Prevention Of Viral Hepatitis Research Articles

Hepatitis B virus infection among illegal drug users in Enugu State, Nigeria: prevalence, immune status, and related risk factors

IntroductionHepatitis B virus infection poses a global health challenge, particularly in low- and middle-income African countries. Illicit drug use exacerbates the problem, with drug users having a higher HBV infection risk and maintaining a quiet transmission pool. This study aimed to determine HBV infection prevalence, immune status, and risk factors among illegal drug users in Enugu State, Nigeria.Materials and methodsA cross-sectional study was conducted in Enugu State, using privileged access interviewer methods to enroll drug users. Pre-tested structured questionnaires were administered after informed consent was obtained. Blood samples were tested for HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb using immunochromatographic rapid test kits. Statistical analysis was performed using SPSS version 25.ResultsOne hundred drug users were recruited into the study. Overall, 7% of the drug users had HBV infection. 61% were found to be susceptible to HBV infection, 15% showed serological evidence of immunity from HBV vaccination and 1% developed natural immunity from HBV exposure. Significant risk factors for HBV infection were age less than 20 years, young age (≤ 20 years) at drug initiation, being single, injecting drugs more than or equal to 20 times per month and injecting with used syringes.ConclusionThis study shows high intermediate endemicity of HBV infection among drug users, low vaccination uptake, and high susceptibility to HBV infection. This calls for the urgent inclusion of drug users in national HBV vaccination campaigns and the adoption of the World Health Organization’s recommendations on the prevention of viral hepatitis among people who inject drugs.

The main directions of prevention of occupational infection viral hepatitis with a contact transmission mechanism in hospitals in Saint-Petersburg

The high level of hepatitis B and C infection in the modern period in the general population increases the frequency of contact of hospital specialists with patients with this infectious pathology. A significant concentration of infection sources in medical organizations and violations in the implementation of disinfection and sterilization algorithms and requirements for hand hygiene of medical workers create conditions for the nosocomial spread of viral hepatitis pathogens with a contact transmission echanism.The aim. Substantiation of the main directions of prevention of occupational infection viral hepatitis with a contact transmission mechanism in hospitals of Saint Petersburg.Materials and methods. A retrospective epidemiological analysis of the annual reports of Saint-Petersburg hospitals was carried out, which contain information on the number of new cases chronic forms of viral hepatitis among specialists of medical organizations and on the number personnel under dispensary supervision for these infectious diseases, as well as on the number of injuries received by hospital staff while performing functional duties, as well as vaccination coverage against viral hepatitis B, measles and diphtheria for the period from 2009 to 2022. The assessment of the equipment of megapolis healthcare institutions modern washing-disinfecting and sterilization equipment was also carried out.Results and discussion. The realization of the possibility of infecting hospital specialists viral hepatitis with a contact transmission mechanism is predetermined by the high concentration of patients with this pathology in healthcare institutions; the presence of occupational injuries during the implementation of medical and diagnostic procedures and disinfection and sterilization measures.Conclusion. A set of measures for early detection of sources of infections with a contact transmission mechanism among patients and staff; disinfection of medical devices using modern disinfection and sterilization equipment; revaccination against hepatitis B and equipping workplaces of specialists with personal protective equipment in full remains relevant for the prevention of occupational infection of medical workers.

Hepatitis A in Adults: Experience from a Moroccan Hospital Center

Background: In children, hepatitis A virus infection is usually symptom-free and provides long-term immunity. However, in changing socio-economic environments, certain adults encounter infection risks, exposing them to symptomatic illness and complications. This study aims to outline the profile of adult hepatitis A patients. Methods: We conducted a retrospective study from 2017 to 2023, involving all patients aged over 14 years who presented with acute hepatitis and tested positive for anti-HAV antibodies. Demographic, laboratory and clinical data were analyzed. Results: The analysis involved 109 cases (mean age 21 +/- 6 years, 57.8% males). All patients were symptomatic. Among them, 71.6% presented with a pseudo-flu-like syndrome, 89% with jaundice, 50.5% with fever and 30.2% with gastrointestinal symptoms. Thirty patients were hospitalized (26.6%), among them one subfulminant was recorded. Clinically, hepatomegaly was found in 8 patients (7.3%). One patient had presented with a skin rash. Serum alanine aminotransferases levels were more than 50 times the normal range in 47.7% of cases, with an average bilirubin level of 89 mg/l. Severe acute hepatitis was observed in 26.6% of patients. Conclusion: Our findings revealed that over 25% of adult patients experienced severe acute hepatitis, with one patient progressing to acute liver failure. These results underline the importance of raising awareness of hygiene practices and prompt a study of the overall seroprevalence of hepatitis in the adult population in order to improve viral hepatitis prevention and control strategies in the country.

