Hepatitis C Virus Seropositivity Research Articles

Trends in Discard of Kidneys from Hepatitis C Viremic Donors in the United States.

Kidneys from hepatitis C virus (HCV) viremic donors have become more commonly accepted for transplant, especially after effective direct-acting antiviral therapy became available in 2014. We examined the contemporary trend of kidney discard from donors with HCV seropositivity and viremia. Data from the Organ Procurement and Transplantation Network were used to identify deceased donor kidneys recovered for transplant. The exposure was donor HCV antibody status in the first analyses, and donor HCV antibody and viremia status in the second analyses. Multilevel, multivariable logistic regression was used to assess the association of these HCV exposure measures with kidney discard, adjusted for donor characteristics. Multilevel analyses were conducted to account for similar kidney discard pattern within clusters of organ procurement organizations and regions. Among 225,479 kidneys recovered from 2005 to 2019, 5% were from HCV seropositive donors. Compared with HCV seronegative kidneys, the odds of HCV seropositive kidney discard gradually declined, from a multivariable-adjusted odds ratio (aOR) of 7.06 (95% confidence interval [95% CI], 5.65 to 8.81) in 2014, to 1.20 (95% CI, 1.02 to 1.42) in 2019. Among 82,090 kidneys with nucleic acid amplification test results in 2015-2019, 4% were from HCV viremic donors and 2% were from aviremic seropositive donors. Compared with HCV aviremic seronegative kidneys, the odds of HCV viremic kidney discard decreased from an aOR of 4.89 (95% CI, 4.03 to 5.92) in 2018, to 1.48 (95% CI, 1.22 to 1.81) in 2019. By 2018 and 2019, aviremic seropositive status was not associated with higher odds of discard (2018: aOR, 1.13; 95% CI, 0.88 to 1.45; and 2019: aOR, 0.97; 95% CI, 0.76 to 1.23). Despite the decrease in kidney discard in recent years, kidneys from viremic (compared with aviremic seronegative) donors still had 48% higher odds of discard in 2019. The potential of these discarded organs to provide successful transplantation should be explored.

Assessment of coronary artery disease extension and severity in hepatitis C-infected patients

ObjectivesTo assess extension and severity of coronary artery disease (CAD) in patients with hepatitis C viral infection.BackgroundChronic HCV infection causes hepatic and systemic inflammation via increased levels of proatherogenic chemokines and cytokinesPatients and methodsThis prospective cohort study was conducted on 200 stable patients scheduled for elective coronary angiography. All patients were evaluated by history taking and clinical, coronary angiography, and laboratory investigations, and the severity of the coronary lesions was estimated using the Gensini score.ResultsThere were statistically significant differences between both groups regarding the presence of ischemic ST-T changes, where 38 patients of group A had those changes, whereas 67 patients of group B had them (P = 0.009). There was a statistically significant difference between both groups regarding ejection fraction% and segmental wall motion abnormalities. Overall, 78% of hepatitis C virus (HCV)-positive patients had significant CAD (group A) compared with 60% of patients with HCV negative (group B), with P = 0.006. Moreover, one-vessel affection was mainly among HCV-negative patients (55%) versus 34.6% in HCV-positive patients, with significant difference between both group (P = 0.003). Moreover, there was a statistically significant positive correlation between CAD severity according to Gensini score and HCV seropositivity (Gensini score in group A was 46.9 ± 53.7 vs. 17.9 ± 28.1 in group B; P < 0.001).ConclusionWe have demonstrated an association between HCV infection and the severity of coronary atherosclerosis assessed with Gensini score, and the proposed mechanism was exaggerated inflammation in response to hepatitis virus infection.

High Seroprevalence of Hepatitis C Virus Antibody in Breast Cancer Patients in Egypt.

Background:Hepatitis C virus (HCV) is a known risk factor for hepatocellular carcinoma. Several epidemiological studies have pointed out to an association of HCV infection with other extrahepatic malignancies. The role of chronic HCV in breast cancer causation is less clear. Egypt is an endemic area of HCV infection with resulting significant morbidity. The association between HCV status and breast cancer risk in Egyptian women is hitherto unknown.Methods:A retrospective study was performed. The prevalence of anti-HCV seropositivity was estimated in a sample of women with a breast cancer diagnosis, retrieved from the hospital records, and was compared to the raw data of a population study in Egypt. Anti-HCV negative and positive patients were compared regarding the disease course and outcome.Results:Retrospective analysis revealed a markedly high prevalence of anti-HCV seropositivity in young breast cancer patients. In patients younger than 45 years, 13.4% were anti-HCV positive. Seropositivity was 6-fold higher in these patients than in adult females of the same age without cancer diagnosis (P = .003). The biological type, tumor size, nodal status, and disease-free survival were not affected by the patients’ HCV status.Conclusion:Young Egyptian breast cancer patients have a dramatically high prevalence of HCV seropositivity. Further population studies are strongly required to investigate the epidemiological association of these two significant health problems.

