Markers Of HBV Infection Research Articles

Clinical and morphological correlations in occult hepatitis B

to estimate the proportion of OHB in the structure of fatal outcomes in chronic viral hepatitis (CVH) and to characterize its clinical course and structural changes on autopsy materials. A total of 455 autopsy cases of CVH were examined for its etiology in the S.P. Botkin Clinical Hospital of Infectious Diseases in 2014-2016. An in-depth prospective clinical analysis was made to investigate 28 cases of OHB in the stage of decompensated liver cirrhosis, which had subsequently culminated in death. The criteria of inclusion were history data and clinical symptoms of CVH in the detection of markers for hepatitis A, C, and D and HIV in serum HBcAb in the absence of HBsAg. HBsAbs were also determined. Along with the traditional morphological examination, immunohistochemistry (IHC) for HBsAg and HBcAg was carried out. There were 108 CVHB cases (23.7% of the total cases of CVH), including 77 OHB cases (71.3% of those of CVHB) while HBsAg was not determined. HBsAb-negative patients were more often observed to have clinical signs of jaundice (p<0.05) and skin itching (p<0.05). Dyspepsia and hemorrhagic manifestations prevailed in patients with HBsAb (more than 10 IU/l) (p<0.05). All the cases were found to have characteristic morphological signs of CVH, including intranuclear inclusions and nuclear polymorphism in 10.7% of deaths. There was an IHC-positive reaction to VHB antigens in 28.6% of the patients and a doubtful reaction in 25.0%. Serum НВсAb may serve as a diagnostic marker for HBV infection. Clinical and morphological correlations enabled the authors to state that CVHB was present in all cases in the absence of serum HBsAg in the patients.

Predictive Value of Hepatitis B Core-Related Antigen (HBcrAg) During the Natural History of Hepatitis B Virus Infection.

The natural history of HBV infection includes immune tolerance (IT), immune clearance (IC), HBeAg-negative inactive/quiescent carrier (ENQ), and HBeAg-negative hepatitis (ENH) phases. As the current biomarkers for discriminating the four phases still have some weaknesses, additional serological indicators are needed. Hepatitis B core-related antigen (HBcrAg) encoded with the precore/core gene contains denatured HBeAg, HBV core antigen (HBcAg), and a 22-KDa precore protein (p22cr) and has been demonstrated to have a close association with the natural history of hepatitis B infection. However, no specific cutoff values and diagnostic parameters have been identified to evaluate the diagnostic efficacy. This study aimed to clarify the distribution of HBcrAg levels and evaluate the diagnostic performance during the natural history of HBV infection in a Western Chinese population. In this study, 294 samples were collected from treatment-naive HBV infection patients in different phases (IT = 64; IC = 72; ENQ = 100, and ENH = 58). We detected the HBcrAg values and analyzed the relationship between HBcrAg and HBV DNA. HBsAg and other clinical parameters were quantitatively detected. The HBcrAg levels of IT, IC, ENQ, and ENH were 9.30 log U/mL, 8.80 log U/mL, 3.00 log U/mL, and 5.10 log U/mL, respectively (p < 0.0001). Receiver operating characteristic curve analysis demonstrated that the areas under the curves (AUCs) for HBcrAg and quantitative HBsAg at cutoff values of 9.25 log U/mL and 4.355 log IU/mL for distinguishing the IT phase from the IC phase were 0.704 and 0.694, with a sensitivity of 53.13% and 79.69% and specificity of 76.39% and 59.72%, respectively. AUCs of HBcrAg and quantitative HBsAg at cutoff values of 4.15 log U/mL and 2.395 log IU/mL for discriminating between the ENQ and ENH phases were 0.931 and 0.653, with a sensitivity of 87.93% and 91.38% and specificity of 84.00% and 39.00%, respectively. HBcrAg levels varied significantly among the four natural phases of HBV infection and had higher predictive performance than quantitative HBsAg for distinguishing between ENQ-patients and ENH-patients and a similar performance as HBsAg for the discrimination between IT and IC phases, which indicated that HBcrAg could be a potential serological marker for HBV infection.

Hepatitis B viremia in completely immunized individuals negative for anti-hepatitis B core antibody.