Prevention of Viral Hepatitis and HIV Infection among People Who Inject Drugs: A Systematic Review and Meta-Analysis.

This study aimed to explore the current evidence on preventing blood-borne virus infections among people who inject drugs (PWID). We conducted a comprehensive search across three databases (PubMed, Embase, Cochrane Library) for relevant articles published in English between 2014 and 2023. We followed the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines, assessed the quality of the paper using the revised Cochrane Risk of Bias Tool (ROB 2), and conducted a meta-analysis using RevMan 5.3. Completing the harm reduction program (HRP) participation and receiving all three vaccine doses resulted in a 28% reduction in the risk of HBV infection (OR: 0.72, 95% CI: 0.37-1.42). Various interventions increased the willingness of PWIDs to undergo HCV treatment (OR: 5.91, 95% CI: 2.46-14.24) and promoted treatment adherence (OR: 15.04, 95% CI: 2.80-80.61). Taking PrEP, participating in HRP, and modifying risky behaviors were associated with a 33% reduction in the risk of HIV infection (OR: 0.67, 95% CI: 0.61-0.74). Conducting referrals, providing counseling, and implementing antiretroviral therapy resulted in a 44% reduction in the risk of viral transmission (OR: 0.56, 95% CI: 0.47-0.66). Co-infection may potentially compromise effectiveness, so it is important to consider drug resistance.

Measuring sustainability of opioid agonist therapy programs in the context of transition from Global Fund support

BackgroundProgrammatic and financial sustainability of health responses dependent on donor funding has risen as a major concern. In the HIV field in particular, it generated a number of instruments and assessments on sustainability and processes related to donor transition planning. The authors aimed to develop an instrument specific to opioid agonist therapy (OAT) programs as they were addressed only marginally by the HIV-specific assessments.MethodsThe development of the OAT sustainability instrument used desk review of existing HIV sustainability concepts and tools, an International Advisory Board, and piloting to validate the instrument.ResultsThe new OAT sustainability instrument is comprised of the three parts: the conceptual framework, methodological guidelines and a practical implementation tool for assessing the degree of OAT sustainability at the country level. It measures sustainability in the three broad areas for sustainability measuring–Policy & Governance; Finance & Resources; and Services. The selection of indicators and their composites for the three sustainability areas extensively used the United Nations and World Health Organization’s guidance on health system building blocks, on care and HIV and viral hepatitis prevention among people using opioids and for opioid dependence, and the definition of access to health framed by the United Nations Convent on Economic, Social and Cultural Rights. The instrument’s methodological guidelines require the engagement of a national consultant to conduct desk review, key informant interviews and focus groups for measuring discrete milestones and adding qualitative information for interpretation of the data, progress and opportunities. The guidelines advise engaging a country-specific multi-stakeholder advisory group for planning, validation and follow-up of the assessment. The pilot of the instrument in 3 countries in 2020 validated it and required minor adjustments in the instrument. By mid-2023, the instrument has been successfully applied in 5 countries.ConclusionsThe developed instrument enables a comprehensive review of the resilience of OAT programs and their ability to scale up and to inform a roadmap for improved sustainability. While developed in the context of Eastern Europe and Central Asia, it has been reviewed by a global advisory panel and could be easily adapted outside this regional context.

2A2 protein of DHAV-1 induces duck embryo fibroblasts gasdermin E-mediated pyroptosis

The duck hepatitis A virus type 1 (DHAV-1) causes rapid death in ducklings by triggering a severe cytokine storm. Pyroptosis is an inflammatory form of programmed cell death that is directly related to an increase in pro-inflammatory cytokine levels. Only a few studies have explored the mechanisms underlying pyroptosis in virus-infected avian cells. In this study, we established an avian infection model in vitro by infecting duck embryo fibroblasts (DEFs) with the virulent DHAV-1 LY0801 strain. DHAV-1 infection induced pyroptosis in the DEFs by activating gasdermin E (GSDME) protein via caspase-3-mediated cleavage. The genes encoding the different structural and non-structural DHAV-1 proteins were cloned into eukaryotic expression plasmids, and the 2A2 protein was identified as the key protein involved in pyroptosis. The HPLC-tandem mass spectrometry (HPLC-MS/MS) and co-immunoprecipitation (Co-IP) analysis established that DHAV-1 2A2 directly interacted with the mitochondrial anti-viral signaling protein (MAVS) both intracellularly and in vitro. Furthermore, we got the results that N-terminal 1–130 aa of 2A2 was involved in the interaction with MAVS and the C-terminal TM domain of MAVS is necessary for the interaction with 2A2 by Co-IP analysis. To our knowledge, this is the first study to reveal that DHAV-1 protein interacts with host proteins to induce pyroptosis. Our findings provide new insights into the molecular pathogenesis of DHAV-1 infection, and a scientific basis for the prevention and treatment of duck viral hepatitis.