Prevalence of asymptomatic hepatitis B virus and hepatitis C virus infections in patients with maintenance hemodialysis of a tertiary care hospital in western Maharashtra

Introduction: Patients on Maintenance Hemodialysis (HD) are at high risk of viral hepatitis due to blood transfusion, prolonged vascular access, exposure to infected patients and contaminated equipments etc. Knowledge of the prevalence of such infections is very important to access magnitude of the problem because these infections play important role in the morbidity and mortality of hemodialysis (HD) patients. Aim and Objectives: This study was done to determine the prevalence of Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections in patients on hemodialysis at our tertiary care hospital of Western Maharashtra. Materials and Methods: Settings and Design: Hospital based cross sectional study was conducted for six months in HD unit at our tertiary care hospital. All patients (n=135) were screened for Hepatitis B surface antigen and antibodies to HCV (anti-HCV). Prevalence, age and sex wise distribution as well as risk factors for transmission of these infections were observed. Results: Total 135 HD patients were screened for presence of HBV and HCV infections. Of these, 39 (28.9%), 20 (14.8%), 6 (4.4%) were found to be having HCV, HBV and Dual HBV and HCV infection respectively. Conclusions: HCV was the most prevalent among HD patients than HBV. History of multiple blood transfusions, HD outside center or longer duration of HD were all important risk factor noted for high prevalence of sero-positivity for HBV and/or HCV. Strict adherence to universal precautions careful attention to hygiene and strict sterilization of dialysis machines are important to prevent further transmission of these viruses. Keywords: Hemodialysis, HBsAg, Anti HCV antibodies, Hepatitis.

Prevalence of Transfusion Transmissible Infections in Beta-Thalassemia Major Patients of Pakistan: A Systematic Review

Introduction: β-thalassemia major (TM) is one of the most prevalent inherited hemoglobinopathies in Pakistan. It has one of the highest prevalence of transfusion-dependent TM patients globally, with an estimated greater than 100,000 active cases. Each year, an estimated 5000-9000 new cases of TM are being diagnosed in the country. Blood transfusions (BT) are essential in the management of severe TM; it is critical to have a safe BT to reduce the risk of transfusion transmissible infections (TTIs). Frequent blood transfusions in these patients increase their risk of acquiring TTIs compared to the general population. In this systematic review, we aimed to identify the prevalence of TTIs in transfusion-dependent β -thalassemia major patients in Pakistan. Methods &amp; Material: We performed a systematic literature search to identify studies related to the TTIs and transfusion-related infections in Pakistan from January 1, 2010, to January 31, 2020. The search was conducted using PubMed and PakMediNet (Largest medical database of Pakistan), with initial search retrieved 981 studies. Among these, 166 studies met the inclusion criteria. After further screening by reviewing the articles for relevance and availability of full-length articles, only 14 studies met the final criteria for qualitative synthesis. Results Analysis of 14 studies (n=3786) showed that the seroprevalence of Hepatitis B virus (HBV) of 3.13% (0.66 % to 7.4%) and Hepatitis C virus (HCV) of 26 % (5.56% to 68.2%). There were only two studies reported HIV seroprevalence of 0 % &amp; 0.5% (n=6). The rate of seropositivity for HBV and HCV was directly related to the number of transfusions, higher ferritin levels, and older age groups. There was an increase in the HCV rate with the increasing age of patients. Thalassemia patients who were older than ten years of age had a greater HCV compared to those who were less than ten years of age, i.e., 22% vs. 8.4%, p:0.005, respectively. The mean age was higher in HCV reactive children than non-reactive children. A comparison of HCV in healthy donors vs. thalassemia patients showed a rate of 1.9% vs. 13.1% for T.M. patients. There was HCV infection rate of 74% in the group with greater than 100 BTs compared to 33 % in a group with fewer than 35 BTs. The rate of HCV increased to 75% for the patients who had more than 100 BTs. The majority of the patients were males (51% to 88%). The seroprevalence of TTIs was higher in males than in females (73.4% vs. 26.6%). On average, a single TM patient is exposed to at least 17 different donors annually, requiring 1-2 transfusions every month. The free BT is accessible only in 1 out of 4 thalassemia centers. The majority of patients either need to bring their donors or are dependent on an external source of financial aid as they could not afford the cost of BT treatment. More than half of thalassemia patients (57.2%) need to contact multiple BT centers to search for required blood products. About 42.1% of parents of TM patients did not know about TTIs, whereas 31.6% of them did not know about the bloodborne transmission of HBV and HCV. The majority of parents of TM children had a low income, with 75% of them having income less than 10,000 Pakistani rupees (PKR) per month. The prevalence of TTIs in TM patients was significantly higher (96% vs. 4%) compared to the patients requiring multiple transfusions due to other causes such as leukemia, aplastic anemia, and thrombocytopenia. Conclusion: Our data highlights that the prevalence of transfusion-transmitted infections, especially HCV, is alarmingly higher (26%) in the TM population than in the general population. This is because of a lack of resources, inadequate safety measures, and a fragmented blood transfusion system. These findings warrant the urgent need for better public health measures, safe blood transfusion practices, voluntary remunerated blood-based transfusions, and universal quality-assured donor screening. Without these positive interventions, the current transfusion system can lead to a further worsening of the situation. Large prospective multi-centered clinical trials are required to understand better the high prevalence of TTIs in patients with TM. Disclosures Anwer: Incyte, Seattle Genetics, Acetylon Pharmaceuticals, AbbVie Pharma, Astellas Pharma, Celegene, Millennium Pharmaceuticals.:Honoraria, Research Funding, Speakers Bureau.

