Prevalence Of Hepatitis C Virus Infection Research Articles

Prevalence of HCV Infection Among Hemodialysis Patients in Lanzhou of Northwestern China

ObjectiveTo investigate the prevalence of hepatitis C virus (HCV) infection among hemodialysis (HD) patients in Lanzhou of Northwestern China, we interviewed 565 patients from five randomly sampled HD centers in Lanzhou with a structured questionnaire including sociodemographic characteristics, past medical history and HD-related factors.MethodsThe testing results of anti-HCV and HCV-RNA in a recent HD from clinical information system were collected. A generalized estimated equation (GEE) logistic regression model was used to identify the determinants of HCV infection among HD patients.ResultsThe prevalence of anti-HCV or HCV-RNA infection among HD patients was 1.77% or 1.42% respectively. GEE model showed that history of kidney transplantation (HCV-RNA: OR=19.79, 95%CI: 12.69–30.85) could dramatically increase the risk of current HCV infection in dialysis patients. Compared with never using of blood products, using of blood products (anti-HCV: OR=2.38, 95%CI: 1.22–4.64; HCV-RNA: OR=15.23, 95%CI: 1.79–129.49) could increase the risk of HCV infection in dialysis patients. Moreover, with the increase of HD duration, the risk increased one time or so (anti-HCV: OR=1.83, 95%CI: 1.22–2.72; HCV-RNA: OR=2.00, 95%CI: 1.11–3.61). Furthermore, dialysis in multiple hospitals possessed more than three times risk of HCV infection (anti-HCV: OR=3.56, 95%CI: 3.11–4.08; HCV-RNA: OR=3.35, 95%CI: 1.88–5.96). Besides, HD patients having the history of acupuncture (HCV-RNA: OR=5.56; 95%CI: 1.16–26.67) or surgery (HCV-RNA: OR=6.39; 95%CI: 2.86–14.29) caused an about-six-times risk of current infections.ConclusionIt could be concluded that the prevalence of HCV infection was mild and using of blood products or kidney transplantation, long dialysis duration, dialysis in multiple hospitals, surgery or acupuncture treatment were some risk factors of HCV infection among HD patients in Lanzhou of Northwestern China.

Screening of Occult Hepatitis B and C Virus Infection in Working Children, Tehran, Iran

Background: Working children are susceptible to infection with various infectious microorganisms. Unfortunately, the difficulties of working children are growing at a remarkable speed worldwide. Objectives: The aim of this research was to determine the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, as well as to evaluate the level of anemia, calcium, and phosphorus in working children. Methods: This cross-sectional research was performed on 370 Iranian and Afghan working children from February 2018 to May 2019. Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), hepatitis B core antibody (HBcAb), and anti-HCV Ab were evaluated using an enzyme-linked immunosorbent assay (ELISA). Furthermore, HCV-RNA and genomic HBV-DNA in the plasma and peripheral blood mononuclear cell (PBMC) specimens of the participants were investigated. The restriction fragment length polymorphism (RFLP) method was used to determine the genotype of HCV, and sequencing was performed to confirm. Results: The mean age of the participants was 10.1 ± 2.1 years (range, 6 - 15 years), and 229 (61.9%) were male. None of the studied children had any detectable HBV-DNA in the plasma and PBMC. The HCV genome was not detected in the plasma of the children, but HCV-RNA was assessed in the PBMC sample of 1 child (0.3%). Therefore, one of the children had occult HCV infection (OCI). The genotype of HCV in this child was subtype 1a. Furthermore, HBsAb was detected in Iranian (41.5%) and Afghan children (40.0%), and 2 (0.54%) of the working children were HBsAg positive. In 3 participants (0.8%), a positive HBcAb test result was noted. Conclusions: The prevalence of HCV and HBV infection in working children in Iran is extremely rare. However, there is a possibility of the presence of OCI in these children.

Epidemiology of Hepatitis C Virus Infection Among High-risk Populations in Northeastern Iran

