Hepatitis C Virus Prevalence Research Articles

Incidence of Hepatitis C Virus infection and the potential predictors among patients with diabetes mellitus in the Bamenda Regional Hospital in Cameroon

Introduction: Diabetes mellitus (DM) and Hepatitis C Virus (HCV) infections are a global major public health threat. Their co-infections and associated risk factors have been postulated in many countries, unfortunately, no such data exist in Cameroon. This study aims to determine the prevalence and possible predictors of HCV among DM patients. Methods: We conducted a cross-sectional study among DM patients at Regional Hospital Bamenda from February to June 2020. Blood samples were collected and tested for the presence of HCV. Data were analyzed using SPSS version 23. Results: The study comprised 193 participants. The mean (Std. error) age and random blood sugar level of the participants were 46.12(0.9) years and 134.15(4.07) g/dl respectively. HCV prevalence was 3.11% (6). The distribution of HCV infection did not show any significant difference with social demographic factors (p > 0.05). Similarly, HCV was insignificantly (p > 0.05) higher in patients with T2DM 6(3.4%), those with disease duration >5 years 4(4.4%), and those receiving injectable drugs 2(9.1%). Possible predictors (p<0.05) of HCV identified in this study include; uncontrolled diabetes (7.4%), family history of diabetes (19.2%), hepatitis 2(15.4%), alcohol intake (7.6%), multiple sex partners (6.5%), sharing sharp objects (9.1%), those with Tattoos (9.4%), scarification marks (3.6%), as well as those who have been hospitalized (6.7%), or received blood transfusion (25.0%) at least once. Conclusion: HCV testing and linkage to care among DM patients should be made imperative in order to design effective treatment and prevention programs that will reduce the morbidity and mortality rates.

The prevalence of hepatitis C and hepatitis B in lesbian, gay, bisexual and transgender populations: a systematic review and meta-analysis

ObjectivesThis study aimed to systematically review the literature on the prevalence of hepatitis C virus (HCV) and hepatitis B virus (HBV) infections in transgender and LGBT people and determine their pooled estimates worldwide.MethodsDatabases (PubMed, Scopus, Web of Science, Embase, Ovid, Cochrane, PsycInfo) were searched from April 2000 to July 2021. The analyses were executed using the random-effects model in Stata 16.ResultsTen studies, including eight studies on four transgender people and two studies on 2150 LGBTs, were included. The pooled prevalence of HCV and HBV in all transgender populations globally were 9% (95% CI 3–15%) and 11% (95% CI 2–20%), respectively. The corresponding prevalence in male-to-female transgender people were estimated as 5% (95% CI 1–9%) and 6% (95% CI 3–10%), respectively. These estimates in American transgenders were 10% (95% CI 5–25%) and 16% (95% CI 8–23%), respectively.ConclusionThis study was identified the overall prevalence of HBV and HCV infections in transgender people, which were higher than those in the general population.

Modeling the spread of hepatitis C virus amongst people who inject drugs

This article discusses two models, with two different needle assumptions for the transmission of hepatitis C virus (HCV) between people who inject drugs (PWIDs) who share needles and syringes. Our analysis demonstrates that the basic reproduction number R 0 determines how the model behaves. R 0 = 1 is a crucial threshold parameter which divides two qualitatively different scenarios. It has been shown that if R 0 ≤ 1 only a disease-free equilibrium point exists. On the other hand if R 0 > 1 a unique endemic equilibrium point exists as well as the disease-free one. The disease-free equilibrium point is globally asymptotically stable if R 0 ≤ 1 otherwise unstable. We look at an approximation to this model by using the fact that the timescale on which the individual PWIDs inject with needles or syringes is much faster than the timescale of epidemiological change. Also, we showed that if R 0 > 1 the endemic equilibrium point is locally asymptotically stable for our approximation to this model. Additionally, we perform some simulations with realistic parameter values which confirm that if R 0 > 1 then the solutions to this model tend to this endemic equilibrium value giving a steady-state nonzero HCV prevalence. With realistic parameter values for both assumptions we find that R 0 = 2 . 9987 and the total endemic equilibrium fraction of infectious PWIDs is 0.5348 and the total equilibrium fraction of antibody positive PWIDs is 0.65. The total fraction of infectious needles is 0.275.

