Positive Test For Hepatitis Research Articles

Seropositive for hepatitis B and C viruses is associated with the risk of decreased bone mineral density in adults: An analysis of studies from the NHANES database.

Some studies had reported that patients with viral hepatitis are at increased risk of reduced bone mineral density and even osteoporosis. However, the interaction between reduced bone mineral density (BMD) and viral hepatitis remains inconclusive. Therefore, our study collected hepatitis test results and bone mineral density from respondents in the NHANES database. The aim of this study was to investigate whether there is an association between hepatitis and a decrease in bone mineral density. The respondents with both hepatitis- and BMD-related indicators from the NHANES database in the United States from 2005-2010, 2013-2014, to 2017-2020 were collected for this study. BMD were compared between respondents who were positive and negative for respondents related to hepatitis B and C. BMD was measured using dual-energy X-ray absorptiometry of the femur and lumbar spine. Finally, multiple regression analysis was performed between hepatitis B surface antigen (HBsAg) and hepatitis C RNA (HCV-RNA) and BMD in the respondents. A total of 15,642 respondents were included in the hepatitis B surface antigen-related survey. Of these, 1,217 respondents were positive for hepatitis B surface antigen. A total of 5111 hepatitis C RNA-related responders were included. Hepatitis C RNA-positive had 268 respondents. According to the results of the multiple regression analysis, the femoral BMD was significantly lower in HBsAg (+) respondents compared to HBsAg (-) respondents: -0.018 (-0.026, -0.009) (P < 0.01). Moreover, spinal BMD was significantly lower in HBsAg (+) respondents compared to HBsAg (-) respondents: -0.020 (-0.030, -0.010) (P < 0.01). According to the results of multiple regression analysis for hepatitis C RNA, HCV-RNA (+) respondents had significantly lower BMD compared to HCV-RNA (-) respondents: -0.043 (-0.059, -0.026) (P < 0.01). During the analysis of respondents in the NHANES database in the United States, positive tests for hepatitis B surface antigen and hepatitis C RNA were found to be associated with a reduction in BMD. Positive serology for these hepatitis indicators may increase the risk of reduced BMD. Of course, this conclusion still needs to be further confirmed by more large clinical trials.

Comparative Clinical Characteristics of Rheumatic Heart Disease Patients Undergoing Surgical Valve Replacement.

BackgroundTo assess the prevalence patterns of isolated/mixed rheumatic valvular lesions and associated risk factors among rheumatic heart disease (RHD) patients undergoing surgical valve replacement.MethodsAn analytical cross-sectional design was used. Purposive sampling was used to select 87 RHD patients who underwent a first-time valve replacement for mitral, aortic, or both valves between April 1 and October 20, 2016, at Punjab Institute of Cardiology, Lahore, Pakistan. Patients with systemic hypertension, diabetes mellitus type-II, congenital heart defects, coronary artery disease, non-rheumatic valvular degeneration, positive test for hepatitis C, or undergoing concomitant coronary artery bypass graft or a ‘redo’ valve replacement procedure were excluded.A proforma was used to collect preoperative data on patients’ demographics, laboratory investigations, electrocardiogram (ECG), and transthoracic echocardiography reports.ResultsAge (mean ± S.D.) was 32.79 ± 13.06 years, which was divided into four quartile-based groups. Forty-six (52.9%) cases were males. The majority (56.3%) of patients underwent mitral valve replacement. Mitral regurgitation (MR, 80%) was the most common lesion. Of 71 available ECGs, atrial fibrillation was observed in 46.5% cases. Increasing age group was negatively correlated with MR severity (τc = -0.188, p-value = 0.033) and positively with aortic stenosis (AS) severity (τc = 0.141, p-value = 0.010).No significant elevations were observed for anti-streptolysin O titer, C-reactive protein, and leukocyte count, though the erythrocyte sedimentation rate was abnormally high in 46.94% cases.ConclusionsMR was the most common lesion. MR was more severe in younger patients whilst AS was more severe in older cases. There is little evidence of ongoing residual inflammation.

