HBV Cases Research Articles

Treatment of Chronic Viral Hepatitis with Pegylated Interferon in Ivory Coast

Background: In the Ivory Coast, chronic infection by hepatitis B and C virus is the leading cause of cirrhosis and hepatocellular carcinoma. The absence of universal health coverage makes the treatment inaccessible to all. Objectives: To assess the efficacy of Pegylated Interferon in clinical practice in patients with chronic viral hepatitis B and C and determine the hematologic side effects. Patients and Methods: A descriptive retrospective study from January 2012 to November 2013 on a cohort of patients chronic carriers of hepatitis B virus (n = 11) treated with Pegylated Interferon to 180 mcg per week and hepatitis C virus (n = 30) treated with a combination therapy associating pegylated Interferon to 180 mcg per week and Ribavirin assayed according to the genotype. Results: Out of 1860 patients seen in hepatogastroenterology consultation 422 had viral hepatitis B or C that is a prevalence of 22.7% and 41 patients were treated (9.7%) by Pegylated Interferon. Among these 41 patients mentioned earlier, 30 had HCV (73.17%) with a case of HIV + HVC co-infection, 11 patients had HBV (26.83%) including 3 cases of HBV + HDV co-infection. Patients’ age ranged from 24 - 69 years with an average of 49.2 ± 12.2 years including 46.5 years for HBV and 51.9 years for HCV. The sex ratio was 1.56. The original transaminases were on average 93.37 IU/l for AST and 110.47 for ALT. The average RNA HCV was 1,685,331 IU/ml and the DNA HBV 33,312,767 IU/ml. Patients with HCV were of genotype 1 in 56.66%, genotype 2 in 40% and one case of genotype 4 (3.34%) from Central Africa. Fibrosis score at institution of treatment was significant (≥A2 and/or ≥F2) in 86.9% of cases of Fibrotest®, 100% of cases of Fibrometer®. We observed 48.8% of neutropenia < 750/mm3, 33.3% of anemia and 29.3% of thrombocytopenia < 100,000/mm3. There was no dose reduction of Pegylated Interferon and Ribavirin. For HBV there were 3 partial responses, 3 responders including 1 HBV + HDV co-infected non responder to HDV, 2 non responders including 1 HBV + HDV co-infected to Week 48. For HCV, there was 52.94% of cases of sustained viral response (SVR) including 44.44% of genotype 1, 83.33% of genotype 2 and 100% of genotype 4. Conclusion: The free antiviral treatment program helped treat 10% of chronic viral hepatitis B and C. Our results are not different from those of the literature. Difficulties remain in the performance of non supported diagnostic tests.

Screening for HBV, HCV, HIV, HSV and Syphilis in reproductive age group women attending a tertiary care hospital in South India

Introduction: Reproductive tract infections (RTI) and Sexually transmitted infections (STI) are the major contributing illnesses among the women of reproductive age group in a developing country like India. Even though preventive measures has been implemented at all health care levels and treatment seeking behavior has increased to a achievable level, still there is a lack of exact epidemiological data about RTI and STI. Aims and Objectives: To estimate the proportion of HBV, HCV, HIV, HSV and syphilis positive cases by serological methods and to correlate the significance of age with positivity. Materials and Methods: A prospective study conducted among 110 women over a period of one year who presented with symptoms and signs of RTI. Screening for HBV, HCV and HSV done by Enzyme Linked Immuno Sorbent Assay (ELISA). Screening for HIV was done by rapid methods according to NACO guidelines. Screening for syphilis was done by Rapid Plasma Reagin (RPR) test and then positive cases was confirmed by Treponema Pallidum Haemagglutination Assay (TPHA). Results: 25.45% of the samples showed positivity for HSV-2 IgG antibodies. 1.89% of the samples were positive for HbsAg antigen detection. 0.91% showed positivity for Treponema pallidum infection. None of the samples were positive for HIV or HCV infection. Conclusion: As there is an increased chance of acquiring STI in genital tract infections, screening for sexually transmitted infections by serological methods should be made mandatory in women with symptoms and signs of genital tract infections at all health care centres.

