High Risk For Hepatitis Research Articles

HBsAg-negative/anti-HBc-positive patients treated with rituximab: prophylaxis or monitoring to prevent hepatitis B reactivation?

Rituximab (RTX) has been classified as a drug associated with a high risk for hepatitis B virus (HBV) reactivation in HbsAg-negative/anti-HBc-positive patients. However, data on frequency of HBV reactivation are limited especially for RTX monotherapy. Several new recommendations for screening, monitoring and prophylactic antiviral treatment have been published recently. Here, we report the real-life experience in the management and reactivation rate of HbsAg-negative/anti-HBc-positive patients treated with RTX with or without chemotherapy from a large cohort and discuss our results in the light of updated recommendations.

THE PREVALENCE OF HEPATITIS C VIRUS INFECTION AND POTENTIAL RISK FACTORS AMONG MULTIPLY TRANSFUSED PATIENTS

Objective: Patients who frequently receive blood have high risk of hepatitis C virus (HCV) infection. This study aimed to evaluate the prevalence of HCV infection and potential risk factors among multiply transfused patients.Methods: A cross-sectional retrospective study was conducted in the hemophilia unit in Medical City in Baghdad, between June 1, 2016, and January 1, 2017. After taking consents and approval of ethical comity, the medical records of 1158 patients with hemophilia A and B, von Willebrand disease (vWD), thrombasthenia, Factors VII, X, and XIII deficiencies, and hypofibrinogenemia were analyzed for the presence of HCV antibody using (enzyme-linked immunosorbent assay). Cases of hemophilia were classified into mild, moderate, and severe.Results: The prevalence of HCV infection was 13.2%. Of total, 595 (51.4%) patients had hemophilia A and 99 (16.6%) were anti-HCV positive, while 225 (19.4%) had hemophilia B and 28 (12.4%) were antibody positive compared to 9 (7%) in vWD. Of those with hemophilia A, 515 (86.6%) had severe hemophilia, and 32 (32.32%) cases had acquired HCV infection after 1996 (after introduction of HCV screening in blood banks in Iraq). There was a statistically significant association with treatment by Factor VIII only.Conclusion: The prevalence of HCV in patients with inherited bleeding disorder is 13.2%. In this study, it was found that multitransfusion is the only predictor for HCV infection in this group of patients.

THE PREVALENCE OF HEPATITIS C VIRUS INFECTION AND POTENTIAL RISK FACTORS AMONG MULTIPLY TRANSFUSED PATIENTS

Objective: Patients who frequently receive blood have high risk of hepatitis C virus (HCV) infection. This study aimed to evaluate the prevalence of HCV infection and potential risk factors among multiply transfused patients.Methods: A cross-sectional retrospective study was conducted in the hemophilia unit in Medical City in Baghdad, between June 1, 2016, and January 1, 2017. After taking consents and approval of ethical comity, the medical records of 1158 patients with hemophilia A and B, von Willebrand disease (vWD), thrombasthenia, Factors VII, X, and XIII deficiencies, and hypofibrinogenemia were analyzed for the presence of HCV antibody using (enzyme-linked immunosorbent assay). Cases of hemophilia were classified into mild, moderate, and severe.Results: The prevalence of HCV infection was 13.2%. Of total, 595 (51.4%) patients had hemophilia A and 99 (16.6%) were anti-HCV positive, while 225 (19.4%) had hemophilia B and 28 (12.4%) were antibody positive compared to 9 (7%) in vWD. Of those with hemophilia A, 515 (86.6%) had severe hemophilia, and 32 (32.32%) cases had acquired HCV infection after 1996 (after introduction of HCV screening in blood banks in Iraq). There was a statistically significant association with treatment by Factor VIII only.Conclusion: The prevalence of HCV in patients with inherited bleeding disorder is 13.2%. In this study, it was found that multitransfusion is the only predictor for HCV infection in this group of patients.

Prevalence of hepatitis C virus infection in patients hospitalised for ischemic heart disease versus controls - PRO-CARDIO-C study.