The presence of anti-hepatitis B virus (HBV) core antibody (anti-HBc) is considered a sensitive lifetime marker of HBV infection. Here, we examined this dogma by investigating the prevalence of hepatitis B viremia in anti-HBc negative complete vaccines in Taiwan.A total of 795 participants (1.7-20.0 years old) had completed HBV vaccination in infancy and were anti-HBc negative. Serum samples were available for 460 individuals with isolated anti-HBV surface antibodies (anti-HBs) (HBsAg-negative and anti-HBc negative) and for 245 individuals who tested negative for all 3 markers (triple seronegative). All samples were submitted for polymerase chain reaction (PCR) targeting both the preS/S and X/pre-C gene regions.Of the 460 participants with isolated anti-HBs, 26 (5.65%) were positive for HBV by 2-target PCR. Of the 245 triple seronegative samples, 12 (4.90%) were positive for HBV DNA. In the former group, the prevalence of viremia was significantly higher in individuals aged 6 to 10 years than in all other ages combined (11.82% vs 3.7%, P = 0.001). The anti-HBs titers were significantly lower in participants 6 to 10 years old than in all other ages combined (72.06 vs 99.64 mIU/mL, P = 0.038). In total, 7 (0.99%) subjects had quantifiable HBV DNA levels (280-18,820 IU/mL). Sequence analysis of the S gene revealed vaccine escape like mutations.Hepatitis B viremia can occur in completely vaccinated individuals who are negative for anti-HBc.

Global epidemiology of occult HBV infection

Defining the epidemiology of occult HBV infection (OBI) is difficult because it relies on disparate sets of data and on the respective performance of both hepatitis B surface antigen (HBsAg) and HBV DNA detection and quantification. Higher sensitivity of HBsAg decreases OBI prevalence while increased HBV DNA detection increases such prevalence as two sliding indexes. In addition there is, at best, poor correlation in the levels of these two parameters. The prevalence of OBI in a general population depends on the prevalence of the infection, being in the 1:100–1,000 in high prevalence areas (East Asia and West Africa) but below 1:5,000 in Western Europe, North America and Australasia. As a percentage of overall infection OBI remains small ranging between 0.1% and 0.6%. Many studies selected individuals with anti-HBc as only serologic marker of HBV infection providing a biased view of the epidemiology since a larger number of cases are seen in anti-HBs positive individuals. The prevalence of OBI is higher in males than in females and also varies according to genotype, being particularly high for genotype D and E. It is typically identified in people ≥50 years, decades post-infection but at a younger age in sub-Saharan Africa. OBI prevalence is elevated in chronic liver disease (CLD), percentages ranging between 40% and 75% in HBsAg negative hepatocellular carcinoma (HCC). Immunodeficiency whether acquired or induced triggers OBI as a minor expression of HBV reactivation in anti-HBc carriers. As methods of HBV DNA detection increase in sensitivity, more OBI will be identified but the clinical significance of these extremely low levels of viral genome remains to be determined. In the meantime, proper epidemiologic, unbiased, studies should be conducted in general populations, particularly where the infection prevalence is high.

Impact of Universal Hepatitis B Vaccination on Prevalence, Infection-Associated Morbidity and Mortality, and Circulation of Immune Escape Variants in Russia.

Vaccination of newborns against hepatitis B (HB) was introduced in Russia in 1998. Since then the incidence of acute HB has rapidly declined. However, prevalence of chronic HB remains stable. The aim of this study was to estimate the effect of vaccination on HBV-associated morbidity, and to assess the prevalence of HBV immune escape variants after 10 years of vaccination.Methods6,217 sera samples collected from volunteers in six epidemiologically different regions of Russia were tested for serological and molecular markers of HBV infection. A mathematical model developed by the U.S. Centers for Disease Control and Prevention was used to estimate the effect of vaccination and birth dose coverage on the incidence of HB and adverse outcomes of infection.ResultsPrevalence of HBsAg in the study population varied from 1.2% to 8.2%; anti-HBc detection rates were 13.0–46.2%. HBsAg detection rates in epidemiologically significant cohorts were 0.6–10.5% in women of childbearing age; 0–2.4% in children ≤5 years old; 1.9–8.1% in adults ≥30 years old. Mathematical modeling demonstrated that the current 96.1–99.6% level of birth dose coverage increased the effectiveness of vaccination 10–21 times compared to 50% and 0% birth dose coverage scenarios. HBV DNA was detected in 63 sera samples. The frequency of amino acid substitutions in HBsAg was 38% (24/63). Only in 3% (2/63) the mutations were within the a-determinant of HBsAg (M133T and G145S, one case each). None of the identified mutations eluded HBsAg detection, since all these samples tested positive for HBsAg by commercial ELISA.ConclusionDespite a significant decline in acute HB incidence after the introduction of universal vaccination, many undiagnosed potential sources of infection remain. Low prevalence of HBV immune escape variants is a favorable predictor of vaccine effectiveness in the future.

