Hepatitis Type Research Articles

A case study on Ayurvedic management on Kamala w.s.r. to Hepatitis E Virus

Hepatitis is defined as liver inflammation that can be caused on by a number of conditions, including prolonged drug use, heavy alcohol consumption, autoimmune conditions, and exposure to toxins. The term "viral hepatitis" describes the most common type of hepatitis, which is caused by an infection with a virus. In this case, report effect of Ayurveda intervention in HEV is reported. A 55-year, old non-alcoholic, married male patient from an urban area, presented with yellowish discolouration of sclera, urine, upper and lower extremities, reduced appetite, nausea, fatigue with generalized weakness and experiencing upper abdominal pain to the National Institute of Ayurveda Hospital, Jaipur, Rajasthan. On examination, icterus was present, pitting edema present on both lower legs. Hematological examination revealed altered total bilirubin, SGOT, SGPT, Triglycerides, ESR, CRP. Also, sonographic examination revealed a mild hepatomegaly in the patient. The total duration of the treatment was 2 months. The patient was assessed for improvement in hematological parameters, viral markers, and signs and symptoms. after two months, significant improvement was observed in signs and symptoms, and all altered hematological parameters, and viral markers were within normal limits. Hence, presenting this case is evidence to demonstrate the effectiveness of two months of Ayurvedic treatment in managing HEV. The total duration of the treatment was 60 days.

PATHOMORPHOLOGICAL CHANGES IN THE LIVER CAUSED BY HEPATITIS B, C, B+C VIRUSES IN THE DECEASED HIV-INFECTED PERSONS

Pathohistological peculiarities of liver histological preparations of 75 HIV-infected deceased people with chronic viral hepatitis which diagnosed during their life: hepatitis B was in 8, C – in 24, B+C – in 43 patients. It was determined that in all patients (100.0 %), with any type of chronic hepatitis (B, C or B+C) there was a lymphocyte-macrophage infiltration of portal tracts and stroma. In persons with hepatitis B there were a focal and periportal necrosis of hepatocytes in 100.0 % of patients, hydropic dystrophy of hepatocytes - in 87.5 % and liver cirrhosis – in 25.0 %. In patients with hepatitis C a fatty dystrophy of the liver was found in 91.7 % that more often than in patients with hepatitis B (12.5 %, p<0.001), the focal periportal necrosis of hepatocytes was less (12.5 % vs. 100.0 %, respectively, p<0.001) and liver cirrhosis was in 41.7 %.
 In patients with hepatitis B+C, the liver tissue included signs characteristic of both hepatitis B and C: a hydropic dystrophy (69.8 %), fatty dystrophy (30.2 %), periportal bridging necrosis (51.2 %), liver fibrosis (34.9 %). As a result of these complex pathological processes in the liver, a cirrhosis was found more often than in other groups of patients (67.4 % vs. 41.7 % of patients with hepatitis C, p=0.041, and vs. 25.0 % of patients with hepatitis B, p=0.024). Histology activity index of hepatitis and stage of liver fibrosis according to Knodell R.G. (1981) did not differ in frequency in all groups of patients. In all patients a strong negative correlation was found between them (r=-0.607, p<0.001). This finding reflects a decrease in the histological activity of hepatitis against the background of increased fibrotic changes in the body.
 Conclusion. It has been found that the hydropic dystrophy and focal intralobular and periportal bridging necrosis of hepatocytes are characteristic of hepatitis B infection in HIV-infected deceased persons. Hepatitis C is characterized by the fatty dystrophy and cirrhosis of the liver. The presence of hepatitis B+C causes the liver changes characteristic of both hepatitis B and C simultaneously: the hydropic dystrophy, fatty dystrophy, necrosis of hepatocytes. The liver cirrhosis is most often present in patients with hepatitis B+C. The degree of liver fibrosis negatively correlated with the histology activity index of hepatitis.

Acute iucterine hepatitis as a manifestation of severe autoimmune hepatitis

In the article, on the example of a clinical case, a variant of the course of severe acute autoimmune hepatitis type II in a 20-year-old woman is analyzed. The prevalence of this disease are presented. Possible types of autoimmune hepatitis course are discussed. The main diagnostic criteria that indicate the likelihood of autoimmune hepatitis and the tactics of managing these patients are described.
 This clinical case demonstrates that in the absence of epidemiological, anamnestic data indicating a possible viral or toxic liver damage, it is necessary to think and exclude autoimmune liver damage. It is believed that the level of gamma globulin exceeding more than 1.5 times the upper limit of normal and the absence of viral hepatitis are independent predictors of the presence of autoimmune hepatitis, and the earlier immunosuppressive therapy is started, the more favorable the prognosis of the disease.

