Hepatitis Co-infection Research Articles

Co-infection of Dengue and hepatitis A virus among pediatric population: A study from a tertiary care center in central India during 2022-2023.

Co-infection of dengue virus and acute hepatitis A virus in paediatric population is a major health concern in endemic countries. This cross sectional retrospective study was conducted to evaluate the prevalence of hepatitis A virus among the clinically dengue suspected paediatric cases presented at our tertiary care centre during the two-year period (2022-2023). A total of 747 dengue suspected paediatric clinical specimens were included in this study. Serological diagnosis of DENV and HAV was done using Dengue IgM capture ELISA kit and anti-HAV IgM ELISA kits. Out of the 747 dengue suspected paediatric patients, 245 (32.8%) were seropositive for either DENV, HAV, or both viruses and among these 135 (18.07%) were positive for DENV, 110 (14.72%) were positive for HAV, 22 (2.94%) were co-infected with both DENV and HAV. Further, among DENV seronegative cases, 88 (11.78%) clinical samples were found to be HAV positive. Among all the age groups, the highest prevalence of DENV and HAV was observed in 6-10 yrs. The monsoon season observed the highest number of seropositive cases compared to winter season and summer seasons. Fever was found to be most prevalent clinical symptom followed by nausea/vomiting and stomach discomfort. This study underlines the significance of differential diagnosis for the detection of concurrently transmitted viral diseases during the common seasons in the endemic areas. Diagnostic challenges like misdiagnosis events can be solved by advising differential diagnosis especially in paediatric cases.

Co-Infection of Hepatitis A and Hepatitis E Viruses in Outpatients in Dhaka, Bangladesh: A Case Series

Co-Infection of Hepatitis A and Hepatitis E Viruses in Outpatients in Dhaka, Bangladesh: A Case Series

Coinfection of avian hepatitis E virus and different serotypes of fowl adenovirus in chicken flocks in Shaanxi, China.

Last year, eight poultry farms of commercial broilers and commercial layers suffered a serious disease in Shaanxi province, China. After molecular etiological investigation, the disease may be mainly caused by fowl adenovirus (FAdV) (FAdV-4, FAdV-8a, and FAdV-8b) and avian hepatitis E virus (aHEV) (genotype 3 avian HEV) coinfection on these flocks, and this is the first study to find FAdV-4/8a/8b and avian HEV coinfection in a farm. It provides a valuable foundation for the prevention and control of FAdV and avian HEV coinfection in chicken farms.

Prevalence of hepatitis coinfection and substance use among antiretroviral therapy clinic clients with hazardous alcohol use in Vietnam.

The confluence of injection drug use (IDU), alcohol consumption, and viral hepatitis increases morbidity among persons living with HIV (PWH). We present a secondary analysis of a randomized controlled trial of alcohol reduction interventions in Thai Nguyen, Vietnam conducted between 2016-2018. We assessed hepatitis B (HBV) and hepatitis C (HCV) coinfection among PWH reporting hazardous alcohol consumption and examined differences in IDU and alcohol use by coinfection status. Participants were ≥18 years old, living with HIV, and reported hazardous alcohol consumption per the WHO Alcohol Use Disorders Identification Test Consumption (AUDIT-C; score ≥4 for men, score ≥3 for women). At enrollment, participants were tested for hepatitis coinfection with HBV surface antigen tests and rapid serological HCV tests. Demographic information, IDU, and recent alcohol consumption were assessed via behavioral survey and 30-day timeline follow back. Fishers Exact and Kruskal-Wallis tests were used for statistical testing. Hepatitis coinfection was common among the 440 enrolled PWH: HCV: n = 355 (81%); HBV: n = 5 (1%); HBV and HCV: n = 37 (8%). Only 10% (n = 43) of participants had no hepatitis coinfection. Among those who tested positive for HBV, 36% had previously been diagnosed with HBV; among those who tested seropositive for HCV, 18% had previously received an HCV diagnosis. History of IDU was higher among those with hepatitis coinfection (HBV or HCV coinfection: 88%; HBV and HCV coinfections: 97%) than those without hepatitis coinfection (7%; p<0.01). Median days of alcohol consumption in the last 30 days was higher among those with coinfection (HBV or HCV coinfection: 20 (Interquartile Range (IQR): 10-30); HBV and HCV coinfections: 22 (IQR: 13-28) than those without hepatitis coinfection (10; IQR: 6-21; p<0.01). The syndemic conditions of HIV, hepatitis, IDU, and alcohol use are deeply entangled and challenging to parse out. Integrated health services are warranted to reduce the risk of liver-related morbidity.