Discordant diagnostic results due to a hepatitis B virus T123A HBsAg mutant

HBsAg immunoassay results are occasionally discordant among primary and confirmatory assays or with respect to other markers of HBV infection. Such discordance has been observed repeatedly in Canada with samples having a mutation at HBsAg codon 123 (sT123A). Detection of recombinant expressed HBsAg protein having either sT123 or sA123 was evaluated with one manual and six automated HBsAg immunoassays. The recombinant mutant HBsAg was non-reactive by Abbott AxSYM, while the Abbott ARCHITECT Quantitative and Qualitative II, ADVIA Centaur, and VITROS ECi detection signal was reduced compared with the wild-type protein, approaching the assay cut-off for certain assays, dependent upon the level of protein. The Roche Elecsys and manual immunoassays detected both wild-type and mutant proteins comparatively. The sT123A mutation leads to loss of detection by immunoassays commonly used in Canadian diagnostic laboratories, which may produce misleading results and diagnoses.

CD4/CD8 ratio as a predictor of the response to HBV vaccination in HIV-positive patients: A prospective cohort study

BackgroundHepatitis B virus (HBV) and human immunodeficiency virus (HIV) share transmission mechanisms and thus coinfection is frequent. Active immunization against HBV is essential in HIV patients. Reports using standard and reinforced HBV vaccination schedules vary widely in seroconversion rates depending on the characteristics of the included patients. Regional data concerning HBV vaccination in HIV patients are scarce. We aim to determine the serological response to HBV vaccination using standard schedule in HIV-positive patients and to evaluate characteristics that predict seroconversion. Materials and methodsWe performed a single centre prospective study of HBV vaccination with standard schedule in HIV-positive patients. Adults with negative markers of HBV infection were included between November 2012 and December 2014. Anti-HBs titres were measured 4–8 weeks after completion of vaccination schedule. Clinical, laboratory values and HIV characteristics were analyzed to determine their association with seroconversion and adherence to the HBV vaccination schedule. ResultsThe study included 245 HIV-positive patients, 68.9% were male and the mean age was 42.1 years. A total of 80.7% of the patients had undetectable HIV viral loads, 86.1% had CD4 counts >200, and 94.7% were on HAART. The response to vaccination was positive in 62% (95% CI, 56–68%) and mean anti-HBs titres of 646IU/ml. 85.5% of the responders had anti-HBs titres >100IU/ml. An age less than 45 years, no tobacco use and a CD4/CD8 ratio >0.4 were associated with seroconversion in multivariate analysis. The seroconversion rates were 86% in the subgroup of patients who met these criteria. A total of 97.9% of the study population completed the vaccination schedule. ConclusionThe CD4/CD8 ratio was the primary factor associated with positive serological conversion in the multivariate analysis. The seroconversion rates were higher in a selected group of patients who were particularly suitable for the use of the standard HBV vaccination schedule.

A Seroprevalence Study of Hepatitis B and C Virus Infections in a Hospitalized Population in Romania, an Opportunity for a Better National Prevention and Control Strategy.

The most recent prevalence data for hepatitis B virus (HBV) infection in Romania came from an ESEN 2 study (2002), and from a Romanian population-based study performed in 2008. Most of the previous studies were regional and performed in specific groups (blood donors, pregnant women, institutionalized people, etc) and had limited representativeness at the national level, both for HBV and hepatitis C virus (HCV) infection. The scarcity of prevalence data for HBV and HCV infection coming from the routine surveillance was also considered. The aim of our study was to obtain overall and age group specific estimates of the prevalence of HBV and HCV infections markers in Romania, in order to recommend evidence-based public health interventions. The main outcome was the proportion of persons with HBV, HCV and HBV+HCV infection markers, overall and by age group and gender. Our seroprevalence study ensured national representativeness for the targeted hospitalized population. A prospective collection of serum samples in hospital laboratories was completed between September and November 2013, using a systematic sampling. The study respected the confidentiality of personal data. We calculated the sample size using EpiInfo7 and used Z test - Two-tailed probability for statistical significance. The overall prevalence data estimated in our study were HBc Ab 28%, HBs Ag 4.2%, HBs Ab regardless of titer 64.1%, HBs Ab in titer of at least 10 mUI/ml and negative HBc Ab 17.5%; HCV Ab 5.6%; HBc Ab and HCV Ab 2.8%, as markers of double infection. The overall prevalence data estimated in our study for HBs Ag (4.2%) and HCV Ab (5.6%) correspond to a medium endemicity based on the WHO criteria. The estimated prevalence of HBV and HCV infection markers in the study population should represent an opportunity for a better national prevention and control strategy.