Background: Chronic hepatitis C virus (HCV) infection affects 58 million people globally. The frequency of HCV infection in the general Iranian population is less than 0.5%; however, a concentrated epidemic was reported among people who use drugs, particularly those with a history of drug injection. Objectives: This cross-sectional study was performed to assess the prevalence of HCV infection among high-risk groups outside of prison in northeastern Iran. Methods: A total of 962 participants in Razavi Khorasan province were enrolled from 2018 to 2022. They included drug users referred to drug treatment and harm reduction centers and individuals with a history of crimes such as drug use or imprisonment who worked in a private industrial unit. Serum anti-HCV antibodies were assessed using a rapid or ELISA kit, and seroreactive samples were confirmed by single-step reverse transcriptase or qualitative real-time polymerase chain reactions. A P-value < 0.05 was considered statistically significant. Results: The mean age of 707 males and 255 females was 39.8 ± 10.2 years. Anti-HCV antibodies were detected from 129 samples (13.41%), of which 117 were available for polymerase chain reaction testing. HCV RNA was detected in 88 cases (75.2%); the total viremia rate was calculated as 9.26% (88/950). Logistic regression analysis revealed that HCV infection among drug users was significantly associated with older age (P = 0.002), being single (P = 0.009), and history of drug injection (P < 0.001) or incarceration (P = 0.04). Conclusions: The findings showed a considerably high prevalence of HCV infection among people who use drugs in northeastern Iran. To achieve the global goal of viral hepatitis elimination by 2030, we strongly recommend stricter screening and treatment of this infection among such hard-to-access populations in Iran.

Prevalence of Hepatitis C Virus Infection, Genotypes and Subtypes in Migrants from Pakistan in Barcelona, Spain.

BackgroundHepatitis C virus (HCV) is a major cause of chronic liver infection with 71 million people infected worldwide. Pakistan has the second highest prevalence of HCV infection and more than half (52%) of Pakistani living in Spain reside in Barcelona. The aim of this study was to analyse the seroprevalence and viraemic rate and determine the genotypes and subtypes of HCV among Pakistanis living in the southern metropolitan area of Barcelona.MethodsWe included all Pakistani patients seeking primary healthcare in the southern metropolitan area of Barcelona from August 2011 to July 2014. Serum samples were screened for HCV antibodies. HCV viral load was determined by reverse transcription polymerase chain reaction and genotypes and subtypes were performed using Versant HCV Genotype and/or deep-sequencing. Screening for hepatitis B virus (HBV) was also carried out.ResultsAmong 5877 Pakistani patients, 565 (9.61%) were screened for anti-HCV antibodies, with 68 (12.04%) being positive. The viral load was determined in 65, with 31 presenting active infection and the viraemic rate was 47.69% (95% confidence interval 36.02–59.62). HCV genotyping and subtyping were performed in 24 individuals. Most infections corresponded to HCV genotype 3 (91.67%), and high resolution HCV subtyping was performed in 18 samples, 16 of which presented subtype 3a. One subject presented HBV coinfection with undetectable HBV DNA. During the study period, we identified a possible case of HCV vertical transmission followed by spontaneous viraemia clearance in a chronically infected mother with a C/T IL28B genetic polymorphism.ConclusionThese results suggest that general HCV screening protocols in patients from high prevalence countries, such as Pakistan, would be helpful to identify and treat active HCV infections. This could avoid further transmission and contribute to building targeted health policies for micro-elimination of HCV infection in specific communities.

Prevalence of HBV, HCV, and HIV Infections among Patients Undergoing Hemodialysis in Fasa, Iran: A Six-Year Follow-up Study.

Background: Hemodialysis (HD) patients are at risk of viral infections such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency viruses (HIV). Current study aimed to determine the prevalence of HBV, HCV, and HIV among HD patients who attended the dialysis center in Fasa, Iran. Methods: Collectively, 2082 HD patients (1291 men, 791 women) took part in our 6-year follow-up study. Results: 2082 HD patients with a mean age of 56.2±17.8 were included in our study. One (0.09%) patient was HBsAg positive, two (0.18%) patients were anti-HCV positive, and one (0.09%) was anti-HIV positive. There was no significant correlation between the paraclinical parameters of men and women. Conclusion: The present study showed a reduction in the prevalence of HBV, HCV, and HIV infections during 6 years of follow-up in HD patients.

