High Incidence Of Hepatitis Research Articles

Impact of the coronavirus disease 2019 pandemic on drug overdoses in the United States and the effect on cardiac transplant volume and survival

ObjectivesDrug overdose (DO) deaths rose to unprecedented levels during the COVID-19 pandemic. This study examines the impact of COVID-19 on the availability of cardiac allografts from DO donors and the implications of DO donor use on recipient survival. MethodsHeart transplants reported to the United Network for Organ Sharing (UNOS) from January 2017-November 2019 (“pre-COVID”) and March 2020-June 2021 (“COVID pandemic”) were analyzed with respect to DO donor status. Outcomes were analyzed using Kaplan-Meier survival and Cox-regression to identify predictors of survival. Characteristics of discarded cardiac allografts were also compared by DO donor status. ResultsDuring the COVID-19 pandemic 27.2% of cardiac allografts were from DO donors versus 20.5% pre-COVID, a 32.7% increase (p<0.001). During the pandemic, DO donors were younger (84.7% vs. 76.3% <40 years, p<0.001), had higher cigarette use (16.1% vs. 10.8%, p<0.001), higher cocaine use (47.4% vs. 19.7%, p<0.001), and higher incidence of hepatitis C antibodies (26.8% vs. 6.1%, p<0.001) and RNA positivity (16.2% vs. 4.2%, p<0.001). While DO donors were less likely to require inotropic support (30.8% vs. 35.4%, p=0.008), they were more likely to have received cardiopulmonary resuscitation (CPR) (95.3% vs. 43.2%,p<0.001). Recipient survival was equivalent using Kaplan-Meier analysis (log-rank, p=0.33) and survival probability at 36 months was 85.6% (n. at risk=398) for DO donors versus 83.5% (n. at risk=1633) for all other donors. Cox-regression demonstrated that DO donor status did not predict mortality (HR 1.05; 95% CI 0.90-1.23, p=0.53). ConclusionsDuring the COVID-19 pandemic there was a 32.7% increase in heart transplants utilizing DO donor hearts, and DO became the most common mechanism of death for donors. The use of DO donor hearts did not have an impact on short-term recipient survival.

Incidence trends of primary liver cancer in different geographical regions of China from 1978 to 2012 and projections to 2032: An age-period-cohort analysis.

China accounted for 45.3% of new cases of primary liver cancer (PLC) worldwide in 2020. While variations in PLC incidence between different regions of China and decreasing incidence in overall China have been reported, incidence patterns have not been thoroughly explored by region. We examined the nearly status and temporal trends of PLC incidence in different geographical regions in China and project future trends. The age-standardized incidence rate (ASR) was estimated for 1978 to 2012 by different geographical regions and gender in China. Age-period-cohort model was adopted to evaluate age and birth cohort effects on the temporal trend of five registries of China (Hong Kong, Shanghai, Jiashan, Harbin and Zhongshan), Bayesian age-period-cohort model was adopted to project future trends for 2013 to 2032. PLC incidence in China exhibits marked geographical disparity, with the highest incidence in Southwest China, and gender differences being particularly pronounced in South China. While other registries exhibited decreasing trend, Zhongshan exhibited an increasing trend, with the cohort effect showing a marked upward trend for females born in 1916 to 1949 and males born in 1916 to 1962. During 2013 to 2032, the ASR appears to increase by 86.9% for men and 40.0% for women in Zhongshan, while the remaining registries will decline by around 50%. Since the high incidence of hepatitis B virus infection in early birth cohort, recent rise of nonviral risk factors and the severe aging of the Chinese population, it may be critical to tailor future prevention and control strategies for PLC to the distribution of risk factors in different geographical regions.

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 &lt; 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.

Effects of direct acting antiviral therapy on liver stiffness measured by using fibro scan in Egyptian patients with chronic hepatitis C.