Serum microRNA 143 and 223 Gene Expression Profiles as Potential Biomarkers in Individuals with Hepatitis and COVID-19.

MicroRNAs (miRNAs) can act as biomarkers and descriptors of the association between infections and other diseases, such as hepatitis and COVID-19. This study aims to investigate the role of miRNA serum expression according to laboratory data concerning hepatitis and COVID-19. Seventy individuals recruited in Southern and Southeastern Brazil donated serum samples and were divided into four groups: (i) 20 negative subjects, (ii) 20 presenting hepatitis, (iii) 19 with COVID-19 and (iv) 11 with hepatitis and COVID-19. Three miRNAs (miR-122, miR-143 and miR-223) were evaluated using real-time PCR. Hematological and biochemical markers were also analyzed. MiR-143 and miR-223 were downregulated among the hepatitis/COVID-19 group (p < 0.05). A positive correlation was observed between miR-223 and lymphocytes. There was a negative correlation between alanine transaminase (ALT) and aspartate transaminase (AST) for miR-143 and miR-223 and gamma-glutamyl transferase (GGT), alkaline phosphatase (AP) and neutrophil/lymphocyte ratio (NLR) only for miR-223 (p < 0.05). For hepatic fibrosis (FIB-4), miR-122 and miR-143 had a greater association and miR-223 was more associated with a history of vaccination against COVID-19. MicroRNAs 143 and 223 could be useful as biomarkers for hepatitis coinfection with COVID-19.

Current management and awareness of hepatitis coinfection in HIV care: A single-center retrospective study in Japan

BackgroundLiver disease remains a significant concern for people living with HIV (PLWH), especially in those with hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection. This study assessed the prevalence of viral hepatitis coinfections and evaluated the current state of hepatitis management by HIV care providers in Japan. MethodsThis single-center, retrospective, observational study analyzed data from PLWH treated with antiretroviral therapy between April 1, 2023 and March 31, 2024. Data included demographics, ART regimen, hepatitis status, and screening practices of 811 PLWH treated with antiretroviral therapy. ResultsThe median age of the study population was 48 years, and 97.8 % were men. The HBV status was as follows: chronic HBV, 6.5 %; clinical remission, 34.0 %; uninfected, 30.9 %; unknown, 14.2 %. The HCV antibody positivity rate was 3.2 %. Substantial gaps in hepatitis screening and monitoring were identified. Specifically, we found inadequate rates of abdominal ultrasound examinations and HCC screening among patients with HIV and viral hepatitis coinfection. Moreover, only 71.7 % of patients chronically infected with HBV and 61.5 % with HCV underwent abdominal ultrasound examinations in the preceding 12 months—only 5.7 % and 3.8 % of the participants in these groups had had received tumor marker testing in the previous 12 months. ConclusionThere are challenges in hepatitis and HCC screening and monitoring among patients with HIV and viral hepatitis coinfection in Japan. These findings underscore the need to improve adherence to clinical practice guidelines and implement integrated care models to enhance hepatitis management in PLWH.

A dynamical optimal control theory and cost-effectiveness analyses of the HBV and HIV/AIDS co-infection model.