Genotype Base Prevalence of Hepatitis C

Hepatitis C virus (HCV) has a positive sense single-stranded enveloped RNA virus. HCV is one of the most common blood-borne diseases causing significant morbidity and mortality globally. HCV causes acute and chronic hepatitis which can eventually lead to permanent liver damage, hepatocellular carcinoma and death. World Health Organization reported that 3 % of the world’s population is suffering from HCV infection that is about 170 million people. The prevalence of chronic HCV infections in Pakistan is about 5%, with very common individuals being infected with HCV genotype 3a prevalence is in the range of 4.1 to 36% reported from various parts of Khyber Pakhtunkhwa Province of Pakistan. This study was carried out in District Mardan Khyber Pakhtunkhwa. A total 1500 HCV suspected individuals visited District Headquarter hospital Mardan during September 2014 to April 2015 were enrolled. HCV antibodies were detected in about 230 patient serums during this screening. Out of these 230 patients 217 patient were further confirmed by qualitative Real Time PCR. All 217 samples were further analyzed for HCV genotyping by PCR based molecular technique. Genotyping results showed that HCV genotype 3a was found in 156 (72%) of the HCV positive isolates, 2a genotype in 22 (10%) and 3b genotype 17 (8%) and remaining 10% were mixed genotype. HCV genotype genotype 3a was declared as the most prevalent genotype with same in both genders that is 72 %. Genotypes 2a, 2b and 3b were more prevalent among male patients while mixed genotype was mostly observed in female infected individuals. Moreover majority of the infected population were form the age group 41-50 year. In 21-30 years age group the most prevalent genotype 3a after than following in competition 3b, in 31-40 years age group 2a 5 (7%), in years age group 41-50 2a 8 (9%) more prevalent. Keywords: Hepatitis C, Genotypes, Pakistan

Antibodies Against Hepatitis C Virus (Anti-HCV) among Hemodialysis Patients in Makkah, Saudi Arabia

Hepatitis C virus (HCV) infection is the most common cause of chronic liver disease in the world and evaluation of the epidemiology of HCV infection was made possible by the development of a serological assay to detect antibodies to epitopes of HCV. Hemodialysis (HD) is considered to be one of the main risk factors of HCV transmission. The prevalence of antibodies to HCV (anti-HCV) in patients undergoing maintenance dialysis therapy (MDT) was found to be one of the highest among different risk groups and there is wide variation in the prevalence of HCV infection among different dialysis units and countries. Therefore, the prevalence of anti-HCV was studied in patients undergoing MDT. The current study is a cross section one, where a sample of 361 HD patients were selected randomly from HD centers in three governmental hospitals in Makkah city and they were subjected to assessment for the prevalence of anti-HCV by using questionnaires in addition to clinical measurements. The overall prevalence of anti-HCV among HD patients was 49.9% according to clinical measurements and questionnaires. The overall prevalence of anti-HCV among HD patients in Makkah city (49.9%) was comparable to that reported from other parts of the Kingdom of Saudi Arabia (KSA) and it is almost similar to the already reported positivity rate of (43.2%) from the eastern region of KSA and southern regions of KSA (45.5%). However, strict adherence to universal precautions as recommended by the Center for Diseases Control (CDC), meticulous regular disinfection of HD machines, strict isolation of HCV-positive patients, dedicated dialysis machines and nursing staff at new dialysis set-up could possibly be the reasons of relatively low anti-HCV positivity at the current study than that reported by Shaheen et al [34], from four centers in the western region of KSA, (72.3%) and that by Huraib et al [29] in their multi-center study in KSA, (68%) as well as the mean national rate. On the other hand, the use of more sensitive third generation enzyme - linked immunosorbent assay (ELISA) technique, long duration on HD, multiple blood transfusions, patients with dialysis treatment in multi-centers, factors related to infrastructure, environment and operational system might be responsible for the high prevalence of anti-HCV found in this study than that reported by Saeed, et al from Riyadh and those observed in the central region of KSA. Although routes of transmission are still unclear, early detection of all infected patients is mandatory for HCV prophylaxis in HD patients. Furthermore, an intensive educational program for staff members, HD patients and proper evaluation of the HD situation are needed. Thus, observation of appropriate preventive measures by all HD-centers is paramount.

Seroprevalence and risk factors of hepatitis C virus infection in a rural area in Gharbia Governorate (Quotour District)

Background Egypt has the largest prevalence of hepatitis C virus (HCV) in the world with 11–14%. So, it is considered one of the most significant public health problems facing this country. Aim The aim was to estimate the prevalence of HCV infection in a rural area in Gharbia Governorate (Quotour District) and identify risk factors affecting the occurrence of hepatitis C infection in such an area. Subjects and methods This cross-sectional study was carried out in a rural area of Gharbia Governorate (Quotour District). A multistage random sample technique was used to recruit the calculated required sample (400), and a specially predesigned validated questionnaire sheet was the tool used for data collection in this study. Results The study revealed that the prevalence of HCV was 13%. The highest percentage of positive HCV infection was among participants aged more than 50 years old, females, unmarried, illiterate, unemployed, heavy smokers, diabetics, and HCV-positive family history. The risk factors of high positivity were in participants receiving clotting factors, and the most significant ones were reported in those visiting dental clinics. Sharing the same tools within the family was common in most participants, especially glucometer usage, which had a significant effect on positive cases. Conclusion The study revealed that HCV prevalence is 13% in Quotour District. Great attention should be paid to this district and other rural areas, and there should be an increase in awareness about HCV infection through health education programs and strict measures for infection control.

