate ED testing across different regions to inform testing guidelines.

Prevalence and associated risk factors for Hepatitis B and C viruses among refugees in Gambella, Ethiopia

BackgroundCurrently, there is an increased flow of refugees into Ethiopia from neighboring countries. However, there are no post-arrival screening mechanisms for hepatitis B and C viruses which could be an additional burden for the local population. Hence, this study aimed to determine the prevalence and associated risk factors for hepatitis B and C viruses among refugees in Gambella, Ethiopia. It also aimed to determine the knowledge, attitude, and practice concerning hepatitis B and C viruses among participants.MethodsA cross-sectional study was conducted among 453 refugees in Gambella, Ethiopia from January until May 2018. A questionnaire was used to collect data on refugees’ socio-demographic, risk factors, and KAP of hepatitis B and C infections. Five milliliters of blood sample were collected from each participant and the serum was used for HBsAg and anti-HCV antibody screening rapid tests. Positive samples were further tested by ELISA method. Data were performed using SPSS version 20, and a p-value less than 0.05 was considered statistically significant.ResultsThe overall prevalence of HBsAg and anti-HCV among refugees was 7.3% (33/453) and 2.0% (9/453) respectively. Of these, 6.8% (25/370) and 1.4% (5/370) of females were positive for HBsAg and anti-HCV, whereas 9.6% (8/83) and 4.8% (4/83) of males were positive for HBsAg and anti-HCV. The age group of 18–29 and 30–41 years old were related to HCV infection (P = 0.003 and P = 0.020). However, proposed risk factors were not related to HBV and HCV infections. Knowledge assessment showed that 86.5% (392/453) did not know how HBV and HCV infections are transmitted, and 86.8% (393/453) had no information about the availability of HBV vaccine.ConclusionThis study showed intermediate prevalence of hepatitis B and hepatitis C virus in a large refugee camp in Ethiopia. The prevalence of hepatitis C virus was found to increase with age, but no other risk factor for either virus identified as significant. Refugees’ understanding of hepatitis B and C was very limited. This indicates the need for screening policy to be implemented and integrated with other health services and awareness creation about the infection in all refugee camps of Gambella.

Prevalence and Knowledge of Hepatitis B Virus Infection among Pregnant Women in the Ningo-Prampram District, Ghana.

Background Hepatitis B virus (HBV) infection has been suggested to play a role in various adverse birth outcomes. The study determined the prevalence as well as knowledge of hepatitis B virus infection among pregnant women in the Ningo-Prampram District of the Greater Accra Region of Ghana. Materials and Methods A cross-sectional study using simple random sampling technique was used to recruit 213 pregnant women receiving antenatal care in three different health facilities (Prampram Polyclinic (PPC), Dangme Community Hospital (DCH), and Old Ningo Health Center (ONHC)) in the Ningo-Prampram District of Ghana from November 2018 to January 2019. A semi-structured questionnaire was used to collect data which included participants' HBsAg test results, sociodemographic and gynaecological characteristics, and their level of knowledge on HBV infection. Knowledge of the participants on HBV infection was classified as either excellent, good, or poor based on their cumulative percentage scores from the questionnaire according to Al Rubaish system of classification. Results Overall low-intermediate prevalence of HBV infection was 3.3%; however, PPC recorded the highest prevalence of 4.0% while DCH and ONHC recorded 2.82% and 2.50%, respectively. Statistically significant association was observed between HBV infection and the health facility. Majority (77.40%) of the study participants had poor knowledge on HBV infection while only 14 (6.57%) had excellent knowledge on HBV. Regarding excellent knowledge, 8 (11.0%) among the participants were demonstrated by the majority of those who received antenatal care from DCH. Generally, knowledge on HBV and the infection was poor among the study participants. Knowledge on HBV infection was found to be associated with residential status (p = 0.006), educational level (p < 0.001), occupation (p < 0.001), and gestational period (p < 0.001). Participant's knowledge was also significantly associated with the health facility (p = 0.027). Conclusion HBV infection among pregnant women is prevalent in the Ningo-Prampram District even though the prevalence is not very high. The majority of pregnant women in the Ningo-Prampram District inadequate knowledge on HBV infection and it mode of transmission. Intensive public health education on the HBV infection is required in the district to help prevent and manage future transmissions as well as inform the population about the negative side effects of the virus and the need to prevent it by way of vaccination.

