High Prevalence Of HCV Research Articles

Modelling the impact of different testing strategies for HCV infection in Switzerland

ObjectiveHepatitis C virus (HCV) infection is a major cause of liver disease. Since symptoms of chronic liver disease usually appear only late in the course of the disease, infected individuals may remain undiagnosed until advanced disease has developed. We aimed to investigate which screening strategies would be most effective to detect individuals unaware of their infection. MethodsWe developed a mathematical model for HCV disease progression and compared the current practice of HCV testing in Switzerland with the following screening strategies: intensive screening of active injection drug users (IDU), screening of former IDU, screening of individuals originating from countries with high HCV prevalence, screening of individuals born 1951–1985 (birth-cohort) and universal screening. All screening interventions were considered in addition to a baseline scenario that reflected the current practice of HCV testing. ResultsWithin the first 4 years (2018–2021), every year, on average 650 cases were diagnosed in the baseline scenario, 660 with intensified IDU screening, 760 with former IDU screening, 830 with origin-based screening, 1420 with birth-cohort screening and 1940 with universal screening. No difference in liver-related mortality and incidence of end-stage liver disease between the screening scenarios was observed. ConclusionOur results suggest that only large-scale screening of the general population could substantially accelerate the rate of HCV diagnosis and treatment in Switzerland and other countries with similar epidemics. However, this implies screening of a large population with low prevalence, and may trigger considerable numbers of false-positive and borderline test results.

Modelling the potential prevention benefits of a treat-all hepatitis C treatment strategy at global, regional and country levels: A modelling study.

The World Health Organization (WHO) recently produced guidelines advising a treat-all policy for HCV to encourage widespread treatment scale-up for achieving HCV elimination. We modelled the prevention impact achieved (HCV infections averted [IA]) from initiating this policy compared with treating different subgroups at country, regional and global levels. We assessed what country-level factors affect impact. A dynamic, deterministic HCV transmission model was calibrated to data from global systematic reviews and UN data sets to simulate country-level HCV epidemics with ongoing levels of treatment. For each country, the model projected the prevention impact (in HCV IA per treatment undertaken) of initiating four treatment strategies; either selected randomly (treat-all) or targeted among people who inject drugs (PWID), people aged ≥35, or those with cirrhosis. The IA was assessed over 20years. Linear regression was used to identify associations between IA per treatment and demographic factors. Eighty-eight countries (85% of the global population) were modelled. Globally, the model estimated 0.35 (95% credibility interval [95%CrI]: 0.16-0.61) IA over 20years for every randomly allocated treatment, 0.30 (95%CrI: 0.12-0.53) from treating those aged ≥35 and 0.28 (95%CrI: 0.12-0.49) for those with cirrhosis. Globally, treating PWID achieved 1.27 (95%CrI: 0.68-2.04) IA per treatment. The IA per randomly allocated treatment was positively associated with a country's population growth rate and negatively associated with higher HCV prevalence among PWID. In conclusion, appreciable prevention benefits could be achieved from WHO's treat-all strategy, although greater benefits per treatment can be achieved through targeting PWID. Higher impact will be achieved in countries with high population growth.

Prevalence of HIV, Syphilis, Hepatitis-B, and Hepatitis-C among People with Injecting Drugs in Western Terai Highway districts, Nepal