Studies have shown that the co-infection of Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) poses a major threat to the public health due to their combined negative impacts on health and increased risk of complications. Even though, some scholars formulated and analyzed the HBV and HIV co-infection model they did not consider the compartment that contains protected individuals against both HBV and HIV infections. They incorporated the optimal control theory and cost-effectiveness analysis simultaneously. With this in mind, we are motivated to formulate and analyze the HBV and HIV co-infection model, considering the protected group and incorporating optimal control theory and cost-effectiveness. In this study, we have theoretically computed all of the models disease-free equilibrium points, all the models effective reproduction numbers and unique endemic equilibrium points. The two sub-models disease-free equilibrium points are locally as well as globally asymptotically stable whenever their associated effective reproduction numbers are less than one. We reformulated the optimal control problem by incorporating five time-dependent control measures and conducted its theoretical analysis by utilizing the Pontryagin's maximum principle. Using the fourth order Runge-Kutta numerical method and MATLAB ODE45, we performed the numerical simulations with various combinations of control efforts to verify the theoretical results and investigate the impacts of the suggested protection and treatment control strategies for both the HBV and HIV diseases. Also, we carried out a cost-effectiveness analysis of the proposed control strategies. Eventually, we compared our model results with other researcher similar model results whenever cost-effectiveness analysis is not carried out the findings of this particular study suggest that implementing each of the proposed control strategies simultaneously has a high potential to reduce and control the spread of HBV and HIV co-infections in the community. According to the cost-effectiveness analysis, implementing the HBV treatment and the HIV and HBV co-infection treatment measures has a high potential effect on reducing and controlling the HBV and HIV co-infection transmission problem in the community.

Proteomics in low CVD risk black women living with HIV: H-ART to Heart Study

Abstract Background 39 million people worldwide are living with HIV (human immunodeficiency virus), acquired immune deficiency syndrome (AIDS)-related deaths have reduced by 51% since the peak in 2004. BWLWH represent 42% of those infected but only 9% are represented in clinical trials. HIV/AIDS has been shown to be associated with the development of heart failure, pulmonary hypertension and myocarditis. Previous studies in asymptomatic PLWH have revealed a high burden of underlying CVD and subclinical disease. The H-ART to Heart study is designed to examine potential signals and pathways of cardiovascular disease (CVD) in asymptomatic BWLWH with no traditional CV risk factors compared to HIV negative controls (-). Methods A cross-sectional study comparing asymptomatic BWLWH aged 35-55yrs (diagnosed &amp;gt;10 yrs, with undetectable viral loads) to HIV negative controls. Black African/Caribbean women without known CV risk factors (hypertension, hyperlipidaemia, diabetes, smoking, inflammatory arthritis, depression, severe mental illness) or hepatitis co-infection were included. Assessment included blood pressure (BP), 10yr CVD risk calculation % (Q-Risk 3), bloods including lipids. A targeted discovery proteomics approach was used to evaluate 92 unique proteins using the O-link Target 96 Cardiovascular II panel. Results 48 participants were recruited (23 BWLWH; 25 controls), mean duration of HIV was 17.6 years, mean duration of ART was 11.5 years, demographic details - Age 47.7± 44.7±; p=0.06, BP 125/77 v 123/79 ; p=0.89; BMI (kg/m²) 30.1±5.1 v 28.51±4.27 p=0.25; cLDL 3.49±1.22 v 2.42±0.74 p&amp;lt;0.02; Total Chol:HDL ratio 3.01±0.98 v 2.77±0.56 p=0.353; Q-Risk 3 1.92%±1.27 v 1.49%±1.12 p=0.219; There were no significant differences in baseline data apart from higher mean cLDL in BWLWH. Of the 92 proteins tested, 9 were significant in BWLWH (Figure 1). As demonstrated by the Heat map. Conclusion Data from our study of asymptomatic low risk BWLWH with no CVD risk factors indicates several pathways (Figure 2.) for further investigation in this previously under investigated vulnerable patient sub group. Whether this finding is of importance in CV risk assessment of BWLWH remains to be seen.