Prenatal Hepatitis C Screening in Kentucky: Does a Change in the Law Change Clinical Practice? [14A

INTRODUCTION: Prevalence of hepatitis C virus (HCV) infection among pregnant women is highest in Kentucky. ACOG endorses a risk-based approach for prenatal HCV screening; however gaps in identification can occur. In 2018, Kentucky became the first state nationwide to legislatively mandate universal HCV screening for all pregnant women. METHODS: This retrospective study evaluates trends of prenatal HCV testing before and after a universal HCV screening requirement. Women with an ICD-9/ICD-10 code indicating delivery at UK Healthcare (UKHC) in 2016 through 2018 were identified; those with laboratory results for HBsAg in the 10 months prior to delivery were considered to have had prenatal care within UKHC and included in the study cohort. Electronic medical records were reviewed to identify maternal characteristics and anti-HCV test results. RESULTS: Among 5,616 women with deliveries, 3,869 (69%) had documentation of prenatal HBsAg testing and included in the study cohort. Of these, 48 (1.2%) had a diagnosis of HCV infection and an additional 716 (19%) had prenatal anti-HCV testing. Among women screened for HCV, 179 (25%) were anti-HCV positive. A total of 363 women in the cohort had a diagnosis indicating illicit drug use; 53 (15%) were neither tested for HCV nor had an existing HCV diagnosis. Prevalence of prenatal HCV screening increased significantly from 18% at baseline to 31% among women who delivered after the universal screening legislation became effective (P&lt;.0001). CONCLUSION: A significant increase in HCV testing was observed following the universal HCV screening legislation, however testing uptake remained low. Efforts to improve implementation are warranted.

Non-specific activity of Staphylococcus aureus strains producing and not producing cytokine-like substances assessed by immuno-enzyme analysis

A cytokine profile covering cytokine level in various biological fluids isa of great importance un ummunbe-based diagnostics, examinign parameters and stated bof functional asctivity of immune system organs. While using ELISA asw oner of the most common diagnostics tools, it is worth taking into account origin of biological samples. Daily Staphylococcus aureus broth culture supernaturants, positive and negative for cytokine-like substances, were used to determine non-specific activity by using enzyme immunoassay using kits pruchased from the JSC “Vector-Best” (Novosibirsk) as well as kits of LLC “HEMA” (Moscow) to diagnose some infections and hormone levels. We found that in supernatants from some Staphylococcus aureus strain producing cytokine-like substances identical to human, the absence of non-specific cross-activity assessed by ELISA was documednted exсept for the HBsAg test kit, which may indicate high specificity of the other kits studied and indirectly confirm an assumption that staphylococci secrete proteins specifically reacting mainly with antibodies against human cytokines, but can also cross-react with other antigens, but not antibodies.

High hepatitis B virus screening rate among patients receiving systemic anticancer treatment in Japan.

Patients with hepatitis B virus (HBV) infection have a risk of reactivation after chemotherapy. All patients undergoing chemotherapy should be screened for HBV infection. No large-scale studies have been conducted to examine HBV screening practice in Japan. We analyzed health insurance claims equivalent data linked with a nationwide hospital-based cancer registry. Patients diagnosed with cancer in 2014, who were aged 20years and older and those who underwent systemic anticancer treatment in 2014-15 were included. We assessed the HBV screening rates by the HBsAg or anti-HBc tests, HBV-DNA tests, and entecavir prescriptions. Multiple logistic regression models were used to identify factors related to the receipt of screening. Of 177,597 patients (mean [SD] age, 65.6 [12.2] years), 82.6% and 12.9% patients had a solid tumor and hematologic malignancy, respectively. Among them, 88.1%, 6.3%, and 5.5% received cytotoxic chemotherapy, targeted therapy, and anti-CD20 antibodies, respectively. Overall, 70.6% of patients were screened. The positive predictor of HBV screening was receiving anti-CD20 antibodies [odds ratio (OR); 2.23, 95% confidence interval (CI) 2.06-2.41, p < 0.001] and negative predictors were age ≥ 85 (OR 0.76, 95% CI 0.71-0.81), age 75-84 (OR 0.77, 95% CI 0.75-0.79) and targeted therapy (OR 0.69, 95% CI 0.67-0.72). Among the screened patients, 13.2% were tested for HBV-DNA, and 1.49% were prescribed entecavir. The HBV screening rate in Japan is higher than in other countries. Further improvement of the HBV screening rate is needed to prevent reactivation and avoidable deaths of patients with HBV infection.