Prevalence of and Factors Associated With Transfusion-Transmitted Infections Among Multi-transfused Patients, Sana'a City, Yemen, 2019

Background Multi-transfused patients (MTPs) are at higher risk of transfusion-transmitted infections (TTIs) due to their frequent need for blood transfusion. Nevertheless, little is known about the prevalence of TTIs among MTPs and its associated factors in Yemen. Objective We aimed to determine the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV and its associated factors among MTPs. Methods A cross-sectional study was conducted at the Yemeni Society for Thalassemia and at Pediatric Leukemia Unit in Sana’a City. The calculated sample size of 357 was increased to 405 to overcome any nonresponses. By using probability proportional to size sampling, 80 patients with thalassemia, 240 patients with sickle cell anemia, and 85 patients with leukemia were randomly selected. Data were collected through face-to-face interviews with patients or their caretakers by using a predesigned questionnaire covering demographic, socioeconomic characteristics and TTI-associated factors. Blood samples were drawn and were tested for HBsAg, anti-HCV, and HIV I and II by using an electrochemiluminescence immunoassay. Results The overall prevalence of TTIs among MTPs was 13.1% and was significantly highest (37.3%) among patients with leukemia. HBV (16.2%) and HCV (27.5%) prevalence were also highest among patients with leukemia. Only 2 (0.04%) patients were found to be HIV positive among patients with sickle cell anemia. Coinfection with HBV and HCV was only found in 5 patients with leukemia. There was a significant association between TTIs and the receipt of >30 blood units. Only 35% of MTPs were found to be vaccinated against HBV. Conclusions Our findings raise an alarm for the existence of a high risk of TTIs among MTPs, especially among patients with leukemia and those who undergo an increasing number of transfusions. Using advanced technology in blood screening and strict infection prevention during transfusion should be adopted. The rational use of blood/blood substitutes and ensuring that MTPs are vaccinated against HBV are recommended.

Occult hepatitis B virus infection in hepatitis C virus negative chronic liver diseases.

Data concerning the prevalence of hepatitis B virus (HBV) occult infection (OBI) varies greatly in the different studies according to the sensitivity and specificity of the diagnostic approaches and the HBV prevalence in the different populations examined. The clinical implications of OBI are still debated. While the impact of OBI in HBV transmission as well as in HBV reactivation under immunosuppression are well established, the role of OBI in liver disease and hepatocellular carcinoma (HCC) development are still not definitively elucidated. It has been hypothesized that OBI might contribute to worsening the liver disease course when other causes of liver damage co‐exist. Furthermore, much evidence suggests a role of OBI in the hepato‐carcinogenesis processes through both indirect and direct oncogenic mechanisms that might favour HCC development. Data on the OBI clinical implications mainly come from studies performed in patients with hepatitis C virus (HCV) infection. However, HCV prevalence has dramatically fallen in the past years also because of the advent of specific and highly effective direct acting antivirals, with a consequent abrupt change of the worldwide scenario of chronic liver disease. Information about OBI prevalence and possible clinical impact in non‐HCV‐related liver disease are fragmentary, and the objective of this review is to critically summarize the available data in this field.

Hepatitis C seroprevalence among people living with HIV/AIDS and pregnant women in four provinces in Cambodia: an integrated bio-behavioral survey