Hepatitis B Screening Program for patients attending out-patient department (OPD) at Sir Salimullah Medical College Mitford Hospital, Dhaka – An Observational Study

Background: Hepatitis B (HBV) is a major cause of chronic hepatitis, cirrhosis of liver and hepatocellular carcinoma in Bangladesh. It is also the most common cause of death from liver disease in the country. The prevalence of hepatitis B is 5-6% in the general population. So the present status of the virus is considered as an important public health concern of Bangladesh. Objectives: To investigate hepatitis B prevalence among the persons attending the OPD and to increase awareness about hepatitis B. Materials and methods: A cross-sectional observational study was carried out the at the Department of Hepatology, Sir Salimullah Medical College Mitford Hospital, Dhaka on March 17&18, 2022 at Special Treatment Campaign on the occasion of celebration of the birth anniversary of the Father of Nation, Bangabandhu Sheikh Mujibur Rahman. A total of 190 people of both sexes from 18 years to 50 years of age group were enrolled in the study. These people were unaware of whether they were carrying hepatitis B virus or also was not aware of whether they are suffering from any kind of liver disease. Informed consent was taken and a pre-designed structured questionnaire was used. Screening was done by HBsAg detection using rapid diagnostic kit. Result: The mean age of respondents was 35.95±6.42 years with a male to female ratio of 0.83. Most of the respondents were married (72.63%) and Muslim (87.37%). Among them 47.36% of the respondents were service holders. Only 17.89% had a previous history of some types of hepatitis. 25.26% of respondents had history of different types of surgical procedure. 8 (4.2%) participants were found positive for HBsAg on the screening test in our study. Conclusion: This study shows 4.2 % of participants were screening positive among the respondents. This correlate with the intermediate prevalence of hepatitis B in Bangladesh as stated in World Health Organization data. Screening program increases knowledge and awareness among the population and thereby increase treatment seeking, which ultimately reduce incidence of disease and complications as well as death. Sir Salimullah Med Coll J 2023; 31: 3-8

COVID-19 impact on viral hepatitis in Italy: a time-series analysis

Abstract Background Worldwide there has been a sharp decrease in the number of notified cases of any type of viral hepatitis during the pandemic period. This study aims to investigate the impact of COVID-19 on viral hepatitis in Italy. Methods This was a retrospective study that analysed data extracted from the “Integrated Epidemiological System of Acute Viral Hepatitis” (SEIEVA) online platform from 1994 to 2022 in the Piedmont region of Northern Italy. Descriptive statistics were used to compare data from the pandemic period (2020-2022) to three years of pre-pandemic period (2017-2019). Second, a univariate ARIMA temporal forecast model based on the years 1994-2019 was built to predict how many cases should have been registered in the pandemic period. The Wilcoxon test was performed to detect if there was a statistically significant difference between the observed and predicted values. Results The time elapsed between the onset of symptoms and the serological test, potentially indicative of challenges related to hospital access, was delayed by a couple of days (median 7, 2-12 IQR) in the three-year period 2020-2022 compared to 2017-2019 (median 5, 3-9 IQR). The same occurred considering the time between the positive test and the epidemiological interview (median 6, 3-16 IQR vs median 4, 2-9 IQR). Although the ARIMA forecasting model confirmed a downward trend, the observed values of notified cases were lower than expected. A statistically significant difference was found between predicted and observed values (p = 0.004). Conclusions Although it is difficult to assess the impact of COVID-19 on the transmission of viral hepatitis, the results of this study suggest a lower accuracy of the surveillance. It will be important to restore the previous levels of attention and investigation, monitoring the trend in the coming years. The World Health Organization's goal is the eradication of viral hepatitis. COVID-19 may have slowed down the process. Key messages • It is important to keep up the level of attention towards viral hepatitis, which seems to have decreased following the COVID-19 pandemic. • It will be important to pay attention to the trend of notified cases in the coming years to establish more precisely the level of impact of the pandemic.

Associated Bacterial Coinfections in COVID-19-Positive Patients.