Prevalence of hepatitis C virus infection in patients with chronic mental disorders: The relevance of dual disorders

ObjectiveThe prevalence of hepatitis C virus (HCV) infection is higher in people with psychiatric disorders compared to the general population. In addition, patients with severe mental illness are frequently affected by substance abuse, which increases the risk of blood-borne viral infections. Epidemiological studies in samples of hospitalised individuals with chronic mental disorders and dual diagnosis (DD) are lacking. The objective of this study was to investigate the prevalence of HCV infection in a sample of in-patients with severe mental illness. Patients and methodsThis was a retrospective observational study. All patients meeting selection criteria admitted to the Medium-Term Psychiatric Unit of the University of Salamanca Health Care Complex between 2007 and 2018 were included. The primary endpoint was the prevalence of HCV infection. The secondary endpoint comprised the characteristics influencing the occurrence of HCV infection in these patients. ResultsA total of 497 admissions were included and patients’ last admission data were considered for analyses (n=345). The overall prevalence of HCV infection was 3.8% and reached 14.3% among DD patients, who showed a higher prevalence than those without this condition (14.3% versus 3.1%, p=0.009). HCV RNA was detected in 6 individuals at diagnosis who received DAA treatment reaching sustained virological response. ConclusionsThe prevalence of HCV infection in our sample was higher than in the general population, especially among DD patients. Despite the multiple barriers to access healthcare by patients with chronic mental illness, efforts to include this population in screening and treatment are mandatory.

Another Step Toward Hepatitis C Elimination: An Economic Evaluation of an Irish National Birth Cohort Testing Program

ObjectivesWe aimed to evaluate the cost-effectiveness of offering once-off birth cohort testing for hepatitis C virus (HCV) to people in Ireland born between 1965 and 1985, the cohort with the highest reported prevalence of undiagnosed chronic HCV infection. MethodsSystematic and opportunistic HCV birth cohort testing programs, implemented over a 4-year timeframe, were compared with the current practice of population risk-based testing only in a closed-cohort decision tree and Markov model hybrid over a lifetime time horizon. Outcomes were expressed in quality-adjusted life-years (QALYs). Costs were presented from the health system’s perspective in 2020 euro (€). Uncertainty was assessed via deterministic, probabilistic, scenario, and threshold analyses. ResultsIn the base case, systematic testing yielded the largest cost and health benefits, followed by opportunistic testing and risk-based testing. Compared with risk-based testing, the incremental cost-effectiveness ratio for opportunistic testing was €14 586 (95% confidence interval €4185-€33 527) per QALY gained. Compared with opportunistic testing, the incremental cost-effectiveness ratio for systematic testing was €16 827 (95% confidence interval €5106-€38 843) per QALY gained. These findings were robust across a range of sensitivity analyses. ConclusionsBoth systematic and opportunistic birth cohort testing would be considered an efficient use of resources, but systematic testing was the optimal strategy at willingness-to-pay threshold values typically used in Ireland. Although cost-effective, any decision to introduce birth cohort testing for HCV (in Ireland or elsewhere) must be balanced with considerations regarding the feasibility and budget impact of implementing a national testing program given high initial costs and resource use.

Evaluation of Incidence, Genotypes, and Risk Factors Associated with Newly Diagnosed Hepatitis C Cases in Khyber Pakhtunkhwa (KPK), Pakistan

Hepatitis C is a global health concern brought on by the hepatitis C virus (HCV). The risk factors of the disease include injection drug users, contaminated medical instruments, blood transfusion, organ transplant, major surgery, dialysis, dental surgery, and acupuncture. The aim of the current study was to identify the prevalence of active HCV infection, genotypes, and their associated risk factors in newly infected patients of Khyber Pakhtunkhwa (KPK), Pakistan. A total of 230 HCV cases and 245 control subjects were enrolled. Our findings revealed that disease infection rates were higher in female patients (52.6%) than male patients (47.4%). Moreover, the disease was more prevalent in the age group 30–40 years (39.6%). The highest incidence was found in the southern region (51.30%), followed by the northern region (27.82%), and central region (18.26%). In our data set, dental surgery, major surgery, disease in family, barber community, blood received, needles, abroad travel, injection drug users, acupuncture, and organ transplantation were determined as the major associated risk factors of the disease. Odds ratio were significantly higher (10.91%) for those who used acupuncture as compared to those who did not. Similarly, odds were significantly higher (10.03%) for those who had HCV in their family, dialysis (9.377%), dental surgery (7.618%), major surgery (6.813%), barber community (5.328%), and blood received (2.252%) as compared to the control group. Also, the most frequent genotype was 3a (63%), followed by an un-typeable genotype (11.30%).