Introduction: HIV epidemic has become the major problems among people with injecting drugs (PWIDs) in Nepal. The study was carried out to assess the prevalence of sexually transmitted diseases including HIV/AIDS among PWIDs.
 Methods: This descriptive cross-sectional survey was conducted in male PWIDs of age more than 16 years residing in Western to Far West Terai Districts of Nepal who had been injecting drugs for three months prior to the date of the survey" March-April 2017. A two-stage cluster sampling was used to recruit 300 PWIDs from seven Districts. HIV was diagnosed by using standard techniques approved by WHO. Similarly, Syphilis was tested using the "Rapid Plasma Reagin" and Hepatitis C as well as Hepatitis B was tested by using rapid test kits. Demographic data were collected by using structured questionnaire and the data obtained were entered in MS excel was transformed into the SPSS version 21 for the descriptive as well as inferential analysis.
 Results: Prevalence of HIV, HBV, HCV, and STI among PWIDs were 5.3%, 2.7%, 23.7%, and 2.0% respectively. Majority of the PWIDs were literate (93.7%) and their age was below 35
 years. Among the married PWIDs, 32.4% had got married before the age of 19. Similarly, 53.7% of them were living with their female sexual partner, and 95.0% were living with their wife. Ninety six percent of the respondents reported to be ever involved in sexual activity, 77.1% of them initiated the sexual intercourse before the age of 20 years and 41.9% of them had more than one female sexual partner. The survey indicated that 36.3% had been injecting drugs for more than 5 years while 27.7% had been injecting for last 2-5 years and 55.0% of the respondents had injected for the first time at the age of 16-24 years. About one in 10 respondents had started injecting drugs recently.
 Conclusion: There is high prevalence of HIV, HCV, HBV and active syphilis among the PWIDs. Co-infection of HIV and HCV as well as Hepatitis B and C were also prevalent among PWIDs. Comprehensive education and awareness program is required to reduce the prevalence.

Blood-Borne Chronic Viral Infections in a Large Cohort of Immigrants in Southern Italy

Background: The aim of this study was to evaluate the prevalence of blood-borne chronic viral infections in immigrants in Italy, and identify factors associated. Methods: A prospective screening program was performed in seven clinical centers operating in Campania, Apulia and Calabria in southern Italy, to identify immigrants with HBV, HCV or HIV infections. Findings: Of 4·125 immigrants observed in the study period, 3·839 (93·0%) agreed to be screened: 381 (9·9%) resulted HBsAg, 136 (3·5%) anti-HCV, 62 (1·6%) anti-HIV-positive and 1·448 (37·7%) HBsAg-negative and anti-HBc positive. Ongoing or previous HBV infection was observed more frequently in males (p=0·02 and p<0·001, respectively), whereas HIV infection in females (p=0·01). Immigrants from western Africa showed a higher rate of HBsAg positivity (p<0·0001), of HBsAg negativity/anti-HBc positivity (p<0·0001) and anti-HIV positivity (p=0·004) compared with those from other geographical areas. At multivariate analysis, ongoing HBV infection was associated with male gender (OR:1·49, 95% CI: 1·04-2·14) and origin from western Africa (OR: 4·67, 95% CI: 1·70-12·80) and eastern Europe (OR 3·44, 95% CI: 1·17-10·08). HCV infection was independently associated with male sex (OR 1·84, 95% CI: 0·99-3·42); HIV infection was associated with an older age (OR 1·04, 95% CI: 1·01-1·06) and origin from western Africa (OR 4·09, 95% CI: 1·26-13·29), while male gender was a protective factor (OR 0·45, 95% CI: 0·24-0·85). Interpretation: The high prevalence of HBV, HCV and HIV infections in our large cohort of immigrants should constitute a warning to Italian Healthcare Authorities to develop adequate cost-effective screening policies. Funding Statement: This work was financially supported by Gilead for the study “Evaluation of an innovative model to eliminate HCV infection in a high-risk population of undocumented migrants and low income refugees” (EUDRACT: 2017-001024-21). Declaration of Interests: All the authors of the manuscript declare that they have no conflict of interest in connection with this paper. Ethics Approval Statement: The study was approved by the Ethics Committee of the Azienda Ospedaliera Universitaria of the University of Campania Luigi Vanvitelli (214/2012; 481/2018).

A New Generation of Drug Users in St. Petersburg, Russia? HIV, HCV, and Overdose Risks in a Mixed-Methods Pilot Study of Young Hard Drug Users.

Russia has a widespread injection drug use epidemic with high prevalence of HIV and HCV among people who inject drugs (PWID). We conducted a mixed methods study of young (age 18-26) hard drug users in St. Petersburg. Thirty-nine structured and 10 semi-structured interviews were conducted. No HIV cases and two HCV cases were detected among the PWID subsample (n = 29). Amphetamine and other stimulants were common (70%), opioid use was rare and episodic. Consistent condom use was 10%. No PWID reported syringe-sharing, 51% reported other drug paraphernalia sharing. Most (89%) never or rarely communicated with older (30 +) opiate users. A new cohort of drug users in St. Petersburg may have emerged, which is much safer in its injection practices compared to previous cohorts. However, risky sexual practices among this new cohort may expose them to the possibility of sexual transmission of HIV and widespread drug paraphernalia sharing to the HCV epidemic.

