Risk Factors For HCV Infection Research Articles

Genetic Polymorphisms of the IFNLR1 Gene Correlate with HCV Infection and Biochemical Features of Chronic HCV Patients in Yunnan, China

ABSTRACTHepatitis C virus (HCV) infection could lead to serious liver diseases, but the pathogenic mechanisms were not completely clear. Cytokines play critical roles in infection, and the genetic polymorphisms in the cytokine genes are widely studied in infectious diseases. The variations in the IL28B gene were associated with HCV infection, viral clearance, and biochemical features of patients, but the studies of its receptor (IFNLR1/IL10RB) were rare. In this study, we collected 395 chronic HCV patients and 397 normal controls to investigate the genetic role of the IFNLR1 gene. Eight tagSNPs were genotyped, and the haplotypes were constructed. Genotypes CT (23.80% vs. 17.13%) and TT (75.19% vs. 81.36%) of rs7532146 showed higher and lower frequencies in HCV patients than that in controls (P = .022; P = .039). Haplotypes GGAATCTC (P = .028) and AAAGCCCT (P = .002) were risk factors for HCV infection, but haplotype GAAATCTT (P = .027) played protective role in HCV infection. Moreover, we identified that the ALT level was significantly lower in HCV patients with genotype TT of rs4489498 than those with other genotypes (CC vs. TT: P = .037; CT vs. TT: P = .013). HCV viral load was highest in HCV patients with genotype CC of rs4489498 than in patients with other two genotypes (CC vs. CT: P = .006; CC vs. TT: P = .039). In conclusion, the genotypes and haplotypes in the IFNLR1 gene were associated with HCV infection and biochemical features of Chinese HCV patients.

HCV genotype 6 prevalence, spontaneous clearance and diversity among elderly members of the Li ethnic minority in Baisha County, China.

The epidemiology of hepatitis C virus varies widely across geographical regions and ethnic groups. Our previous study showed that 6 strains isolated from Baisha County, Hainan Island, China, were all new genotype 6 (gt6) subtypes which differed significantly from subtypes of other regions. In the current study, we conducted a comprehensive epidemiological survey of HCV in the Li ethnic group, native to Baisha County. Anti-HCV antibodies were detected by 2 independent ELISAs in all participants, and positive results confirmed by the recombinant immunoblot assay (RIBA) and HCV RNA viral loads were measured. Univariate chi-square test and multivariable logistic regression analyses were used to determine the risk factors for HCV infection and spontaneous clearance rates. Indeterminate RIBA results were excluded or included in analyses; consequently, findings were expressed as a range. Direct sequencing of partial regions within NS5B and E1 was employed for genotyping. Among 1682 participants, 117 to 153 were anti-HCV positive (7.0%-9.1%), with 42.7%-52.6% confirmed to have cleared infection. Anti-HCV positivity was associated with older age (≥60years) (OR=0.02, 95% CI 0.01-0.05, P<0.01) and surgery (OR=2.75, 95% CI 1.36-5.57, P<0.01), with no significant difference found between the HCV infection group and the HCV spontaneous clearance group. The gt6 subtype distribution characteristics of Baisha County were unique, complex and diverse. The sequences did not cluster with known gt6 subtypes but formed 4 Baisha community-specific groups. HCV infection in members of the Li minority ethnic group is characterized by high prevalence rates in the elderly, high spontaneous clearance rates and broad gt6 diversity.

The risks of HCV infection among Brazilian crack cocaine users: incorporating diagnostic test uncertainty

Despite the initiative by WHO and other international organizations to eliminate HCV in the medium term, hepatitis C infection is still a major public health problem. Even non-injecting drugs users who engage in harmful or addictive drug use are at greater risk of acquiring the infection, when compared to the general population. This study evaluate risk factors for HCV infection in users of crack/cocaine in Brazil, using multilevel models that incorporate variations in the sensitivity and specificity of the respective diagnostic tests. The sample included all the participants of a national survey on street crack cocaine users with serologically reactive result in the rapid test for the HCV as well as 4 non-reactive controls, matched by sex, age category, and major geographic region of residence. Multilevel logistic regression models were used, with and without incorporation of the diagnostic test’s sensitivity and specificity values. The odds of HCV infection were 85% higher among polydrug users, 7.81 times higher among injecting drug users, and 3.69 times higher in those reporting to have genital ulcers. Statistical modeling strategies that incorporate the sensitivity and specificity of diagnostic tests in challenging settings are useful for studying the association between risk factors and infection status.