HIV testing in persons diagnosed with hepatitis B and C

In the UK, an estimated 101 200 people are living with HIV, 13% of whom are unaware of their infection 1. The first national guidelines for HIV testing published in 2008 recommended the universal offer of an HIV test in health care services for persons diagnosed with hepatitis B and C 2. The latest National Institute for Health and Care Excellence (NICE) testing guidelines (released in December 2016) continue to recommend offering HIV tests to people with HIV indicator conditions, which include hepatitis B and hepatitis C, and in services treating people for hepatitis B and hepatitis C 3. Using the Sentinel Surveillance of Blood Borne Virus Testing (SSBBV), linked to the national HIV and AIDS Reporting System (HARS), we investigated the extent to which the guidelines are being followed. HIV testing information was extracted from the SSBBV for all adults (≥ 15 years old) with a first positive test between 2010 and 2014 for hepatitis C virus (HCV) antibodies, indicative of being ever infected, or for hepatitis B virus (HBV) surface antigen. Persons tested within the SSBBV were matched, using deterministic and probabilistic methodologies, to the HARS, and persons identified as diagnosed with HIV infection prior to their hepatitis diagnosis were excluded. Persons testing HBV positive in antenatal services were also excluded, as women are routinely tested for HIV and HBV as part of the antenatal screening programme. Among persons who tested positive for HCV (32 114), 38.7% (12 429) were tested for HIV on the same day as their HCV test, 6.7% (2158) were tested in the following 6 months, and 54.6% (17 527) had no record of an HIV test during the 6-month period following their positive HCV test (Table 1). Among persons who tested positive for HBV (16 086), the corresponding figures were 34.8% (5593), 10.7% (1722) and 54.5% (8771). In persons who were HCV positive, HIV testing was less likely in older persons [adjusted odds ratio (aOR) per 10-year increase 0.88; 95% confidence interval (CI) 0.86–0.90] and in persons diagnosed in primary care (aOR: 0.6; 95% CI: 0.6–0.7) when compared with secondary care. In persons who were HBV positive, HIV testing was less likely in older persons (aOR per 10-year increase 0.94; 95% CI: 0.92–0.97), but more likely in men (aOR: 1.2; 95% CI: 1.1–1.3) and in those diagnosed in primary care (aOR: 1.2; 95% CI: 1.1–1.3) and sexual health services (aOR: 1.9; 95% CI: 1.7–2.0) when compared with secondary care. The HIV positivity rate in persons tested for HIV within 6 months was 1.9% among persons who were HCV positive and 2.4% among persons who were HBV positive. Of those with no record of an HIV test within 6 months (HCV: 17 527; HBV: 8771), 13 (0.1%) and 10 (0.1%) persons were diagnosed with HIV infection after the 6-month period, respectively, 77% and 60% of whom were diagnosed within 2 years. Although some persons may have received an HIV test in a service not covered by the SSBBV or were lost to follow-up once diagnosed with hepatitis, these data suggest that HIV testing following a positive test for hepatitis is suboptimal in England, regardless of clinical setting. Opportunities have been missed to diagnose persons coinfected with HIV and to offer education on HIV risk reduction strategies. HIV testing rates were higher in sexual health services, but < 20% of individuals with hepatitis are diagnosed within this setting, and greater awareness and implementation of the most recent NICE HIV testing guidelines are needed among all health professionals.

P3.02c-098 An Observational Study of the Efficacy and Safety of Nivolumab in Patients with Advanced NSCLC. A Galician Lung Cancer Group: Topic: IT Clinical