Study of profile of acute viral hepatitis in hospitalized children at a tertiary care center in Gujarat

Background: Viral hepatitis is a significant public health problem throughout the world affecting millions of children. Aims and Objectives: The objective of the study was to determine the profile of acute viral hepatitis (AVH) in pediatric patients admitted in a tertiary care hospital in Gujarat. Materials and Methods: This prospective and hospital-based study was done in a tertiary care hospital in Ahmedabad, Gujarat, India from August 2019 to July 2021. Children up to 14 years of age with AVH who fulfilled the inclusion criteria were included in the study. Results: Mean age of presentation was 8.08 years. Males were more affected than females with male: Female ratio of 2:1. Majority of patients had a history of eating unhygienic food and drinking unsafe water. About 88% were vaccinated for hepatitis B. None of them was vaccinated for hepatitis A. The most common symptoms at presentation were fever (94%), abdominal pain (78%), vomiting (76%), dark colored urine (76%), yellow eyes (73%) and decreased appetite (61%). The most common clinical sign noted was jaundice followed by hepatomegaly. Hepatitis A was the most common etiological agent (86%) followed by hepatitis E (8%). Mixed infection with hepatitis A and E was also seen (4%). There was no mortality. Conclusion: It is very important to create awareness regarding preventive measures such as hygienic food practices, improved sanitation, and increased rates of vaccination for the prevention of viral hepatitis.

Eliminating Viral Hepatitis from India and Southeast Asia by 2030: Challenges and Ways Forward

Abstract This review was conducted to understand the epidemiology of hepatitis in Southeast Asia, examine the current scenario, and suggest a way forward for elimination. A comprehensive desk review was followed by analysis and interpretation. Viral hepatitis fits the criteria for elimination. The availability of safe and effective vaccines against the hepatitis B virus and the effective treatments for the hepatitis C virus makes it possible to eliminate hepatitis. Stepping up interventions such as universal screening, identifying the hotspots, investing in the interventions for elimination, increasing hepatitis testing and linkage to care, attention on adult vaccination, increasing coverage with hepatitis B vaccination for kids, and making hepatitis C treatment available, accessible and affordable are the strategies which need to be expanded. Telemedicine, education and training and hybrid surveillance will help increase access to services for viral hepatitis prevention and treatment. Accelerated efforts to eliminate hepatitis from South East Asia are needed. Key stakeholders need to work together for this agreed goal. The countries need to learn from each other. The primary healthcare approach should be used to achieve the elimination goal.

Interaction between hepatitis B, hepatitis C and smoking in the development of hepatocellular carcinoma: a systematic review and meta-analysis.

This meta-analysis reports the relationship between hepatitis B virus (HBV), hepatitis C virus (HCV), smoking and their combined impact on the development of hepatocellular carcinoma (HCC). We conducted a systematic search of PubMed, Web of Science and Scopus databases up to 15 July 2023. Observational studies investigating the association between HBV, HCV and smoking in the development of HCC were included. We assessed between-study heterogeneity using the I2 statistics. The effect sizes were estimated as odds ratio (OR) with 95% confidence intervals (CIs) using a random-effects model. Out of 20794 studies identified in the initial search, 32 observational studies involving 22282 participants met the inclusion criteria. Our meta-analysis showed that the combined impact of HBV and smoking was associated with an OR of 19.81 (95% CI: 14.77, 26.58), HCV and smoking was associated with an OR of 24.86 (95% CI: 12.41, 49.79), and coinfection of HBV and HCV was associated with an OR of 32.58 (95% CI: 20.57, 51.60). Our findings indicate a significant interaction between HBV, HCV and smoking in the development of HCC and highlight the importance of addressing smoking cessation and viral hepatitis prevention and treatment as potential strategies for reducing HCC.

The elimination of hepatitis D as a public health problem: Needs and challenges.