Aim Egypt has the highest incidence of hepatitis C virus (HCV) infection in the world. Fibrosis development is common in HCV cases, and it is important in disease prediction. The aim of this study was to demonstrate the role of fibro scan in assessment of changes in hepatic stiffness in patients with chronic HCV infection following direct acting antiviral treatment (DAAT). Methods This prospective observational research included 120 patients with compensated HCV infection. All patients were subjected to fibro scan before and after receiving DAAT. Patients' history, clinical examination, laboratory parameters (red - RBCs, and white blood cells - WBCs, hepatic function test, renal function test, coagulation profile, HBsAg, AFP - alpha feto protein, HbA1C, HCVAb) and fibro scan were done for all patients. Results Stiffness may differentiate F0-2 minimal fibrosis from F3-4 massive fibrosis using ROC-curve analysis, with 77.5% sensitivity, 90% specificity, 88.57% positive predictive value (PPV), and 80% negative predictive value (NPV). With sensitivity, specificity, PPV, and NPV of 71.4%, 44.5%, 43.48%, and 71.43%, respectively, the APRI-score can discriminate F0-2 from F3-4 at cutoff of 0.314. At a cutoff of 1.18, Fib4 calculation can discriminate F0-2 from F3-4, with sensitivity, specificity, PPV, and NPV of 78.6%, 64.1%, 63.04%, and 78.57%, respectively. Conclusion Hepatic fibrosis measurements such as fibro scan and non-invasive fibrosis scores (FIB-4) and aspartate aminotransferase (AST) to platelet ratio index (APRI) showed a significant improvement after direct-acting antiviral therapy. Improvements in hepatic function tests, serum creatinine level, and platelet count are also seen.

Role of radiotherapy and its contribution to immunotherapy in hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is a major contributor to cancer-related deaths, with the incidence of HCC increasing in regions of the world with a high incidence of hepatitis B and C. The therapeutic landscape for HCC management has substantially transformed over recent years, shifting towards a multimodal treatment paradigm. This approach provides a range of medical and surgical interventions aimed at managing the disease effectively. Radiotherapy (RT) has surfaced as a critical player in the preoperative management of inoperable HCC, demonstrating potential in downstaging the disease and achieving disease stability. This advantage may potentially be attributed to the abscopal effect, where localized radiation leads to the regression of metastatic cancer outside of the irradiated site through upregulation of the immune system. The advent of recent technological breakthroughs has paved the way for innovative approaches, notably the integration of immunotherapy and RT. This strategy is emerging as a promising avenue for managing HCC. Preliminary findings from the fusion of RT and immunotherapy are encouraging, with ongoing trials keenly evaluating the optimal parameters for therapy administration, such as timing, dosage, and sequence. The development of combined treatments involving immune checkpoint inhibitors (ICIs) has opened new avenues for advanced HCC treatment. Several immunotherapeutic agents with RT are concurrently being explored for their potential contributions to HCC management.

Efficacy and safety of an innovative short-course regimen containing clofazimine for treatment of drug-susceptible tuberculosis: a clinical trial

ABSTRACT In preclinical studies, a new antituberculosis drug regimen markedly reduced the time required to achieve relapse-free cure. This study aimed to preliminarily evaluate the efficacy and safety of this four-month regimen, consisting of clofazimine, prothionamide, pyrazinamide and ethambutol, with a standard six-month regimen in patients with drug-susceptible tuberculosis. An open-label pilot randomized clinical trial was conducted among the patients with newly diagnosed bacteriologically-confirmed pulmonary tuberculosis. The primary efficacy end-point was sputum culture negative conversion. Totally, 93 patients were included in the modified intention-to-treat population. The rates of sputum culture conversion were 65.2% (30/46) and 87.2% (41/47) for short-course and standard regimen group, respectively. There was no difference on two-month culture conversion rates, time to culture conversion, nor early bactericidal activity (P > 0.05). However, patients on short-course regimen were observed with lower rates of radiological improvement or recovery and sustained treatment success, which was mainly attributed to higher percent of patients permanently changed assigned regimen (32.1% vs. 12.3%, P = 0.012). The main cause for it was drug-induced hepatitis (16/17). Although lowering the dose of prothionamide was approved, the alternative option of changing assigned regimen was chosen in this study. While in per-protocol population, sputum culture conversion rates were 87.0% (20/23) and 94.4% (34/36) for the respective groups. Overall, the short-course regimen appeared to have inferior efficacy and higher incidence of hepatitis but desired efficacy in per-protocol population. It provides the first proof-of-concept in humans of the capacity of the short-course approach to identify drug regimens that can shorten the treatment time for tuberculosis.