Hepatocellular Carcinoma during HIV/HBV Co-Infection

HIV/HBV Co-infection constitute a public health problem in sub-Saharan Africa. Its prognosis is high because of late diagnosis. We are reporting a case of HIV/ HBV co-infection detected at the stage of hepatocellular carcinoma with the aim of contributing to a better care for cases of HBV and HIV co-infection. This is about a 43 year-old adult co-infected with HBV and HIV-1. Upon admission into the Department of Infectious Diseases, the review noted a maintained general condition, an icteric conjunctiva, a conjunctival pallor, a weight equal to 60 kg, there was neither dehydration, any hepato splenomegaly or collateral venous circulation. Laboratory tests showed moderate immunosuppression (CD4 = 260/ mm3), moderate anemia (Hb rate = 11, 4 g/dl), thrombocytopenia (platelets = 127 000 /mm3), high alpha fetoproteins (1800 U/ml), on fibrotest the fibrosis score was equal to 0.9 and the activity score to 0.9; Gamma GT = 91 U/l, total Bilirubin = 81.11 micromol/l (N <25.7), a prothrombin rate = 71.70% (N = 70-100), IgM antiHBc = negative. Hepatic ultrasound objectified appearance compatible with cirrhosis. The diagnosis is a post viral hepatitis B hepatocellular carcinoma complicating cirrhosis. HBV/HIV co-infection is serious because of the rapid progression to cirrhosis and hepatocellular carcinoma. Routine screening of viral hepatitis B which is an AIDS marker in HIV-positive people will allow a holistic medical care, necessary to prevent hepatocellular carcinoma

Seroprevalence of Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and HIV Infection Among Replacement Blood Donors at a Tertiary Care Hospital in Kashmir

Aims: As community based studies of seroprevalence of Hepatitis B, Hepatitis C and HIV in Kashmir valley are lacking, the current analysis was aimed to look for the same in replacement blood donors in SMHS Hospital, an associated hospital of Govt. Medical College Srinagar, Kashmir. Material and Method: Relevant information of all the replacement blood donors who had donated whole blood in the department of transfusion medicine, SMHS Hospital, Kashmir from Jan 2000 to Oct 2010 was retrieved from the departmental records. The number of donors who were found positive for HBSAg, HIV and also those found reactive for anti HCV antibodies was calculated. Results: Out of 40616 total blood donors, 40584 were males and only 32 were females. Among all these replacement donors, 0.485 %( n=197) were HBSAg positive, 0.169% (n=69) were reactive for Anti HCV and 0.041% (n=17) were positive for HIV. Since the number of female donors was very less, over all prevalence was calculated and no comparison among sexes was made. HBV and HCV positive cases were seen to have an increased trend while HIV showed a decreased trend towards the end. Conclusion: Seroprevalence of HBV, HCV and HIV though is low in our setup compared to other states but still they are a potential threat to the recipients of the blood as well as to the community and thus stringent measures need to be taken to prevent the transmission of these infections among blood recipients and society as a whole. As replacement donors are not professional blood donors and grossly represent the community, this analysis as such may give us a rough idea about the real prevalence of these infections in our community in absence of the community based epidemiological studies and guide us in carrying out the same in future to estimate the actual prevalence and thus the disease burden in our community.

To Compare Endoscopic Variceal Ligation + Carvedilol Versus Endoscopic Variceal Ligation + Propranolol on Hepatic Vein Pressure Gradient Reduction at 1 Month in Patients with First Episode of Esophageal Varix Bleed: Open Label Randomized Trial

and 0.041% (n = 17) were positive for HIV. Since the number of female donors was very less, overall prevalence was calculated and no comparison among sexes was made. HBV and HCV positive cases were seen to have an increased trend while HIV showed a decreased trend towards the end. Conclusion: Seroprevalence of HBV, HCV and HIV though is low in our setup compared to other states, but still they are a potential threat to the recipients of the blood and thus stringent measures need to be taken to screen the blood to avoid the transmission of these infections to the recipients which would in turn decrease the burden of these transmissible diseases among blood recipients. As replacement donors are not professional blood donors and grossly represent the community, this study as suchmay give us an idea about the real prevalence of these diseases in our community in the absence of community-based epidemiological studies.

Molecular epidemiology of HBV infection in chronic hepatitis B virus infected patients in northeast India.