Estimation of hepatitis C prevalence in the Punjab province of Pakistan: A retrospective study on general population.

BackgroundHepatitis C virus (HCV) infections are amongst the leading public health concerns in Pakistan with a high disease burden. Despite the availability of effective antiviral treatments in the country the disease burden in general population has not lowered. This could be attributed to the asymptomatic nature of this infection that results in lack of diagnosis until the late symptomatic stage. To better estimate and map HCV infections in the country a population-based analysis is necessary for an effective control of the infection.MethodsSerologic samples of ~66,000 participants from all major cities of the Punjab province were tested for anti-HCV antibodies. The antibody-based seroprevalence was associated with socio-demographic variables including geographical region, age, gender and sex, and occupation.ResultsOverall serological response to HCV surface antigens was observed in over 17% of the population. Two of the districts were identified with significantly high prevalence in general population. Analysis by occupation showed significantly high prevalence in farmers (over 40%) followed by jobless and retired individuals, laborers and transporters. A significant difference in seroprevalence was observed in different age groups amongst sex and genders (male, female and transgender) with highest response in individuals of over 40 years of age. Moreover, most of the tested IDUs showed positive response for anti-HCV antibody.ConclusionThis study represents a retrospective analysis of HCV infections in general population of the most populated province of Pakistan to identify socio-demographic groups at higher risk. Two geographical regions, Faisalabad and Okara districts, and an occupational group, farmers, were identified with significantly high HCV seroprevalence. These socio-demographic groups are the potential focused groups for follow-up studies on factors contributing to the high HCV prevalence in these groups towards orchestrating effective prevention, control and treatment.

Study of Oncoprotein 24p3 as Diagnostic Marker for Hepatocellular Carcinoma on Top of Hepatitis C Virus

Background: Hepatitis C virus is one of the main causes of chronic liver disease worldwide. Egypt has the highest prevalence of HCV in the world, estimated nationally at 14.7% and is therefore confronted with a disease burden of historical proportions that distinguishes this nation from others. In HCC, 24P3 is overexpressed in tissues and closely associated with the proliferation and invasion of HCC cells.24P3 is mainly expressed in myeloid cells and later assigned to a cluster of at least three lipocalins on the long arm of human chromosome 9. Aim of the Work: was to shed the light on the role of oncoprotein 24p3 as a diagnostic marker in patients with hepatocellular carcinoma complicating hepatitis C virus. Subjects and Methods: This case control clinical study was carried out on 60 subjects who were divided into three groups: Group I: Twenty Patients diagnosed with HCC on top of HCV. Group II: Twenty Patients diagnosed with HCV without HCC. Group III: Twenty normal subjects with matched age and sex as a control group. Studied groups were subjected to abdominal ultrasonography, triphasic CT for patients with focal lesions, laboratory investigations including; liver function tests included hepatitis markers and serum 24P3, detected by enzyme linked immunosorbent assay (ELISA). Results: The study revealed a significant increase in AFP in Group I compared to Group II and in Group II compared to Group III. A significant difference P=0.001 was found among the three different groups. The cutoff for AFP was >20ng/mL, sensitivity was 70%, specificity was 85%, PPV 90%, NPV 65% and accuracy 78%. There was a significant increase of 24P3 in Group I compared to Group II and in Group II compared to Group III. A statistical significance p=0.001 was found among the three different groups. The cutoff for 24P3 was >250ng/mL and its sensitivity, specificity, PPV, NPV, and accuracy were all 100%. Based on the present study, 24P3 has a higher sensitivity, specificity and accuracy as compared to AFP, a famously used biomarker in HCC. Conclusion: Serum 24P3 levels in patients with HCV may be used as a guide for progression and prognosis of HCC. In these patients, if 24P3 levels were found to be high, serum alpha‑ feto protein and ultrasonographic examination could be repeated at more frequent intervals. This may also be used as a guide in terms of the treatment plan. Measurement of 24P3 in sera of large number of patients and follow up may pave the way to pick up early stage of HCC and showed its prognostic effect.