A same day 'test and treat' model for chronic HCV and HBV infection: Results from two community-based pilot studies in Egypt.

Prompt access to confirmatory viral load testing and staging of liver disease are key barriers in uptake of treatment for chronic hepatitis B and C infection. Our objective was to establish the feasibility of a same day 'test and treat' model in two distinct community-based settings in Egypt through use of key point-of-care(POC) portable tools for HCV and HBV viral load assessment and staging of liver disease followed by treatment initiation. Community sites were a village in northern Egypt (site 1) and a government office in Cairo (site 2). The following model was adopted: community awareness raising in the week before project initiation; site assessment to ensure optimal placement and calibration of equipment and clinical care set-up; transfer of key portable laboratory instruments to the sites (four cartridge GeneXpert, FibroScan and abdominal ultrasound); screening using rapid diagnostic tests for HCV-Ab and HBsAg, with immediate venous or finger-stick blood sampling for HCV-RNA and HBV-DNA assay, FibroScan staging of liver disease and ultrasound screening for liver cancer. At site 1, 475 individuals were screened over a single day, 125 were positive for HCV-Ab and 4 for HBsAg, 43 of 56 new HCV diagnoses were HCV RNA positive, and 3 of 4 HBsAgpositive were HBV DNA positive, 40 initiated HCV treatment, and one HBVtreatment. At site 2, 3188 individuals were screened over 3days, 157 were positive for HCV-Ab, and 27 for HBsAg; 38 of 76 new HCV diagnoses were HCV RNA positive, and 15 of 18 HBsAgpositivewere HBV-DNA positive. Across both sites, 78 patients were counselled and initiated on treatment for HCV and 12 for HBV within 3 and 4hours, respectively, of initial positive rapid diagnostic test result. We have shown the feasibility of a same day 'test and treat' model for chronic HCV and HBV infection in two community-based settings in Egypt that achieved high levels of linkage to care and initial treatment.

Seroprevalensi Hepatitis B pada Pemulung Sampah di Kota Palangka Raya

Hepatitis B is a hepatitis B virus (HBV) infection which can exacerbate the liver and cause acute and chronic disease. The most susceptible group to hepatitis B transmission is waste pickers. This study aimed to determine: (1) the level of Hepatitis B virus infection among waste pickers in several temporary waste shelters in Palangka Raya, and (2) risk factors for hepatitis B virus infection in waste pickers in several temporary waste shelters in Palangka Raya. The observational analytic study using a cross-sectional study design was used in this research. The purposive sampling technique was carried out to involve 32 waste pickers in Palangka Raya. Examination of hepatitis B screening through HBsAg test to waste scavenger blood samples using the Rapid Test method. The results showed that the rate of hepatitis B infection based on positive HBsAg examination was 3.1% of respondents. Risk factors for transmission or exposure to hepatitis B that are directly related to the activity of garbage scavengers are not using protective equipment (PPE) gloves and bare hands waste collection, respectively 3.6% and 6.7%

An electronic alert system increases screening for hepatitis B and C and improves management of patients with haematological disorders

Treatment of haematological disorders in patients with chronic hepatitis B or resolved infection (anti-HBc-positive) is associated with a risk of hepatitis B reactivation. Moreover, patients with chronic hepatitis C have a higher risk of haematological malignancies than general population. An electronic alert system was developed to promote screening of hepatitis B (HBV) and C (HCV) in patients starting haematological therapies. The system included screening and linkage to care and a request for testing in those without data. From March, 2017 to March, 2018 data from 420 consecutive patients with haematological diseases were included. At first prescription before the alerts, the HCV and HBV screening rate was 60.5%. Following the alerts, an additional 115 were screened, increasing the overall screening rate to 87.9%. Anti-HBc alone was detected in 57, anti-HCV in 13, and HBsAg in 2 patients. Overall, 68% of patients with any viral hepatitis markers were previously not know, and the impact was particularly important for anti-HBc detection (47/57 unknown). Nucleoside analogues were prescribed in 28 (49.1%) anti-HBc-positive and the 2 HBsAg-positive patients. Prospective follow-up with HBV DNA and HBsAg testing showed no cases of HBV reactivation. An estimated 1.2 HBV reactivations were avoided as consequence of the alert system. In summary, an electronic alert system increased viral hepatitis screening in patients receiving haematological treatment and led to improvements in the management of these patients, including avoided HBV reactivation.