Prevalence of Co-infection of Hepatitis B Virus and Hepatitis C Virus among Human Immunodeficiency Virus Patients on Antiretroviral Therapy at A Tertiary Care Centre, Eluru, Andhra Pradesh, India

HIV, HBV, and HCV can form a pretty challenging trio when they coexist. Managing co-infection is crucial for the overall health of the individual, especially considering the potential impact on the liver. Regular monitoring and appropriate medical care can make a significant difference in the outcome for co-infected patients. To ascertain the seroprevalence of HBV and HCV in individuals with HIV attending the Anti-Retroviral Therapy (ART) center affiliated with a tertiary care hospital in Eluru, Andhra Pradesh. Over an 8-month duration, blood samples were obtained from all the individuals visiting the ART Centre. These samples underwent screening for surface antigen of HBV (HBsAg) and antibodies against HCV (anti HCV) by using rapid card tests. Positive samples were subsequently validated through ELISA testing. Baseline CD4 counts, CD4 count after receiving ART were assessed in individuals with HIV alone and those with coinfection of HBV. HIV viral load tests were conducted in individuals with HIV infection and those with coinfection of HBV, assessing their response to ART. Statistical analysis was applied to examine the obtained results. Among the 4382 participants, the seroprevalence of HBV &amp; HCV was 0.02%. The baseline CD4 values averaged 310 for HIV mono-infection cases and 223 for HIV/HBV co-infection cases, indicating a statistically significant distinction with a P value of 0.03. Likewise, the mean values of the CD4 counts after taking ART in individuals with HIV alone and those with coinfection of HBV were 675 and 599, respectively, with a statistically significant P value of 0.05. The study revealed a substantial enhancement in the effectiveness of ART, as indicated by HIV-1 viral load values, in both mono-infection and co-infection cases. Considering the similarity in the main transmission routes of HIV, HBV, and HCV, it is anticipated that hepatotropic viruses would be present in individuals with HIV infection.

Seropositivity and coinfection of hepatitis B and hepatitis C viruses in Central India: A hospital-based study.

Hepatitis B virus (HBV) and Hepatitis C virus (HCV) show similarity in the transmission, distribution, hepatotropism, and leading to chronic asymptomatic infection. Coinfection of HBV and HCV can lead to more severe liver disease and an increased risk for progression to hepatocellular carcinoma (HCC). Most of the people with chronic infection are unaware of their HBV and HCV infections, hence facilitating these to go undiagnosed until these viruses have caused serious liver damage and they act as a potential source of infection for the community at large. Therefore, the present study aimed to find the prevalence of HBV and HCV along with incidences of coinfection of HBV and HCV in patients seeking hospital care in central India. A five-year hospital-based study was carried out at the tertiary care hospital in Central India from 2018 to 2022. A total of 72402 patients attending the outdoor patients and admitted indoor patients who were advised for HBV and HCV for screening before any invasive/surgical procedure and patients who presented with symptoms of acute or chronic liver disease were included in this study. Screening was done by immunochromatography-based card test followed by the confirmation of all samples by enzyme immunoassay. Seroprevalence of HBV and HCV was found to be 3.71% and 1.91%, respectively. Coinfection with HBV/HCV was seen in 0.13% of the individuals. The overall prevalence of HBV, HCV, and HBV-HCV coinfection was significantly higher in the male population as compared to females. The study findings of seroprevalence of HBV and HCV among the hospital-based population will help to get a baseline understanding of the disease burden in central India. The HBV/HCV coinfection rate also raises serious concerns owing to its high prevalence rate among the younger age.

Viral hepatitis in persons living with HIV in the post-COVID era.