BackgroundUnderstanding the extent of viral hepatitis burden in specific subgroups, such as pregnant women and people living with HIV/AIDS (PLWHA), and their geographic distribution is essential for evidence-informed policy and mobilizing resources for targeted treatment and prevention efforts. However, in Cambodia, the epidemiology of hepatitis C remains uncertain. We estimated the hepatitis C virus (HCV) burden and transmission risk factors among PLWHA and pregnant women attending antenatal care (ANC) in Cambodia.MethodsBetween March and April 2016, we conducted a cross-sectional survey in four diverse geographical areas: the capital city of Phnom Penh and three provinces. We collected information on demographic characteristics and risk behaviors and performed HCV antibody (Anti-HCV) testing among pregnant women attending public ANC clinics and among those receiving HIV care at the hospitals. We computed the prevalence of HCV among the two population subsets and performed logistic regression analyses to identify risk factors associated with HCV antibody positivity.ResultsOf 935 participants enrolled, 510 (54.6%) were pregnant women and 425 (45.4%) were PLWHA. Anti-HCV prevalence was significantly higher in PLWHA than in pregnant women (29/425, 6.8% vs 5/510, 0.9%, P < 0.001). Of the geographic regions, Preah Sihanouk province (Southwest) had the highest anti-HCV prevalence among PLWHA (12.0%, P = 0.031). There was no significant geographic difference in anti-HCV prevalence among pregnant women. In multivariable analyses (data subset to PLWHA), HCV infection was significantly associated with having a family member positive for HCV (OR = 7.6 [95% CI: 1.01–57.84], P = 0.048) and a history of intravenous medication injection in the last 5 years (OR = 7.1 [95% CI: 2.79–18.10], P < 0.001).ConclusionsHCV infection is relatively common among Cambodian PLWHA, likely related to intravenous medication injection and intra-familial viral transmission. Systematic HCV testing and care among PLWHA (and possibly their family members) might be necessary. Setting up a surveillance system for HCV might also be beneficial for some geographical regions and populations.

Global change in hepatitis C virus prevalence and cascade of care between 2015 and 2020: a modelling study

Since the release of the first global hepatitis elimination targets in 2016, and until the COVID-19 pandemic started in early 2020, many countries and territories were making progress toward hepatitis C virus (HCV) elimination. This study aims to evaluate HCV burden in 2020, and forecast HCV burden by 2030 given current trends. This analysis includes a literature review, Delphi process, and mathematical modelling to estimate HCV prevalence (viraemic infection, defined as HCV RNA-positive cases) and the cascade of care among people of all ages (age ≥0 years from birth) for the period between Jan 1, 2015, and Dec 31, 2030. Epidemiological data were collected from published sources and grey literature (including government reports and personal communications) and were validated among country and territory experts. A Markov model was used to forecast disease burden and cascade of care from 1950 to 2050 for countries and territories with data. Model outcomes were extracted from 2015 to 2030 to calculate population-weighted regional averages, which were used for countries or territories without data. Regional and global estimates of HCV prevalence, cascade of care, and disease burden were calculated based on 235 countries and territories. Models were built for 110 countries or territories: 83 were approved by local experts and 27 were based on published data alone. Using data from these models, plus population-weighted regional averages for countries and territories without models (n=125), we estimated a global prevalence of viraemic HCV infection of 0·7% (95% UI 0·7-0·9), corresponding to 56·8 million (95% UI 55·2-67·8) infections, on Jan 1, 2020. This number represents a decrease of 6·8 million viraemic infections from a 2015 (beginning of year) prevalence estimate of 63·6 million (61·8-75·8) infections (0·9% [0·8-1·0] prevalence). By the end of 2020, an estimated 12·9 million (12·5-15·4) people were living with a diagnosed viraemic infection. In 2020, an estimated 641 000 (623 000-765 000) patients initiated treatment. At the beginning of 2020, there were an estimated 56·8 million viraemic HCV infections globally. Although this number represents a decrease from 2015, our forecasts suggest we are not currently on track to achieve global elimination targets by 2030. As countries recover from COVID-19, these findings can help refocus efforts aimed at HCV elimination. John C Martin Foundation, Gilead Sciences, AbbVie, ZeShan Foundation, and The Hepatitis Fund.

Global prevalence of hepatitis C in prisoners: a comprehensive systematic review and meta-analysis.