The present study aimed to evaluate the molecular epidemiology of HBV in chronic HBV infected cases from northeast India (NEI), since scanty data are available from the region which has a predominant ethnically distinct tribal population. A total of 523 clinically diagnosed index chronic HBV infected cases and 172 asymptomatic patients (based on family screening) were enrolled with informed consent. Patients were stratified based on serology, imaging, pathology, and clinical data and grouped as chronic HBV and cirrhotic cohorts. Analysis for serum HBV DNA levels and HBV genotyping was performed, and was statistically co-related with disease severity. Males were more prone to chronic HBV infection. Majority of the patients who had Chronic HBV infection based on family screening were females (59.88%), majorly wives of index patients. Mean viral load in Chronic HBV patients was almost 4.5-folds higher than cirrhosis patients, and was significantly associated with e-antigen positive status(P < 0.001) in both groups. HBV genotype D was the most prevalent genotype (62.30%) in NEI. Mixed genotype infection of A + D was found from Assam, along with C + D cases (1.29%) cumulatively. There is a high prevalence of HBV genotype C (13.96%) in our studied cohort which was found to be associated with higher viral load(P = 0.018), e-antigen positivity(P = 0.043), and increased cirrhosis risk compared to Chronic HBV cases [OR = 1.670]. Family contacts in NEI are prone to infection with HBV and development of Chronic HBV. Higher presence of e-positive cases and genotype C along with the mixed genotypes in NEI is unique and of significance with reference to predisposition to disease severity and even response to antiviral therapy.

Public health response to a large-scale endoscopy infection control lapse in a nonhospital clinic.

To determine whether transmission of blood-borne pathogens (BBPs) (hepatitis B virus [HBV], hepatitis C virus [HCV] and HIV) occurred as a result of endoscopy reprocessing failures identified during an inspection of a nonhospital endoscopy clinic in 2011. The present analysis was a retrospective cohort study. Registered notification letters were mailed to 6992 patients who underwent endoscopy from 2002 to 2011 at one Canadian nonhospital endoscopy clinic, informing them of the infection control lapse and offering BBP testing. Multimedia communications and a telephone line supplemented notification. A retrospective study of patients with BBPs was performed with viral genetic testing and risk factor assessment for eligible patients. Risk for infection among patients whose procedure was within seven days of a known positive patient was compared with those whose procedure was performed more than seven days after a known postive patient. The seven-day period was selected as the period most likely to present a risk for transmission based on the documented cleaning procedures at the clinic and the available literature on virus survival. Ninety-five percent (6628 of 6992) of patients/estates were contacted and 5042 of 6728 (75%) living patients completed BBP testing. Three were newly diagnosed with HBV and 14 with HCV. Twenty-three and 48 tested positive for previously known HBV or HCV, respectively, 367 were immune to HBV due to natural infection and one was immune to HBV due to immunization. None tested positive for HIV. Sequencing did not reveal any relationships among the 46 unique case patients with viral genetic test results available. Ninety-three percent of patients reported alternative risk factors for BBP. An increased risk for infection among those who underwent a procedure within seven days of a known HBV or HCV case was not demonstrated. Endoscopy reprocessing failures were not associated with an increased risk for BBP among individuals tested.

Update on hepatitis B and C virus diagnosis.

Viral hepatitis B and C virus (HBV and HCV) are responsible for the most of chronic liver disease worldwide and are transmitted by parenteral route, sexual and vertical transmission. One important measure to reduce the burden of these infections is the diagnosis of acute and chronic cases of HBV and HCV. In order to provide an effective diagnosis and monitoring of antiviral treatment, it is important to choose sensitive, rapid, inexpensive, and robust analytical methods. Primary diagnosis of HBV and HCV infection is made by using serological tests for detecting antigens and antibodies against these viruses. In order to confirm primary diagnosis, to quantify viral load, to determine genotypes and resistance mutants for antiviral treatment, qualitative and quantitative molecular tests are used. In this manuscript, we review the current serological and molecular methods for the diagnosis of hepatitis B and C.

Abstract 5181: Genomic and transcriptomic somatic alterations of hepatocellular carcinoma in non-cirrhotic livers