Aim of the studyOngoing national screening programmes suggest that the prevalence of chronic hepatitis C (CHC) in Poland ranges between 0.5% and 1%. It has been recently noted that patients with confirmed coronary artery disease may be at higher risk for hepatitis C virus (HCV) infection.Material and methodsTesting for the presence of anti-HCV antibodies was performed in a group of patients admitted to the Cardiology Department with symptomatic ischemic heart disease (IHD) and in patients hospitalised in the Dermatology Department.ResultsA total of 1171 patients underwent anti-HCV testing: 672 patients in the Cardiology Department (K group) and 499 patients in the Dermatology Department (D group). Twenty-eight (2.4%) positive anti-HCV results were detected. The prevalence of positive anti-HCV antibodies in groups K and D was 2.23% and 2.61%, respectively (p > 0.05). Presence of HCV RNA was confirmed in 15 cases (1.28%) – 7 patients in group K and 8 patients in group D (1.04% and 1.6%, respectively; p > 0.05).ConclusionsOur findings suggest that this patient cohort has increased risk of HCV infection, which may influence screening strategies.

A very high prevalence of hepatitis C virus infection among patients undergoing hemodialysis in Kosovo: a nationwide study

BackgroundPatients on hemodialysis are at high risk for hepatitis C virus (HCV) infection if measures for effective control of HCV infection in the hemodialysis environment are not implemented. Whereas in developed countries isolated small-scale outbreaks of HCV in hemodialysis units are occasionally reported, HCV transmission in the hemodialysis environment still represents a substantial problem in low-resource countries. This study systematically assessed the prevalence of HCV infection among all patients at all hemodialysis centers in Kosovo, determined the HCV genotype distribution, and reviewed the main risk factors associated with HCV infection in this group of patients.MethodsFrom January to March 2013, blood samples from all patients undergoing hemodialysis at all seven hemodialysis centers in Kosovo were collected. The samples were screened for the presence of anti-HCV antibodies, and seropositive samples were also tested for HCV RNA. Genotyping was performed by sequencing the core region of the HCV genome. Subsequently, face-to-face interviews were conducted with consented patients attending hemodialysis in December 2015 and with the management of all hemodialysis centers in Kosovo.ResultsThe overall seroprevalence of HCV infection among hemodialysis patients in Kosovo was 53.0% (354/668), ranging from 22.3 to 91.1% at different centers. HCV RNA was detected in 323/354 (91.2%) seropositive patients. The most frequent HCV genotype was genotype 1a (62.2%), followed by genotypes 4d (33.1%), 1b (4.0%), and 2c (0.7%). The duration of hemodialysis and receiving dialysis at more than one center were identified as independent significant predictors of anti-HCV positivity. Shortage of staff, lack of resources, and inconsistent use of hygienic precautions and/or isolation strategies were observed.ConclusionsThe prevalence of HCV infection among hemodialysis patients in Kosovo is extremely high. The relatively low prevalence of HCV infection in the general population, predominance of two otherwise rare HCV genotypes among hemodialysis patients, and longer history of hemodialysis as a predictor of HCV infection all indicate nosocomial transmission due to inappropriate infection control practices as the main transmission route.

Talking About Hepatitis C: FAQs From Young Adults Who Inject Drugs.

Young adults who inject drugs and live in rural communities are at high risk for hepatitis C virus (HCV) infection. Recent changes in HCV treatment must be communicated within these communities to improve access to care and reduce HCV transmission. Field workers in the ¡VÁLE! Hepatitis Treatment and Integrated Prevention Services study identified frequently asked questions (FAQs) posed by young-adult participants at high risk for HCV during screening and educational sessions. From 2016 to 2018, 183 young adults (44.3% women; 85.8% Latino/a) younger than 30 years who inject drugs and reside in Rio Arriba or Doña Ana counties in New Mexico were enrolled. The research team compiled deidentified questions during field enrollments. FAQs were reviewed and categorized into four major domains, including risk/prevention, screening, treatment, and reinfection. FAQs were addressed by a team of medical and public health professionals, using the most current research and recommendations. These FAQs address important gaps in HCV knowledge among young adults who are at high risk for infection. The FAQs also highlight the importance of risk reduction counseling provided by frontline public health providers as well as access to safe and effective HCV treatments for young adults who inject drugs.