Infection with hepatitis D virus leads to liver disease and cancer most rapidly of all hepatitis viruses. However, knowledge about hepatitis D remains poor and the burden and impact are underestimated, even though some 12-15 million people mainly in low- and middle-income countries may be affected. Its epidemiology is changing, with increasing migration leading to increased risks of infection and disease. A recent Viral Hepatitis Prevention Board meeting reviewed the current epidemiological status, improvements in diagnostic testing, advances in the development of novel antiviral agents in phase III trials and the need for a greater public health response, such as new guidelines and recommended testing of all people newly identified as infected with hepatitis B virus for hepatitis D virus infection. It identified issues and needs for attention with regard to prevention, diagnosis and treatment.

Knowledge and awareness of viral hepatitis and influencing factors among the general population aged 15–69 years in Zhejiang Province, China

ABSTRACT This study aimed to determine the level of viral hepatitis knowledge as well as the self-awareness of hepatitis B virus surface antigen (HBsAg) positive individuals, to provide data support for the next steps in viral hepatitis prevention and control. We conducted a cross-sectional survey to assess the knowledge of viral hepatitis among the general population aged 15–69 years in Zhejiang Province, China. A total of 3,626 individuals were surveyed with 10 questions. The knowledge level of the participants is reflected by the scores from the survey. Adequate knowledge was defined as a score of ≥ 6. The knowledge rate was defined as the ratio of the number of individuals with adequate knowledge to the total number of individuals. The knowledge rate of viral hepatitis among the general population aged 15–69 years in Zhejiang Province was 52.34% (mean score, 5.23). The majority of participants (52.51%) had adequate knowledge of viral hepatitis. Multiple logistic regression analysis showed that medical staff had the best knowledge of viral hepatitis, followed by individuals with university or higher education, those aged 40–49 years, and those with a history of hepatitis B vaccination. 34.16% of HBsAg positive participants were aware of their infection status before. The mean score of knowledge of viral hepatitis was significantly lower among HBsAg-positive than HBsAg-negative individuals. Knowledge of viral hepatitis in Zhejiang Province was still low, especially among HBsAg-positive individuals with no awareness of their infection status. More effort should be needed to improve public awareness of viral hepatitis.

Viral hepatitis in Asia-Pacific: a post-COVID-19 reset

Viral hepatitis in Asia-Pacific: a post-COVID-19 reset

A Current Management Strategy for Children with Chronic Viral Hepatitis B, Based on International and National Guidelines.

Peculiarities of the course of chronic viral hepatitis B in children cause an important medical and social problem of health care, despite the implementation of modern treatment and prevention protocols. Pathogenetic mechanisms of the development and progression of viral hepatitis B infection, the presence of occult poorly diagnosed form, the impossibility of completely eliminating the virus and the specificity of the immune response in children are still not fully solved scientific problems. The aim of this review is to examine current strategies for the diagnosis and treatment of chronic hepatitis B in children, based on international and national guidelines. A detailed analysis of modern guidelines on the course and pathogenesis of viral hepatitis B infection confirms the fact that chronic hepatitis B is characterised by a complex interaction between the immune system of the virus and the patient, whose dynamic balance is not only responsible for the various phases of chronic viral hepatitis B infection but also leads to the result of antiviral treatment. Despite the introduction of vaccination of children against hepatitis B, the level of viral hepatitis B vaccination of children in Ukraine remains insufficient, which leads to the further spread of the infection. Currently available antiviral drugs can provide functional treatment of viral hepatitis B infection in a limited number of patients, but today's Ukrainian realities have caused a change in approach to the treatment and monitoring of patients, which may negatively affect the implementation of the key goals of the World Health Organization Global Strategy on the prevention, diagnosis and treatment of viral hepatitis.

Impact of COVID-19 pandemic and anti-pandemic measures on tuberculosis, viral hepatitis, HIV/AIDS and malaria-A systematic review.