Injection drug use and sexually transmitted infections among men who have sex with men: A retrospective cohort study at an HIV/AIDS referral hospital in Tokyo, 2013-2022.

Men who have sex with men (MSM) who use injection drugs (MSM-IDU) are at high risk of sexually transmitted infections (STIs), but the long-term incidence is unclear. We conducted a single-centre retrospective cohort study using the clinical records of non-haemophilia men with human immunodeficiency virus (HIV) who visited the Institute of Medical Science, the University of Tokyo (IMSUT) Hospital, located in Tokyo, Japan, from 2013 to 2022. We analysed 575 patients including 62 heterosexual males and 513 MSM patients, of whom 6.8% (35/513) were injection drug use (IDU). Compared to non-IDU MSM, MSM-IDU had a higher incidence of hepatitis C virus (HCV) (44.8 vs 3.5 /1,000 person-years (PY); incidence rate ratio (IRR) [95% confidence interval (95% CI)], 12.8 [5.5-29.3], p<0.001) and syphilis (113.8 vs 53.3 /1,000 PY; IRR, 2.1 [1.4-3.1], p<0.001). The incidence of other symptomatic STIs (amoebiasis, chlamydia, and gonorrhoea infections) was <4/1,000 PY. In multivariable Poisson regression analysis, HCV incidence was associated with MSM (IRR, 1.8×106 [9.9×105-3.4×106], p<0.001), IDU (IRR, 10.1 [4.0-25.6], p<0.001), and syphilis infection during the study period (IRR, 25.0 [1.2-518.3]/time/year, p<0.001). Among men with HIV, the prevalence of IDU in MSM and the long-term incidence of STIs in MSM-IDU were high. IDU and sexual contact are important modes of transmission of HCV among HIV-infected MSM in Tokyo.

External Validation of the United Kingdom Transplant Benefit Score in Australia and New Zealand.

Introduction: In Australia and New Zealand, liver allocation is needs based (based on model for end-stage liver disease score). An alternative allocation system is a transplant benefit-based model. Transplant benefit is quantified by complex waitlist and transplant survival prediction models. Research Questions: To validate the UK transplant benefit score in an Australia and New Zealand population. Design: This study analyzed data on listings and transplants for chronic liver disease between 2009 and 2018, using the Australia and New Zealand Liver and Intestinal Transplant Registry. Excluded were variant syndromes, hepatocellular cancer, urgent listings, pediatric, living donor, and multi-organ listings and transplants. UK transplant benefit waitlist and transplant benefit score were calculated for listings and transplants, respectively. Outcomes were time to waitlist death and time to transplant failure. Calibration and discrimination were assessed with Kaplan-Meier analysis and C-statistics. Results: There were differences in the UK and Australia and New Zealand listing, transplant, and donor populations including older recipient age, higher recipient and donor body mass index, and higher incidence of hepatitis C in the Australia and New Zealand population. Waitlist scores were calculated for 2241 patients and transplant scores were calculated for 1755 patients. The waitlist model C-statistic at 5 years was 0.70 and the transplant model C-statistic was 0.56, with poor calibration of both models. Conclusion: The UK transplant benefit score model performed poorly, suggesting that UK benefit-based allocation would not improve overall outcomes in Australia and New Zealand. Generalizability of survival prediction models was limited by differences in transplant populations and practices.

Accuracy of hepatitis B disease surveillance, Gannan prefecture, Gansu province, China; 2017.