Age- and risk factor-based serologic screening for Hepatitis C virus among an Urban, high-risk population.

Hepatitis C virus (HCV) screening among individuals born between 1945 and 1965 (ie birth cohort) may augment risk factor-based screening. We assessed HCV seropositivity among injection drug users (IDUs) and birth cohort members from New York City. We assessed HCV risk factors and seropositivity in 7722 participants from community health, HIV prevention, syringe exchange and drug treatment programmes. A total of 26.6% were HCV seropositive, 55.8% were born between 1945 and 1965, and 82.2% had ever injected drugs. Among all participants, HCV seropositivity was higher among IDUs compared to non-IDUs (60.5% versus 7.7%, odds ratio (OR) = 18.5, 95% confidence interval (CI) [16.2, 21.1], P<.0001) and among birth cohort members compared to non-birth cohort members (31.3% versus 22.3%, OR=1.6, 95%CI [1.4, 1.8], P<.0001). Within the birth cohort, HCV seroprevalence among IDUs was 68.5% versus 11.8%, OR=16.2, 95%CI [13.7, 19.3]. After adjustment, HCV seroprevalence was higher in IDUs, previously incarcerated, whites (<42years) and 'other races' (versus blacks), HIV-infected, those who snorted heroin, those with liver disease history, and those who had sex with an HCV-seropositive partner. HCV seroprevalence among IDU, birth cohort members, was considerably higher than among the general population. In this high-risk, urban population, the association between IDU and HCV seropositivity was approximately ten times that between birth cohort membership and HCV seropositivity.

Prevalence of Transfusion Transmissible Infections in Beta-Thalassemia Major Patients in Pakistan: A Systemic Review

β-thalassemia major (TM) is one of the most prevalent inherited hemoglobinopathies in Pakistan. It has one of the highest prevalence of transfusion-dependent TM patients globally, with an estimated greater than 100,000 active cases. Blood transfusions (BT) are essential in the management of severe TM; it is critical to have a safe BT to reduce the risk of transfusion transmissible infections (TTIs). Frequent blood transfusions in these patients increase their risk of acquiring TTIs compared to the general population. We performed a systematic literature search to identify studies related to the TTIs and transfusion-related infections in Pakistan from January 1, 2010, to January 31, 2020. The search was conducted using PubMed and PakMediNet, with initial search retrieved 981 studies. Among these, 166 studies met the inclusion criteria, and only 14 studies met the final criteria for qualitative synthesis. Analysis of 14 studies (n = 3786) showed the seroprevalence of hepatitis B virus (HBV) of 3.13% (0.66% to 7.4%) and hepatitis C virus (HCV) of 26% (5.56% to 68.2%). There were only two studies that reported HIV seroprevalence of 0% and 0.5% (n = 6). The rate of seropositivity for HBV and HCV was directly related to the number of transfusions, higher ferritin levels, and older age groups. There was an increase in the HCV rate with the increasing age of patients. Thalassemia patients, who were older than ten years of age, had an HCV rate of 22% compared to only 8.4% in patients younger than ten years of age. A comparison of HCV in healthy donors vs. thalassemia patients showed a rate of 1.9% vs. 13.1% for TM patients. The majority of the patients were males (51% to 88%). The seroprevalence of TTIs was higher in males than in females (73.4% vs. 26.6%). On average, a single TM patient is exposed to at least 17 different donors annually, requiring 1-2 transfusions every month. Our study highlights that the prevalence of transfusion-transmitted infections, especially HCV, is alarmingly higher (26%) in the TM population than in the general population. There is limited data regarding the prevalence of HIV, syphilis, and malaria in this population. This is mainly due to a fragmented system of blood transfusion, weak regulations, and lower rates of voluntary blood donations. These findings warrant better health measures to improve the blood donation system and specialized care for TM patients.