Study the response of Qurevo (ombitasvir, paritaprevir, and ritonavir) in end-stage renal disease patients with hepatitis C virus

BackgroundOut of the 185 million people infected with hepatitis C virus (HCV) worldwide according to the World Health Organization (WHO), Egypt had the highest prevalence of HCV reaching 13% of its population with an estimated number of 12 million people. The prevalence of HCV infection among hemodialysis (HD) patients ranged from 6 to 60%. HD patients have an increased overall mortality risk if they have chronic HCV when compared to those without HCV infection. Treatment of HCV with the new direct-acting antiviral agent (DAA) therapy Qurevo “ombitasvir/paritaprevir/ritonavir” with ribavirin in ESRD was approved in many countries compared to traditional HCV treatment that faced restrictions in the setting of chronic kidney disease (CKD).Aim of the studyTo evaluate the efficacy and safety of Qurevo/ribavirin regimen in HCV-infected HD patients.Patients and methodsA prospective cohort study evaluated the outcome of 12-week ombitasvir (NS5A inhibitor)/paritaprevir (NS3/4A protease inhibitor)/ritonavir with ribavirin combination therapy for 50 HCV-infected HD patients, over a period of 15 months from December 2016 to February 2018. The primary endpoint was sustained virologic response 12 weeks after therapy (SVR12) and after 24 weeks of therapy (SVR24).ResultsThe SVR12 rate was 96% (48/50); 2 patients (4%) were non-responders to treatment at SVR12, and another 2 (4%) were relapsers after SVR12. As regards the adverse events, the most frequent were fatigue/asthenia in 44 patients (88%) and worsening anemia (Hb dropped to < 10 g/dl) in 42 patients (84%). GIT upset occurred in 10 patients (20%), sleep disorders in 8 patients (16%), decreased appetite in 8 patients (16%), respiratory distress in 6 patients (12%), headache and dizziness in 6 patients (12%), and muscle spasms in 4 patients (8%). Itching (pruritus) occurred in 3 patients (6%). Death occurred in 4 patients (8%) after SVR24 most probably not due to DAA but may be due to myocardial infarction, pulmonary edema, severe hypotension on hemodialysis sessions, and shock due to blood loss in retroperitoneal hematoma following peritoneal dialysis not related to DAA therapy. Hepatic decompensation, hypersensitivity (angioedema), teratogenicity, and drug interactions did not occur in any patient (0%). Other events occurred in 11 patients (22%). They were parenchymal liver changes in ultrasound at the end of therapy after being normal before therapy (in 3 patients), thrombocytopenia, increased alkaline phosphatase, hiccough, deterioration of hypertension, urinary tract infection, lower limb cellulitis, vaginal bleeding, and chest infection (in 1 patient each). SVR12 was achieved in 100% of patients who had to stop or modify the ribavirin dose; this means that ribavirin absence did not affect the SVR in these patients.ConclusionOur results confirm the efficacy of Qurevo “ombitasvir/paritaprevir/ritonavir” with ribavirin combination therapy in ESRD patients (on regular hemodialysis) with HCV infection with anemia as the most frequent adverse event.

The Burden of Hepatitis B, Hepatitis C, and Human Immunodeficiency Viruses in Ovarian Cancer Patients in Nairobi, Kenya

Ovarian cancer (OC) is a gynecological malignancy characterized by high morbidity and mortalities due to late-stage diagnosis because accurate early diagnostic biomarkers are lacking. Testing of Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Human immunodeficiency virus (HIV) infections in OC patients is pertinent in light of the emerging evidence of their contribution to poor prognosis. We, for the first time, investigated the prevalence of HBV, HCV, and HIV infections in a Kenyan cohort of OC to inform optimal management. We recruited a cohort of women above 18 years of age, comprising 86 OC patients and 50 healthy controls. Participants’ blood samples were serologically screened for HBV, HCV, and HIV. We found seroprevalence rates of 29.1%, 26.7%, and 1.2% for HBV, HIV, and HCV, respectively, in OC patients. The healthy control group had HBV and HIV seroprevalence rates of 3.9% for each with no positive HCV case. HBV/HIV coinfection was noted only in the OC group with a positivity rate of 17.4%. In summary, we found higher HBV and HIV seroprevalence in Kenyan OC patients compared to the healthy control group, whereas HCV prevalence was reflective of the general population. Hence, we recommend screening for HBV and HIV among OC patients destined for anticancer treatment.