Hepatitis B is a major global public health threat. According to China's National Notifiable Disease Reporting System (NNDRS), Gannan Tibetan Autonomous Prefecture (Gannan) had the highest incidence of hepatitis B in Gansu Province during 2004 to 2016. We evaluated NNDRS hepatitis B case reports from Gannan to determine accuracy of diagnosis and to understand factors associated with inaccuracy. We reviewed medical records with hepatitis B diagnosis hospitalized in seven county hospitals in Gannan between January 1, 2016 and July 31, 2017. Using national "Classification and Diagnostic Procedures for Hepatitis B," we independently reclassified the diagnoses. We determined the positive predictive value (PPV) of reported hepatitis B cases. We investigate clinicians' understanding of the diagnostic and reporting criteria for hepatitis B by questionnaire. We reviewed and re-categorized 400 inpatients reported. Sixteen cases had been reported as acute hepatitis B, but on re-categorization, none were acute hepatitis B cases. PPVs for chronic hepatitis B and unclassified hepatitis B cases were 66% and 15% respectively; 327 (82%) of the reported hepatitis B cases were inaccurately classified; 261 were carriers, 59 were reported previously, and 7 did not have hepatitis B. The actual incidence of hepatitis B in Gannan in 2016 was estimated to be 19/100,000, significantly below the reported incidence of 106/100,000. Among reported cases, 81% had been tested for Alanine aminotransferase, 52% for hepatitis C antibody, 80% with liver ultrasound, 32% for hepatitis A antibody, and 7% for hepatitis B virus (HBV) DNA. Not all cases were tested for anti-HBc IgM or hepatitis E antibody or had a liver biopsy. In the knowledge test, 56% of clinicians accurately diagnosed three simulated cases of acute hepatitis B, and 17% correctly diagnosed two simulated cases chronic hepatitis B; 22% knew that "a client with only HBsAg positivity need not be reported." The falsely high incidence in Gannan was due to diagnostic and reporting inaccuracies. We recommend that clinicians and laboratorians receive additional training in hepatitis B diagnostic criteria and reporting standards, including appropriate use of IgM anti-HBc tests. Hepatitis B surveillance data should be periodically reviewed and evaluated for accuracy.

Evaluation of Hepatitis B viral Serological Patterns and HBV DNA levels in Hepatitis B subjects at Nauth Nnewi, Southeastern Nigeria

Nigeria is one of the countries with the highest incidence of Hepatitis B Virus (HBV) infection worldwide. The inaccessibility and unaffordability of HBV DNA quantification (viral load) assay which is the key laboratory test for therapy initiation, and monitoring is a challenge to HBV management. This study aimed at evaluating the HBV DNA viral load differences across the serological markers of HBV in order to develop a more cost-effective diagnostic algorithm for Hepatitis B management. Cross sectional study design was used with a total of 264 subjects comprising of 88 HBsAg seropositive treatment naïve subjects, 88 HBsAg seropositive subjects on antiviral therapy as case subjects and 88 age-matched apparently healthy HBsAg seronegative individuals were recruited as control subjects. Hepatitis B Virus DNA assay was performed using real time PCR technique, Hepatitis B core Antibody Immunoglobulin M and Hepatitis D Virus Immunoglobulin G assay. Immunochromatography was used for HBV Panel, Hepatitis C Virus assay and Human Immunodeficiency Virus testing. The non-treatment group has higher viral load (M=805.50 IU/ml) compared with treatment group (M = 65.50 IU/ml) (p&lt;0.001). There was a significant difference in the HBV DNA levels of the four serological patterns observed in the study (P&lt; 0.001). Among the four serological patterns observed, the second pattern with positive surface antibody, positive envelope antigen and negative envelope antibody showed highest viral load (M= 46850189.50 IU/ml) followed by the third pattern with negative surface antibody, negative envelope antigen, and negative envelope antibody (M=46555 IU/ml). The first pattern which has negative surface antibody, negative envelope antigen and positive envelope antibody has the lowest viral load (M=21.00 IU/ml) followed by the fourth pattern with positive surface antibody, negative envelope antigen and positive envelope antibody (M=493.00 IU/ml). This study showed that HBV serological markers can predict viral load and should be used as its alternative in resource poor settings.

PREVALENCE OF HEPATITIS A VIRUS, HEPATITIS B VIRUS, AND HEPATITIS C VIRUS, AMONG PATIENTS WITH HEPATIC JAUNDICE IN SANA’A CITY, YEMEN: A HOSPITAL BASED STUDY