Hepatitis C virus (HCV), one of the most significant causes of liver inflammation, has a high annual mortality rate. The unfavorable hygiene conditions and inadequate health monitoring in many prisons increase the risk of blood-borne infections such as hepatitis C. The growing incidence of this disease among prisoners results in overspill transmission to the general population from undiagnosed prisoners that have been released. Therefore, the aim of this study was to investigate the prevalence of hepatitis C among the world's prison population. A systematic review and meta-analysis of studies on the prevalence of hepatitis C was carried out using the keywords "Prevalence", "Hepatitis C", and "Prisoner" in the Iranian and international databases SID, MagIran, Iran Doc, Science Direct, Scopus, PubMed, and Web of Science (WoS) from January 1990 to September 2020. After transferring the articles to the information management software EndNote and eliminating duplicate studies, the remaining studies were reviewed based on inclusion and exclusion criteria, three stages of primary and secondary evaluation, and qualitative evaluation. Comprehensive meta-analysis software and Begg and Mazumdar and I2 tests were used for data analysis and assessment of dissemination bias, and heterogeneity, respectively. Out of 93 studies (22 from Asia, 26 from Europe, seven from Africa, 29 from America, and nine from Australia) with a total sample size of 145,823 subjects, the prevalence of hepatitis C in prisoners worldwide was estimated to be 17.7% (95% confidence interval, 15-20.7%). The highest prevalence of hepatitis C on the continents included in this study was reported in prisoners incarcerated in Australia and Oceania, with 28.4% (95% CI: 21.6-36.4) in nine studies, and Europe, with 25.1% (95% CI: 19.4-31.8) in 26 studies. All studies used an ELISA test for the detection of HCV antibodies. The results showed a prevalence of HCV of 17.7% in prisoners worldwide, ranging between 10 and 30% over five continents (Asia, Europe, America, Africa, and Australia and Oceania). The highest prevalence was reported in Australia and Oceania (28.4%), indicating the need to pay more attention to this issue on the continent. It is necessary to reduce the incidence of the disease in prisons by appropriate policy-making and the development of accurate and practical programs, including the distribution of free syringes and examination, testing, and screening of prisoners.

Hepatitis C virus micro-elimination within a clinic for people with HIV: challenges in the home stretch.

To describe a pharmacist-led campaign aimed at reducing the proportion of people with HIV with ongoing chronic hepatitis C virus (HCV) infection and delineating barriers to HCV care in this patient population. An electronic report and retrospective chart review were used to identify patients who remained with HCV infections after a previous treatment initiative. A clinical pharmacist and pharmacy resident approached the remaining HCV patients during their routine visits for HIV care to offer and coordinate direct-acting antiviral (DAA) treatment. The primary end-point was to compare the prevalence of chronic HCV before and after the intervention period. Barriers to care were also evaluated, with logistic regression performed to identify predictors of sustained virologic response (SVR) attainment. Forty-six patients were included in the analysis (4.2% of clinic population), with HCV prevalence falling to 0.6% (six patients) by the end of the study (p<0.0001). The HCV care cascade in the cohort was as follows: 70% agreed to and received DAA therapy, 63% initiated therapy, and 50% achieved SVR. The top barriers to care at baseline included recreational drug use (67%), poor engagement in care (61%), and mental health disorders (28%). Poor engagement in care and active recreational drug use were associated with decreased odds of achieving SVR in bivariate analysis. A coordinated effort can make strides towards reducing the overall burden of HCV in this challenging population. The HCV care cascade remains tied to the HIV continuum of care, with poor engagement in care remaining an important rate-limiting step impeding micro-elimination.

A clinical and molecular epidemiological survey of hepatitis C in Blantyre, Malawi, suggests a historic mechanism of transmission.