Seroprevalence of Hepatitis-B virus and Hepatitis-C virus in pregnant women in Hyderabad.

Introduction: Infections of the hepatitis B virus (HBV) and the hepatitis C virus (HCV) are major global public health problem. Approximately 350 million and 190 million people worldwide are infected with HBV and HCV respectively. &#x0D; Objective: To evaluate seroprevalence of hepatitis B and C among pregnant women of Hyderabad.&#x0D; Methodology: This prospective cross sectional study conducted at Pathology department of a tertiary care hospital of Hyderabad during Jan 2019 to July 2019. During period of study data of 500 pregnant women recorded on pre structured proforma after taking informed consent. Causes of hepatitis other than B or C virus were excluded. Status of HCV and HBV was confirmed using Elisa method.&#x0D; Results: showed 7% seropositivity for HCV and 4.2% for HBV among pregnant women.&#x0D; Conclusion: Among pregnant females, in Hyderabad there is a higher seropositivity of anti HCV antibodies as compared to HBsAg. Both seropositivity to HBV and HCV was found to be more prevalent in the 30-39 year age group.&#x0D; Keywords: Pregnant women, Hyderabad, Seroprevalence HCV, Seroprevalence HBV.&#x0D;

Prevalence of Hepatitis C Virus in an Endemic Area of Thailand: Burden Assessment toward HCV Elimination.

Chronic hepatitis C virus (HCV) infection can lead to liver cirrhosis and hepatocellular carcinoma. To eliminate HCV infection in an endemic area, an epidemiological baseline of the current HCV infection in the population is required. We therefore aimed to evaluate the HCV burden in the Thai Province of Phetchabun, which has the highest HCV infection rate in the country. Toward this, a province-wide district-based representative sampling of 4,769 individuals ages 35-64 years previously shown to represent high-risk age-groups were tested for anti-HCV antibodies using the automated chemiluminescent microparticle assays. Active HCV infection and subsequent genotyping were determined from serologically reactive samples by amplification of the HCV core gene. We found that 6.9% (327/4,769) were anti-HCV positive, of which 75.8% (248/327) had detectable HCV RNA and 5.8% (19/327) were in the presence of hepatitis B virus coinfection. Nucleotide sequencing and phylogenetic analysis revealed that HCV genotype 6 was the most prevalent (41%, 101/248), followed by genotype 3 (31%, 78/248), and genotype 1 (28%, 69/248). Socioeconomic and demographic factors including male gender, education, and agricultural work were associated with HCV seropositivity. From these results, we defined the regional HCV genotypes and estimated the HCV burden necessary toward the implementation of pan-genotypic direct-acting antivirals, which may be appropriate and effective toward the diversity of genotypes identified in this study. Micro-elimination of HCV in Phetchabun may serve as a model for a more comprehensive coverage of HCV treatment in Thailand.