Antimicrobial Prophylaxis for Adult Patients With Cancer-Related Immunosuppression: ASCO and IDSA Clinical Practice Guideline Update

To provide an updated joint ASCO/Infectious Diseases Society of America (IDSA) guideline on antimicrobial prophylaxis for adult patients with immunosuppression associated with cancer and its treatment. ASCO and IDSA convened an update Expert Panel and conducted a systematic review of relevant studies from May 2011 to November 2016. The guideline recommendations were based on the review of evidence by the Expert Panel. Six new or updated meta-analyses and six new primary studies were added to the updated systematic review. Antibacterial and antifungal prophylaxis is recommended for patients who are at high risk of infection, including patients who are expected to have profound, protracted neutropenia, which is defined as < 100 neutrophils/µL for > 7 days or other risk factors. Herpes simplex virus-seropositive patients undergoing allogeneic hematopoietic stem-cell transplantation or leukemia induction therapy should receive nucleoside analog-based antiviral prophylaxis, such as acyclovir. Pneumocystis jirovecii prophylaxis is recommended for patients receiving chemotherapy regimens that are associated with a > 3.5% risk for pneumonia as a result of this organism (eg, those with ≥ 20 mg prednisone equivalents daily for ≥ 1 month or on the basis of purine analog usage). Treatment with a nucleoside reverse transcription inhibitor (eg, entecavir or tenofovir) is recommended for patients at high risk of hepatitis B virus reactivation. Recommendations for vaccination and avoidance of prolonged contact with environments that have high concentrations of airborne fungal spores are also provided within the updated guideline. Additional information is available at www.asco.org/supportive-care-guidelines .

Public Health Response to Hepatitis B Exposure

In 2015, an estimated 257 million people were living with chronic hepatitis B virus (HBV) globally, with estimates in the United States as high as 2.2 million.1–3 Only 25% of infected individuals in the United States are aware of their HBV infection, and less than 10% are able to access care and tre

Mitogen-activated protein kinase eight polymorphisms are associated with immune responsiveness to HBV vaccinations in infants of HBsAg(+)/HBeAg(\u2212) mothers

BackgroundInfants born to hepatitis B surface antigen (HBsAg) positive mothers are at a higher risk for Hepatitis B virus (HBV) infection. Host genetic background plays an important role in determining the strength of immune response to vaccination. We conducted this study to investigate the association between Tumor necrosis factor (TNF) and Mitogen-activated protein kinase eight (MAPK8) polymorphisms and low response to hepatitis B vaccines.MethodsA total of 753 infants of HBsAg positive and hepatitis Be antigen (HBeAg) negative mothers from the prevention of mother-to-infant transmission of HBV cohort were included. Five tag single nucleotide polymorphism (SNPs) (rs1799964, rs1800629, rs3093671, rs769177 and rs769178) in TNF and two tag SNPs (rs17780725 and rs3827680) in MAPK8 were genotyped using the MassARRAY platform.ResultsA higher percentage of breastfeeding (P = 0.013) and a higher level of Ab titers were observed in high responders (P < 0.001). The MAPK8 rs17780725 AA genotype increased the risk of low response to hepatitis B vaccines (OR = 3.176, 95% CI: 1.137–8.869). Additionally, subjects with the AA genotype may have a lower Ab titer than subjects with GA or GG genotypes (P = 0.051). Compared to infants who were breastfed, infants who were not breastfed had an increased risk of low response to hepatitis B vaccine (OR = 2.901, 95% CI:1.306–6.441).ConclusionsMAPK8 polymorphisms are associated with immune response to HBV vaccinations in infants of HBsAg(+)/HBeAg(−) mothers.