Identification of markers of opportunistic infections and viral hepatitis in oncohematological patients

The purpose of the study To estimate the prevalence of markers of herpesvirus infections and pneumocystosis in patients of the hematological department. To identify whether the contamination of hematological patients with hepatitis B and C (HBV, HCV) affects on the activation of opportunistic infections (OIs). Materials and methods There were examined 94 patients of the hematological department, including 48 patients with markers of HBV infection and 46 cases without them. Obtained results Markers of acute OIs (simple herpes virus type 1- 6,4%, EBV - 14,9%, CMV - 6,4%, and Human Herpesvirus 6- 13,8% and 33,0% of pneumocystosis) in hematological patients were determined more frequently than in donors. Comparative analysis of the data revealed the excess of the proportion of cases with markers of acute HHV-6 infection in hematological HBV patients in comparison with a group of hematologic patients without markers of HBV infection (22,9% against 4,4%, p

Hepatitis Delta Virus Infection in Romania: Prevalence and Risk Factors.

Hepatitis delta virus (HDV) infection is associated with accelerated progression of fibrosis, early occurrence of hepatic decompensation and an increased risk for hepatocellular carcinoma. Epidemiological data on hepatitis delta virus (HDV) in Romania are still lacking. To assess the prevalence, virological, clinical and epidemiological features of HDV infection in Romanian patients. We conducted a multicenter study in 10 centers. Data on sociodemographic characteristics and potential risk factors were collected through a questionnaire. Virological markers of HBV and HDV infection, biochemical and clinical features of liver disease were evaluated. The study population comprised 2,761 HBsAg(+) patients with a mean age of 43.8+/-13.8 years, out of whom 5.2% were HBeAg(+) and 55.7% were males. Liver cirrhosis was detected in 17.9% of patients, while 80.4% had chronic hepatitis. The prevalence of IgG anti-HDV(+) patients was 23.1%, out of whom 16.4% were HDV RNA positive. The highest prevalence of HDV infection was encountered in patients aged 50-59 years (28.9%) and patients aged >/= 60 (24.8%) (p=0.0001). Seroprevalence of HDV was significantly higher in AgHBs(+) cirrhotics vs. noncirrhotics (43.4% vs 19.0%, p=0.0001). Risk factors for HDV infection were: occupational hazard, no HCV chronic infection, lack of anti-HBV vaccination, presence of blood transfusions, any previous surgery, frequent hospitalization or endoscopies, tattoos, body piercing, use of glass syringes, number of female sexual partners. HBsAg(+) population in Romania is characterized by a high prevalence of HBeAg(-) HBV infection as well as HDV co-infection. A cohort phenomenon for HDV prevalence is also observed similar to that of HCV/HBV monoinfections.

A cross-sectional serosurvey on hepatitis B vaccination uptake among adult patients from GP practices in a region of South-West Poland.