Hepatitis C Virus Infection as a Predictor of Complications and Increased Costs Following Primary Lumbar Fusion Surgery

Retrospective cohort study. The aim of this study was to identify whether hepatitis C virus (HCV) diagnosis influences in-hospital lengths of stay (LOS), postoperative complications, readmission rates, or costs following primary posterior lumbar fusions in an elective setting. Although joint arthroplasty literature has shown increased complication rates and costs for patients seropositive with HCV without liver disease compared to those without HCV, this comorbidity has not been explored in the spine literature. To our knowledge, this is the first publication in the lumbar spine literature to solely focus on HCV as the disease burden. A national database was queried for patients who underwent primary lumbar spine fusion for degenerative lumbar pathology with Medicare insurance from 2005 to 2014. The 90-day postoperative complication rates, readmission rates, and treatment costs were queried. To limit confounding, HCV patients were matched with a control cohort of non-HCV patients using patient demographics, treatment modality, and comorbid conditions, and then analyzed by multivariate logistic regression. Patients with active liver disease were excluded to better isolate HCV as the comorbidity. A cohort of 28,841 patients were included in the final analysis. Postoperatively, compared to those without HCV infection, those with HCV had significantly higher odds of blood transfusions (odds ratio [OR]: 3.06), pneumonia (OR: 2.49), respiratory failure (OR: 2.49), urinary tract infections (OR: 1.89), wound-/implant-related infections (OR: 1.74), cerebrovascular events (OR: 1.70), or any postoperative complication within 90 days (OR: 2.93; all P < 0.0001). Furthermore, HCV positive patients had higher day of surgery costs ($28,713.26 vs. $25,448.26, P < 0.0001) and 90-day costs ($33,447.39 vs. $29,016.77, P < 0.0001). There was not a significant difference for patients with HCV infection compared to those without in regard to hospital LOS (10 days vs. 8 days, P = 0.332) and rates of a 90-day readmission (0.37% vs. 0.22%; OR: 1.70, 95% confidence interval: 1.00-2.90, P: 0.050). In patients undergoing primary lumbar fusion, a seropositivity for HCV without liver disease is associated with higher costs and complication rates, including higher rates of blood transfusion requirements and pneumonia-related complications. This data shed new light on elective spine surgery in HCV patients and may influence the risks and benefits considerations for surgeons considering lumbar fusion in this population. 3.

Hepatitis C virus or hepatitis B virus coinfection and lymphoma risk in people living with HIV.

Chronic hepatitis C virus (HCV) and hepatitis B virus (HBV) infections are associated with increased risks of lymphomas in the non-HIV setting. Their impacts on HIV-associated lymphomas deserved further studies in the modern combined antiretroviral therapy (cART) era. We evaluated the associations between HCV, HBV and HIV-related lymphomas in the Lymphovir-ANRS-CO16 cohort. Prevalence of HCV seropositivity and chronic HBV infections were compared with those observed in the French Hospital Database on HIV (FHDH-ANRS-CO4). Between 2008 and 2015, 179 patients with HIV-related lymphomas from 32 French hospitals were enrolled, 69 had Hodgkin's lymphoma (39%), and 110 non-Hodgkin's lymphoma (NHL) (61%). The prevalence of HCV infection was higher in patients with NHL than in the FHDH-ANRS-CO4 [26 versus 14%, odd ratio (OR): 2.15; 95% confidence interval (1.35-3.32)] whereas there was no association between Hodgkin's lymphoma and chronic HCV infection. Chronic HBV infection was not associated with NHL in our cohort with a prevalence of 5 versus 7% in FHDH-ANRS-CO4 but tended to be associated with Hodgkin's lymphoma [prevalence of 14%, OR: 2.16 (0.98-4.27)]. Chronic HCV infection tended to pejoratively impact 2-year overall survival in patients with NHL: 72% [57%, 91%] versus 82% [74%, 91%], hazard ratio: 2.14 [0.95-4.84]. In contrast, chronic HBV infection did not correlate with outcome. In the modern cART era, chronic HCV infection is associated with an increased risk of NHL in PLWHIV and tends to pejoratively impact overall survival. HBV infection is not associated with the risk of NHL but with a borderline increase of Hodgkin's lymphoma risk.

Seroprevalence of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in patients undergoing nasopharyngeal biopsy