Nivolumab is an immune checkpoint inhibitor antibody and it has demonstrated durable responses and tolerability in pretreated patients with advanced NSCLC. This is an observational study to evaluate the efficacy and safety of nivolumab in previously treated patients with advanced NSCLC in the expanded access program. Eligibility criteria included, histologically confirmed NSCLC clinical stage IIIB vs IV, evaluable disease, at least one prior therapy, performance status of 0/1 and an adequate organ function. Exclusion criteria included, positive test for hepatitis B, C or human immunodeficiency virus, severe autoinmune disease and patients with systemic corticosteroids or immunosuppressive medications. Patients received nivolumab 3 mg/kg IV (60 min) every 2 weeks until progressive disease (PD) or unacceptable toxicity. The aim of the study was to report the efficacy and safety profile of Nivolumab in pretreated patients with advanced NSCLC of our everyday clinical practice. The exploratory assessments include response rate (RR), progression-free survival (PFS), overall survival (OS) and treatment related adverse events (AEs). From August of 2015 to February of 2016, with a median follow time of 7 months, 66 patients were enrolled from 7 different centers. The patients demographics were: median age 60 years, 19 female and 47 male; 7 never smoked and 59 former or current smoker; 45 patients adenocarcinoma, 4 large-cell carcinoma, 12 squamous-cell carcinoma and 4 NSCLC; 20 stage IIIB and 46 stage IV; 17 with central nervous system metastasis; 30 received 2 or more prior therapy lines and 62 had PS 1. Among 48 patients evaluated, 3% had complete response, 21% partial response, 27% disease stabilization and 21% disease progression. At the time of database lock, the median of PFS was 2.03 IC 95% (1.2-2.7) and OS was not reached. Grade 1-2 treatment related adverse events (AEs) occurred in 38 patients and the most common ones were asthenia (25), rash/pruritis (12), anorexia (7), endocrine (5) and diarrhea (4). Each of the toxicities were manageable and there were no grade 3-4 AEs or treatment-related deaths. Early data from this study suggests that Nivolumab is effective and well tolerated in patients with pretreated advanced NSCLC.

An observational study of the efficacy and safety of nivolumab in pretreated patients with advanced non small cell lung cancer (NSCLC): A Galician Lung Cancer Group Clinical Practice.

e20612 Background: Nivolumab is an immune checkpoint inhibitor antibody and it has demonstrated durable responses and tolerability in pretreated patients with advanced NSCLC. This is an observational study to evaluate the efficacy and safety of nivolumab in previously treated patients with advanced NSCLC in the expanded access programme. Methods: Elegibility criteria included, histologically confirmed NSCLC clinical stage IIIB vs IV, evaluable disease, at least one prior therapy, performance status of 0/1 and an adequate organ function. Exclusion criteria included, positive test for hepatitis B, C or human immunodeficiency virus, severe autoinmune disease and patients with systemic corticosteroids or immunosuppressive medications. Patients received nivolumab 3 mg/kg IV (60 min) every 2 weeks until progressive disease (PD) or unacceptable toxicity. The aim of the study was to report the efficacy and safety profile of Nivolumab in pretreated patients with advanced NSCLC of our everyday clinical practice. The exploratory assessments include response rate (RR), progression-free survival (PFS), overall survival (OS) and treatment related adverse events (AEs). Results: From August of 2015 to January of 2016, with a median follow time of 6 months, 34 patients were enrolled from 5 different centers. The patients demographics were: median age 62 years, 9 female and 25 male; 14 never smoked and 20 former or current smoker; 22 patients adenocarcinoma, 2 large-cell carcinoma, 8 squamous-cell carcinoma and 2 NSCLC; 13 stage IIIB and 20 stage IV; 7 with central nervous system metastasis; 22 received 2 or more prior therapy lines. Among 20 patients evaluated, 7 had partial response, 10 disease stabilization and 3 disease progression. At the time of database lock, the median of PFS and OS was not reached. Grade 1-2 AEs occurred in 22 patients and the most common ones were fatigue (11) and rash/pruritis (7). Each of the toxicities were manageable and there were no grade 3-4 AEs or treatment-related deaths. Conclusions: Early data from this study suggests that Nivolumab is effective and well tolerated in patients with pretreated advanced NSCLC.

Descarte de córneas por sorologia positiva do doador no Banco de Olhos do Hospital São Paulo: dois anos de estudo

To investigate discarded corneas due to positive serologic tests in donors from the Hospital São Paulo Eye Bank (BOHSP) during a two-year period. Retrospective study of records from cornea donors between January 2006 and December 2007. Information such as serologic test results (Hepatitis B, C, and HIV), source of corneal tissue, donor's gender and age were tested for correlation. 902 corneas were processed by BOHSP; 12.9% (116) were discarded due to donor's positive test for hepatitis B, C, or HIV; 20.5% (185) were also discarded due to inconclusive result of serological tests; percentage of corneas discarded due to positive or inconclusive serological tests during this period was 33.4% (301). This study confirms the importance of serological tests in order to prevent disease transmission to corneal transplant recipients. However, new tests are necessary to decrease the number of inconclusive tests and decrease the number of discarded corneas.