Background and Objectives: The aim of this study was to identify specific rhino- and oropharyngeal microbiological pathogens as well as associated comorbidities that favor SARS-CoV-2 infection and corelate them. Materials and Methods: This prospective clinical study enrolled 61 patients (28 COVID-19-positive and 33 controls) who were tested for other comorbidities and co-existence of associated oral pathogenic microbiota. Results: A total of 247 bacterial isolates were identified in the bacterial cultures in both groups. Viral hepatitis type A was more prevalent in the COVID-19-positive group (p = 0.026), as was the presence of oral candidiasis (p = 0.006). In the control group, a moderate direct relationship was observed between the Beta hemolytic streptococcus group G and dermatitis, and strong direct relationships were observed between the Beta hemolytic streptococcus group G and external otitis, Streptococcus pyogenes and dental alveolitis, and Streptococcus pyogenes and chronic lymphocytic leukemia. In the test group, strong direct relationships were observed between Hemophilus influenzae and pulmonary thromboembolism; Staphylococcus aureus and autoimmune thyroiditis; post-viral immunosuppression, chronic coronary syndrome, and hypernatremia; Beta hemolytic streptococcus group C and rheumatoid polyneuropathy; Beta hemolytic streptococcus group G and hyperkalemia, hypothyroidism, secondary anemia, and splenomegaly; and active oral candidiasis and SARS-CoV-2 viral pneumonia. The following relationships were strong, but inverse: Beta hemolytic streptococcus group G and acute respiratory failure, and active oral candidiasis and SARS-CoV-2 viral bronchopneumonia. Conclusions: Briefly, COVID-19-positive patients have the predisposition to build up associated comorbidities and coinfections, which can be the expression of the immune burden that this virus generates to the host.

Construction of a screening and evaluation system for anti-hepatitis B virus drugs based on quadratic exponential smoothing model

Abstract Exploring the construction of an anti-hepatitis B virus drug screening and evaluation system is to better develop anti-HBV virus drugs. In this paper, we analyzed the types of hepatitis B virus present in different hepatocytes, starting from the hepatitis B cell line model. Based on the quadratic, exponential smoothing model, a QES-LSTM viral gene detection model was constructed by introducing a long and short term memory neural network, and experimental analysis of the sensitivity and specificity of viral gene detection was conducted for this model. From the sensitivity experiments, the sensitivity of HBV DNA, DHBV DNA and DHBV cccDNA were 60 copies/ml, 60 copies/ml and 10 copies/ml, respectively. From the specificity experiments, the mean values of specificity of HBV DNA, DHBV DNA, and DHBV cccDNA were 0.489, 0.481, 0.429, respectively, 0.429, which showed positive amplification compared to other types. This indicates that effective discrimination of HBV viral genes is needed in the construction of an anti-HBV virus drug screening and evaluation system, which in turn allows targeted screening of drugs for the treatment of the HBV virus.

Fatty liver is associated with significant liver inflammation and increases the burden of advanced fibrosis in chronic HBV infection

BackgroundConcurrent non-alcoholic fatty liver disease (NAFLD) is common in patients with chronic HBV infection. But the impact of fatty liver on the histologic progression of HBV infection remains controversial.MethodsConsecutive HBV-infected patients who underwent liver biopsy between 2016 and 2021 were included. Alcohol consumption and other types of viral hepatitis were excluded. All biopsies were scored for grading and staging by Scheuer’s score, and the steatosis was scored as an estimate of the percentage of liver parenchyma replaced by fat. Logistic regression analyses were applied to assess the associated factors for significant liver inflammation (G ≥ 2), significant fibrosis (S ≥ 2) and advanced fibrosis (S ≥ 3).ResultsAmong the 871 HBV-infected patients, hepatic steatosis was prevalent in 255 patients (29.28%). Significant liver inflammation was present in 461 patients (52.93%). Significant fibrosis was observed in 527 patients (60.51%), while advanced liver fibrosis was observed in 171 patients (19.63%). Patients with concomitant NAFLD were more likely to have significant liver inflammation and advanced fibrosis. Fatty liver was an independent risk factor for significant liver inflammation (OR: 2.117, 95% CI: 1.500-2.988), but it could not predict the development of fibrosis. Especially, in HBV-infected patients with persistent normal ALT (immune tolerant and inactive carrier phase), the presence of significant liver inflammation was higher in NAFLD than those without NAFLD. The prevalence of advanced liver fibrosis was higher in NAFLD than non-NAFLD only in the immune tolerant phase, while NAFLD did not increase fibrosis burden in other stages of HBV infection. We developed a predictive model for significant liver inflammation with the area under receiver operating characteristic curve (AUROC) of 0.825, and a model for significant fibrosis with the AUROC of 0.760.ConclusionsNAFLD is independently associated with significant liver inflammation, and increases the burden of advanced liver fibrosis in HBV-infected patients. The influence of NAFLD on the degree of liver inflammation and fibrosis is different in distinct clinical phases of chronic HBV infection.