BackgroundHepatitis B is a significant health burden in Poland with nosocomial transmission being the main source of infection. Therefore, HBV vaccination is widely recommended for those not covered by the national immunisation program. Objective: To assess the coverage and influencing determinants of HBV vaccination among adult patients attending GP clinics as well as to establish serological status in terms of HBV infection.MethodsPatients who were seen consecutively in March 2013 at four randomly selected GP practices located in Zgorzelec county, in south-western part of Poland, were invited to participate and complete questionnaires on socio-demographic data and other factors related to vaccination. A pilot study was done in one urban GP practice in the city of Gryfino (Gryfino county), the results have been included in the study. Patients’ immunisation status was assessed basing on vaccination cards and anti-HBs titer with the use of third-generation testing methods. In addition, serum samples were assayed for anti-HBc total.ResultsResponse rate: 99.3 %. Of 410 participants (66.1 % females, median age 56 years), 55.4 % (95%CI:50.5-60.1 %) were previously vaccinated; in those 11.5 % took 2 doses, 66.1 % - 3 doses,18.1 % – 4 doses. Elective surgery was the main reason (57.7 %) for HBV immunization, 4.8 % - were vaccinated due to recommendations by GPs. The multivariable logistic regression model revealed that living in a city (OR 2.11), and having a surgery in the past (OR 2.73) were each associated with greater odds of being vaccinated. Anti-HBc total prevalence among those unvaccinated was 13.6 % (95%CI:9.3 %-19,5 %), and 7.2 % (95%CI:4.4-11.8 %) among those vaccinated.ConclusionsLow HBV immunization coverage among adult patients from GP clinics and the presence of serological markers of HBV infection among both - those unvaccinated and vaccinated call for comprehensive preventative measures against infection, including greater involvement of family doctors. Although interventions should cover the whole population, inhabitants living in the rural areas should be a group of special interest. Preoperative immunization for HBV seems to be an efficient public health tool to increase the vaccination uptake.

Hepatitis B virus infection among institutionalized mentally ill patients in Brazil

ObjectivesThe main objective was to evaluate HBV infection and occult HBV infection (OBI) cases in mentally ill patients based on serological and molecular profiles. Material and methodsSerum samples of 333 long-stay mentally ill patients were tested for the prevalence of HBV markers by serological (ELISA) and molecular (PCR) assays. The PCR products were sequenced to determine viral genotypes. ResultsIt was observed a global prevalence of 12.9% (43/333) for HBV infection markers, considering HBsAg and/or anti-HBc positivity. Fourteen samples tested positive for anti-HBs alone. All samples positive (n=57) for any HBV serological markers were tested for HBV-DNA and six were positive: HBsAg/anti-HBc (n=1), anti-HBc/anti-HBs (n=1), anti-HBs alone (n=1), and anti-HBc alone (n=3). The rate of OBI was 9.2% (5/54) from samples that were anti-HBc and/or anti-HBs positive. All sequenced samples were characterized as genotype A. ConclusionThe high rate of HBV infections found in this study suggests the possibility of HBV transmission due to risk factors displayed by some patients, and highlights the importance of vaccination of susceptible patients and the staff of that institution.

Expression quantitative trait loci for TNFRSF10 influence both HBV infection and hepatocellular carcinoma development.

Tumor necrosis factor receptor superfamily member 10 (TNFRSF10) is a death domain-containing receptor for the apoptotic ligand TNFSF10, which involves multiple processes, including hepatocarcinogenesis and immune response against HBV infection. Several single nucleotide polymorphisms (SNPs) were identified as expression quantitative trait loci (eQTLs) for TNFRSF10. To assess the association of TNFRSF10 eQTL SNPs with the risk of hepatocellular carcinoma (HCC) and chronic HBV infection, we designed a case-control study that included 1,300 HBV-related HCC patients, 1,344 chronic HBV carriers, and 1,344 subjects with HBV natural clearance, and then genotyped two TNFRSF10 eQTL SNPs (rs79037040 and rs2055822). We found that rs79037040 GT/TT genotypes were associated with a decreased HCC risk (adjusted odds ratio [OR] = 0.83, 95% confidence intervals [CIs] = 0.71-0.97, P = 0.021) but an increased chronic HBV infection risk of borderline significance (adjusted OR = 1.14, 95%CIs = 0.98-1.33, P = 0.085). In contrast, the rs2055822 G allele was a risk factor for HCC (adjusted OR = 1.12, 95%CIs = 1.00-1.25, P = 0.041) but a protective factor for chronic HBV infection (adjusted OR = 0.89, 95%CIs = 0.80-0.99, P = 0.038). Furthermore, we observed a dose-dependent relationship between the number of alleles (rs79037040-T and rs2055822-A) and the risk of HCC and chronic HBV infection. In comparison with "0" alleles, having "1-4" alleles was significantly associated with decreased HCC risk and increased HBV infection risk. These findings suggest that eQTL SNPs for TNFRSF10 may be susceptibility markers for HCC and chronic HBV infection.

Effect of Previous Exposure to HBV on Liver Histology and Treatment Response in CHC Patients.