Clinical and histological efficacy of pegylated interferon and ribavirin therapy of recurrent hepatitis C after liver transplantation

Treatment of recurrent hepatitis C in liver transplant is controversial. The aim of our study was to evaluate the clinical and histological efficacy of pegylated interferon alpha 2b (PEG-IFN) and ribavirin therapy of recurrent hepatitis C after liver transplantation (LT). We prospectively included 47 liver transplant patients with: 1) a positive test for hepatitis C virus (HCV)-ribonucleic acid (RNA) in serum; 2) alanine aminotransferase (ALT) >45 UI/mL; and 3) a liver biopsy showing chronic hepatitis without rejection in the previous 2 months. Patients received PEG-IFN (1.5 microg/kg/week) and ribavirin (800-1,000 mg/day) for 12 months. Follow-up was based on biochemical (ALT), virological (RNA-HCV), and histological (liver biopsy) examinations. Follow-up lasted a minimum of 6 months after the end of antiviral therapy. Sustained virological response (SVR) was achieved in 23% of the patients. A total of 33 (70%) patients had normalized ALT levels at the end of therapy. Inflammatory portal and lobular score declined significantly in patients with SVR (P < 0.05) but not in nonresponder patients. Fibrosis did not change significantly in either group. SVR was significantly associated with low gamma-glutamyltransferase GGT (P = 0.04) and HCV-RNA levels (P = 0.03), a virological response at 12 weeks (P = 0.002) and patient's compliance (P = 0.04). Ten (21%) patients were withdrawn prematurely due to adverse effects. In conclusion, Therapy with PEG-IFN and ribavirin achieved SVR and a significant histological improvement in 23% of liver transplant recipients with chronic hepatitis C. Toxicity is an important drawback of this therapy.

Serum γ‐glutamyltransferase within its normal concentration range is related to the presence of diabetes and cardiovascular risk factors

Although many studies have reported an association between serum gamma-glutamyltransferase (GGT) and cardiovascular risk factors, the mechanism of this relationship has not been clarified. The medical records of 29,959 subjects (age, median 48, range 14-90 years; 16,706 men, 13,253 women) who visited the Center for Health Promotion at Samsung Medical Center for a medical check-up between January 2001 and December 2003, were investigated. Subjects with hepatic enzyme/GGT concentrations higher than three times the upper limit of the reference range, a positive test for hepatitis C virus antibody, a positive test for hepatitis B virus surface antigen, currently taking anti-diabetic/anti-hypertensive/anti-lipid medication, or a white blood cell (WBC) count higher than 10,000 cells/ml, were excluded. The subjects of each gender were classified into five groups according to their serum GGT concentrations, into quartiles of the normal range of GGT (groups 1, 2, 3 and 4) and into a group with elevated GGT (group 5). As the group number increased (group 1 --> 5), the frequencies of all of the following increased: (i) diabetes and impaired fasting glucose (IFG); (ii) hypertension, obesity (body mass index > or = 27 kg/m2), dyslipidaemia (LDL-cholesterol > or = 4.1 mmol/l and/or triglyceride > or = 2.46 mmol/l, or HDL-cholesterol < 1.16 mmol/l); (iii) metabolic syndrome. Moreover, these significant relationships between GGT concentrations within its normal range and the presence of diabetes/IFG, hypertension, obesity, dyslipidaemia, and metabolic syndrome persisted after adjusting for several clinical and biochemical variables and for the presence of fatty liver based on ultrasonographic findings. Odds ratios (95% CI) for group 4 (highest quartile of normal range of GGT) vs. group 1 (lowest quartile of normal range of GGT); the referent group, were 3.16 (2.15-4.65) for diabetes, 2.24 (1.73-2.90) for IFG, 1.93 (1.59-2.33) for obesity, 1.38 (1.23-1.55) for dyslipidaemia and 2.88 (2.28-3.65) for metabolic syndrome in men. In women, the odds ratios were 2.72 (1.34-5.52), 3.67 (2.26-5.97), 2.10 (1.61-2.74), 1.80 (1.58-2.04) and 3.57 (2.52-5.07), respectively. Our data show that, even within its normal range, serum GGT concentrations are closely associated with the presence of diabetes and cardiovascular risk factors, and that these associations are independent of a fatty liver by ultrasonography.