Hepatitis C virus (HCV) is a leading cause of liver disease worldwide. There are no previous representative community HCV prevalence studies from Southern Africa, and limited genotypic data. Epidemiological data are required to inform an effective public health response. We conducted a household census‐based random sampling serological survey, and a prospective hospital‐based study of patients with cirrhosis and hepatocellular carcinoma (HCC) in Blantyre, Malawi. We tested participants with an HCV antigen/antibody ELISA (Monolisa, Bio‐Rad), confirmed with PCR (GeneXpert, Cepheid) and used line immunoassay (Inno‐LIA, Fujiribio) for RNA‐negative participants. We did target‐enrichment whole‐genome HCV sequencing (NextSeq, Illumina). Among 96,386 censused individuals, we randomly selected 1661 people aged ≥16 years. Population‐standardized HCV RNA prevalence was 0.2% (95% CI 0.1–0.5). Among 236 patients with cirrhosis and HCC, HCV RNA prevalence was 1.9% and 5.0%, respectively. Mapping showed that HCV RNA+ patients were from peri‐urban areas surrounding Blantyre. Community and hospital HCV RNA+ participants were older than comparator HCV RNA‐negative populations (median 53 vs 30 years for community, p = 0.01 and 68 vs 40 years for cirrhosis/HCC, p < 0.001). Endemic HCV genotypes (n = 10) were 4v (50%), 4r (30%) and 4w (10%). In this first census‐based community serological study in Southern Africa, HCV was uncommon in the general population, was centred on peri‐urban regions and was attributable for <5% of liver disease. HCV infection was observed only among older people, suggesting a historic mechanism of transmission. Genotype 4r, which has been associated with treatment failure with ledipasvir and daclatasvir, is endemic.

Occurrence Rate of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) Co - infection among Expectant Mothers Attending Antenatal Clinic in Rivers State University Teaching Hospital

The global burden of co-infection with human immunodeficiency virus (HIV), hepatitis B and C virus (HBV and HCV) has a negative impact in Sub-Saharan Africa.When HIV, HBV and HCV co-exist, they become life threatening and with high fatality rate particularly in gestation in which transmission occurs vertically, causing fetal and neonatal hepatitis. The study aimed at examining the occurrence rate of Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV) and Hepatitis C Virus (HCV) co - infection among expectant mothers attending antenatal clinic in Rivers State University Teaching Hospital (RSUTH). The study population comprised of one hundred and fifty (150) pregnant women. Venous blood was used in the study and screened for hepatitis B surface antigen (HBsAg), anti-HCV, and anti-HIV antibodies using commercially available immunoassay test kits. The prevalence of HCV, HIV and HBsAg among the pregnant subjects in relation to age group 21-30 and 31-40 in the study revealed a seropositive percentage of 0.7% and 1.3%. The other groups, however, showed no positive result among the three viruses. Furthermore, 0.7% of the pregnant women in their first, second and third trimester were co-infected with HCV and HBsAg while 1.3% out of 36.7% and 0.7% out of 61.3% of pregnant women within the age groups 21-30 and 31-40 respectively were seropositive for HIV. In relation to gestational age, it was seen from the study that 0.7% of the pregnant women in their first, second and third trimester were seropositive for HCV and HBsAg respectively, while 2% of the HIV seropositive pregnant women were in their first trimester. The overall seroprevalence of HCV, HIV and HBsAg as revealed in the study showed that infection was found to be 2% respectively among the pregnant women. The reduced prevalence of hepatitis B (HBsAg), hepatitis C (HCV) and human immunodeficiency virus (HIV) infection observed in the study among pregnant women attending antenatal care in the Rivers State University Teaching Hospital may be attributed to the increase in the awareness amongst the general populace in Port Harcourt especially couples about the consequences of sexually transmitted diseases such as HIV, Hepatitis B as well as Hepatitis C. In other words, there is reduction in seroprevalence of HBsAg, HCV and HIV which is premised on the efficacy of sensitization particularly on HBV vaccination and preventive protocols for HIV.

Point-of-care hepatitis C screening with direct access referral to improve linkage to care among halfway house residents: a pilot randomised study.