Coinfection with hepatitis viruses A to E is frequent in persons living with HIV (PLWH) and causes significant morbidity and mortality. Oro-fecal transmissible hepatitis A and E mostly produce acute self-limited episodes in poor income regions and in non-vaccinated travelers. In high-income countries, outbreaks of hepatitis A occur in men having sex with men (MSM) and chronic hepatitis E is occasionally reported among PLWH with severe immunodeficiency. Chronic hepatitis B, C, and D are frequent in PLWH in highly endemic regions and globally in persons who inject drugs (PWID) and MSM. Progression to liver cirrhosis and development of hepatocellular carcinoma (HCC) is major clinical complications in coinfected patients. Current estimates for PLWH are of 38 million worldwide. Roughly 12% have chronic viral hepatitis (5 million). Coinfection figures are of 5-10% for HBV (2-4 million), 4% for HCV (1.5 million), and 15% of HBsAg+ for HDV (0.5 million). Oral direct-acting antivirals (DAA) cure almost all treated patients with hepatitis C. However, given that there is no protective HCV immunity, PLWH with high-risk behaviors may experience HCV reinfection episodes. Tenofovir is the drug of choice in PLWH with chronic hepatitis B, given its dual effect on HIV and HBV. Lifelong oral tenofovir suppresses HBV replication and ameliorate liver damage. However, the risk of HCC persists even in the absence of cirrhosis. Finally, HDV causes the worst of viral hepatitis with faster progression to cirrhosis and HCC. An entry inhibitor, bulevirtide, has recently been approved and another drug, lonafarnib, is completing Phase 3 trials. Combination antiviral therapy for hepatitis D could improve dramatically the poor prognosis of HIV-HDV coinfected patients. The resumption of good medical practices in PLWH after the big disruption caused by COVID-19 will reduce the burden of viral hepatitis coinfections. Renewed efforts on HAV and HBV vaccination of susceptible individuals and earlier and wider prescription of antiviral therapy for HBV, HCV, and/or HDV coinfection should be prioritized in PLWH. The benefits of innovative strategies for viral hepatitis, including pre-exposure prophylaxis or use of long-acting antivirals, warrant further consideration in PLWH.

Stochastic modeling and analysis of Hepatitis and Tuberculosis co-infection dynamics

Abstract Several mathematical models have been developed to investigate the dynamics of Tuberculosis (TB) and Hepatitis B virus (HBV). Numerous current models for TB, HBV, and their co-dynamics fall short in capturing the important and practical aspect of unpredictability. It is crucial to take into account a stochastic co-infection HBV–TB epidemic model since different random elements have a substantial impact on the overall dynamics of these diseases. We provide a novel stochastic co-model for TB and HBV in this study, and we establish criteria on the uniqueness and existence of a non-negative global solution. We also looked at the persistence of the infections as long its dynamics are governable by the proposed model. To verify the theoretical conclusions, numerical simulations are presented keeping in view the associated analytical results. The infections are found to finally die out and go extinct with certainty when Lévy intensities surpass the specified thresholds and the related stochastic thresholds fall below unity. The findings also demonstrate the impact of noise on the decline in the co-circulation of HBV and TB in a given population. Our results provide insights into effective intervention strategies, ultimately aiming to improve the management and control of TB and HBV co-infections.

Challenges in the Treatment of Coinfection of Visceral Leishmaniosis and Hepatitis B/C Viruses

There is a significant research gap in India due to incomplete investigation of seroprevalence of co-infection with visceral leishmaniasis (VL), hepatitis B (HBV) and hepatitis C (HCV). This study attempts to fill this gap by providing an in-depth analysis of the prevalence and consequences of these co-infections. The study of 32 VL patients revealed that 28 (8.88%) tested positive for HBV, 1 (0.317%) for HCV and 3 (0.95%) for both HBV and HCV. These results highlight how difficult it is to treat people with two diseases at the same time. An example of how co-infection makes treatment much more difficult is the fact that a patient with both VL and HBV required six courses of anti-leishmaniasis medication. The study shows how important it is for VL patients to be tested regularly for HBV and HCV to improve treatment response and support India's plan to get rid of kala-azar. Accurate identification of co-infections is necessary to reduce the overall burden of the disease and develop effective treatment regimens. Systematic testing of VL patients for HBV and HCV not only helps in controlling and perhaps even eliminating kala-azar, but also makes it easier to treat each patient as an individual, improving their health. In areas where viral hepatitis is prevalent, this strategy is particularly important as these diseases represent a double burden on public health. Implementing integrated treatment regimens and routine screening can reduce the impact of co-infection and advance the public health goal of kala-azar elimination. To improve patient outcomes and advance public health goals, the results of this study strongly support the integration of comprehensive screening programs into existing healthcare systems to improve the treatment of VL patients.