Hepatitis C infection among Dutch haemophilia patients: a nationwide cross‐sectional study of prevalence and antiviral treatment

Hepatitis C is a major co-morbidity among patients with haemophilia who received inadequately or non-virus-inactivated clotting factor concentrates before 1992. The objectives of this study were to investigate the prevalence of hepatitis C and the use of antiviral therapies during the last decade among patients with haemophilia in the Netherlands. We performed a cross-sectional study and a questionnaire was sent to all 1519 patients known with haemophilia in the Netherlands between 2001 and 2002. The study population for the present study consisted of 771 patients who had received clotting factor products before 1992 of whom 638 reported their hepatitis C status. In total, 441 of the 638 (68%) patients ever had a positive test for hepatitis C virus (HCV); 344 patients (54%) had a current infection, and 97 (15%) had cleared the virus. Among 344 patients currently HCV infected, 111 (32%) had received treatment for hepatitis C, while 34% (33/97) of patients with an infection in the past had been treated for hepatitis C. In 2002 the prevalence of hepatitis C among patients with haemophilia who received clotting factor products before 1992 was 54%. The majority of patients with a current HCV infection had not been treated with antiviral therapy.

Lack of immunization documentation in Minnesota refugees: challenges for refugee preventive health care.

Children and adults immigrating to the United States without documentation of vaccinations or evidence of immunity should receive age-appropriate immunizations. To learn how often immunization documentation is lacking, we reviewed medical screening records of 1,389 primary refugees over 18 months of age who came Minnesota during 1998. Restricting our analysis to those age groups for whom specific immunizations are recommended, 81.1% of refugees lacked documentation of receiving three doses of diphtheria and tetanus vaccines; 78.8% lacked documentation of one dose of measles vaccine, and 63.8% lacked documentation of three doses of polio vaccine. Of refugees without a known positive test for hepatitis B antigen or antibody, 99.5% lacked documentation of receiving three doses of hepatitis B vaccine. Documentation rates decreased with increasing age, and were lowest for refugees from sub-Saharan Africa (p < 0.001). Refugees and other immigrants may face a number of barriers to receiving necessary immunizations. Health care providers seeing these new arrivals need to ensure that they do fail to receive recommended vaccinations and other preventive health care.

Risk Factors for HTLV-I Among Heterosexual STD Clinic Attenders

Human T-cell lymphotropic virus type 1 (HTLV-I) status was assessed in 994 patients attending a sexually transmitted disease (STD) clinic in Kingston, Jamaica, between November 1990 and January 1991 for a new STD complaint. Of 515 heterosexual men, 36 (7.0%) were HTLV-I seropositive, as were 38 (7.9%) of 479 women. HTLV-I seroprevalence increased with age in women. A history of blood transfusion was associated with HTLV-I in both sexes, significantly so in men [odds ratio (OR) 4.7, confidence interval (CI) 1.1-17 for men; OR 1.9, CI 0.6-5.0 for women]. Further analysis excluded all persons reporting a transfusion. On multiple logistic regression analysis, independent associations with HTLV-I infection in men were shown for marital status (OR 3.5, CI 1.2-10 for married/common law vs. single/visiting unions), agricultural occupation (OR 9.0, CI 2.0-41), bruising during sex (OR 2.9, CI 1.0-8.1), > or = 15 years at first sexual intercourse (OR 2.9, CI 1.0-8.2), and a positive test for hepatitis B surface antigen (OR 7.3, CI 1.2-52). In women, associations were shown for two or more sex partners in the 4 weeks prior to complaint (OR 4.9, CI 1.8-13), 11 or more lifetime sexual partners (OR 5.9, CI 1.3-27), aged < 15 years at first sexual intercourse (OR 2.3, 1.0-5.4), bruising during sex (OR 2.7, CI 1.1-6.6), microhaemagglutination-Treponema pallidum positivity (OR 3.6, CI 1.6-8.4), and human immunodeficiency virus infection (OR 14, CI 2.1-92).(ABSTRACT TRUNCATED AT 250 WORDS)

Renal transplantation is not contraindicated in asymptomatic carriers of hepatitis B surface antigen.