Viral Hepatitis: When to be Considered in Clinical Routine?

Chronic viral hepatitis can remain unrecognized but may nevertheless lead to liver cirrhosis and hepatocellular carcinoma. Thus, patients with elevated liver enzymes as well as risk groups need to be screened and treated for viral hepatitis. These groups include, in particular, migrants from countries with high HBV or HCV prevalence, persons with previous or current intravenous drug use, and homosexual men. For HBV- or HCV-associated diseases, such as panarteriitis nodosa, cryoglobulinemic vasculitis or B-cell lymphoma, antiviral therapy may lead to remission. Prior to high-dose immunosuppressive therapy, especially with regimes containing rituximab, chronic or resolved HBV infection must be ruled out or antiviral prophylaxis may be required to avoid a potentially fatal HBV reactivation.

The hepatitis C infection in Iran: a policy analysis of agenda-setting using Kingdon\u2019s multiple streams framework

BackgroundHepatitis C virus (HCV) infection causes a large number of deaths annually worldwide. Policies play an important role in regulating healthcare agendas and prioritising of health-related issues. Understanding these priorities is very important in health. The objective of this study was to investigate HCV-related issues and their influence on agenda-setting in Iran.MethodsA qualitative design was used. Data were collected by carrying out a review of documents and interviews. A comprehensive search was conducted to identify documents related to HCV-related policies in Iran. Semi-structured interviews were conducted with both purposive and snowball sampling of 14 interviewees related to the HCV programme in Iran, including government officials, civil society, development partnership members and academicians. Documents and interview data were analysed manually and using MAXQDA Version 10 software. Kingdon’s multiple streams framework was used to guide data analysis.ResultsThe factors which influenced HCV-related agenda-setting were lack of proper information of the HCV epidemiology before the 1990s, lack of diagnostic facilities, neighbouring countries with high HCV prevalence, the stigma of HCV, high prevalence in prisoners, international evidence and high costs generated by HCV. The factors related to policy were effective treatment methods, drug production inside Iran, Iran Hepatitis Network, support outside government group elites and academicians. The factors related to political will were international influence, changes in the government and parliament support.ConclusionThe findings of this study showed that there are various national and international factors that play a role in shaping HCV-related policies. It seems that, if HCV is put into the agenda, it can be eliminated in Iran by 2030 by supporting and implementing appropriate programmes from decision- and policy-makers.

Frequency of Dermatological Disorders Associated with Hepatitis C Virus Infection in Sharkia Governorate, Egypt

Background and study aim: Egypt has the highest HCV prevalence in the world. Cutaneous lesions are found in some patients of HCV infection. This study was conducted to determine frequency and types of dermatological disorders present in chronic HCV infection in Sharkia governorate, Egypt. Patients and Methods: 157 Patients of chronic hepatitis C divided into 2 groups; group 1: Includes 117 patients with chronic HCV infection who didn’t receive antiviral treatment group 2: Includes 40 patients with chronic HCV infection who received antiviral treatment (peg- interferon and ribavirin). Detailed history taking, clinical and dermatological examination was carried out. Biochemical profile including complete blood count, platelet count, and cryoglobulins were done. Results: The percentage of dermatological manifestations increase with the severity of liver cirrhosis. Pruritus was the predominant dermatological manifestation in untreated and treated patients (37.9%) and (52.9%) respectively. There was significant statistical difference between positive and negative cryoglobulineamic patients in the untreated group regarding different dermatological manifestations with high percentage of pruritus, vasculitis and purpura in patients with cryoglobulin positivity (p= 0.04). Conclusion: Skin manifestations are present in 61% of chronic HCV patients and less frequent in treated group. The frequency of skin manifestations increases with the advancement of liver disease. Pruritis is the most frequent manifestation in all patients.

HCV-Ab sero-prevalence in persons who inject drugs in a Province of Southern Italy: results of a screening program

Introduction: Persons who inject drugs (PWID) represent a group with high prevalence of HCV, and an active reservoir at high risk of reinfection. In Italy there are incomplete data about the real prevalence of this condition, due to the lack of a systematic screening. The latest data from 2016 report an overall testing for HCV only in 20,5% of these subjects. The recent availability of a safe and efficacious cure for HCV infection increased the necessity of a better knowledge of this issue, to provide the correct linkage-to-care of these patients. This is necessary to reach the “micro-elimination” of HCV in a such high-risk population, in view of the “HCV elimination” set for 2030 by WHO.