Down-Classification of Hepatitis C Virus Diagnostics: Implications for Screening and Diagnosis.

In November 2021, the United States Food and Drug Administration reclassified 2 types of hepatitis C virus (HCV) diagnostic tests (HCV antibody and HCV nucleic acid) from class III to class II, providing a less burdensome pathway to market for diagnostic companies. This down-classification is anticipated to facilitate innovation in HCV diagnostics, particularly for new point-of-care viral detection assays, and ultimately support HCV elimination efforts by increasing the ease of screening as well as test-and-treat models of HCV care.

A multispecies competitive nanobody-based ELISA for the detection of antibodies against hepatitis E virus

The hepatitis E virus (HEV) is an emergent zoonotic virus causing viral hepatitis worldwide. Clinically, hepatitis E is not easily distinguished from other types of acute viral hepatitis. There is a need for HEV diagnostic assays to detect and prevent interspecies transmission among susceptible populations. Nanobodies (Nbs) are expressed recombinantly in different systems, produced with high yields, and have superior physicochemical properties compared with conventional antibodies (Ab). Several Nbs against ORF2, the capsid protein and main antigen, were selected and produced in E. coli. Nb39 and Nb74 specifically recognized HEV ORF2 (genotypes 3 and 4). A competitive ELISA (cELISA) was developed and validated using a reference panel of human (n = 86) and swine sera (n = 116) tested in comparison with a commercial kit. The optimal cutoff values determined by ROC analysis were 69.16% (human) and 58.76% (swine); the sensitivity and specificity were high: 97.4% (95% CI 86.5–99.5%) and 95.8% (95% CI 86.0–98.8%) for human vs. 100% (95% CI 93.5–100%) and 98.3% (95% CI 91.0–99.7%) for swine. Further, the cELISA detected total anti-HEV antibodies in wild boar, deer, and mice. To our knowledge, this is the first report of production of Nbs against HEV-3 ORF2 for diagnostic purposes.

Correlation between IL-35 and viral load in patients with liver hepatitis type B in Baghdad

Hepatitis, including autoimmune hepatitis, alcoholic hepatitis, drug-induced hepatitis, bacterial hepatitis, viral hepatitis, and others, was a typical occurrence in clinical work. Hepatitis B virus (HBV) and hepatitis C virus (HCV), both non-cytopathic viruses, were shown to be frequent in liver damage. It has been observed that IL-35 is linked to a reduction in inflammation and can limit T-cell proliferation and the activity of its effector cells. The hepatitis B virus is a virus that causes liver disease. Serum IL-35 was shown to be higher in chronic hepatitis B virus patients. At the same time, research has discovered that Tregs and other cell types (such as activated myeloid, endothelial cells, and regulatory B cells) can secrete IL-35. The quantity of specific viral DNA or RNA in a blood sample is known as viral load count, and it is one of the potential biomarkers of hepatitis. A high viral load suggests that the immune system has failed to combat viruses. Real-time quantification of hepatitis B (HBV) DNA viral load is possible. Hepatic chronic, cirrhosis, and undetected patients are measured using polymerase chain reaction (PCR) and non-invasive methods. In the ordinary course of HBV infection, HBV DNA is the only thing that survives. HBV DNA levels represent viral levels and derive from mature infectious particles. Reproducibility. Various hospital-based and community-based case-control and cohort studies have repeatedly demonstrated substantial correlations between blood HBV DNA levels and the risk of liver cirrhosis and HCC. Chronic hepatitis B has a variable course in disease activity with a risk of clinical complications like liver cirrhosis and hepatocellular carcinoma. As clinical symptoms present in a late stage of the disease, identifying risk factors is important for early detection and, therefore, improving prognosis. Recently, two REVEAL-HBV studies from Iraq have shown a positive correlation between viral load at any point in time and the development of cirrhosis and hepatocellular carcinoma. Keywords: Hepatitis B virus HBV, Interleukin-35 IL-35, polymerase chain reaction PCR.