COVID-19 pandemic puts an enormous strain on health care systems worldwide and may have a detrimental effect on prevention, treatment and outcomes of tuberculosis (TB), viral hepatitis, HIV/AIDS and malaria, whose ending is part of the United Nations 2030 Agenda for Sustainable Development. We conducted a systematic review of scientific and grey literature in order to collect wide-ranging evidence with emphasis on quantification of the projected and actual indirect impacts of COVID-19 on the four infectious diseases with a global focus. We followed PRISMA guidelines and the protocol registered for malaria (CRD42021234974). We searched PubMed, Scopus, preView (last search: January 13, 2021) and websites of main (medical) societies and leading NGOs related to each of the four considered infectious diseases. From modelling studies, we identified the most impactful disruptions; from surveys and other quantitative studies (based e.g. on surveillance or program data), we assessed the actual size of the disruptions. The identified modelling studies warned about under-diagnosis (TB), anti-retroviral therapy interruption/decrease in viral load suppression (HIV), disruptions of insecticide-treated nets (ITN) distribution and access to effective treatment (malaria), and treatment delays and vaccination interruptions (viral hepatitis). The reported disruptions were very heterogeneous both between and within countries. If observed at several points in time, the initial drops (partly dramatic, e.g. TB notifications/cases, or HIV testing volumes decreased up to -80%) were followed by a gradual recovery. However, the often-missing assessment of the changes against the usual pre-pandemic fluctuations hampered the interpretation of less severe ones. Given the recurring waves of the pandemic and the unknown mid- to long-term effects of adaptation and normalisation, the real consequences for the fight against leading infectious diseases will only manifest over the coming years.

MATERNAL DEATHS IN PUNJAB: A 3-YEAR AUDIT FROM A TERTIARY LEVEL GOVERNMENT INSTITUTE

Objective: This study aims to recognize the most common causes and delays in maternal death. Methods: This is an observational study from Government Medical College Amritsar from the period December 2017 to November 2020 which included all cases of maternal death irrespective of gestational age and up to 42 days postpartum. Results: Maternal mortality ratio in our institute during 3-year study period (2018–2020) was 1081 per 100,000 live births. About 90.9% of the maternal deaths were unregistered emergency cases, 11.7% were brought dead, and 33.8% deaths took place within 24 h of admission. Direct obstetric causes were the most common causes of maternal death (49%), while indirect causes were responsible for 42.8% deaths. Hypertensive disorders and hemorrhage were responsible for almost one third cases and severe anemia was an aggravating factor in 31.5%. Maternal deaths were associated with type 1 delay in 57.6%, type 2 delay in 9% cases, and type 3 delay in 21.2%. Conclusion: Hypertensive disorders of pregnancy and obstetric hemorrhage continue to be the leading threats to maternal lives. Improvement in public health services and special campaigns focusing on prevention of viral hepatitis and other infectious diseases can be helpful in decreasing maternal death due to indirect causes. Need of the hour is quality intrapartum and emergency obstetric care at first referral units. Indirect causes of maternal death are a significant public health issue which needs to be addressed.

MODERN METHODS OF TREATMENT OF VIRAL HEPATITIS

This scientific article discusses the causes of viral hepatitis, classification of hepatitis, symptoms, diagnosis of the disease, treatment and prevention of viral hepatitis.

The Future of Pharmacist-Delivered Status-Neutral HIV Prevention and Care.

The Future of Pharmacist-Delivered Status-Neutral HIV Prevention and Care Paul J. Weidle PharmD, MPH, John T. Brooks MD, Sheila Salvant Valentine JD, and Demetre Daskalakis MD, MPH Affiliation Paul J. Weidle, John T. Brooks, Sheila Salvant-Valentine, and Demetre Daskalakis are with the Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD & TB Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Note. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. CopyRightCorrespondence should be sent to Paul J. Weidle, PharmD, MPH, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS USB-5, Atlanta GA, 30329 (e-mail: [email protected]gov). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints” link. CONTRIBUTORS All authors contributed to the writing and provided critical review of the editorial. https://doi.org/10.2105/AJPH.2022.307190 Accepted: November 23, 2022 Published Online: January 05, 2023

A national level survey on knowledge, attitude and practices among Indian nurses on viral hepatitis.