P2‐050: Evaluating hepatitis C core antigen as a screening test in populations at high risk of hepatitis C virus (HCV) infection

P2‐050: Evaluating hepatitis C core antigen as a screening test in populations at high risk of hepatitis C virus (HCV) infection

Quantification of HBV core antibodies may help predict HBV reactivation in patients with lymphoma and resolved HBV infection

Absence or low anti-HBV surface antibody (anti-HBs) is associated with an increased risk of HBV reactivation in patients with lymphoma and resolved HBV infection receiving rituximab-containing chemotherapy. Quantification of anti-HBV core antibody (anti-HBc) is a new marker associated with the natural history and treatment response of chronic HBV infection. This study investigated whether baseline anti-HBc and anti-HBs levels may better predict HBV reactivation. We prospectively measured the HBV DNA levels of patients with lymphoma and resolved HBV infection receiving rituximab-cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisolone-based chemotherapy and started an antiviral therapy upon HBV reactivation, defined as a greater than 10-fold increase in HBV DNA compared with previous nadir levels. Anti-HBs and anti-HBc were quantified by a double-sandwich assay. Receiver-operating-characteristic-curve analysis was used to determine the optimal baseline anti-HBc/anti-HBs levels for predicting HBV reactivation. HBV reactivation occurred in 24 of the 197 patients enrolled, with an incidence of 11.6/100 person-years. For the 192 patients with enough serum samples for analysis, low anti-HBs (<56.48 mIU/ml) and high anti-HBc (≥6.41 IU/ml) at baseline were significantly associated with high risk of HBV reactivation (hazard ratio [HR] 8.48 and 4.52, respectively; p <0.01). The multivariate analysis indicated that (1) patients with both high anti-HBc and low anti-HBs at baseline (36 of 192 patients) had an HR of 17.29 for HBV reactivation (95% CI 3.92-76.30; p <0.001), and (2) HBV reactivation may be associated with inferior overall survival (HR 2.41; 95% CI 1.15-5.05; p = 0.02). Baseline anti-HBc/anti-HBs levels may predict HBV reactivation in these patients with lymphoma and help optimize prophylactic antiviral therapy for high-risk patients. In this study, we identified a subgroup of patients with lymphoma and resolved hepatitis B virus infection that had a high risk of hepatitis B virus reactivation after receiving rituximab-containing chemotherapy. These findings will help optimize a preventive strategy, especially in hepatitis B virus endemic regions with limited healthcare resources. Clinical trial number: NCT 00931229.

Prophylaxis for Hepatitis B Virus Reactivation after Allogeneic Stem Cell Transplantation in the Era of Drug Resistance and Newer Antivirals: A Systematic Review and Meta-Analysis

Patients undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT) are at a very high risk of hepatitis B virus reactivation (HBVr). Lamivudine is commonly used as prophylaxis against HBVr in high-risk patients undergoing allo-HSCT. Unfortunately, its efficacy is diminishing due to the development of HBV mutant drug-resistant strains. With the availability of newer antiviral agents such as entecavir, telbivudine, adefovir, and tenofovir, it is important to assess their role in HBVr prophylaxis. A comprehensive search of 7 databases was performed to evaluate efficacy of antiviral prophylaxis against HBVr in allo-HSCT patients (PubMed/Medline, Embase, Scopus, Cochrane Library, Web of Science, CINAHL, and ClinicalTrials.gov (June 21, 2017)). We identified 10 studies, with 2067 patients undergoing allo-HSCT; these primarily evaluated the use of lamivudine and entecavir as prophylaxis against HBVr in patients undergoing allo-HSCT because there were little or no data about adefovir, telbivudine, or tenofovir as prophylaxis in this specific patient population. Thus, included studies were categorized into 2 main prophylaxis groups: lamivudine and entecavir. Results of our meta-analysis suggest that entecavir is very effective against HBVr, although further clinical trials are required to test efficacy of new antivirals and explore the emerging threat of drug resistance.

Hepatitis C Treatment in Patients with Drug Addiction Is Effective or Not Effective?