Metabolic dysfunction-associated steatohepatitis exhibits sex differences in people with HIV.

People with HIV are at increased risk for metabolic dysfunction-associated steatohepatitis (MASH). Although sex differences are documented in the general population, their role in the context of HIV is less understood. This was a multicentre cohort study including people with HIV without viral hepatitis coinfection. A FibroScan-AST (FAST) score >0.35 was used to diagnose MASH with significant liver fibrosis (stage F2-F4). We investigated sex-based differences in MASH trends as a function of age using a segmented linear mixed-effects model. Random effects accounted for clustering by the four sites. Adjusted models included ethnicity, diabetes, hypertension, and detectable HIV viral load. We included 1472 people with HIV (25% women). At baseline, the prevalence of MASH with fibrosis by FAST score was lower in women than in men (4.8% vs. 9.2%, p = 0.008). Based on the adjusted model, male sex (+0.034; p = 0.04), age per year (+0.003; p = 0.05), detectable HIV viral load (+0.034; p = 0.02), and hypertension (+0.03; p = 0.01) were positively associated with MASH with fibrosis. Although men exhibited generally higher FAST scores, FAST scores increased in women during the critical biological age of presumed perimenopause to menopause (between 40 and 50 years), reaching levels similar to those in men by the age of 55 years. Despite women with HIV having a lower prevalence of MASH with fibrosis than men, they exhibit an acceleration in FAST score increase around the perimenopausal age. Future studies should target adequate consideration of sex differences in clinical investigation of metabolic dysfunction-associated steatotic liver disease to fill current gaps and implement precision medicine for people with HIV.

Hepatitis co-infection in paediatric HIV: progressing treatment and prevention.

To analyse the main evidence and recommendations for the management of hepatitis co-infection in children living with HIV. We analysed available data pertaining to the natural history of liver disease and treatment of co-infected children. Viral hepatitis co-infection in people living with HIV (PLHIV) is a global problem owing to the shared routes of transmission, particularly in areas of high endemicity for the three viruses. Viral hepatitis co-infection can accelerate liver disease progression and increase morbidity and mortality, even in patients on suppressive antiretroviral treatment (ART). Viral hepatitis should be routinely screened in PLHIV and, once diagnosed with viral hepatitis, PLHIV should be closely monitored for liver disease progression and complications. Children living with HIV-HBV co-infection should be treated with ART containing agents which are active against both viruses. Children living with HIV-HCV co-infection should receive directly acting antivirals (DAA) to eradicate HCV infection. Prevention measures to reduce vertical and horizontal transmission of HBV and HCV (anti-HBV vaccination and immunoglobulins, anti-HBV treatment in pregnancy, anti-HCV DAAs in people of childbearing age, avoiding blood contact, sexual barrier precautions) should be adopted and encouraged, particularly in high endemicity countries.