Viral Hepatitis in Pregnancy: ACOG Clinical Practice Guideline No. 6.

The purpose of this document is to describe the specific types of viral hepatitis, their implications during pregnancy, the risk of perinatal transmission, and issues related to both treatment and prevention of infection. Pregnant or postpartum women and individuals who screen positive for viral hepatitis infection. The onset of these conditions may have predated the perinatal period or may have occurred for the first time in pregnancy or the first year postpartum. This guideline was developed using an a priori protocol in conjunction with a writing team consisting of one specialist in obstetrics and gynecology appointed by the ACOG Committee on Clinical Practice Guidelines-Obstetrics and one external subject matter expert. ACOG medical librarians completed a comprehensive literature search for primary literature within Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, EMBASE, PubMed, and MEDLINE. Studies that moved forward to the full-text screening stage were assessed by two authors from the writing team based on standardized inclusion and exclusion criteria. Included studies underwent quality assessment, and a modified GRADE (Grading of Recommendations Assessment, Development, and Evaluation) evidence-to-decision framework was applied to interpret and translate the evidence into recommendation statements. This Clinical Practice Guideline includes recommendations on hepatitis B virus and hepatitis C virus screening in pregnancy; prepregnancy, antepartum, intrapartum, and postpartum management for patients with hepatitis B virus infection or hepatitis C virus infection; management of accidental and occupational exposure to hepatitis B virus or hepatitis C virus in pregnant health care workers; and hepatitis A virus and hepatitis B virus vaccination in pregnancy. Recommendations are classified by strength and evidence quality. Ungraded Good Practice Points are included to provide guidance when a formal recommendation could not be made because of inadequate or nonexistent evidence.

Gastroenterological manifestations of IgG4 associated disease. Literature review, clinical case

IgG4‑associated disease is a disorder with an unknown etiology and multi‑organ damage caused by a specific inflammatory process, characterized by periductal inflammatory infiltrate mainly by CD4+‑T lymphocytes, IgG4+‑plasma cells, storiform fibrosis, atrophy of acinar tissue, which often results in pancreatic duct stenosis. A great number of target organs are involved in the pathological process, one primary localization of the pathological process without damage to other organs is observed in only 10 — 20% of patients. Mostly affected are middle‑aged and elderly men. The pathological process is stipulated by a pronounced tissue infiltration with lymphocytes and plasma cells, followed by fibrosis development. The clinical picture varies widely, depending on the combination of affected target organs. The long‑term prognosis of the disease has not been sufficiently studied due to the small number of observations, the variety of clinical forms and the variability of treatment approaches. IgG4‑associated lesions have been described for localization in pancreas, biliary tract and gallbladder, liver, esophagus, stomach and intestines, retroperitoneal space, mammary glands and thyroid and prostate glands, salivary and lacrimal glands, kidneys and ureters, lymph nodes, skin and bones. The article presents a review of current literature on gastroenterological lesions in IgG4 associated diseases, as well as a clinical case of a patient with IgG4‑autoimmune pancreatitis type 1, IgG4‑sclerosing cholangitis, autoimmune hepatitis type 1 complicated by 3 type diabetes mellitus. The diagnosis of an IgG4‑associated disease in gastroenterological practice causes some difficulties. However, the timely diagnosis and administration of adequate treatment can significantly improve the quality of life of the patient and prevent the development of complications.

Encapsulation of an Antioxidant in Redox-Sensitive Self-Assembled Albumin Nanoparticles for the Treatment of Hepatitis.

Hepatitis is an inflammation of the liver caused by the inadequate elimination of reactive oxygen species (ROS) derived from Kupffer cells. Edaravone is clinically used as an antioxidant but shows poor liver distribution. Herein, we report on the design of a Kupffer cell-oriented nanoantioxidant based on a disulfide cross-linked albumin nanoparticle containing encapsulated edaravone (EeNA) as a therapeutic for the treatment of hepatitis. Since the edaravone is bound to albumin, this results in a soluble and stable form of edaravone in water. Exchanging the intramolecular disulfide bonds to intermolecular disulfide bridges of albumin molecules allowed the preparation of a redox responsive albumin nanoparticle that is stable in the blood circulation but can release drugs into cells. Consequently, EeNA was fabricated by the nanoscale self-assembly of edaravone and albumin nanoparticles without the additives that are contained in commercially available edaravone preparations. EeNA retained its nanostructure under serum conditions, but the encapsulated edaravone was released efficiently under intracellular reducing conditions in macrophages. The EeNA was largely distributed in the liver and subsequently internalized into Kupffer cells within 60 min after injection in a concanavalin-A-induced hepatitis mouse. The survival rate of the hepatitis mice was significantly improved by EeNA due to the suppression of liver necrosis and oxidative stress by scavenging excessive ROS. Moreover, even through the postadministration, EeNA showed an excellent hepatoprotective action as well. In conclusion, EeNA has the potential for use as a nanotherapeutic against various types of hepatitis because of its Kupffer cell targeting ability and redox characteristics.