Focal brain lesions in an HIV infected patient : A Diagnostic dilemma

Background— Focal brain lesions associated with HIV infection can be due to cerebrovascular diseases, primary CNS lymphoma, toxoplasmosis, progressive multifocal leukoencephalopathy or other opportunistic infections. We report a challenging case of an adult HIV infected male with focal brain lesions. Case Description-- A 62 years old male, presented with history of cough with mucoid expectoration for 3 months and abnormal behaviour for 2 weeks. Clinical examination revealed delayed obeying of commands and no other sensorimotor deficits. MRI brain revealed ill-defined space occupying lesions involving bilateral frontal lobes. HIV antibodies and HBsAg tests were positive. CT chest revealed multiple cavitatory lesions in left upper lobe. Pharyngeal candidiasis was seen during bronchoscopy. Bronchoscopic alveolar lavage revealed Nocardia species. Tests for MTB were negative. Lung biopsy showed Cytomegalovirus pneumonitis with Aspergillosis. PET scan revealed non FDG avid gliotic changes in brain. CSF and bone-marrow examinations were normal. Brain lesion was considered to be a manifestation of Nocardiosis and biopsy was planned. CD4 count was 103/mm3. Intravenous ceftriaxone, ganciclovir, caspofungin, fluconazole and oral septran were started. Patient was started on HAART(Tenofovir, lamivudine, efavirenz) 1 week later, after explaining the risk of Immune reconstitution inflammatory syndrome. CNS lesion biopsy revealed High grade B-cell Non- Hodgkin’s lymphoma. Palliative external Radiotherapy to whole brain was given. The patient has improved clinically and is on regular follow up from 1 year. Conclusion— Extensive evaluation and work up is required in cases of focal brain lesions in patients with HIV. Brain biopsy often provides the definitive diagnosis.

A clinical investigation to assess the association between serum bilirubin levels and coronary artery disease: A case-control study

Aims: The aim of the present study was to assess the association between serum bilirubin levels and coronary artery disease in comparison with controls without coronary artery disease. Material and methods: A cross-sectional study was conducted in the Department of medicine, India from Jan 2019 to Jan 2020. Total of 160 subjects were included in the study with 80 cases and 80 controls. General and systemic examination was conducted on all study subjects including laboratory investigations like complete blood count, renal function test, lipid profile, viral markers such as HBsAG, HCVIgM and liver function test which includes total bilirubin, direct and indirect, liver enzymes, albumin and globulin levels. Results: The mean age among the cases male and female respectively was 62.76±8.2 and 63.85±8.3 and controls group were 61.85±8.4 and 62.38±8.5 years male and female respectively. 60% were male and 40% female in case group and 63.75% patients were male and 36.25% patients were female in control. The most common risk factors for CVD like diabetes, hypertension, smoking, obesity and family history of CVD was found to be slightly higher among the cases than the control groups but it was not found to be statistically significant and it proves that the controls were matched for almost all the risk factors for CVD except for dyslipidemia which was found to be significantly higher among the CVD patients than the controls. The mean duration of CVD was 4.4±2.8 years. The various liver function test parameters were compared between the cases and controls it was found that the serum bilirubin levels which includes total bilirubin, direct bilirubin and indirect bilirubin was found to be lower among the case group compared to the control group and this difference was found to be statistically significant, whereas the other parameters like SGOT, SGPT and GGT levels did not show much difference between the case and control groups and the difference in values were not statistically significant. Conclusion: The relationship between the decreased serum bilirubin levels and the event of CAD; in this manner, bilirubin level can fill in as a prognostic factor, together with other significant factors for recognizing an individual who is in the peril of coronary artery disease.

THE IMPACT OF POSITIVE ANTI-HBC MARKER ON PERMANENT DEFERRAL OF VOLUNTARY BLOOD DONORS IN EASTERN CROATIA AND ESTIMATION OF OCCULT HEPATITIS B VIRUS INFECTION RATE.