EPIDEMIC MANIFESTATIONS OF HIV COMBINED WITH CHRONIC VIRAL HEPATITIS IN THE FAR EASTERN FEDERAL DISTRICT

Coinfection represents one of the most complex public health issue for therapy and epidemiological surveillance worldwide. The latter in the Russian Federation includes no specific monitoring after HIV and chronic viral hepatitis (CVH) coinfection. Objective: to perform a retrospective epidemiological analysis of CVH, HIV-infection, HIV+CVH coinfection incidence, conduct integral assessment of HIV+CVH coinfection epidemic manifestations in the Far Eastern Federal District (FEFD) during the years 2007-2022. It was established that HIV-infection and HIV+CVH coinfection incidence showed a unilateral long-term growth trend reaching in 2022 up to 4.3 cases/100000 population (by 6-fold higher than in 2007), which for HIV-infection incidence was as high as 30.7 cases/100000 population (by 2-fold higher than in 2007). CVH incidence decrease with average long-term decline comprising 4.4% per year and in 2022 reaching 26.1 cases/100000 population. Primorsky krai had highest incidence of HIV+CVH coinfection in 2022 that exceeded average level recorded among territories of the FEFD by 2.3-fold. Primorsky Krai is a territory historically characterized by widespread of HIV-infection and CVH in human population partly due to broad drug use. Ranking of HIV+CVH coinfection incidence revealed territories with favorable epidemic situation as follows: Kamchatka krai, Khabarovsk krai, Republic of Sakha (Yakutia), Magadan oblast. HIV infection and CVH are long-lasting conditions so that individuals with verified diagnosis may remain a source of infection, analyzing disease incidence alone was found to be insufficient for assessing epidemic situation. Therefore, a comprehensive analysis was carried out to calculate integral index based on the sum of ranks of HIV+CVH coinfection incidence, prevalence and average long-term incidence, prevalence of CVH among HIV-positive subjects. Ranking of the integral index established unfavorable epidemic situation for HIV+CVH coinfection in the Magadan region and Republic of Sakha (Yakutia). Both territories had an upward incidence trend, high prevalence of CVH among HIV-positive subjects. In addition, the Magadan region had highest prevalence of HIV+CVH coinfection. Primorsky krai and Jewish autonomous region were also classified as unfavorable. Existing epidemiological surveillance after HIV-infection needs to be supplemented with separate monitoring over HIV+CVH coinfection. Estimating an integral index in addition to evaluation of incidence for assessment of the epidemic situation over coinfection will improve the analysis.

Investigation of hepatitis B virus mutations associated with immune escape and drug resistance in human immunodeficiency virus-infected patients

Background Co-infection of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) has an impact on high HBV replication and progression to liver cancer. These may lead to cross-resistance of drugs due to therapeutic pressure or liver toxicity. These require continuous monitoring of HBV variants for better diagnosis and treatment strategies. Methods Convenience sampling was used to collect fifty archival sera from Inkosi Albert Luthuli Central Hospital. The Sera were subjected to HBsAg screening using ELISA, DNA extraction, PCR amplification, Sanger sequencing, phylogenetic and mutation analysis. A correlation test was performed to measure the association between polymerase and surface mutations. Results Of the 50 samples, 86% (N= 43/50) were HBsAg positive; 82% (N=41/50) PCR positive and 92% (N=38/41) sequenced. The HBV sequences showed similarity to genotype A (73% [N=19/26]) and (24% [N=7/26]) as genotypes B, C, D, E, F, and G. Prevalence of the mutations in the Surface region was (47% [N=18/38]); including diagnostic failure (K122R and T143S) and vaccines escape mutations (P127T, G145R, S207N, Y200T, E164D, Y206H and L209V). The mutations in the RT was at (36% [N=14/38]) with drug resistance mutations (DRM) at (50% [7/14]). Mutations showed resistance to lamivudine (LMV) at (35% [5/14]), telbivudine (LdT) at (29% [4/14]), (14% [2/14]) for entecavir (ETV) and (21% [3/14]) for adefovir (ADV). One sample had a combination of L180M, M204V, S202K, and M250I mutations. There was no statistical significance between S and RT mutations at P&gt;0.005 and the statistical correlation between RT and SHB mutations was weak at 0.877. Conclusions Our findings highlight the prevalence of HBV genotype A in HIV-infected patients in South Africa. We provide evidence of mutations linked to immune evasion and drug resistance. Mutations have no statistical significance but can have clinical Implication on the diagnosis and treatment of HBV in HBV/HIV co-infected individuals.