Despite being preventable and treatable, viral hepatitis remains a major public health problem in India. In the line of their duties, nursing professionals are constantly at risk of infection. To combat viral hepatitis, it is essential to ascertain the level of knowledge, attitude, and practices among nursing professionals. A descriptive cross-section study was conducted at a tertiary public hospital, as a nation-wide online survey after ethical clearance and participants' consent. A convenience sampling, from November 2021 to September 2022, yielded a total of 4532 nurses, nursing students and educators. A self-administered 62-item questionnaire on viral hepatitis with four sections: demographic details, knowledge (33-items), attitude (5-items), and practice (24-itmes) was prepared by expert panel and had a content validity and reliability >0.8. The scale was compiled onto the SurveyMonkey app, field tested before administration and widely circulated on email. The response rate of the survey was 77%. Frequency, percentage, and the odds ratio (at 95% confidence interval) were analyzed on SPSS v22.0. Majority were females (87.1%) aged <30 years (60%) with <5 years' experience (57.8%). Almost equal number worked in public or private sector and was holders of diploma (44.5%) or degree (43.8%). Overall poor knowledge (85.3%), unfavorable attitude (86.2%), and unsafe practices (55.6%) were exhibited by nurses; 42.2% encountered needle stick injury last year and 49.8% had never checked Anti-HBs titer. In the event of needle stick injury, 74.78% cleansed with soap and water; used antiseptics or washes (33.5%), placed finger in mouth (5.10%), forced wound bleed (17.3%), scrub wound (17.54%), or apply bandage (12.58%). Multivariate analysis of factors influencing knowledge of viral hepatitis was educational qualification, designation, and type of health facility. As nursing professionals are constantly at risk, there is an urgent need to raise awareness about hepatitis, the post-exposure prophylaxis and vaccination status. Every healthcare facility should include training and capacity building for nurses about risk, prevention, transmission, and management of viral hepatitis, as an integral part of orientation and continuing education on-the-job; follow stringent policies; and set-up mechanisms for monitoring and follow up. Further, policymakers and statutory bodies need to ensure the standards of nursing practice and improve the health of nurses and their patients.

Incidence of Presenting Hepatitis A in the Peja Regional Hospital during 2019–2020

Introduction: Hepatitis is a very common inflammation of the cells of the liver. Hepatitis can be temporary (acute) or long-term (chronic) depending on whether it lasts less than or more than six months. The hepatitis A virus infects humans and some primates and is the cause of infectious hepatitis. Purpose and objectives: Viral hepatitis infections are also present in our country, so the purpose of working on this topic is to expand knowledge in terms of Viral Hepatitis A, Their Epidemiology, and Preventive Measures. Materials and Methods: In the realization of this paper, the method of the literature review was used, in addition, information was presented on the number of patients with viral hepatitis A in the regional hospital of Peja, the Republic of Kosovo for the period 2019/2020. Results: From the results obtained it is clear that the number of patients with Hepatitis A was low and thankfully in non-significant values. However, the fact that the number of Hepatitis B patients is increasing, and especially the increase in the number of Hepatitis C cases, remains a matter of concern, and it is worth noting that care should be taken to prevent the spread of these viruses at a very high rate. Conclusion: Given the risk posed by these infections, the prevention of viral hepatitis requires an organized and ongoing program of education and treatment. Recommended measures for the prevention of viral hepatitis are: Ensuring adequate sanitary and personal hygiene. Drink only water that is controlled, Avoid drinking alcohol, Avoiding any non-particularly recommended medication acetaminophen (Tylenol) and sedatives for 3-12 months because such medications are hepatotoxic, Frequent breaks during the day and a good night's sleep. Eating small, frequent, high-carbohydrate, low-fat meals. Following the guideline for preventing the transmission of the disease to patients and other persons who are not infected, Timely immunization reports all cases of hepatitis to the health department.

Hepatitis B and Hepatitis C in large vehicle drivers in center of Iran (Yazd)

Introduction: Hepatitis B and C are major health problems in many countries, especially developing areas. The frequency of hepatitis B is less than 0.8%, and chronic hepatitis C is less than 0.5% in the general population of Yazd in the center of Iran. Large vehicle drivers have some risk factors for acquiring hepatitis B and C infection. This is important because viral hepatitis complications, including cirrhosis and encephalopathy, may lead to road accidents. This study aims to determine the frequency of hepatitis B and C in large vehicle drivers.&#x0D; Material and Methods:In this cross-sectional descriptive study, 516 inter-province large vehicle drivers were tested for HBS Ag and HCV Ab in 2018. Liver function tests, physical examination, and abdominal sonography were done for all subjects with positive HBS Ag and/or anti- HCV.&#x0D; Results: Eight drivers (1.6%) had HBS Ag, and 7 cases (1.4%) had HCV Ab. There was a significant relation between hepatitis B and journey numbers in the month (P-value=0.048); when the drivers have more journeys, they are at higher risk for hepatitis B. None of the patients had cirrhosis.&#x0D; Conclusion: The hepatitis B and C frequency among large vehicle drivers was 1.6% and 1.4%, respectively. Our findings indicate that hepatitis B and C frequency is significantly higher than in the general Iranian population (P-value=0.014 (. Hepatitis complication such as Cirrhosis and hepatic encephalopathy cause traffic accidents. So prevention, diagnosis, and treatment of viral hepatitis are important in this group.