To analyze the influence of previous exposure to HBV on liver histology and treatment outcomes in chronic hepatitis C (CHC) patients. Case control study. Rawalian Liver Clinic, Department of Medicine, Holy Family Hospital, Rawalpindi, from January 2011 to December 2012. Medical records of CHC patients attending the Rawalian Liver Clinic were retrospectively analyzed. Virological and treatment responses along with histological changes were compared between cases (anti-HBc positive) and controls (anti-HBc negative). Significance was determined through chi-square test at p < 0.05. Among the 592 CHC patients, 254 (42.9%) had serological evidence of a positive anti-HBc (cases) and 338 (57.1%), patients had negative anti-HBc (controls). No significant difference was found between ETR, SVR and treatment responses (n=220) between the two groups. Out of 65 patients whose liver biopsy data was available, cases were more likely to respond in the absence of fibrosis [63.2%, (n=24) vs. 36.8%, (n=14), p=0.001]. The controls responded more in the presence of fibrosis [100% (n=9) vs. 0, p=0.001]. There was no significant effect of anti-HBc positivity on grades of inflammation and consequent treatment response (p=0.14). There are a significant number of CHC patients with markers of previous HBV infection in Pakistani population. Previous HBV (anti-HBc positive) does not seem to have an adverse effect on liver histology and treatment responses in HBV infection.

Characterization of HBV Among HBV/HIV-1 Co-Infected Injecting Drug Users from Mombasa, Kenya.

Hepatitis B (HBV) and Human Immunodeficiency virus (HIV) are both bloodborne viruses. Markers of either active or past HBV infection are present in many HIV infected patients. Worldwide, HBV prevalence varies geographically and endemicity is classified as low (<2%) or high (>8%). Genotypically, prevalence varies among different populations, with genotype A having a wide distribution. In Kenya, the prevalence of HIV-1/HBV co-infection ranges from 6-53% depending on the sub-population, with genotype A as the most common. To determine the prevalence and characterize HBV in HBV/HIV co-infected injecting drug users (IDUs) from Mombasa, Kenya. Blood samples were collected from HIV-infected IDUs in Mombasa, Kenya. Hepatitis B surface antigen (HBsAg) was tested by enzyme immunoassay (EIA). HBV DNA was extracted by SMITEST R&D kit. Polymerase chain reaction (PCR) was done; followed by population sequencing of HBV preS, core and full genome using specific primers. Analysis was done phylogenetically with reference sequences from the Genbank. Seventy two HIV-positive samples were collected from IDUs in Mombasa in February and March 2010. Of these, 10 (13.89%) were HBsAg-positive by EIA. Nine of the 10 samples (12.5%) were PCR positive for HBV in the preS region; from these, four HBV full length sequences were obtained. Phylogenetic analysis showed that all belonged to genotype A1. The prevalence of HBV co-infection among HIV-infected IDUs in Mombasa, Kenya was 12.5%. Phylogenetically, sequences obtained from this study showed clusters that were distinct from reported Kenyan reference sequences from the Genbank. The findings point to an existence of a transmission network among IDUs in Mombasa. This further suggests that HBV genotypes in Kenya may be regionally diverse.

The role of Screening for Herpes Simplex Virus in Candidates of Renal Transplantation

Background: Herpes Simplex Virus (HSV) infection in immunocompromised hosts like kidney transplant patients causes more morbidity and mortality than the general population. Objectives: The aim of this study was to evaluate the role of screening for HSV in donors and recipients of kidney transplantation. Materials and Methods: From October 2012 to November 2013, this cross sectional study was conducted on donors and recipients who were referred to our kidney transplant center in Ahvaz city, Iran. A standardized questionnaire was used to collect social and demographic data. The patients and donors were screened for HSV IgG and IgM antibodies by direct fluorescent antibody (DFA).Other routine pretransplant laboratory studies were also performed. Results: Overall 37 people (22 donors, 20 males and 2 females with mean age of 30 ± 5 years; 15 recipients, eight males and seven females with mean age of 45 ± 6 years) were enrolled in this study. All of the recipients were on hemodialysis. The markers of HBV and HCV infection were negative in 100% of recipients and donors. Herpes Simplex Virus (HSV) IgG antibody was positive in 93.33% of recipients (n = 14) and 77.27% of donors (n = 17). Herpes Simplex Virus (HAV) IgM antibody was positive in 33.33% of recipients (n = 5) and 13.63% of donors (n = 3). Conclusions: Herpes Simplex Virus is a common infection in donor and recipient candidates for kidney transplantation in Khuzestan province of Iran, and it seems that we need to perform screening for this infection to avoid kidney donation from seropositive donors to seronegative recipients.