Background: Hepatic jaundice results from abnormal metabolism of bilirubin in the liver. The main hepatic jaundice causes are severe damage to hepatocytes due to autoimmune diseases, infectious diseases, drugs/ medication induced, or, less commonly, hereditary genetic diseases.&#x0D; Aim: The aim of this study is to determine the prevalence of hepatitis B Virus (HBV), hepatitis A virus (HAV), and hepatitis C virus (HCV), in patients with hepatic jaundice as causes of acute viral hepatitis (AVH) in Sana'a city, Yemen.&#x0D; Subjects and Methods: Data of patients with hepatic jaundice tested for hepatitis B surface antigen, total anti-HCV antibody, and anti-HAV immunoglobulin M (IgM) by enzyme-linked immunosorbent assay were collected from Class I Viral Diagnostic Laboratories in Sana'a for 3 years. Then the statistical analysis of the data was used where the descriptive analysis was calculated: frequency and percentage, as well as the association of infection with sex and age group by means of detection odds ratio, 95% CI and X2 more than 3.9 and P&lt;0.05 were considered statistically significant.&#x0D; Results: The study included 644 males (43.8%) and 826 females (56.2%), while most patients were less than 21 years old. The rate of Hepatitis viruses positive was 27.6% positive. Hepatitis A virus infection was the most common virus diagnosed accounting for 259 cases (17.6% of the total), while HBV was less common with 104 (7.1%) and HCV only 42 cases (2.9%). The highest incidence of hepatitis B was in 11-20 years patients (18.2%), with an associated OR 9.3 (p &lt; 0.0001). The highest incidence of hepatitis C was in 31-40 years patients (7.3%), with an associated OR 3.3 (p&lt;0.0001).&#x0D; Conclusion: Alarmingly changing the epidemiology and dynamics of hepatitis A-C viruses in Yemen, a detailed study is required to understand the definite disease problem caused by these viruses. It is noticeable in this study the high prevalence of hepatitis A virus and hepatitis B virus in the Yemeni population with hepatic jaundice. Also, to our knowledge, this study is the first to report epidemiological transformation of hepatitis A virus in Sana'a, Yemen.&#x0D; &#x0D; Peer Review History: &#x0D; Received: 13 November 2021; Revised: 11 December; Accepted: 30 December, Available online: 15 January 2022&#x0D; Academic Editor: Dr. Nuray Arı, Ankara University, Turkiye, ari@ankara.edu.tr&#x0D; UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. &#x0D; Received file: Reviewer's Comments:&#x0D; Average Peer review marks at initial stage: 5.5/10&#x0D; Average Peer review marks at publication stage: 7.0/10&#x0D; Reviewers:&#x0D; Dr. Gulam Mohammed Husain,, National Research Institute of Unani Medicine for Skin Disorders, Hyderabad, India, gmhusain@gmail.com&#x0D; Dr. Salfarina Ramli, Department of Pharmacology and Pharmaceutical Chemistry, Faculty of Pharmacy, Universiti Teknologi MARA, 42300 Puncak Alam, Selangor, Malaysia. salfarina2892@uitm.edu.my &#x0D; Similar Articles:&#x0D; PREVALENCE OF DIFFERENT HEPATITIS B VIRUS GENOTYPES AND RISK FACTORS ASSOCIATED AMONG SELECTED YEMENI PATIENTS WITH CHRONIC HEPATITIS B INFECTION &#x0D; SERO-EPIDEMIOLOGICAL STUDY OF HEPATITIS B, C, HIV AND TREPONEMA PALLIDUM AMONG BLOOD DONORS IN HODEIDA CITY- YEMEN &#x0D; EXPLOSION OF HEPATITIS B AND C VIRUSES AMONG HEMODIALYSIS PATIENTS AS A RESULT OF HEMODIALYSIS CRISIS IN YEMEN

Comparative evaluation of various strategies medical care for chronic hepatitis С in the Republic of Sakha (Yakutia)