Barriers and facilitators of hepatitis C treatment uptake among people who inject drugs enrolled in opioid treatment programs in Baltimore

BackgroundHepatitis C virus (HCV) infection is a major public health issue among people who inject drugs (PWID) with prevalence of 50–80% in the United States. Effective, simple, oral direct acting agents (DAA) of short duration with minimal side effects have been associated with cure rates > 95%. However, HCV treatment uptake among PWID remains low. We characterized the HCV care continuum, HCV treatment knowledge, as well as barriers and facilitators to HCV treatment uptake among PWID enrolled in two opioid treatment programs (OTPs) in Baltimore, Maryland, USA. MethodsBetween July and November 2016, 124 HCV infected PWID were recruited from two opioid treatment programs in Baltimore through convenience sampling. Participants completed a 50-item questionnaire to assess HCV treatment knowledge, attitudes, and practices. Progress through the HCV care continuum was assessed based on a series of questions assessing evaluation for HCV treatment, recommendation for HCV treatment by a provider, and HCV treatment initiation. HCV status was assessed based on participant self-report. ResultsThe median age was 52 years (IQR 44–58), 56% were male, the majority were African American (69%), and 19% reported HIV coinfection. Participants had been tested for HCV at their primary care provider's (PCP's) office (34%), drug treatment center (20%), emergency room (11%), or prison (9%), and most (60%) had been diagnosed with HCV over 5 years prior. The majority reported that HCV was a major health concern for them (91%), were aware there were new treatments for HCV (89%), and that the new treatments cure most people (69%). More than half (60%) had seen a health professional who could treat HCV, 40% had HCV therapy recommended by their HCV specialist, and 20% had started or completed treatment. In univariable analysis, PWID were significantly more likely to have been treated if they were HIV co-infected (OR 3.4 (95% CI 1.3–9.2)) or had a partner or friend concerned about their HCV (OR 3.4 (95% CI 1.2–9.7)), and were significantly less likely to have been treated if they had used any illicit drugs in the preceding 6 months (OR 0.4 (95% CI 0.2–0.99). In multivariable analysis, having a friend or partner concerned about their HCV remained significantly associated with HCV treatment (OR 5.0 (95% CI 1.4–17.7)). When questioned about what would facilitate HCV treatment, the majority (85%) reported that a friend telling them that HCV treatment had helped them and having HCV treatment provided at their opioid treatment program would make them more likely to engage in HCV treatment. ConclusionDespite a high prevalence of HCV among opioid treatment program patients and the availability of effective treatments, uptake remains low. We identified several key barriers and facilitators that can affect HCV treatment uptake.

Epidemiological Study of Hepatitis B, C and HIV Cases among the Foreigners Visiting Sulaimani City from 2013 Through 2016

Hepatitis B, C and HIV infections present a great public health problem worldwide. More than 350 million of world's populations have chronic HBV infection and near 1 million people are dying due to this infection each year. About 150-200 million of world's population have chronic HCV infection that leads to nearly 350 000 deaths annually. On the other hand HIV remains as a major global public health issue. In 2015, about 36.7 million people were living with HIV and 1.1 million people died of HIV related illnesses.&#x0D; To find the prevalence of HB, HCV and HIV infection among the foreigners who visited Sulaimani city in 2013 through 2016 and evaluate the common risk factors in those who had a positive results in 2016. This study was conducted between 1stof January 2016 and 31st December 2016. A total number of 275,979 foreigners who were referred formally to the central laboratory- residency department in Sulaimani city for screening for (HBsAg, HCV Ab and HIV Ab) from 2013 through 2016 were analyzed and all the foreigners who visited Sulaimani city in 2016 were included with assessment of demographic data and risk factors among the positive cases. Among 275,979 foreigners who visited Sulaimani city from 2013 through 2016, theoverall prevalence of HBV infection was0.47%(1318 cases), HCV 0.01 %( 267 cases) and HIV 0.01 %( 30 cases). In 2016 the highest prevalence of HBV infection was among Syrians which was 2.5% while highest HCV prevalence was among Europeans 0.82%. Ages of the patients ranged between (18-65) years, 85.4% were males, 65.2% of males and 45.7% of females were married. Dental procedures, surgery, blood transfusion and family history were common risk factors.&#x0D; HBV infection was highest among Syrian foreigners. While the highest HCV prevalence was among Europeans. An immediate action plan is needed to screen all Syrian refugees in our region for HBV, HCV and HIV to determine active infection and treat accordingly and also impose preventive measures to halt the spread of the infections.