Kinetic of Hepatitis B core-related antigen (HBcrAg) levels in chronic hepatitis B during NUC therapy

Introduction: Hepatitis B core-related antigen (HBcrAg) combines the antigenic reactivity of denatured HBeAg, HBcAg and the core-related protein p22cr. HBcrAg has been introduced as additional marker of HBV infection. High levels of HBcrAg were an independent risk factor for HCC in a large Japanese cohort, while low levels may indicate inactive carrier status.

Blunt wires in oral and maxillofacial surgery

he use of wires in maxillofacial surgery is simple, quick, conomical, and minimally invasive.1 However, the sharp nds can lead to a higher than normal number of wire-stick njuries (Fig. 1) with the potential risk of virus-associated iseases and infections such as hepatitis B (HBV), hepatiis C (HCV), and human immunodeficiency viruses (HIV).2 homas et al. reported that anti-HCV was found in 2.0% of ral surgeons, and serological markers of HBV infection in 1.2%.3 Most percutaneous injuries sustained by medical practiioners occur with sharp needles. Over the last 2 decades, dvances in the prevention of accidental needlestick injuries uring operation have included the development of needles ith blunt, tapering points, and this suggests that the use f blunt wires would also reduce the risk of percutaneous njuries (Fig. 1).4 Surgical wires are made of surgical stainless steel, and for edical purposes are delivered as a round bar. The sharp, ut ends can be blunted on a grinding disc but this is timeonsuming and has a high risk of injury. Another method is o cut and blunt the wires using a laser-beam welding system. aser-beam welding, which has high power density (around MW/cm2), can result in the rapid heating and cooling of mall zones. Cutting is done manually with a neodymiumoped yttrium aluminium garnet (Nd:YAG) Dentaurum laser Dentaurum, JP Winkelstroeter KG, Ispringen, Germany) for anual use. The workpiece is positioned under the stereomicroscope f the device. After a short exposure (0.5–20 ms), the wire elts to form beads at the ends (Fig. 2). The wires are held in

Ultrastructure of hepatorenal cell populations in patients with HCV and HBV infection markers. Hepatorenal associations.

Hepatorenal cell populations were studied in patients with HCV and HBV infection markers and renal dysfunction. Pronounced mosaicism of ultrastructural changes in hepatocytes was associated with polymorphic cytopathic effects caused by RNA-genome hepatitis C virus and DNA-genome hepatitis B virus. The destructive component of the tubular compartment predominated in renal biopsy specimens from patients, with subsequent degeneration of the tubular epithelium associated with progressive interstitial fi brosis. Immunohistochemical studies detected HCV NS3Ag and HBcAg structural marker in the tubular epitheliocytes. An appreciable part of the structural and functional changes in the liver in patients with HCV and HBV infections was caused by the therapeutic complex, including programmed hemoperfusion.

O3-5-1 - Safe Administration of Ambulatory Chemotherapy Center

Background: Previous studies of the safety of outpatient chemotherapy of severe adverse events (SAEs) and chemotherapy errors do not clearly consider the prevention. Objective: We treat approximately 2,500 outpatient-years with chemotherapy without explicit criteria in our ambulatory chemotherapy center (ACC). Our purpose is to develop safety, efficiency and risk management in our ACC by clarifying safety standards. Method, We investigated 3,067 case-years that reserved chemotherapy at ACC between Jun, 2012 and May, 2013. We have studied the effectiveness using criteria received chemotherapy in our ACC. In addition, to prevent HBV reactivation, we have tested newly-outpatients (n = 332) for serologic markers of HBV infection before chemotherapy.Results: The median age was 65 years. Treatment-related grade 3 or 4 adverse events were discontinued or deferred. HBsAg-positive, HBsAb-positive and HBcAb-positive patients were 0.9%(3 of 332), 13.8% (46 of 332) and 15% (3 of 332). Nobody developed HBV reactivation in our ACC.Conclusion: In this study, the chemotherapy received rate is relatively high, SAEs are low. The results suggest strategies for prevention in the outpatient chemotherapy.