Changing the Epidemiology and Pattern of Hepatitis B and C in the South of Fars Province, Southern Iran: 2015 - 2021

Background: Hepatitis B and C are now recognized worldwide as dangerous infectious diseases which impose many physical and economic problems on individuals, families, and society. Objectives: This research was designed to demonstrate the trends of hepatitis B and C in the south of Fars province, southern Iran, from 2015 to 2021. Methods: The current research was a cross-sectional analytical study. All patients infected with hepatitis B and C from 2015 to mid-2021 were enrolled, and their information was registered in the health department of the Larestan Faculty of Medical Sciences. The Cochran-Armitage trend test was used to determine hepatitis B and C incidences. Results: A total of 306 cases of hepatitis B and 128 cases of hepatitis C were registered. The mean age of the individuals with hepatitis B was 40.15 ± 18.95 years, and that of those with hepatitis C was 45.12 ± 13.31 years. The overall incidence of hepatitis B and C was estimated at 18.44 and 7.71 per 100,000 population, respectively. The highest incidence of hepatitis B was observed, with 50.91 and 26.01 per 100,000 population in 2019 and 2018, respectively, and the lowest incidence was reported in 2016 (1.46 cases per 100,000 population). The highest incidence of hepatitis C, with 17.94 and 15.01 per 100,000 people, was reported in 2018 and 2019, respectively, and the lowest incidence (0.36 per 100,000 population) was in 2016. The finding of the Cochrane-Armitage trend test for both types of hepatitis B and C indicated that the trend of hepatitis incidence from 2015 to 2021 had significantly increased (P Trend < 0.001). Conclusions: In general, the incidence of hepatitis B and C has increased significantly; therefore, it is necessary to implement preventive and control programs.

1274-P: High Prevalence of Type 2 Diabetes without Traditional Risk Factors among Men Who Inject Drugs in Chennai, India

South Asians with type 2 diabetes (T2DM) are predominately normal- or underweight, due to early loss of beta cell function in addition to insulin resistance. Substances of misuse are an additional stressor on beta cells and may lead to an increased prevalence of T2DM. We determined the prevalence of T2DM and its correlates among people who inject drugs (PWID) in Chennai. We conducted a cross-sectional analysis among male PWID. T2DM was defined as fasting glucose ≥126mg/dL or a prior diagnosis. Logistic regression was used to identify correlates of T2DM. Among 1039 PWID, median age was 38.9 years (IQR 32.1, 44.9) and median BMI was 19.7 kg/m2 (IQR 17.8, 22.9). The most common injected substance was heroin (94.8%, n=998). T2DM prevalence was 8.4% (n=87), among whom 60% were underweight or normal weight and 64% had normal waist circumference. On univariable regression analysis, T2DM was not associated with greater frequency of drug use, type of drug, HIV, or Hepatitis C. On multivariable analysis, age >40 years (OR 3.0, 95% CI 1.3-6.8) and high waist circumference (OR 1.9, 95% CI 1.1-3.2) were associated with T2DM. The prevalence of T2DM among PWID is similar to India as a whole, though most cases would not be detected by screening using weight or waist circumference. Integrating universal metabolic disease screening into substance abuse treatment programs may help reduce morbidity and mortality from T2DM. Disclosure P.Chebrolu: None. S.Mehta: Research Support; Abbott Diagnostics. A.Mcfall: None. T.Brown: Advisory Panel; Merck & Co., Inc., Gilead Sciences, Inc., ViiV Healthcare, Jannsen. A.Srikrishnan: None. M.Kumar: None. H.Iqbal: None. J.S.Mathad: None. G.Lucas: None. S.S.Solomon: Research Support; Gilead Sciences, Inc., Abbott. Funding National Institute on Drug Abuse (R01DA026727); Fogarty International Center (D43TW009337); Weill Cornell Department of Medicine; National Institute of Allergy and Infectious Diseases (K24AI120834 to T.B.)