Introduction:Patients with drug addiction have high risk for hepatitis C virus (HCV). Effective treatment response is essential to optimize treatment for drug abusers infected by hepatitis C virus.Aim:The aim of this present study was to show that hepatitis C treatment in patients with drug addiction is effective like patients without drug addiction.Material and Methods:Total amount of 57 patients with hepatitis C (25 drug abuser and 32 non–drug abuser) that referred to Shahid Motahari clinic of Shiraz were selected. All patients infected with HCV treated by combination regimens of ribavirin, sofosbuvir and interferon. Patients received sofosbuvir (400mg once a day) in combination with peg-IFN-alpha (92a180m/w›92b1/5m/kg/w) and RBV (under 75 kg 1000mg, over 75 kg 12000kg) for 12 weeks. The Kolmogorov–Smirnov test was used for testing normality. Associations between variables were analyzed using a Chi-square, Fisher exact, T student and Mann–Whitney U test.Results:Out of 25 HCV patients (43.9%) were drug addicts and 32 patients (56.1%) were non-drug addicts. Insomnia (61.4%), fatigue (63.1%) and debility (49.1%) were more common adverse effects of therapy in drug abusers and non-drug abusers. Alanine transaminase (ALT) and HCV RNA was normal in the end of therapy (EOT). White blood cell (WBC) count decreased in during two-week after starting of the treatment and then increased to normal levels at the end of treatment. Reduction of WBC count was considerable in during two-week. Hematologic result was not considerable. Reduction of hemoglobin was <10 g/dL in 9.37% of non-injecting drug addicts and <8.5 g/dL in 6.25% of injecting drug addicts. The results of this study did not demonstrated a significant relationship about sustained virologic response (SVR) between the drug abusers and non-drug abusers (P = 0.99).Conclusions:In conclusion, patients with drug addiction can receive hepatitis C treatment on the history of their past or current drug use status. Combination therapy with sofosbuvir plus peginterferon and ribavirin can lead to high treatment response in HCV patients were drug abuser. In addition, this treatment combination was with low discontinuation rates and low adverse effects. Effective intervention in HCV patients with drug addiction to reduce injection- related risk.

Hepatitis B reactivation and outcomes in persons treated with directly acting antiviral agents against hepatitis C virus: results from ERCHIVES.

Higher risk of hepatitis B reactivation (HBV-r) has been reported in patients with hepatitis C treated with newer directly acting antiviral agents (DAAs). To determine the proportion of persons who develop HBV-r and its clinical consequences among DAA treated vs pegylated interferon/ribavirin (PEG/RBV) treated persons. We calculated the proportion of persons who developed HBV viral reactivation (HBV-r; new detectable HBV DNA or increase of >1 log10 ); serum alanine aminotransferase flare (>5 times baseline); all-cause mortality and hepatic decompensation in persons treated with a newer DAA regimen or PEG/RBV. Kaplan-Meier curves were used to demonstrate survival and hepatic decompensation by treatment group and HBV-r. In 34 632 persons treated with DAA and 23 475 treated with PEG/RBV, HBV-r rate per 1000 person-years was 30.04 (10.41, 49.67) and 25.42 (95% CI 17.23, 33.62) respectively (P = .8). When stratified by SVR or by baseline HBsAg status, HBV-r was not different between groups. Kaplan-Meier survival curves comparing each regimen stratified by presence or absence of HBV-r did not demonstrate a significant difference in incidence of hepatic decompensation over time. For overall survival, there was no difference between PEG/RBV treated persons with or without HBV-r. For DAA treated persons, those with HBV-r had a shortened survival, though the numbers at risk were small. HBV-r is relatively uncommon after DAA therapy and not higher than among those treated with a PEG/RBV regimen. The small numbers of persons treated with a DAA regimen who do develop HBV-r have a shortened survival compared to those without HBV-r.

A large proportion of people who inject drugs are susceptible to hepatitis B: Results from a bio-behavioural study in eight German cities