Hepatitis C is a major public health problem and measures against it require the development of a national strategy and concept of a prognostic model. This is relevant for Yakutia, as a tremendous region with extremely specific and severe climatic and social conditions that cause a high incidence of hepatitis C.Objective: to evaluate the effectiveness of various scenarios for the development of the epidemiological situation of hepatitis C in RS (Y) depending on the strategy for providing medical care to people with chronic hepatitis C.Material and Methods. The work uses the materials of official statistics of the Federal State Institution of Rospotrebnadzor for RS (Y) and information from the register «Chronic viral hepatitis in RS (Y). To assess the burden of disease, the main scenarios were analyzed using the dynamic Excel model.Results and discussion. RS (Y) is a disadvantaged territory of the Russian Federation for parenteral viral hepatitis, including hepatitis C. According to the register «Chronic viral hepatitis in RS (Y)», 14643 people are registered, of which with chronic hepatitis C — 7395, which amounted to 50,5%. The proportion of HCV infection in the group of people with cirrhosis is 44.1%, with hepatocellular carcinoma 59,3%, and 76% in the total structure of the dead. Implementation of the WHO scenario for hepatitis C will reduce mortality by 65%, the number of people with hepatocellular carcinoma by 66%, decompensated cirrhosis by 66% and reduce the overall incidence by 34% by 2030.Conclusion. Achieving the WHO goals by 2030 seems realistic when creating a regional strategy to eliminate HCV in RS (Y), which includes increasing access to therapy with modern drugs with direct antiviral effects, an interdisciplinary approach to the diagnosis and management of patients with chronic hepatitis C, specialties about the problem of chronic hepatitis C and the possibility of curing it.

High incidence of hepatitis B core antibody positivity in metabolic-associated fatty liver disease-related cirrhosis.

Background and Aim:The coexistence of metabolic-associated fatty liver disease (MAFLD) in the course of chronic hepatitis B virus infection increases liver-related morbidity. A positive correlation was found between positive hepatitis B core antibody (anti-HBc) and the risk of cirrhosis and hepatocellular carcinoma (HCC) in MAFLD. The relationship between anti-HBc positivity and MAFLD progression to fibrosis, cirrhosis, and liver-related outcomes was determined.Materials and Methods:This is a retrospective study including 242 patients with biopsy-proven MAFLD, 130 patients with clinically diagnosed MAFLD-related cirrhosis, and 62 patients with MAFLD-related or cryptogenic HCC. Anti-HBc antibody results were compared with clinical outcomes.Results:Anti-HBc positivity was associated with fibrosis severity (p=0.005). Anti-HBc was positive in 19 (20.2%), 33 (25.8%), 53 (35.3%), and 27 (43.5%) patients with F0–F1 fibrosis, F2–F3 fibrosis, cirrhosis (F4), and HCC, respectively. Median steatosis score was grade 3 in anti-HBc positive patients and grade 2 in negative patients (p=0.07). Anti-HBc positivity was not associated with significant fibrosis (≥F2), cirrhosis, and any liver related complications including HCC.Conclusion:Higher anti-HBc positivity was found in MAFLD patients with advanced fibrosis and cirrhosis compared to patients with early stage fibrosis. No relation was found between anti-HBc positivity and development of cirrhosis, HCC or other liver related complications.

The Profile of the Patients with Double Infection HIV and TB in South West of Romania.

Background: Co-infection with human immunodeficiency virus (HIV) / tuberculosis (TB) raises important diagnostic and treatment problems as the lung is one of the target organs for HIV. Studies have shown that an HIV patient is 5-15 times more likely to switch from Koch's bacillus-infected status to active tuberculosis. Material and method: Retrospective study on 207 patients with HIV/TB coinfection in the Oltenia area registered in the Regional Center for Monitoring and Evaluation of HIV/AIDS infection in Craiova to define the profile of patients with double TB-HIV infection in southern Romania for cases registered between 2005-2015. Results: 53.14% of patients were females. Most cases were from rural areas (56.10%) Half of them are born between 1988 and 1990 but only 5% graduated university. 66.18% don’t have a job and are supported by state with a monthly minimum income. 29.4% are smokers. More than 60% of cases had pulmonary TB and other 25% had concomitant pulmonary and extrapulmonary TB. TB and HIV have been diagnosed almost at the same time in 25% of cases. At the time of TB diagnosis 75% of patients had CD4+lymphocytes count <200cel/ml. We also noticed the absence of prophylaxis for TB in patients infected with HIV (PIH) and high incidence of hepatitis B (30.43%). Conclusions: Clinical expression, radiological and bacteriological aspects are often atypical in HIV/TB coinfected patients. The lack of TB prophylaxis and TB endemicity in the studied area may justify the large number of TB cases in HIV-infected patients.

Examining Liver Cancer Patients and a High-Risk Group in a Vulnerable Area: An Experience from the Ulleung Liver Cancer Prevention and Management Project.