Abstract Background: In 2014, it is estimated that there will be over 30,000 new cases of hepatocellular carcinoma (HCC) and an estimated 20,000 subjects will die of this disease in the U.S. alone. Risk factors include chronic HBV/HCV infections, cirrhosis, alcohol abuse, diabetes, and fatty liver disease. However, an important subset of HCC occurs in the absence of any such risk factors. We surveyed the genomic and transcriptomic landscape of this subset of HCC. Methods: We performed whole genome and transcriptome sequencing of 30 matched tumor and non-tumor liver samples from resections performed at Washington University School of Medicine. Somatic variants identified in this discovery set were extended to a set of 89 additional cases by custom capture sequencing for a total of 119 HCCs profiled. All data were processed through The Genome Institute's Genome Modeling System (GMS) to analyze for viral integrations, SNVs, Indels, CNVs, fusions, SVs, expression and differential expression. Results: We report here for the first time the unique landscape of somatic alterations of HCC arising in non-cirrhotic liver. We detected and validated over 3,010 SNVs and indels in coding regions and 2,390 fusion transcripts, as well as extensive copy number and expression changes. We identified a single undiagnosed HBV case with viral integration occurring at the TERT promoter. We also confirmed recent reports of a recurrent TERT promoter mutation (G1295228A) occurring in at least 56% of cases. Additional recurrent mutations were observed in previously reported genes such as CTNNB1, TP53, AXIN1, and ARID1A, along with an increased frequency of RB1 loss, novel recurrent mutations of APOB, fusions in NR1H4, and other alterations. These molecular features were tested for association with clinical variables and outcome. Pathway analysis of recurrently altered genes suggests that, in the absence of external factors, genomic aberrations in basic liver metabolism genes may promote malignant transformation to HCC. Citation Format: Obi L. Griffith, Yiing Lin, Malachi Griffith, Jasreet Hundal, Allison Regier, Robert Fulton, Elizabeth M. Brunt, Richard K. Wilson, William Chapman, Elaine R. Mardis. Genomic and transcriptomic somatic alterations of hepatocellular carcinoma in non-cirrhotic livers. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 5181. doi:10.1158/1538-7445.AM2014-5181

Expression and clinical significance of myeloid derived suppressor cells in chronic hepatitis B patients.

We here document discovery of expression profile of myeloid derived suppressor cells (MDSCs) in chronic hepatitis B (CHB) patients and changes in the course of disease. The study population was composed of 75 outpatient HBV cases and 15 healthy control cases. Peripheral blood samples were collected for separation of mononuclear cells. Levels of MDSCs labeled with Lin-DR-CD11b+CD33+ obtained from peripheral blood mononuclear cells (PBMC), were revealed to have significant differences between the CHB and other groups. They were 0.414% for health control cases and 0.226% for CHB cases (Z=-2.356, p=0.0189). It also observed that the group of HBeAg positive cases had significant difference in MDSCs/ PBMC median (X(2)=11.877, p=0.003), compared with group of HBeAg negative cases and the healthy control group. It suggested considerable MDSCs might be involved in HBeAg immune tolerance. In addition, negative correlations between MDSCs/PBMC and parameters of ALT, AST and TBil, while positive correlation between MDSCs/ PBMC and ALB parameter were found. Multiple comparisons between the four phases and health control phase again, there was a statistically sifnificant difference (X(2)=17.198, p=0.002). Taken together, these findings may provide a new immunotherapy strategy for reduced the expression levels of MDSCs in CHB patients, through induction of an autoimmune response to virus removal.

Su1472 Prognosis and Therapy for Ruptured Hepatocellular Carcinoma (HCC): Should Naive HCC Rupture Be Included in T4?

G A A b st ra ct s age 61.6 ± 14.4 years old) underwent measurement of SWV in liver parenchyma. In terms of the course of chronic hepatic disease, 56 cases were HCV, 64 cases were HBV, and 40 cases were nBnC. Among the 160 cases, 35 cases had HCC (HCV 23, HBV 5, nBnC 7). We used a Siemens ACUSON S2000 and scanned right liver lobe segment 5 six times with an intercostal approach, and calculated the mean SWV. ROC curves and multiple logistic regression analysis were used to evaluate HCC oncogenesis. Results: The mean SWVs (mean ± standard deviation) in the groups with HCC and without HCC were 1.28±0.46 vs. 1.85±0.53 (p<0.0001) in all cases, 1.43±0.54 vs. 1.93±0.50 (p=0.0009) in HCV cases, 1.17±0.29 vs. 1.51±0.46 (p=0.0191) in HBV cases, and 1.31±0.57 vs. 1.89±1.62 (p=0.0225) in nBnC cases, respectively. The SWVs in all HCC cases were significantly higher than those in non-HCC cases. The cut-off values (m/sec) with best discrimination between HCC cases and non-HCC cases were 1.42 in all cases, 1.36 in HCV cases, 1.67 in HBV cases, and 1.54 in nBnC cases. The areas under the ROC curve (AUC) were 0.839, 0.805, 0.705, and 0.814, respectively. We evaluated discrimination between HCC cases and non-HCC cases by multivariate analysis of mean SWV, age, sex, HCV infection, and HBV infection. Independent risk factors were mean SWV, age, and HCV infection. Conclusions: These data suggest that SWV may be useful for noninvasively evaluating the risk of HCC oncogenesis in chronic hepatic disease.