Linkage to care among individuals with substance misuse remains a barrier to the elimination of the hepatitis C virus (HCV). We aimed to determine whether point-of-care (PoC) education, screening and staging for liver disease with direct access to hospitals would improve linkage to care among this group. All participants were offered PoC education and HCV screening. HCV-positive participants were randomised to standard care (controls) or direct access, which provided a direct pathway to hospitals. Linkage to care was determined by reviewing electronic medical records. Linkage of care cascade was defined as attendance at the specialist clinic, confirmation of viraemia by HCV RNA testing, discussion about HCV treatment and initiation of treatment. 351 halfway house residents were screened. The overall HCV prevalence was 30.5% (n = 107), with 69 residents in the control group and 38 in the direct access group. The direct access group had a significantly higher percentage of cases linked to specialist review for confirmatory RNA testing (63.2% vs. 40.6%, p = 0.025), HCV treatment discussion (p = 0.009) and treatment initiation (p = 0.01) compared to the controls. Overall, only 12.6% (n = 13) had treatment initiation during follow-up. PoC HCV screening with direct access referral had significantly higher linkage to HCV treatment initiation (adjusted odds ratio 9.13, p = 0.005) in multivariate analysis. PoC HCV screening with direct access improves linkage to care and simplifies the HCV care cascade, leading to improved treatment uptake. PoC education, screening, diagnosis and treatment may be an effective strategy to achieving HCV micro-elimination in this population.

High-Risk Injection-Related Practices Associated with anti-HCV Positivity among Young Adults Seeking Services in Three Small Cities in Wisconsin

Background Hepatitis C virus (HCV) infection has been increasing among people who inject drugs (PWID), younger than 30 years, and living in rural or suburban areas. We examined injection-related behaviors of young PWID to determine factors associated with HCV infection. Methods From September 2013-May 2015, respondent-driven and snowball sampling were used in 3 suburban areas of Wisconsin to recruit PWID 18-29 years who reported injection drug use in the previous 12 months. Participants were tested for HCV antibody (anti-HCV) and reported injection-related behaviors/practices via self-administered computer-based survey. We calculated anti-HCV prevalence and assessed associated factors using multivariable logistic regression. Results Forty-two percent (117/280) of participants were male, 83% (231/280) were white, and median age was 23 years. Overall HCV prevalence was 33%, but HCV prevalence among males was 39%. Adjusting for age, sex, race/ethnicity, education, relationship status, insurance status and income, anti-HCV positivity was associated with higher injection frequency (> 100 times in the past six months) (aOR = 3.07; 95% Confidence Interval (95% CI): 1.72-5.45), ever shared syringes (aOR = 5.15; 95% CI: 2.52-10.51), past week/last use receptive rinse water sharing (aOR = 1.88; 95% CI: 1.06-3.33), past week/last use receptive filter sharing (aOR = 3.25; 95% CI: 1.61-6.54), reusing syringes (aOR = 1.91, 95% CI: 1.08-3.37), history of overdose (aOR = 8.82; 95% CI: 2.26-3.95), and having ever injected another PWID (aOR = 8.82; 95%CI 3.94-19.76). Discussion Anti-HCV positivity is associated with high-risk injection practices. Young PWID would benefit from access to evidence-based interventions that reduce their risk of infection, link those infected to HCV treatment, and provide education to reduce further transmission.

Distribution of Anti - Hepatitis C Virus antibody in a tertiary care center

Background: Hepatitis C virus remains the leading cause of chronic liver disease and hepatocellular carcinoma. Little evidence exists in Albania according to HCV prevalence and its distribution in different groups. Objective: Aim of this study was to determine the prevalence of hepatitis C virus (HCV) infection in patients diagnosed in the laboratory of a tertiary care center. Methods: In the study were included a total of 1793 patients who were tested for anti - HCV antibodies with chemiluminescence (CLIA) method. Results: 233 out of 1793 patients were positive for anti - HCV antibodies resulting in a prevalence of 12.44%. Prevalence of anti - HCV antibodies was higher in hemodialysis patients, 35.74%. More positive anti - HCV antibodies was present in males than in females’ group. Conclusion: The anti-HCV prevalence among patients is higher and highlight the importance of re-defining risk groups and monitoring of patients and health care worker as part of nosocomial infection programs. Keywords: Hepatitis C virus, anti - HCV antibody, RNA viral load, Prevalence

Hepatitis C prevalence and quality of health services among HIV-positive mothers in the Democratic Republic of the Congo