Ulleung county is a small island on the eastern side of the Korean peninsula. The Ulleung Liver Cancer Prevention and Management Project was launched in order to minimize newly developing liver cancer within this region. Population-based regional cancer registry data were analyzed to investigate the status and characteristics of registered liver cancer patients. The Interagency Workgroup of the project provided a special screening program from 1 November to 3 November 2018, and from 23 April to 25 April 2019, undertaking liver cancer screening and health behavior surveys. Logistic regression analysis was used to determine factors associated with recent liver cancer screening. In Ulleung county, hepatocellular carcinoma was identified as the main type of liver cancer, accompanied by a high incidence of hepatitis B. Approximately 25.0% of the participants were not aware of their liver condition. People who were aware of their liver condition and those who reported a general understanding of hepatitis B were more likely to have undergone recent liver cancer screening. To prevent the development and spread of the disease in the community, adequate infrastructure for cancer screening and an enhanced monitoring system are required, along with measures to create awareness to periodically determine liver condition in high-risk groups.

Incidence trend and age-period-cohort analysis of reported hepatitis C among residents aged 30 to 79 in northeastern China, 2008 to 2017.

The purpose of this study was to acquire the epidemic trend of age-standardized reported incidence and to analyze the age effect, period effect, and cohort effect on the reported incidence of hepatitis C in Jilin Province, China.We collected the annual reported incidence data of hepatitis C by gender (2008-2017). Annual percentage change and annual average percentage change were calculated by joinpoint Poisson regression analysis. The age effect, period effect, and cohort effect on the incidence of hepatitis C were estimated by an age-period-cohort model, and the relative risk was determined.Joinpoint regression analysis showed that the age-standardized reported incidence of hepatitis C indicated a declining trend integrally. Among people aged 30 to 44 (youth), the incidence trend declined the fastest, while trends declined the slowest among women and the overall population aged over 66 (elderly people) and men aged 45 to 65 (middle-aged group). The results of the age-period-cohort model showed that the reported incidence increased first and then decreased with age. Throughout the period, the risk of hepatitis C also increased first and then decreased. Compared with the median birth cohort of the same age group, the birth cohort of the patients with the highest incidence of hepatitis C was in the 1930s, followed by the 1940s and 1950s. The birth cohort of the patients with the lowest incidence was in the 1980s, followed by the 1970s and 1960s.Although the overall reported incidence trend of hepatitis C is declining and the risk of the young birth cohort is low, many factors affecting infection and testing with hepatitis C still exist in China. We should focus on high-risk population management and formulate corresponding public health strategies to accelerate the implementation of the global health strategy to eliminate hepatitis C published by the World Health Organization.

High incidence of Hepatitis C virus infection observed in the PROUD study of HIV pre-exposure prophylaxis.

High incidence of Hepatitis C virus infection observed in the PROUD study of HIV pre-exposure prophylaxis.

Evaluation of HBsAg Quantification as Surrogate to HBV DNA Viral Load in Hepatitis B Infected Patients in Anambra State, Nigeria

Hepatitis B is an infectious disease of great public health importance. Nigeria is one of the countries with the highest incidence of Hepatitis B Virus (HBV) infection worldwide. However, the accessibility and affordability of HBV DNA quantification (viral load) assay is the key laboratory test for therapy initiation, and monitoring is a challenge to HBV management. This study aimed at determining the relationship between HBV DNA quantification and routine haemato-serological parameters in order to develop a more cost-effective diagnostic algorithm for Hepatitis B management. Cross sectional study design was used with a total of 264 subjects comprising of 88 HBsAg seropositive treatment na&#239ve subjects, 88 HBsAg seropositive subjects on antiviral therapy as case subjects and 88 age-matched apparently healthy HBsAg seronegative individuals were recruited as control subjects. Hepatitis B Virus DNA assay was performed using real time PCR technique while ELISA technique was used for Hepatitis B surface antigen quantification. HBsAg quantification showed strong positive correlation with HBV DNA viral load both in treatment and non-treatment groups (r = 0.673; p

Belgorod region - the territory endemic for hepatitis E.