SUMMARYRecently an increase has been reported in the number of HBV transmissions from anti-HBc positive blood donors that were repeatedly negative in HBsAg and nucleic acid testing using the most sensitive tests available. The aim of the study was to show the effect of anti-HBc antibody testing performed in 2006 on permanent deferral of voluntary blood donors (VBDs), and to estimate occult hepatitis B infection (OBI) rate in this population after the introduction of mandatory molecular testing in the 2013-2016 period. More than 30,000 blood donations collected during the 2005-2007 period and more than 14,000 VBDs having donated blood during the 2013-2016 period after the introduction of molecular testing from eastern Croatia were included in the study. Serologic testing was performed with HBsAg assay throughout the study period, and anti-HBc assay was only performed in 2006. As part of the confirmatory algorithm testing, all HBsAg positive and unclear results were tested with molecular tests. Anti-HBc prevalence among VBDs in 2006 was 1.5%, with a rate of 1:197, whereas HBsAg prevalence was stable from 2005 to 2007 (0.04%, 0.1% and 0.1%, respectively). The calculated OBI rate from 2013 to 2016 was 1:30,250. Ten of 161 (12.4%) VBDs had serologic anti-HBc-only pattern. Anti-HBc testing in 2006 resulted in statistically more deferrals of VBDs compared to 2005 and 2007, and to the rest of Republic of Croatia. The strategy of universal anti-HBc testing of VBDs in addition to the existing HBsAg and molecular screening could be an additional measure to prevent HBV transmission by blood and blood components.

Hepatitis b and c: an assessment of risk exposure and prevalence among preclinical medical students in Northwestern Nigeria

Background: The risk of transmission of hepatitis B and C (HBV and HCV) infection is of particular concern among medical students training in high endemic regions. In this study,we investigated the risk and prevalence of hepatitis B and C viruses among preclinical medical students in a government-owned medical school in northwestern Nigeria.Methods: We employed a cross-sectional studytargeting the whole population of preclinical medical students of Kaduna State University, Kaduna State northwestern Nigeria. Data were collected usinga self-administered, semi-structured questionnaire and blood testing for HBsAg and HCV antibodies using rapid screening kits.Data were analyzed using SPSS version 22.Results: A total of 133 students participated, and 79.7% of them had a previous risk exposure to injuries by sharps. The seroprevalence for HBV and HCV was 0.8% for both infections. Complete HBV vaccination uptake (3 doses)before enrolment in medical school was 18.8%. The knowledge that HBV infection is preventable was a significant determinant for the previous testing for hepatitis B and C.Conclusion: Risk exposure to injuries by sharps was high in preclinical students. But their seroprevalence for both hepatitis B and C were low. Keywords: Hepatitis B and C viruses;prevalence; medical students;sharp injuries

Asymptomatic hepatitis B virus-positive patients visiting dental outpatient department in North India: A multicentric study

Background: In India, it is estimated that nearly 3%–4% of the population is affected by hepatitis-B virus (HBV). During the initial stage of the disease, the patient is asymptomatic, and there is a possibility for cross infection to dental surgeons and to other patients. The purpose of this study was to find the incidence of such HBV-infected asymptomatic patients visiting dental clinics of North India. Materials and Methods: This prospective study was conducted in the outpatient department at five different centers of North India. Three centers in Uttar Pradesh, one centre in Bihar, and one centre in Himachal Pradesh. All the patients visiting dental OPD were advised hepatitis-B surface antigen (HbsAg) screening test day before dental procedure, and the procedure was planned on the next day or on the second day after reports were submitted. Those patients who were found positive for HbsAg were further tested for HBV DNA using polymerase chain reaction technique. Results: Five thousand patients were screened, of 5000 patients, 4840 patients submitted complete blood test reports. One thousand six hundred and ninety patients were female and 3150 patients were male. The male-to-female ratio was 1:2.5. Fifty patients were found to be hepatitis B positive. Thirty patients of hepatitis B were in early infective stage. It was found that forty patients were positive for HBV DNA, whereas ten patients were negative. Conclusion: Incidence of asymptomatic hepatitis-B positive patients visiting oral surgery outpatient department in North India is 1%. We recommend routine HbsAg testing and proper sterilization of dental instruments in all dental surgical procedures.