Seroprevalence of HIV, Hepatitis B and C Viruses Infections among Candidates for Cataract Surgery

Introduction: The safety issue of mass surgeries in areas of higher endemicity for HIV, HBV and HCV is raised. Objective: The objective was to determine the frequency of HIV, HBV and HCV among people undergoing a cataract surgery during humanitarian surgical mission. Patients and Method: This prospective study was conducted at CHU Owendo from April to September 2018. Cataract-operated patients were the targeted population. Rapid screening tests were used for diagnosis. Parameters such as age, sex, frequency of HIV, HBV, HCV, and co-infections were analyzed. Sero-positivity was correlated with age and sex. A total of 1403 patients were included. Statistical analysis was performed with EPI Info 7.2 (Chi2 uncorrected, Mann-Whitnney and Wilcoxon, p < 0.05). Results: Patients mean age was 66.3 ± 11.6 years; 42.1% of them were male. With 18.0% of the study population, HIV-positive people had mean age of 78.4 ± 9.3 years, compared to 61.2 ± 10.1 years for sero-negative (p < 0.001). HIV prevalence was 4.6% (95% CI = [3.7 - 5.9]), HBV was 2.9% (95% CI = [2.1 - 3.9]), and HCV was 11.8% (95% CI = [10.2 - 13.6]). Co-infections occurred in 1.2% (95% CI = [0.8 - 1.9]) of patients undergoing surgery. Conclusion: This study showed high prevalence of HIV, HBV and HCV among patients undergoing cataract surgery with predominance for HCV. Viral co-infections prevalence was also significant.

Estimating HIV and HCV prevalence among people who inject drugs in 5 Ukrainian cities using stratification-based respondent driven and random sampling

BackgroundUkraine, a country of 45.5 million people, has one of the most volatile HIV and HCV epidemics in the world. In this paper, we estimate the prevalence of HIV and HCV among PWID in five Ukrainian cities. MethodsA cross-sectional study was conducted in 2014–2015, based on stratified hybrid sampling with random and respondent driven sampling in five cities: Kyiv, Odesa, Mykolaiv, Dnipro and Lviv. Using data on HIV and HCV antibody testing from 1613 respondents, we evaluate selection bias in the sampling methods by analyzing spatial and network patterns of sampling processes. We develop and apply inverse probability weights in order to estimate the HIV and HCV prevalence in each city, as well as in the overall sample. FindingsThe aggregate HIV prevalence for the five cities is 35.1% (95% CI: 29.5%–38.5%) but this varied considerably by city: in Kyiv the HIV prevalence is 26.6% (95% CI: 20.3.8%–33.4%), in Odesa – 38.2% (95% CI: 29.8% and 47.1%), in Mykolaiv - 42.0% (95% CI: 34.3%–49.2%), in Dnipro – 58.8% (95% CI: 52.2%–65.8%), and in Lviv 24.6% (95% CI: 18.8%–30.8%). The aggregate HCV prevalence estimate for the five cities is 58.6% (95% CI: 54.9%–61.7%). The highest HCV prevalence is estimated in Kyiv – 84.8% (95% CI: 78.5%–90.1%). HCV prevalence in Odesa is the lowest and estimated to be 36.5% (95% CI: 29.5%–45.1%), in Mykolaiv – 49.1% (95% CI: 41.5%–57.0%), in Dnipro – 56.1% (95% CI: 50.3%–63.4%) and in Lviv 38.5% (95% CI: 31.8%–45.0%). ConclusionsMonitoring behavioral and health outcomes of PWID on a regular basis is necessary for determining prevention and treatment priorities for HIV and HCV infections in Ukraine and elsewhere. The heterogeneity of the local epidemics provides insights into the best prevention and treatment strategies to be deployed in low-resource settings.