STUDY ON THE PREVALENCE OF HEPATITIS B VIRUS INFECTION IN ODISHA STATE OF INDIA (2021-2022)

Viruses has a more impact on a human population. Hepatitis means the inflammation of the liver; it’s most commonly affected by the viruses. The hepatic viruses consist of A, B, C, D, E. The hepatic viruses A and E are spread by Faeco-oral route and B, C, D are spread by parenteral route. And recorded as the major cause of hepatitis . All types of viral hepatitis are seen in indian population. WHO recommends HB vaccination at birth to tackle the burden of hepatitis B. Among which the Odisha state in the eastern part of India is most prevalent to hepatitis b viral infection the most common reason of it is Odisha consist of the 1/3 rd of the tribal population of the India. We show the comparison between the tribes and the particularly vulnerable tribal population.

Viral hepatitis, hallmarks and molecular features

Hepatitis is a liver inflammation which has different etiologies, it can be caused pharmacologically or can be associated with fatty liver or alcohol consumption. However, viral infection as the most important cause. Recently, the World Health Organization (WHO) has published reports of outbreaks of hepatitis of unknown etiology in several countries in children less than 16 years. In this review we describe the general aspects of viral hepatitis, the molecular description of the hepatotropic viruses, laboratory findings, molecular diagnosis, prevention strategies. In addition, the main characteristics of some viruses that are not hepatotropic but have been previously reported to be related to some types of hepatitis are mentioned. Finally, a brief description of new cases of hepatitis of unknown origin is given and the adverse effects of SARS COV-2 vaccines are briefly discussed.

Current Therapy of Chronic Viral Hepatitis B, C and D.

The majority of chronic viral hepatitis cases are induced via infection with the hepatitis B virus (HBV), hepatitis C virus (HCV), or hepatitis D virus (HDV). These patients are at increased risk for progressive liver disease leading to cirrhosis as well as hepatocellular carcinoma (HCC). HBV infection is well controlled by the currently available nucleosides as well as nucleotides, and the development of cirrhosis can be prevented. Additionally, it has been shown that HBV-induced liver fibrosis can regress during successful antiviral treatment; however, a "functional cure", i.e., loss of HBsAg, is a rare event when these drugs are used. Therefore, novel therapeutic strategies are aiming at the selective suppression of HBsAg levels in combination with immunostimulation. The development of directly acting antivirals (DAAs) has revolutionized HCV therapy, as almost all patients can be cured via this treatment. Additionally, DAA therapy has few, if any, side effects, and is generally well tolerated by patients. HDV remains the most challenging type of chronic viral hepatitis. Although novel therapeutic options have recently been approved, response rates are still less favorable compared to HBV and HCV. This review discusses current and future options for the treatment of chronic HBV, HCV, and HDV infection.

Intrahepatic and extrahepatic clinical manifestations and treatment progress for hepatitis type E

Hepatitis type E virus (HEV) is one of the main causes of acute hepatitis globally and has thus gained attention as a public health issue. The diverse clinical manifestations of hepatitis type E are typically acute and self-limiting with mild symptoms, but populations with underlying liver disease or immunocompromised patients can have severe and chronic symptoms. Severity and chronicity can arise and manifest as fulminant hepatitis, chronic hepatitis, or even hepatic failure. HEV infection-induced hepatic failure (acute-on-chronic liver failure), based on the different backgrounds of chronic liver disease, is a clinical phenotype of severe HEV infection that requires attention. In addition, HEV infection can exhibit extrahepatic clinical manifestations of multi-system and organ involvement like neurological diseases (Guillain-Barré syndrome), renal diseases (membranous/membranous proliferative glomerulonephritis, cryoglobulinemia), and blood diseases (thrombocytopenia). At home or abroad, there are no antiviral drugs approved, particularly for HE treatment. Since most acute HE can resolve spontaneously, no special treatment is required clinically. However, in patients with severe or chronic HE, ribavirin (RBV) monotherapy and/or pegylated interferon-combination therapy have achieved certain antiviral effects. Combined small-molecule drugs and RBV have been attempted to treat HEV, but high-level evidence-based treatment is still lacking. Thus, new, highly effective anti-HEV drugs are clinical priorities to address these concerns. Severe and chronic HEV infections' clinical phenotype, early detection, mechanism, intervention, and outcome need additional study.