Objectives:We aimed to determine the seroprevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) in patients undergoing nasopharyngeal biopsy (NPB). Materials and Methods: The medical records of patients who had undergone NPB under local anesthesia between 2009 and 2020 were retrospectively analyzed in our clinic. The hepatitis B surface antigen (HBsAg), HCV antibody (anti-HCV), and HIV antibody (anti-HCV) were recorded in all patients. Age, gender, and pathology result of the patients were also recorded. The patients were divided into two groups (benign and malignant) according to the pathology results. The study included 666 patients with a mean age of 38.5±17.2 years (range, 6-89 years). Serology positivity was detected in 18 patients (2.7%) for HBsAg, in 4 patients (0.6%) for anti-HCV, and in 2 patients (0.3%) for anti-HIV. All serology-positive patients were older than eighteen. The HBV seropositivity rate was significantly higher in males (p=0.003). No statistically significant difference was found between male and female genders for HCV and HIV seropositivity (p>0.05). Reactive lymphoid hyperplasia (70.7%) and chronic inflammation (27.8%) were the most common results in the benign group. Undifferentiated Nasopharyngeal Carcinoma (58.9%) and B-cell non-Hodgkin lymphoma (17.8%) were the most common subtypes in the malignant group. There was no statistically significant difference between benign and malignant groups for HBV, HCV, and HIV seropositivity rates (p>0.05). Preoperative serological testing in patients undergoing NPB is required for increasing awareness of HBV, HCV, and HIV infections among healthcare personnels. Otolaryngologists must have the highest awareness of occupational infections deriving from blood and body fluids. It is necessary to take precaution measures including personal protective equipment during procedures.

Seroprevalence of hepatitis B virus and hepatitis C virus infection in haemodialysis patients at tertiary care hospital in Western Rajasthan, India

CONTEXT: Viral hepatitis has become the most common viral infections encountered in dialysis patients. Patients undergoing haemodialysis (HD) have a significantly increased risk of exposure to hepatitis B, hepatitis C, HIV and other blood-borne viruses. Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are the most important causes of morbidity and mortality among HD patients. Patients on routine maintenance HD fail to maintain protective titres against HBV that further poses the risk of developing viral hepatitis. In this study, we are studying the prevalence of HBV and HCV infection among patients undergoing maintenance HD. SETTING AND DESIGN: This was a cross-sectional study. METHODS: This study aims to detect and compare the seroprevalence of HBV and HCV infection among chronic HD patients. This study was conducted from July 2015 to January 2017. All patients (n = 150) of various age groups admitted during the study period for maintenance HD at our tertiary care hospital were included. Viral markers were detected using third-generation enzyme-linked immunosorbent assay kits available commercially. STATISTICAL ANALYSIS USED: Statistical analysis was done with the help of statistical package for SPSS. RESULTS: Out of 150 patients recruited into the study, 7 (4%) were positive for hepatitis B surface antigen and 29 (19.33%) were positive for HCV. One (0.67%) patient was found positive for both HBV and HCV infections. In this study, the duration of dialysis was significantly correlated with seropositivity for both HCV and HBV (P ≤ 0.0001). The number of blood units transfused was also found to be significantly associated with seropositivity (P ≤ 0.0001). CONCLUSIONS: The prevalence of HCV is more common compared to HBV infection in HD patients. Seropositivity significantly correlates with duration of dialysis. The number of blood units transfused is also significantly associated with seropositivity.

Transfuzijom prenosive infekcije (TTIs) među donorima krvi banke krvi tercijarne zdravstvene ustanove u Indiji - studija zasnovana na podacima

Objectives: Transfusion Transmitted Infections (TTIs) are infections caused by potential pathogens which are transmitted to the blood recipients through blood transfusion. This study was primarily carried out to detect seropositivity of the markers of Hepatitis-B virus (HBV), Hepatitis-C virus (HCV), Human immunodeficiency virus (HIV) and Syphilis in the blood donors at a tertiary care hospital in Srinagar, J&amp;K, India over an of 4 years. Material and Methods: Blood donations over 4 years from Jan.2015 to Dec. 2018 were reviewed retrospectively from the records of blood bank for seropositivity for HBV, HCV, HIV and Syphilis. Results: A total of 31733 blood units were collected out of which 24494 (77.19%) were replacement and 7239 (22.81%) were voluntary. The seroprevalence of HBV, HCV, HIV and Syphilis was 0.22% (72), 0.16% (52), 0.009% (3) and 0.01% (5) respectively. A decreasing trend of all the major TTIs was observed over these years. Prevalence of all the four TTIs was observed highest in replacement donors as compared to voluntary donors. Conclusion: Seroprevalence of all the TTIs was low as compared to the studies from rest of the country. Extensive donor selection and screening procedures will help in improving blood safety more. Efforts should be made to maximise voluntary donations and minimise replacement donations.