Prevalence of hepatitis B and hepatitis C infection from a population-based study in Southern India.

This study aims to estimate the prevalence of hepatitis B (HBV) and C (HCV) in the population through field-screening camps conducted by Chennai Liver Foundation, in the southern state of Tamil Nadu, India. This is the largest population-based study from Tamil Nadu. A total of 75 camps were conducted across 14 districts of Tamil Nadu (2014-2017). Screening was done by rapid point-of-care assays (SD-bioline tests) and confirmed by enzyme-linked immunosorbent assay (Monolisa tests). Those tested negative were offered first dose of HBV vaccine. Positive patients with HBV count of more than 2000 IU/ml or HCV-RNA positive on quantitative analysis were treated. A total of 18 589 people were screened, with HBV infection detected in 303 (prevalence 1.63%) and HCV infection in 56 (prevalence 0.3%), with significant variation among districts. Males contributed to about three-fourths of detected HBV [233/303 (77%)] or HCV [41/56 (73%)] infection. Screening detected a higher overall HBV/HCV infection rate in rural [203 (2.52%) infections in 8047 people] than in urban [156 (1.47%) infections in 10 542 people] areas (P<0.0001). Slum areas had a HBV prevalence of 5%. In a dialysis unit, all patients were found to have either HBV/HCV infection. A total of 162/303 (54%) people with HBV and 27/56 (48%) with HCV infection were treated, and 7704 people received the first dose of HBV vaccine. The prevalence of HBV was 1.63% and HCV was 0.30% in Tamil Nadu. Three-fourths of HBV/HCV infected people were males. Prevalence of HBV/HCV was higher in rural areas. Slum area and dialysis unit had high HBV and HCV prevalence.

Determination of hepatitis B, C and D prevalence among urban and Amerindian populations from the Eastern Brazilian Amazon: a cross sectional study

BackgroundThis study was conducted to determine the prevalence of HBV, HCV, and HDV in urban populations and Amerindians living in the state of Tocantins (Eastern Amazon).MethodsA total of 948 individuals were recruited in Tocantinopolis city (Tocantins state) of whom 603 were Amerindians (from 6 tribes) and 345 were non-Amerindians (6 urban areas of Tocantinópolis city). Anti-HCV, HBsAg, anti-HBc, anti-HBs, anti-HBc IgM, anti-HBe, HBeAg, and anti-delta antibodies were determined using enzyme immunoassay.ResultsHBV cleared infection (both anti-HBc/anti-HBs+), chronic inactive/immune controlled HBV infection (anti-HBc + only), previous HBV vaccination (anti-HBs + only), active HBV infection (HBsAg+), individuals susceptible to HBV, and anti-HCV reactivity were found in 12.9, 1.8, 27.2, 0.5, 57.7, 1.2% in Amerindians and 12.1, 2.0, 37.1, 0.3, 55.4, 0.3% in non-Amerindians respectively. Out of 139 anti-HBc reactive individuals, 70 were anti-HBe reactive and none presented HBeAg or anti-HBc IgM. Anti-HBc prevalence was associated to older age (p < 0.0001). Overall anti-Delta prevalence was 0.3% and regarding anti-HBc reactive individuals, anti-delta prevalence was 3.4 and 0% in Amerindians and non-Amerindians respectively.ConclusionsOverall low prevalence of HBV and HCV infection was found in the populations studied, but high HBV and HCV prevalence was observed in Amerindians compared to non-Amerindians suggesting that these individuals have a higher likelihood of acquiring to these infections. Anti-delta antibodies were found among Amerindians from Eastern Amazon suggesting a risk for this population. Of note is that nearly half of Amerindians had no anti-HBs, indicating a need for HBV vaccination campaigns in this population.

Effect of Hepatocellular Carcinoma on Mortality Among Individuals With Hepatitis B or Hepatitis C Infection in New York City, 2001-2012.