Prevalence and Risk Factors of Hepatitis B Virus Infection in Bahrain, 2000 through 2010

Hepatitis B infection is one of the world's major infectious diseases with about 350 million chronic carriers. Because no data is published on the prevalence and risk factors of this important disease in Bahrain, this article evaluates the available data from 2000 to 2010 to estimate the prevalence of the infection and to evaluate the risk factors. Epidemiologic data on HBV cases were collected from the major hospitals and health centers in Bahrain and statistically analyzed. Over this indicated decade, 877,892 individuals were screened for HBV infection and 5055 positive cases were reported in Bahrain. The prevalence of HBV infection during that period was 0.58%. Although there was no significant difference in the prevalence over the period of 10 years, the actual number of positive cases has almost doubled in the later years especially in 2007 and 2008. The prevalence was significantly higher among males (62.3%; P<0.01). Most cases were associated with non Bahrainis and the prevalence was significantly higher among them (68.3%; P<0.01) than it was among Bahrainis (31.7%). Seventy eight percent (2877/3690) of non Bahraini cases were for citizens of six countries which are highly endemic for HBV, namely India, Pakistan, Bangladesh, Philippines, Indonesia and Ethiopia. Dental procedures and surgical operations were the main risk factors of infection as 37.2% and 35.6% of the patients were probably infected through this route. The prevalence of hepatitis B virus infection in Bahrain indicates that Bahrain had low HBV endemicity for the last 10 years (2000–2010). Our study verifies the significant role played by expatriates/immigrants in the present epidemiology of hepatitis B in Bahrain. Increasing HBV vaccination of high risk groups, active educational and media campaign, screening HBV infection during pregnancy, and surveillance of hepatitis B infected individuals will further decrease the prevalence of the disease in Bahrain.

Nutrient Adequacy and Incidence of Common Complications in Women on ART in Manipur State, India.

A cross sectional study to study the food intake, nutrient adequacy and incidence of common complications & adverse events in Manipur state, India, was carried out on 442 women on ART in 2 hospitals, RIMS & JNIMS from April, 2009-October 2012. Anthropometric assessments, diet survey by 24 hours recall method, & hemoglobin estimation was done. Average mean age of the women was 37.62 years. 55.7% consisted of widows, 68.8% had monthly income less than Rs. 5000 per month, 86.2% of the women got the virus from their husbands who were ex-IDUs. Mean intake of cereals, roots & tubers were significantly higher when compared against the recommended levels while intake of all other remaining items was significantly lower. Mean daily intake of protein, fat, calcium and vitamin-C were more than RDA whereas the intake of energy, iron, carotene, thiamin, riboflavin & niacin were less. Average BMI was 21.04, average W: H was 0.84. Mean hemoglobin was 10.36 g/dl, 55.9% had mild anemia. There were 12 cases of HCV, 4 cases of HBV, 15 cases of TB. Most recorded discomfort was anorexia (43 cases) and heartburn/ bloating (33 cases). Study suggested compulsory diet counseling with nutritional supplementation & monetary assistance, to have important

Prevalence of genotype D in chronic liver disease patients with occult HBV infection in northern region of India.

Etiology of nearly 30% cases of chronic viral hepatitis remains undetected. Occult HBV infection (OBI) has emerged as an important clinical entity in this scenario. Apart from prevalence and clinical outcome of OBI patients genotype was determined in northern region of India. A total of 847 patients with chronic liver disease (CLD) were screened for common viral etiologies and others serological markers of HBV. Amplification of surface, precore and polymerase genes of HBV was performed in patients negative for other etiologies. Genotyping and sequencing of the precore region was performed for OBI cases. Twenty-nine (7.61%) cases of OBI were identifiedof which 9 had chronic liver disease (CHD), 11 liver cirrhosis (LC) and 9 hepatocellular carcinoma (HCC). Majority of OBI cases were detected by amplification of surface gene 26 (89.6%), followed by pre-core gene 12 (41.3%). Their liver functions tests were significantly deranged in comparison to overt HBV cases. IgG anti HBc was present in 8 (27.6%) OBI cases. Mutation was observed in 8 (32%) in pre-core region at nt. 1896 of overt HBV cases. Genotype D was the predominant genotype. OBI in our study was characterized by predominance of genotype D and more severe clinical and biochemical profile in comparison to overt HBV. IgG anti HBc positivity could be utilized as a marker of OBI. We recommend use of sensitive nested PCR for diagnosis of OBI, amplifying at least surface and precore gene.