Belgorod region is the territory with the highest incidence of hepatitis E in the Russian Federation. The aim of the study was to comprehensively characterize the circulation of hepatitis E virus (HEV) in the Belgorod region, including the study of population immunity to the virus, determining the prevalence of infection among the pig population and analysis of the genetic diversity of HEV from patients and animals. Serum samples of a conditionally healthy population (n = 2027) of all age groups were tested for anti-HEV IgG and IgM by ELISA with commercial assays. HEV RNA was determined in fecal samples from pigs aged 2-4 months (n = 526), in sewage samples from pig farms (n = 10), as well as in stool samples from patients with hepatitis E (n = 6) using reverse transcription polymerase chain reaction (RT-PCR). Phylogenetic analysis was performed for an amplified 300 nt fragment corresponding to HEV open reading frame 2. The prevalence of anti-HEV IgG in general population averaged 16.4% (95% CI: 14.8-18.1; 332/2027). The proportion of individuals who had both anti-HEV IgM and IgG averaged 2.8% (95% CI: 2.2-3.6; 57/2027). The incidence rate of anti-HEV IgG increased with age, from 2.8% (95% CI: 1.3-5.8) in children aged 1-14 years to 40.1% (95% CI: 34.9-45.6) in people 70 years or older. The detection rate of HEV RNA in pigs was 20% (95% CI: 16.8-23.6; 105/526). HEV RNA was detected in 2 out of 10 sewage samples. The HEV sequences isolated from patients with hepatitis E, pigs, and sewage samples in Belgorod region belonged to the HEV genotype 3, had a 95-100% homology, and formed common clusters on a phylogenetic tree. The high prevalence of HEV in pigs population has led to the formation of an endemic territory in the Belgorod region, which is the center of pig breeding. Measures aimed at reducing the circulation of HEV among pig population and decontamination of sewage from pig farms are necessary to control HEV infection.

Real-world assessment of an integrated clinical model on oral hepatitis C therapy at Southern Ohio Medical Center

Background: The area and population served by the Southern Ohio Medical Center (SOMC) is one that has been hit hard by the opioid epidemic, resulting in a very high incidence of Hepatitis C virus infected individuals. In this rural area, many patients have struggled with access to specialty healthcare. In January 2018, specialty pharmacy services were started. The main goals were to provide a valuable and personalized service to patients and increase access to specialty medications. When taken as prescribed, HCV therapies can lead to high cure rates (>95%). The program integrated a clinical pharmacist and pharmacy liaison in the infectious disease clinic to begin providing in-clinic education, 24/7 support, prior authorization assistance, financial aid assistance, refill reminders, and other services to patients. The specialty pharmacy service has assisted many local patients to obtain treatment for HCV. The following data analysis details the study design and results. Aims: The study was completed to assess the impact of the clinic-based specialty pharmacy program on medication access, affordability, and clinical outcomes for patients with HCV. Methods: The study was IRB-approved. Endpoints measured were SVR12 rates, rates of patient return for SVR12 labs, and out-of-pocket costs for patients using the SOMC Specialty Pharmacy. To be eligible for the study, patients must have started an HCV regimen written by an SOMC provider after January 1, 2018. Data was collected by reviewing patient electronic medical records and pharmacy dispensing records. Results: The study included 67 HCV patients who utilized the SOMC specialty pharmacy program to obtain treatment. Thirty-seven of the patients were male, none had liver decompensation, and 65 were treatment-naïve. By offering in-clinic specialty pharmacy services to patients, SOMC was able to remove barriers, such as cost, to improve specialty medication access and adherence. This resulted in 100% medication access and therapy completion rates for participating patients. SVR12 rates were higher than clinical trials. Finally, the average out of pocket cost to patients was found to be $0.75, with 90% of patients having zero copay. Clinical pharmacists and pharmacy liaisons played a key role in achieving this result by providing in-person education to patients, securing financial assistance for patients, and regularly following-up with patients regarding their therapy. Conclusions: Clinic-based health system specialty pharmacy programs can play a vital role in improving medication access and adherence, leading to better clinical outcomes. By offering on-site specialty pharmacy services, SOMC provides a personalized patient experience and affordable access to specialty prescriptions. These elements help ensure patients adhere to their treatment regimens over time and fully realize the benefits of their specialty medications.