BackgroundPeople who inject drugs (PWID) are at high risk of hepatitis B virus (HBV) infection by sharing needles and drug use paraphernalia. In Germany, no routine surveillance of HBV prevalence and vaccination coverage among PWID exists. MethodsSocio-demographic and behavioural data were collected between 2011 and 2014 through face-to-face interviews, during a bio-behavioural survey of PWID recruited in eight German cities. Dried blood spots (DBS) prepared with capillary blood were tested for HBV markers. Factors associated with past/current HBV infection and vaccination status were analysed by univariable and multivariable analysis using logistic regression. The validity of self-reported HBV infection and vaccination status was analysed by comparison to the laboratory results. ResultsAmong 2077 participants, the prevalence of current HBV infection was 1.1%, of past HBV infection was 24%, and of vaccine-induced HBV antibodies was 32%. No detectable HBV antibodies were found in 43%. HBV infection status was significantly associated with study city, age, years of injecting, use of stimulants, migration status, and homelessness; HBV vaccination status was significantly associated with study city, age, and level of education. Correct infection status was reported by 71% and correct vaccination status by 45%. ConclusionsHBV seroprevalence among PWID was about five times higher than in the general population in Germany, confirming PWID as an important risk group. Targeted information campaigns on HBV and HBV prevention for PWID and professionals in contact with PWID need to be intensified. Routinely offered HBV vaccination during imprisonment and opioid substitution therapy would likely improve vaccination rates among PWID.

Low levels of hepatitis C diagnosis and testing uptake among people who inject image and performance enhancing drugs in England and Wales, 2012-15

IntroductionPeople injecting image and performance enhancing drugs (IPEDs) have traditionally not been perceived as being at high risk of hepatitis C virus (HCV) infection. However, recent studies indicate the HCV antibody (anti-HCV) prevalence in this group is 10-times that in the general population. HCV testing uptake and undiagnosed infections are examined using data from a voluntary unlinked-anonymous survey. MethodPeople injecting IPEDs across England and Wales completed a short bio-behavioural survey (2012–15). Anti-HCV status and self-reports of HCV testing were used in the analysis. ResultsThe participants median age was 31 years, 98% were men, 14% had also injected psychoactive drugs and the anti-HCV prevalence was 4.8% (N=564). Among those who had never injected psychoactive drugs the anti-HCV prevalence was 1.4%; among those who had recently injected psychoactive drugs (preceding 12 months) prevalence was 39% and among those who had done this previously 14% (p<0.001). Overall, 37% had been tested for HCV: among those who had recently injected psychoactive drugs 78% had been tested, as had 56% of those who had injected psychoactive drugs previously; 33% of those never injecting psychoactive drugs were tested (p<0.001). Overall, 44% of those with anti-HCV were aware of this; however, only 14% of those who had never injected psychoactive drugs were aware. ConclusionsOne-in-twenty people who inject IPEDs have anti-HCV. HCV infections among those who had never injected psychoactive drugs were mostly undiagnosed, though this group had a lower prevalence. Targeted HCV testing interventions are also needed for those injecting IPEDs.

High Incidence of Hepatitis B Virus Infection in Hemodialysis Patients at Sanglah General Hospital and It’s Risk Factors

Background: Patients receiving maintenance hemodialysis (HD) are at higher risk for Hepatitis B Virus (HBV) infections than in general population. Strict infection control is essential to prevent nosocomial transmission. We aimed to investigate the incidence of HBV infection in the HD population in Sanglah General Hospital as well as risk factors acquired HBV infection.Method: All adult patients receiving maintenance HD (n=267) in 3 dialysis units at Sanglah Hospital were studied between March to June 2016. In this study, medical record of patients on maintenance hemodialysis were reviewed and the patients were interviewed by the researchers to collect data regarding the serology status of these patients before and during HD, and potential risk factors which could be associated with HBV acquisition.Results: Participant mean age was 54.07 ± 0.80 years and 154 (57.7%) were male.We found 21 patients (7.8%) were sero-positive for HBV (HBsAg positive) with mean titer was 9.26±1.85. Of the sero-positive patients,1 patient (4.8%) were known to be infected before the initiation of HD and 20 patients (95.2%) were infected during HD. Incidence of HBV infection during HD was 7.5% (20/266). Sero-positive patients were younger with mean age was 51.81±2.76 years, had longer time on dialysis and had previous blood transfusions. Risk factors, which significant associated with hepatitis B infection were history of transfusion (p0.01; OR: 2.49; 95%CI: 1.29-8.18) and duration of hemodialysis (p 0.01; OR: 1.07; 95% CI: 1.03-3.74).Conclusion: Patients on maintenance HD in Sanglah General Hospital have a high incidence of HBV infection. The factors associated with HBV infection are highly suggestive of nosocomial transmission within HD units. History of transfusion and duration of hemodialysis were significant risk factors for HBV infection in patients receiving maintenance HD.