BackgroundHepatocellular carcinoma (HCC) is a complication of chronic hepatitis B and C virus (HBV and HCV) infection. New York City (NYC) has a high prevalence of HBV and HCV, and infected persons likely face increased mortality from HCC and other causes. We describe the mortality profile of NYC residents with HBV or HCV, emphasizing the contributions of HCC and HIV coinfection.Methods Two existing data sets were combined to examine all individuals diagnosed with HBV or HCV in NYC first reported to the Health Department during 2001–2012 and their HCC, HIV, and vital status. Logistic regression was used to calculate the odds of HCC diagnosis by viral hepatitis status, whereas Cox proportional hazard regression was used to estimate the hazard of death by HCC/HIV status.ResultsIn total, 120 952 and 127 933 individuals were diagnosed with HBV or HCV, respectively. HCV-infected individuals had 17% higher odds of HCC diagnosis than HBV-infected individuals and 3.2 times higher odds of HIV coinfection. Those with HCV were twice as likely to die during the study period (adjusted hazard ratio, 2.04; 95% confidence interval, 1.96–2.12). The risk of death increased for those with HIV or HCC and was highest for those with both conditions.ConclusionsHCC and HIV represent substantial risks to survival for both HBV- and HCV-infected individuals. Individuals with HBV need close monitoring and treatment, when indicated, and routine HCC screening. Those with HCV need increased, timely access to curative medications before developing liver disease.

Prevalence of hepatitis C viral infection among injecting drug users in a Saudi Arabian hospital: A point cross sectional survey.

Hepatitis C Virus is an important cause of preventable morbidity and mortality among Injecting Drug Users worldwide. The aim of this study is to determine the prevalence and correlations of HCV infection among IDUs in Saudi Arabia. A point cross-sectional survey was conducted between May 2012 and Nov 2012 to determine hepatitis C viral antibodies serological status using venous blood among IDUs (N=300) accessing care at Al-Amal Hospital in the Kingdom of Saudi Arabia, as well as to determine clinical correlates of hepatitis C infection among the Injecting Drug Users. There was an overall HCV prevalence of 42.7% among IDUs studied. Low level primary education, single marital status, being unemployed and commencing Injecting Drugs beyond the age of 15 years have higher specific prevalence of HCV among IDUs population. There was statistically significant association between clinical assessments of the participants who were abusing drugs generally, dependent on drugs, specifically abusing cocaine, amphetamines, opioids, cannabinoids and alcohol with HCV antibodies seropositivity. There was no statistical significant relationship between drug induced sleep/sexual disorder and psychosis/delusion with HCV seropositivity. This study demonstrated a relatively high prevalence of HCV among IDUs in KSA. Targeted public health preventive strategies are necessary to halt the spread of HCV among IDUs in KSA. The resultant benefits of these will include reduction in morbidity and mortality as well as improved socioeconomic wellbeing of the IDU’s population.

Epidemics of HIV, HCV and syphilis infection among synthetic drugs only users, heroin-only users and poly-drug users in Southwest China

The number of poly-drug users who mix use heroin and synthetic drugs (SD) is increasing worldwide. The objective of this study is to measure the risk factors for being infected with hepatitis C (HCV), human immunodeficiency virus (HIV) and syphilis among SD-only users, heroin-only users and poly-drug users. A cross-sectional study was conducted in 2015 from a national HIV surveillance site in Southwest China, 447 poly-drug, 526 SD-only and 318 heroin-only users were recruited. Poly-drug users have higher drug-use frequency, higher rates of drug-sharing and unsafe sexual acts than other users (p < 0.05). About a third (36.7%) of poly-drug users experienced sexual arousal due to drug effects, which is higher than the rate among other drug users. Poly-drug users had the highest prevalence of HIV (10.5%) and syphilis (3.6%), but heroin-only users had the highest prevalence of HCV (66.0%) (all p < 0.05) among three groups. Logistic regression shows among poly-drug users, having sex following drug consumption and using drugs ≥1/day were the major risk factors for both HIV (Adjusted odds ratio (AOR) = 2.4, 95% CI [1.8–3.4]; 2.3, [1.6–3.1]) and syphilis infection (AOR = 4.1, [2.1–6.9]; 3.9, [1.8–5.4]). Elevated risk of both HIV and syphilis infection have been established among poly-drug users.