Blood-Borne Hepatitis in Opiate Users in Iran: A Poor Outlook and Urgent Need to Change Nationwide Screening Policy

ObjectiveIran has the highest rate of opiate use worldwide. However, most opiate users are not screened for hepatitis virus infections. This study aimed to provide accurate, detailed data on the size of the opiate user population at risk of developing these infections.MethodThis seroprevalence study was conducted in the city of Shiraz, southern Iran. All participants were screened for HBV, HCV and HIV infection. The data were analyzed with SPSS.ResultAmong 569 participants, 233 (40.9%) were injection drug users (IDU), 369 (64.8%) were heterosexual, 84 (14.7%) were bisexual and 15 (2.6%) were homosexual. One hundred nine (19.1%) were HCV antibody-positive, 18 (3.1%) were HBS antigen-positive, 72 (12.6%) were HBc antibody-positive and 23 (4%) were HIV-positive. Among IDU compared to non-IDU, positivity rates for HBS antigen (5.5 vs 1.4%), HBc antibody (22.7 vs 5.6%), HCV antibody (40.3 vs 4.4%) and HIV (7.7 vs 1.4%) were higher (P < 0.05). Most patients with HBV (80.7%) and HCV infection (83.4%) were HIV-negative. In the cumulative analysis, only history of imprisonment was a statistically significant determinant of infection by HCV or HBV in opiate users. ConclusionThe current policy of screening only HIV-positive drug users for HBV and HCV in Iran misses most cases of HBV and HCV infection. We therefore recommend urgent revision of the nationwide protocol by the Ministry of Health in Iran to implement routine screening of all opiate users and especially IDU for these viruses, regardless of their HIV status.

Prevalence of Hepatitis B and C among Blood Donors in Jos South LGA, Plateau State, Nigeria

Hepatitis B and C infections are infectious liver diseases that result from infection with hepatitis B and C viruses and are transmitted via contact with contaminated blood and body fluids. This study was to determine the prevalence of HBV and HCV infection among blood donors in Jos South Local Government Area. Two hundred and forty-five volunteers were screened for HBsAg and anti-HCV using Enzyme Linked Immunosorbent Assay (ELISA) tests. Fifty-one (51) volunteers (20.8%) were positive for HBsAg, 12 (4.9%) were positive for anti-HCV while 3 (1.2%) were found to be co-infected with both the viruses. Volunteers in the age group 20-29 years had the highest prevalence of HBV (9.8%) and HCV (2.45%) infections. Those between the ages of 10-19 had the least prevalence of HBV infection (1.2%) while ages 40-49 years had the least prevalence. Based on sample location, Dadin Kowa had the highest infection rate of HBV (5.7%) while Zawan had the least prevalence of HBV (2.0%). Zaramaganda had the highest infection rate of HCV infection (2.0%) while Dadin Kowa had the least (1.2%) and Turu Vom and Zawan having no infections. Gender analysis showed that males had the higher prevalence (15.9%) for HBV and 4.1% for HCV higher than the females with 4.9% for HBV and 0.8% for HCV. The distribution by marital status showed that the single and married subjects had equal prevalence, 10.2% for HBV while for HCV the married had a higher prevalence of 2.85% than the single who had a 2.05% prevalence. This study also revealed that all the cases of HBV and HCV co-infections came from Zaramaganda area in Jos and among married people aged between 20 to 29 years. Co-infection was 0.8 and 0.4% for males and females, respectively. These results revealed the presence and circulation of HBV and HCV in the studied areas. Other details have been discussed in the study.