Hepatitis C virus and risk of extrahepatic malignancies: a case-control study

Epidemiological studies have demonstrated an increased risk of non-Hodgkin lymphoma (NHL) in patients with chronic hepatitis C virus (HCV) infection. Therefore, we investigated the risk of extrahepatic malignancies associated with HCV infection. Inpatients diagnosed with lymphoma, breast, thyroid, kidney, or pancreatic cancer (research group, n = 17,925) as well as inpatients with no malignancies (control group, n = 16,580) matched by gender and age were enrolled from The First Affiliated Hospital of Nanjing Medical University between January 2008 and December 2016. A case-control study was conducted by retrospective analysis. The difference in HCV prevalence was analyzed between the research group and the control group. Also, the research group was compared to the 2006 National Hepatitis C sero-survey in China. A total of 86 cases were positive for anti-HCV in the research group. Compared with the control group (103 cases were anti-HCV positive), no significant associations between extrahepatic malignancies and HCV infection were observed. Meanwhile, compared to the 2006 National Hepatitis C sero-survey, we observed a significant association between the chronic lymphoma leukemia/small lymphocytic lymphoma (CLL/SLL) and HCV seropositivity in females in the research group aged 1–59 years old (OR = 14.69; 95% CI, 1.94–111.01). HCV infection had a potential association with CLL/SLL in females aged 1–59 years old. Our study did not confirm an association between HCV infection and the risk of extrahepatic malignancies. In regions with a low HCV prevalence, the association between HCV infection and extrahepatic malignancies needs further investigation.

High rate of hepatitis C virus and human immunodeficiency virus false-positive results in serologic screening in sub-Saharan Africa: adverse impact on the blood supply.

False positivity in blood screening may cause unnecessary deferral of healthy donors and exacerbate blood shortages. An international multicenter study was conducted to estimate the frequency of HCV and HIV false seropositivity in seven African countries (Burundi, Cameroon, Democratic Republic of Congo, Madagascar, Mali, Mauritania, and Niger). Blood donations were tested for hepatitis C virus (HCV) and human immunodeficiency virus (HIV) with rapid detection tests (RDTs), third-generation enzyme immunoassays (EIAs), or fourth-generation EIAs. HCV (456/16,613 [2.74%]) and HIV (249/16,675 [1.49%]) reactive samples were then confirmed with antigen/antibody assays, immunoblots, and nucleic acid testing. Partial viral sequences were analyzed when possible. The HCV reactivity rate with RDTs was significantly lower than with EIAs (0.55% vs. 3.52%; p < 0.0001). The HIV reactivity rate with RDTs was lower than with third-generation EIAs (1.02% vs. 2.38%; p < 0.0001) but similar to a fourth-generation assay (1.09%). Only 16.0% (57/357) and 21.5% (38/177) of HCV and HIV initial reactive samples, respectively, were repeatedly reactive. HCV and HIV infections were confirmed in 13.2% and 13.7%, respectively, of repeated reactive donations. The predominant HCV genotype 2 and 4 strains in West and Central Africa showed high genetic variability. HIV-1 subtype CRF02_AG was most prevalent. High rates (>80%) of unconfirmed anti-HCV and anti-HIV reactivity observed in several sub-Saharan countries highlights the need for better testing and confirmatory strategies for donors screening in Africa. Without confirmatory testing, HCV and HIV prevalence in African blood donors has probably been overestimated.

Hepatitis B virus seroprevalence among HIV-infected patients receiving combination antiretroviral therapy three decades after universal neonatal hepatitis B immunization program in Taiwan.

This multicenter study aimed to evaluate the seroprevalence of hepatitis B virus (HBV) and the use of combination antiretroviral therapy (cART) among patients receiving HIV care in Taiwan. We retrospectively reviewed the medical records of HIV-infected adult patients who initiated cART at 11 designated hospitals in Taiwan between 2012 and 2016. The clinical information collected included serological profiles on HBV, hepatitis C virus (HCV), and syphilis, plasma HIV RNA load, nadir CD4 cell count, and antiretrovirals with activity against both HBV and HIV (tenofovir disoproxil fumarate [TDF], lamivudine [LAM], and emtricitabine [FTC]). We analyzed 1800 HIV-infected patients; 1742 (96.8%) were male and 794 (44.1%) were born after July, 1986, when nationwide universal neonatal HBV vaccination was implemented. HBsAg positive results were 11.6% (209/1800), which decreased significantly from 18.1% (182/1006) in those born before July 1986 to 3.4% (27/794) in those born after. In multivariable analysis, HBsAg positivity was significantly associated with age (adjusted odds ratio [aOR] 1.06, 95% confidence interval [CI] 1.05-1.08), CD4≧200cells/μL (aOR 0.73, 95% CI 0.53-0.99), and HCV seropositivity (aOR 1.62, 95% CI 1.06-2.50). Of 209 HBV/HIV-coinfected patients, 31.1% started cART containing only LAM with anti-HBV activity, while 68.9% started cART containing TDF plus LAM or coformulated TDF/FTC. The overall prevalence of HBV/HIV coinfection remained high among HIV-infected patients in Taiwan. Despite recommendations of the HIV treatment guidelines for the management of HBV infection, a substantial proportion of HIV/HBV-coinfected patients received cART containing only LAM for HBV infection.