Epidemiology of hepatitis B virus and/or hepatitis C virus infections among people living with human immunodeficiency virus in Africa: A systematic review and meta-analysis.

Due to their common routes of transmission, human immunodeficiency virus (HIV) coinfection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) has become a major public health problem worldwide, particularly in Africa, where these viruses are endemic. Few systematic reviews report the epidemiological data of HBV and/or HCV coinfection with HIV in Africa, and none provided data on the case fatality rate (CFR) associated with this coinfection. This study was conducted to investigate the prevalence and case fatality rate of HBV and/or HCV infections among people living with human immunodeficiency virus (PLHIV) in Africa. We conducted a systematic review of published articles in PubMed, Web of Science, African Journal Online, and African Index Medicus up to January 2022. Manual searches of references from retrieved articles and grey literature were also performed. The meta-analysis was performed using a random-effects model. Sources of heterogeneity were investigated using subgroup analysis, while funnel plots and Egger tests were performed to assess publication bias. Of the 4388 articles retrieved from the databases, 314 studies met all the inclusion criteria. The overall HBV case fatality rate estimate was 4.4% (95% CI; 0.7-10.3). The overall seroprevalences of HBV infection, HCV infection, and HBV/HCV coinfection in PLHIV were 10.5% [95% CI = 9.6-11.3], 5.4% [95% CI = 4.6-6.2], and 0.7% [95% CI = 0.3-1.0], respectively. The pooled seroprevalences of current HBsAg, current HBeAg, and acute HBV infection among PLHIV were 10.7% [95% CI = 9.8-11.6], 7.0% [95% CI = 4.7-9.7], and 3.6% [95% CI = 0.0-11.0], respectively. Based on HBV-DNA and HCV-RNA detection, the seroprevalences of HBV and HCV infection in PLHIV were 17.1% [95% CI = 11.5-23.7] and 2.5% [95% CI = 0.9-4.6], respectively. Subgroup analysis showed substantial heterogeneity. In Africa, the prevalence of hepatotropic viruses, particularly HBV and HCV, is high in PLHIV, which increases the case fatality rate. African public health programs should emphasize the need to apply and comply with WHO guidelines on viral hepatitis screening and treatment in HIV-coinfected patients. PROSPERO, CRD42021237795.

Hepatitis C Virus Epidemiology in Lithuania: Situation before Introduction of the National Screening Programme.

In 2022, the Lithuanian health authorities decided to pay general practitioners a fee for performing serological tests for hepatitis C virus (HCV) antibodies in the population born from 1945 to 1994 once per life and annual HCV testing for PWID and HIV infected patients. This study aimed to assess trends in HCV-related mortality in the country and the prevalence of HCV infection among patients with liver diseases and evaluate possibilities of screening for HCV infection at a primary health care center. Age-standardized mortality rates in 2010–2020 were calculated for deaths caused by chronic hepatitis C and some liver diseases. Data on HCV infection among patients with liver cirrhosis, cancer and transplant patients were collected from the tertiary care hospital Kauno Klinikos. The prevalence of anti-HCV and risk factors of HCV infection was assessed among patients registered with the health care center in Klaipeda, where a pilot study of screening was performed. No steady trend in mortality was observed. Analysis of medical documentation showed that 40.5% of patients with liver cirrhosis, 49.7% with cancers and 36.9% of transplant patients were HCV infected. Over the year, 4867 patients were screened in the primary health care center. Positive anti-HCV prevalence was 1.7% (2.1% in men and 1.3% in women). Blood transfusion and being a blood donor before 1993 also having tattoos were associated with higher odds of HCV infection. The study revealed the active participation of individuals in HCV screening.

Worldwide prevalence of hepatitis B virus and hepatitis C virus among patients with cirrhosis at country, region, and global levels: a systematic review