A new co-infection model for HBV and HIV with vaccination and asymptomatic transmission using actual data from Taiwan

The co-infection of Human Immunodeficiency Virus (HIV) and Hepatitis B virus (HBV) poses a major threat to public health due to their combined negative impacts on health and increased risk of complications. A novel fractional mathematical model of the dynamics of co-infection between HBV and HIV for Taiwan is presented in this paper. Detailed analyses are conducted on the possible impact of HBV vaccination on the dynamics of HBV and HIV co-infection. The next-generation matrix technique is used to calculate the fundamental reproduction number R 0 = max{R 1, R 2}, where R 1 and R 2 are the reproduction numbers for HBV and HIV, respectively. The disease-free and endemic equilibria of the co-infection model are calculated. An extensive investigation is carried out to determine the local and global stability of the disease-free equilibrium point through Rough Hurtwiz criteria and the construction of Lyapunov function, respectively. We demonstrate that when R 1 < 1 < R 2, HBV infection is eradicated, but HIV remains prevalent. If R 2 < 1 < R 1, the opposite outcome occurs. The real data from 2000-2023 for Taiwan is used to fit the model. The fitting results show how effectively our model handles the data. In addition, numerical simulations are run for different scenarios to observe how the vaccine and fractional parameters changed the model state variables, as well as how the solutions behaved and how quickly they reached the model’s equilibrium points. According to the model’s numerical analysis, greater vaccination efforts against HBV have a positive effect on the propagation of co-infection.

Seroprevalence and molecular characterization of viral hepatitis and HIV co-infection in the Central African Republic.

The Central African Republic (CAR) is one of the countries with the highest prevalence of viral hepatitis infection in the world. Coinfection with HIV increases the morbidity and mortality beyond that of mono-infection with either hepatitis or HIV. The present study describes the geographic distribution of viral hepatitis infections and molecular characterization of these viruses in the CAR. Out of 12,599 persons enrolled during the fourth Multiple Indicator Cluster Survey of 2010 in the CAR, 10,621 Dried Blood Spot (DBS) samples were obtained and stored at -20°C. Of these DBS, 4,317 samples were randomly selected to represent all regions of the CAR. Serological tests for hepatitis B, D, and C viruses were performed using the ELISA technique. Molecular characterization was performed to identify strains. Of the 4,317 samples included, 53.2% were from men and 46.8% from women. The HBsAg prevalence among participants was 12.9% and that HBc-Ab was 19.7%. The overall prevalence of HCV was 0.6%. Co-infection of HIV/HBV was 1.1% and that of HBV/HDV was 16.6%. A total of 77 HBV, 6 HIV, and 6 HDV strains were successfully sequenced, with 72 HBV (93.5%) strains belonging to genotype E and 5 (6.5%) strains belonging to genotype D. The 6 HDV strains all belonged to clade 1, while 4 recombinants subtype were identified among the 6 strains of HIV. Our study found a high prevalence of HBV, HBV/HDV and HBV/HIV co-infection, but a low prevalence of HCV. CAR remains an area of high HBV endemicity. This study's data and analyses would be useful for establishing an integrated viral hepatitis and HIV surveillance program in the CAR.

Comprehensive Treatment of Generalized Tuberculosis with Endobronchial Valves

The article describes a clinical case of generalized tuberculosis manifested by tuberculous spondylodiscitis and disseminated pulmonary tuberculosis with extensive drug resistance and bilateral multiple destruction. The chemotherapy regimen compiled according to the sensitivity pattern of the pathogen, sequential implantation of two endobronchial valves and their long-term (18 months) synergic effect made it possible to cure pulmonary tuberculosis with healing of all multiple bilateral destruction. The same chemotherapy regimens allowed achieving cure of tuberculous spondylodiscitis. Co-infection of hepatitis C provided no negative impact on the treatment course.