Prevalence and clinical course of hepatitis delta infection in Greece: A 13-year prospective study

Hepatitis D virus (HDV) has decreased in Europe, but recent reports indicate a rising trend. We report the epidemiological changes, clinical progress, and effect of treatment on the natural course of HDV infection in Greece during the last 13 years. Prospective data were extracted from the HepNet.Greece Cohort-Study. Since 1997, 4673 chronic HBV (CHB) cases (4527 adults, 146 children) have been followed prospectively. Two thousand one hundred thirty-seven patients were tested for anti-HDV [101 (4.7%) positive]. Anti-HDV testing in Greece decreased significantly (57.0% before 2003, 35.3% thereafter; p<0.001). Anti-HDV prevalence among HBsAg-positives was 4.2%; lower in native Greeks (2.8%) than in immigrants (7.5%) or in children (15.3%; p<0.001). Within 2.3 years of follow-up, HDV occurred in 11/2047 HBsAg-positive patients (2.2 new delta-infected adults and 8.7 children per 1000 HBsAg-positive annually). HDV-positive compared to CHB adults were younger (p=0.035) and had more active and advanced disease at baseline, as indicated by laboratory indices and the higher prevalence of cirrhosis at younger age. During a 4.2-year median observation, significantly more anti-HDV-positive than CHB adults developed a liver-related first event (20.0% vs. 8.5%, p Log-rank=0.014).Treatment was received by 46/90 (51.1%) patients, 40 of them interferon-based. In multivariable analysis, interferon significantly decreased disease progression in HDV-positive patients [HR=0.14 (95% CI: 0.02-0.86; p=0.033)]. In Greece, HDV serology is currently tested in only one-third of HBsAg-positive patients. HDV prevalence is lower in native Greeks compared to immigrants, who may contribute >50% of the HDV infection burden in Greece. Data show that HDV infection is a rapidly progressive disease, but interferon-based treatment may alter its course.

P6.064 Integrating Simultaneous Triple Point-Of-Care Screening for Syphilis, Hepatitis B and HIV in Antenatal Services Through Rural Outreach Teams in Guatemala

BackgroundIn May 2012, a simultaneous triple point-of-care screening programme for syphilis, hepatitis B (HBV) and HIV was integrated in antenatal services in rural Guatemala. The programme included screening for pregnant...

Prevalence of hepatitis B and C virus infections and their related risk factors in Libya: a national seroepidemiological survey

A high prevalence of hepatitis B (HBV) and C virus (HCV) infections has been reported among specific patient groups in Libya; a survey was thus designed to determine the extent of the problem at the national level. A multi-stage sampling design covering all administrative areas of Libya was applied, covering > 65,000 individuals of all age groups. All subjects gave a blood sample and completed a questionnaire on demographic and risk behaviour data. The prevalence of HBV surface antigen (HBsAg) and anti-HCV were 2.2% and 1.3% respectively. The prevalence of anti-HCV increased with age, rising gradually after age 30 years, in contrast to a stable prevalence of HBsAg in all age groups 10+ years. Age-adjusted risk factors for HCV infection were previous hospitalization, surgical operations, previous blood transfusions and intravenous drug use; for HBV infection only family exposure or contact with HBV case were identified.

Risk Factor Associated with Hepatitis B Incidence in Pondok Pesantren Putri Ibnul Qoyyim Yogyakarta

Hepatitis B virus has been a problem in developing countries. The transmission of HBV is through the exposure to the blood or secret of the infected patients. Woman has 3 times higher risk to get HBV than men. The pleminary observation revealed that in Pondok Pesantren Putri QoyyimYogyakarta 20-30 students shared a room. It also showed poor hygene that might lead to environmental based transmission. No sepesific sympthom for HBV infection in the early phase causes people unaware of getting infected. This study was aimed at finding out factors associated with HBV case among students in Pondok Pesantren Putri Ibnul Qoyyim Yogyakarta. This was an observational study using Cross Sectionl approach including 97 female students. The data were collected using interview, observation and blood testing to find out the marker of possitive HbsAg. The independent variable was blood transfussion history, the use of shrynge, piercing , permanent tattoo, accupunture, mouth cavity examination or dentist, family history of hepatitis,the tooth brush sharing or nail cutter.The resut showed that out of 97 female students subjected to blood test, 2 had a possitive HbsAg. Univariate analysis showed that factors associated with hepatitis B is the family history (OR=7.636; 95% Cl= 0.445-130.985 p=0,002). Multivariate analysis showed that family history of hepatitis B was significantly associated with the hepatitis B incidence (OR= 5. 704; 95% Cl= 0. 287-113. 276, p=0.004). Family history of hepatitis B is the risk factor for hepatitis B incidence in Pondok Pesantren Putri Ibnul Qoyyim Yogyakarta. Health education on the risk of geeting infected by Hepatitis B virus should be in the first priority.