Recent reports showing that the presence of positive tests for hepatitis B surface antigen (HBsAg) is associated with prohibitively high morbidity and mortality suggest that such patients should not be considered for kidney transplantation. The clinical outcome and serology including hepatitis B DNA assays of 11 patients who were HBsAg-positive at the time of transplantation, as well as the hepatic complications in all 200 kidney transplantations during the same period, were analyzed. In the 11 HBsAg-positive patients, no clinical or laboratory evidence suggesting deterioration in liver function over a mean follow-up period of 8.0 +/- 1.7 years was found. Of six patients with fatal or severe chronic liver disease, only one was HBsAg-positive at the time of transplantation and showed no deterioration over 9 years. Two immunosuppressed patients developed anti-HBs antibodies after acute hepatitis B infection. A review of the literature leads to the conclusion that previous reports of poor patient prognosis may represent patients who first showed HBsAg positivity after transplantation or who had preexisting HBsAg-related liver disease. The present findings suggest that asymptomatic patients with positive tests for HBsAg should not be excluded from kidney transplantation programs.

Hepatitis A in Mauritius: an apparent transition from endemic to epidemic transmission patterns.

Between January 1984 and December 1985 a large outbreak of viral hepatitis occurred in the island nation of Mauritius (population 986,000). No hepatitis epidemics had occurred there since the 1930s. The outbreak involved 2428 reported cases; however, reporting levels were thought to be extremely low. All of the island's nine geographical districts were affected, but cases were concentrated in five districts mostly in the central and northern parts of the island. The highest attack rate occurred in children aged five to nine; persons above age 14 were almost unaffected. The male:female ratio of cases was 1.1:1. Evidence to support hepatitis A virus (HAV) as the infecting agent included; (1) clinical illness was compatible with hepatitis A; (2) the age profile of cases was typical for community-wide hepatitis A outbreaks; (3) the rate of positive tests for hepatitis B surface antigen in suspected hepatitis patients did not increase during the outbreak; and (4) nine of nine clinically ill children tested were serum-positive for IgM anti-hepatitis A virus antibody. Transmission was probably by the person-to-person route; no common source was implicated. The outbreak appears to represent a transition from a 40-year pattern of endemic HAV transmission on the island to an epidemic pattern.

Survey of hepatitis B viral markers at a public day school and a residential institution sharing mentally handicapped students.

The prevalence of hepatitis B virus markers was studied among employees and clients at a nonresidential public school for the mentally handicapped and at a privately operated residential facility. In the residential institution, 73 (80%) of 91 clients and 15 (16%) of 92 workers had positive tests for hepatitis B virus markers. Twenty-three clients, including six carriers of hepatitis B surface antigen (subtype ayw), received their education their education at the public school. Only two students (4%) who did not live at the residential institution and one employee (2%) had positive tests for hepatitis B virus markers. One of these students had acute hepatitis B infection, with hepatitis B surface antigen subtype ayw; the subtyping suggested that he had acquired the infection from one of the six carriers from the residential institution. Testing for IgM antibody to hepatitis B core antigen in single serum samples facilitated the identification of acute and chronic hepatitis B infection in children and staff of both facilities. The results show hepatitis B can be transmitted in this setting, and vaccination may be warranted for susceptible students and staff.

Hepatitis B in United States soldiers in Korea.

We studied US soldiers hospitalized in Korea during 1977 because of acute icteric hepatitis. The clinical characteristics of this illness were similar to those noted in previous studies of this population. In contrast to earlier reports, however, hepatitis B virus was shown to be the single most important cause. Of 139 patients with acute viral hepatitis, 76 (55%) had positive tests for hepatitis B surface antigen (HBsAg) and 63 (45%) were HBsAg-negative on a single determination by radioimmunoassay (AUSRIA II) approximately one week after the onset of symptoms. Nonparenteral transmission was the primary mechanism of hepatitis B infection in this sexually active population. Only one patient had evidence of parenteral drug use. Our increased recognition of hepatitis B virus in these patients can be explained entirely by increased sensitivity of the current radioimmunoassay methods for HBsAg. High rates of nonparenteral transmission of B virus within the populations of developing countries are well recognized. Our findings show that hepatitis B virus can be the major cause of nonparenterally acquired acute hepatitis among foreigners in contact with such a population.