Hepatitis C virus (HCV) contributes to liver-related morbidity and mortality throughout Africa despite effective antivirals. HCV is endemic in the Democratic Republic of the Congo (DRC) but data on HCV/HIV co-infection in pregnancy is limited. We estimated the prevalence of and risk factors for HCV/HIV co-infection among pregnant women in the Kinshasa province of the DRC. This cross-sectional study was conducted as a sub-study of an ongoing randomized trial to assess continuous quality improvement interventions (CQI) for prevention of mother-to-child transmission (PMTCT) of HIV (CQI-PMTCT study, NCT03048669). HIV-infected women in the CQI-PMTCT cohort were tested for HCV, and risk factors were evaluated using logistic regression. The prevalence of HCV/HIV co-infection among Congolese women was 0.83% (95% CI 0.43-1.23). Women who tested positive for HCV were younger, more likely to live in urban areas, and more likely to test positive during pregnancy versus postpartum. HCV-positive women had significantly higher odds of infection with hepatitis B virus (HBV) (aOR 13.87 [3.29,58.6]). An inverse relationship was noted between HCV infection and the overall capacity of the health facility as measured by the service readiness index (SRI) (aOR:0.92 [0.86,0.98] per unit increase). Women who presented to rural, for-profit and PEPFAR-funded health facilities were more likely to test positive for HCV. In summary, this study identified that the prevalence of HCV/HIV co-infection was < 1% among Congolese women. We also identified HBV infection as a major risk factor for HCV/HIV co-infection. Individuals with triple infection should be linked to care and the facility-related differences in HCV prevalence should be addressed in future studies.

Prevalence and genotype distribution of hepatitis C virus within hemodialysis units in Thailand: role of HCV core antigen in the assessment of viremia

BackgroundIndividuals with end-stage renal disease have a higher risk of hepatitis C virus (HCV) acquisition during long-term hemodialysis (HD). Our report was designed to investigate HCV prevalence and genotype, in addition to the clinical use of HCV core antigen (HCVcAg), within multiple HD facilities in Thailand.MethodsThis cross‐sectional report was investigated between January and June 2019. HCV infection was assessed by anti-HCV and confirmed active infection by measuring HCV RNA and HCVcAg. HCV genotype was determined by phylogenetic analysis using nucleotide sequences of NS5B region.ResultsOverall, 140 of 3,305 (4.2%) patients in 15 dialysis centers had anti-HCV positive. Among them, HCV RNA was further assessed in 93 patients and was detectable in 59 (63.4%) persons. Considering HCV viremia, HCVcAg measurement exhibited high accuracy (96.8%), sensitivity (94.9%) and specificity (100%) in comparison with HCV RNA testing. Moreover, individuals infected with HCV received a longer duration of dialysis vintage when compared to anti-HCV negative controls. The major sub-genotypes were 1a, 1b, 3a, 3b, 6f and 6n. Regarding phylogenetic analysis, there were 7 clusters of isolates with high sequence homology affecting 17 individuals, indicating possible HCV transmission within the same HD centers.ConclusionsHCV frequency and common sub-genotypes in HD centers were different from those found in the Thai general population. HCVcAg might be an alternate testing for viremia within resource-limited countries. Enhanced preventive practices, dialyzer reuse policy and better access to antiviral therapy are crucial for HCV micro-elimination within HD facilities.

People who inject drugs in metropolitan Chicago: A meta-analysis of data from 1997-2017 to inform interventions and computational modeling toward hepatitis C microelimination.

Progress toward hepatitis C virus (HCV) elimination in the United States is not on track to meet targets set by the World Health Organization, as the opioid crisis continues to drive both injection drug use and increasing HCV incidence. A pragmatic approach to achieving this is using a microelimination approach of focusing on high-risk populations such as people who inject drugs (PWID). Computational models are useful in understanding the complex interplay of individual, social, and structural level factors that might alter HCV incidence, prevalence, transmission, and treatment uptake to achieve HCV microelimination. However, these models need to be informed with realistic sociodemographic, risk behavior and network estimates on PWID. We conducted a meta-analysis of research studies spanning 20 years of research and interventions with PWID in metropolitan Chicago to produce parameters for a synthetic population for realistic computational models (e.g., agent-based models). We then fit an exponential random graph model (ERGM) using the network estimates from the meta-analysis in order to develop the network component of the synthetic population.