Hepatitis C Virus Screening Among Adolescents Attending a Drug Rehabilitation Center.

Hepatitis C virus (HCV) infection has a strong association with intravenous drug use (IVDU). IVDU is a growing public health concern, even in the adolescent population. To our knowledge, there are no published HCV screening studies targeting high-risk adolescents who attend drug rehabilitation centers.This study was designed to determine the seroprevalence of HCV infection utilizing point-of-care (POC) testing at an adolescent drug rehabilitation center and gain a preliminary understanding of the acceptance rate for HCV screening in this high-risk population. This single-center, observational study was conducted at a major drug rehabilitation center in northeast Ohio from July 2016 to June 2017. The consented adolescents who presented at the center were recruited to participate in HCV screening. The participants were administered a survey to assess their demographics and risk behavior profile followed by HCV testing utilizing a POC test. During the study period, 150 adolescents were admitted to the drug rehabilitation center, of whom 100 were approached and 85 agreed to participate. Forty percent of the participants (34/85) were females, and 78% (66/85) were white. HCV prevalence among participants was 5% (4/85), all of whom were females. History of heroin use was reported by 15% (13/85) and it was associated with HCV seropositivity; 100% (4/4) of all HCV-positive individuals reported the use of heroin vs only 11% (9/81) of HCV-negative individuals (P = .0004). Our study showed a high prevalence of HCV among adolescents attending a drug rehabilitation center with high acceptance of POC HCV testing.

Characteristics associated with anti-HCV serological markers in prisoners in the state of Paraná, Brazil: a case-control study

BackgroundThe prison system in Paraná, Brazil, is experiencing serious problems related to the increasing number of prisoners. Control of hepatitis C virus (HCV) has become more intense because the incarcerated population is considered a high-risk group for contagious diseases due to the favorable conditions found in prisons for the spread of these morbidities. The objective of this study was to identify features associated with hepatitis C infection among male prisoners in correctional institutions of Paraná state, Brazil. MethodsThis was a case-control study (27 cases and 54 controls) of men incarcerated in 11 penitentiaries in Paraná, Brazil. Information was obtained through a questionnaire in a cross-sectional epidemiological survey on HCV infection during the period from May 2015 to December 2016. Eligible men were recruited after testing positive for anti-HCV antibodies. Cases and controls were selected based on serological results of enzyme-linked immunosorbent assays and were matched by age, location of the penitentiary, and time in prison. Logistic regression analysis was used to identify risk factors for HCV seropositivity. ResultsThe main significant independent risk factor for the acquisition of HCV infection was the use of injectable drugs (OR = 4.00; 95%CI:1.41–11.35; p < 0.001). ConclusionsThis study provides evidence that HCV infection is associated with drug use by this population. This information is pivotal for tailoring prevention programs and guiding specific socioeducational measures that aim to reduce or prevent HCV transmission within the prison setting.

Seroprevalence of Anti-HIV-1, Anti-HIV-2, Hepatitis B Surface Antigen, and Anti-HCV in Eye Donors in a Tertiary Eye Hospital, Chennai, India, in the Past 13 years (2005-2017).

To understand the seroprevalence of HIV, hepatitis B surface antigen (HBsAg), and hepatitis C virus (HCV) in serum samples collected from eye donors between 2005 and 2017 at Sankara Nethralaya, Chennai, India. The reports of 7136 eye donors serologically screened for antibodies to HIV-1 and HIV-2, HBsAg, and antibodies to HCV were retrospectively analyzed. Among the 7136 serum samples screened during this study period, the serum samples of 14 donors (0.20%) were reactive to HIV-1 antibodies, 78 donors (1.09%) were positive for detection of HBsAg, and 37 donors (0.52%) were positive for HCV antibodies. Of interest, coinfections of HIV-1 and HBV, and HIV-1 and HCV were detected in 2 and 1 serum sample of the eye donors, respectively. This retrospective study indicates that there is a trend of reduction in the seropositivity for HIV, HBV, and HCV among eye donors in Chennai over the last decade.