Using database linkages to monitor the continuum of care for hepatitis C virus among syringe exchange clients: Experience from a pilot intervention

Because many people who inject drugs (PWID) are at high risk of hepatitis C virus (HCV) and have poor access to medical care, many HCV-infected PWID remain undiagnosed and unaccounted for in surveillance systems. Syringe exchange programs (SEPs) are an under-utilized resource for collecting information missing from surveillance systems. Partnerships with public health agencies represent a potentially innovative approach to studying the HCV epidemic for PWID. The goal of this study was to characterize the HCV care continuum for a cohort of PWID using database linkages.

The level of knowledge of hepatitis B infection among Turkish dental students

Aim: Dentists are at high risk of hepatitis B infection. The aim of this study was to evaluate the knowledge of students from Ordu univeriyt, faculty of dentistry on hepatitis Materials and Methods: Questionnaires consisting of 76 questions related to students’ socio-demographic status, knowledge of hepatitis infection about the ways of transmission, prevention and risk groups, and vaccination status were distributed to all dental students. Results: Total of 155 students participated in the study and completed the questionairre. The level of knowledge of the 4th and 5th year students was significantly higher than the other students (p=0.001). Fifth year students had significantly better knowledge about the transmission and prevention ways of the hepatitis when compared with the 1st year students B (p=0.001). Although, only 60% percent of the students have been vaccinated, the vaccination rates were higher in both 4th and 5th year-students when compared to the other classes. Fourty-one percent of the students did not know that HBV is contagious during asymptomatic period. Conclusion: There was a lack of knowledge about the hepatitis B infection especially among the 1st and 2nd year students. Therefore, the continuous education of infectious diseases is required starting from the first year of the dental school.

Scientific basis of surveillance and control of hepatitis E in the temperate climate

Purpose of the study. Epidemiological characteristics of hepatitis E in the territory of the Central European region of Russia (on the example of the Nizhny Novgorod region) for the scientific justification of the system of epidemiological monitoring and surveillance of this infection. Materials and methods. Samples of blood sera from patients with a diagnosis of hepatitis (n=860); «сonditionally healthy» population, livestock keepers (n=3108); migrants from the republics of Central Asia (n=160). Twelve years of dynamic monitoring of the prevalence of antibodies to the hepatitis E virus among an adult «conditionally healthy» population (n=1359). To resolve the issue of the prescription period for infection, the avidity of IgG antibodies to the hepatitis E virus (n=37) was determined by an experimental series of the test system produced by «Diagnostic Systems». Serological markers of hepatitis E virus infection was determined by ELISA using commercial test kits. For the detection of HEV RNA in faeces samples of pigs analyzed by PCR using an experimental set of «Interlabservice». Results. Manifestations of the epidemic process the hepatitis E in Russia Central European region are characterized by: substantially higher than the conventional parameters, the intensity of the manifest (from 0,9±0,20 /0000 to 6,9±1,70 /0000), and the latent components (from (1,03±1,0% to 9,3±2,2%); a high proportion of the hepatitis E (from 8,3±2,3% to 13,0±2,9%) in the etiological structure of acute viral hepatitis; low manifestation; active involvement of the epidemic process in persons aged 30-49 years, workers of livestock farms (from 6,4±1,3% to 31,1±0,4%) and enterprises in the meat industry (from 9,1±3,8% to 19,1±2,9%) and migrants from regions with high activity of epidemic process (31,9±3,7%). Workers of cattle-breeding complexes and the enterprises of meat processing industry in areas of temperate climate are at high risk of hepatitis E infection. A significant prevalence of hepatitis E in the human population non-endemic regions may be due not only to importation of infection from endemic areas, but also by contact with animals and/or possible ingestion of insufficiently cooked meat that in the conditions of sporadic morbidity is indicative of mainly zoonotic nature of hepatitis E in the framework of realization of fecal-oral mechanism of transmission. Conclusion. The conducted research allowed to characterize the epidemiological features of hepatitis E in the territory of the Central European region of Russia and served as the basis for developing a system of epidemiological supervision and control for this differentiated nosology.