Treatment outcomes of HIV patients with hepatitis B and C virus co-infections in Southwest China: an observational cohort study

BackgroundAntiretroviral therapy (ART) has reduced mortality among people living with HIV (PLWH) in China, but co-infections of hepatitis B virus (HBV) and hepatitis C virus (HCV) may individually or jointly reduce the effect of ART. This study aimed to evaluate the impacts of HBV/HCV coinfections on treatment drop-out and mortality among PLWH on ART.MethodsA retrospective cohort study analysis of 58 239 people living with HIV (PLWH) who initiated antiretroviral therapy (ART) during 2010–2018 was conducted in Guangxi Province, China. Data were from the observational database of the National Free Antiretroviral Treatment Program. Cox proportional hazard models were fitted to evaluate the effects of baseline infection of HBV or HCV or both on death and treatment attrition among PLWH.ResultsOur study showed high prevalence of HBV (11.5%), HCV (6.6%) and HBV-HCV (1.5%) co-infections. The overall mortality rate and treatment attrition rate was 2.95 [95% confidence interval (CI) 2.88–3.02] and 5.92 (95% CI 5.82–6.01) per 100 person-years, respectively. Compared with HIV-only patients, HBV-co-infected patients had 42% higher mortality [adjusted hazard ratio (aHR) = 1.42; 95% CI 1.32–1.54], HCV-co-infected patients had 65% higher mortality (aHR = 1.65; 95% CI 1.47–1.86), and patients with both HCV and HBV co-infections had 123% higher mortality (aHR = 2.23; 95% CI 1.87–2.66).ConclusionsHBV and HCV coinfection may have an additive effect on increasing the risk of all-cause death among PLWH who are on ART. It is suggested that there is need for primary prevention and access to effective hepatitis treatment for PLWH.Graphical

Opt-out universal HCV and HIV screening in a Canadian emergency room: a cross-sectional study

ObjectivesTo determine the prevalence of undiagnosed hepatitis C virus (HCV) and HIV cases in a population sample tested in the emergency room (ER) and to evaluate linkage-to-care.SettingCanadian university hospital.ParticipantsAdults born...

Prevalence of hepatitis B and C virus infections and immunity among hemodialysis patients in the Mazandaran province, Northern Iran.

ABSTRACTBackground:Hemodialysis (HD) is one of the most common causes of blood-borne infections. In order to prevent viral hepatitis and confront with the virus on the next step, health providers specify infected patients by screening and vaccination. This study is designed to investigate the prevalence of Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections in HD patients in Mazandaran, Iran.Methods:The medical records of 216 patients referred to the hemodialysis centers were evaluated in this cross-sectional study between 2019 and 2020. The collected data was analyzed using t-test and Chi-square.Results:Among 216 patients, 106 cases were female (49.07%) and 110 subjects were male (50.9%). The mean age was 40.1 y/o in females and 50.9 y/o in the male patients. The study recorded nine HBs-Ag positive (prevalence: 0.06%) and 15 HCV-Ab positive (prevalence: 6.94%) patients. Also, the most common co-morbidities were diabetes and hypertension. It was observed that 13 patients from 34 patients with negative HBs-Ag (who had 10–100 U HBs-Ab in the first stage) experienced sudden drop in the antibody titration to less than 10 U (P < 0.05). From 50 HBs-Ag negative patients with HBs-Ab more than 100 U in the first stage, antibody titration of five patients was decreased to less than 10 U in the second stage (P < 0.05).Conclusions:The prevalence of HCV and HBV was low in HD patients in Mazandaran province. However, due to the large number of patients with non-protective HBs-Ab levels, there is a risk of an increased prevalence of the disease.