SummaryBackgroundEmpirical, updated country-level estimates on the proportion of cirrhosis attributable to viral hepatitis are required. We estimated the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in patients with cirrhosis at country, regional, and global levels as an approximation for the fractions of cirrhosis attributable to viral hepatitis.MethodsIn this systematic review, we searched MEDLINE, Embase, Web of Science, and Scielo between Jan 1, 1993, and Aug 1, 2021. Studies were eligible if they reported on the prevalence of both HBV and HCV infection in representative studies of at least 20 patients with cirrhosis. Studies were excluded if they used first-generation HCV assays or were from a selected population of patients with cirrhosis (eg, patients selected based on specific causes, veterans, injecting drug users). Two authors (CJA and CdM) selected and extracted aggregated data from the selected publications. Data were extracted for study recruitment period, age, sex, and cause of cirrhosis, among others. Data about heavy alcohol consumption and non-alcoholic fatty liver disease (NAFLD) were also extracted when available. Aggregated data from studies from key publications were requested from the authors of the original study if selection of patients was unclear or information on causes was missing. We estimated the country-specific prevalence of causes of cirrhosis by pooling study-level data from the same country using a random-effects model. Subsequently, we estimated the regional (WHO region and UN subregion) and global prevalence by weighting the country-specific prevalence by the number of new liver cancer cases that occurred in 2020, as estimated in GLOBOCAN. The study was registered with PROSPERO, CRD42020149323.FindingsOur database searches identified 21 338 records, and a further nine records were identified by scanning references of key publications. After excluding duplicates and assessing full-text articles for eligibility, 520 publications from 86 countries or territories (and reporting on 1 376 503 patients with cirrhosis) were included in the systematic review. The prevalence of HBV infection was lower among patients with cirrhosis in Europe, the Americas, and Oceania (UN subregional prevalence ranges 3–14%) than in Africa and Asia (8–61%). HCV infection prevalence was heterogenous, even within regions (12–83%). The combined prevalence of HBV and HCV infection exceeded 50% in most Asian and African regions. Globally, among patients with cirrhosis, 42% had HBV infection and 21% had HCV infection. The contribution of heavy alcohol use was highest in Europe (country range 16–78%), the Americas (17–52%), and Oceania (15–37%) and lowest in Asia (0–41%). Data on NAFLD were limited.InterpretationHBV and HCV could account for almost two thirds of the global burden of cirrhosis. With the availability of effective interventions for the prevention or treatment of HBV and HCV, the data presented in this study will help to effectively allocate resources towards viral hepatitis elimination and to design interventions at the country level.FundingInternational Agency for Research on Cancer, World Health Organization.

Hepatitis C virus (HCV) infection among patients with sickle cell disease at the Korle-Bu teaching hospital

BackgroundHepatitis C virus (HCV) infection is a blood borne infection that remains potentially transmissible through blood transfusions. Sickle cell disease (SCD) is a common inheritable haemoglobinopathy in Ghana that requires multiple blood transfusions as part of its management. The SCD patient is therefore at a high risk of HCV infection; however, data on the occurrence of HCV in SCD patients has not been documented in Ghana. This study sought to determine the prevalence and genotypes of HCV infection in SCD patients.Materials and methodsThis was a cross-sectional study which enrolled 141 sickle-cell disease patients from the Ghana Institute for Clinical Genetics, Korle-Bu Teaching Hospital (KBTH). Patient information was obtained through a structured questionnaire. Aliquots of the plasma obtained was used for both serology with Advanced Quality Rapid Anti-HCV Test Strip and molecular testing by RT-PCR with primers targeting the HCV core gene. The amplified DNA were purified and subjected to phylogenetic analysis to characterize HCV genotypes.ResultsTwelve (9%) out of the 141 patients were sero-positive for HCV total antibodies. HCV RNA was amplified from 8 (6%) out of the total number of patients’ samples. One of the 12 sero-positives was HCV RNA positive. Five (63%) out of the 8 HCV RNA positive samples were successfully sequenced. The phylogenetic tree constructed with the study and GenBank reference sequences, clustered all five study sequences into HCV genotype 1.ConclusionThe HCV seroprevalence of 9% among sickle cell disease patients is higher than reported for the general Ghanaian population which is 3%. Genotype 1 is the common HCV genotype infecting SCD patients. Sickle cell disease is likely to be a high-risk group for HCV inapparent infections in Ghana as seroprevalence does not correlate with viremia. However, even with higher seroprevalence, the group must be given priority in resource allocation for preventive, diagnostic and therapeutic strategies.

An Easy-to-Implement Risk Score for Targeted Hepatitis C Virus Testing in the General Population.

ABSTRACTDespite the effectiveness of available treatments, hepatitis C virus (HCV) remains a major public health problem, mainly due to the high percentage of undiagnosed individuals. We aim to create an easy-to-implement risk score to facilitate targeted HCV testing in the general population. This is a substudy derived from a prospective study in primary care in Madrid (Spain). Participants completed a 21-question risk assessment questionnaire, followed by HCV testing for those with at least one positive response and those >50 years of age, even if they did not answer positively. We used the population >50 years of age to fit a logistic regression model to create a score predicting the risk of a positive test result. We then performed a sensitivity analysis by applying the score obtained to the population <50 years of age, to assess its diagnostic accuracy. Data collected from 2,302 participants were included in the analysis. The prevalence of HCV infection was 1.3%. Five items were selected, showing a C-statistic of 0.896, i.e., male sex, Eastern European origin, use of intravenous drugs, self-perceived risk of acquired HCV infection, and past hepatitis or unexplained liver disease. The sensitivity was 98%, and the negative likelihood ratio was 0.05 for participants with scores of 0 (49.8% in our sample), ruling out HCV infection with high probability. We obtained similar estimates in the population <50 years of age. This tool achieved high diagnostic accuracy to target HCV testing. This could help optimize resources when universal screening is not feasible.IMPORTANCE Despite the highly effective treatments currently available, HCV remains one of the major public health problems related to an infectious agent, mainly because a high percentage of individuals remain undiagnosed. Universal screening has been proposed as a way to end this epidemic; however, it is not feasible in all settings due to different implementation barriers. With this work, we aim to collaborate in improving the diagnosis of HCV infection by creating a simple 5-item score that rules out HCV infection with a very high probability. Almost one-half of the participants in our sample did not present any affirmative answers to these questions, and their probability of being infected was close to 0%. This tool could be a useful strategy and could be considered a cost-effective alternative to optimize resources when universal screening is not feasible.

Analysis of drug-related infectious diseases in people who inject drugs - Pilsen Region, 2003-2018.

The aim of the study is to analyse drug-related infectious diseases (DRID) rates for people who inject drugs (PWID) in the Pilsen Region in order to identify the main determiners of infection risk and also to provide a foundation for comparison between this region and the others in the Czech Republic. In a descriptive cross-sectional study, we analysed the Pilsen Region's data on PWID. The data was transcribed from the 2003 to 2018 internal database of the Ulice Outreach Programme. In addition to the data regarding the testing of DRID, we analysed commercial sex work (CSW) and the PWID's duration of drug use, age and current address. The statistical analysis was performed using SPSS, primarily employing logistic regression (i.e., backward elimination method) to explore predictors of seropositivity. Moreover, we calculated its prevalence from an epidemiological perspective. In total, 384 PWID were tested, from which 54.7% were males, and 84.1% were from Pilsen. The average age for initiation of using drug was 19.37 years. The most used drug was methamphetamine (64.8%), 77 women (20.1%) were reported to be CSW. The prevalence of DRID was as follows: hepatitis C virus (HCV) 37.24%, syphilis 1.82%, hepatitis B virus (HBV) 0.78%, and HIV infection 0.26%. The analysis showed that men had a lower risk of syphilis than women. Individuals who started their drug use via injection had a 1.365-times higher risk of DRID in comparison to those who initiated intravenous drug use later in their drug-using lives. We identified a significant association between the drug type and the risk of HCV infection: the main predictor of seropositivity was the use of fentanyl, which posed a 1.930-times higher risk than in the case of methamphetamine. This study is the first descriptive cross-sectional study implemented in the Pilsen Region in the Czech Republic with a focus on the subpopulation of PWID with individual data. A high prevalence of HCV infection still persists but the prevalence of HBV and HIV infections in this study (and generally in the Czech Republic) is relatively low compared to foreign studies. Syphilis is not closely associated with injecting-drug use, but rather with the sexual behaviour of the people who use drugs intravenously. The most important predictor of seropositivity for syphilis was CSW. We also found the duration of being a CSW to be significant influence. The women who had been CSWs for less than 5 years had a significantly lower risk of syphilis than those who had prostituted for more than 5 years.

The prevalence of hepatitis C and hepatitis B in lesbian, gay, bisexual and transgender populations: a systematic review and meta-analysis

ObjectivesThis study aimed to systematically review the literature on the prevalence of hepatitis C virus (HCV) and hepatitis B virus (HBV) infections in transgender and LGBT people and determine their pooled estimates worldwide.MethodsDatabases (PubMed, Scopus, Web of Science, Embase, Ovid, Cochrane, PsycInfo) were searched from April 2000 to July 2021. The analyses were executed using the random-effects model in Stata 16.ResultsTen studies, including eight studies on four transgender people and two studies on 2150 LGBTs, were included. The pooled prevalence of HCV and HBV in all transgender populations globally were 9% (95% CI 3–15%) and 11% (95% CI 2–20%), respectively. The corresponding prevalence in male-to-female transgender people were estimated as 5% (95% CI 1–9%) and 6% (95% CI 3–10%), respectively. These estimates in American transgenders were 10% (95% CI 5–25%) and 16% (95% CI 8–23%), respectively.ConclusionThis study was identified the overall prevalence of HBV and HCV infections in transgender people, which were higher than those in the general population.