2225. Acute Hepatitis C Virus Infections in HIV-Infected Persons in the Era of Direct-Acting Antiviral Therapy

BackgroundAcute hepatitis C (HCV) infection can be sexually transmitted in HIV-infected men who have sex with men (MSM). Since 2014, direct-acting antivirals (DAA) have successfully cured many persons with chronic HCV infection. We examined the incidence of acute HCV infection in HIV-infected persons before and after the widespread use of DAA therapy.MethodsWe used the HIV Atlanta Veterans Affairs Cohort Study (HAVACS) to examine the incident rate (IR) of acute HCV infections during the period of 01 January 2013 to 31 December 2013 (pre-DAA era) and in the post-DAA era (January 1, 2017 to December 31, 2017). Acute HCV infection was identified using HCV seroconversion or HCV viremia with a negative HCV antibody. We also describe the demographic, clinical characteristics, and virologic outcomes of acute HCV infection cases observed since 2014.ResultsIn the pre-DAA era, 56 cases of acute HCV were seen among 1,378 persons (IR: 40.6 per 1000). In the post-DAA era, 29 cases were seen among 1,433 persons (IR: 20.2 per 1,000). HAVACS persons seen in 2017 were 52% less likely to be diagnosed with acute HCV infection than those seen in 2013. Of the seven acute HCV cases examined in detail, the median age is 41 years (range 33–60 years). All cases were male and African American race. Two persons had active IV drug use in addition to unprotected anal intercourse as a risk factor for HCV infection. The median CD4 just prior to HCV infection was 753 cells/cm2 (range: 590–1,046 cells/cm2). One person had a detectable HIV viral load (527 copies/mL) just prior to HCV infection while the other 6 persons had undetectable HIV viral loads. The peak AST ranged from 147 to 1,256 IU/L (median: 798 IU/L) while the peak ALT ranged from 171 to 1,530 IU/L (median: 855 IU/L). The median total bilirubin is 3.5 mg/dL. One person spontaneously cleared his HCV infection, two were treated with DAA therapy, and the other four are under active monitoring.ConclusionAcute HCV infections have significantly decreased in HIV-infected persons in the DAA era. However, acute HCV infections can cause severe transaminitis and jaundice. More work is needed to prevent HCV infections in HIV-infected persons.Disclosures All authors: No reported disclosures.

Hepcare europe: Hepcheck; reaching vulnerable populations

Introduction: HepCare Europe is a three year EU funded project involving collaboration with four member states. The vision for the project is to create an innovative, integrated system for Hepatitis C HCV testing & treatment among key ‘at-risk’ groups, including people who inject drugs PWID’s and the homeless, through outreach to the community and integration of primary and secondary care services. With clinical sites in Dublin, London, Seville and Bucharest, and economic evaluation in Bristol UK, the consortium has developed a number of work packages focused on operationalizing the multiple components of testing, care and cure that are key components of the strategy to eradicate HCV in the European Union. Consortium members include UCD Ireland SAS Spain SVB Romania University of Bristol UK and University College London UK Theory/Method: The HepCheck component of the project offered screening across the four clinical sites in Dublin, London, Seville and Bucharest. Point of care testing was offered to ‘at- risk’ groups who are frequently marginalized with respect to health service engagement. Screening was conducted in prisons, opioid substitution treatment clinics and in homeless services. Results: A total of 1,749 individuals were screened, 31.2 % n=559 tested HCV antibody positive. To date 40% n= 222 individuals have attended a specialist appointment for HCV treatment. In-depth analysis of the data is ongoing including identification of risk factors for HCV infection, levels of HCV related liver disease, prevalence of blood borne viruses and linkage to care. Discussion: In order to achieve World Health Organisation WHO HCV elimination targets by 2030 we need to identify and successfully treat the most vulnerable HCV individuals in the community. Conclusion: Community based screening intervention can enhance HCV diagnosis for at risk populations but referrals to/ attendance at secondary care remains a challenge for this cohort. Lessons Learned: The HepCheck data highlights the potential for developing interventions to enhance engagement with HCV screening and entry to the cascade of care required to cure HCV. Suggestions for future Research: Based on the findings of this study further research is required to develop community based interventions to ensure that the most vulnerable populations are engaged with the HCV care pathway and have the opportunity of treatment and cure.

Update on Transmission Modes of Hepatitis C Virus Among Volunteer Iranian Blood Donors: Analysis of a Matched Case-Control Study by Penalized Conditional Logistic Regression

Background: Reducing the risk of transfusion transmitted infections (TTI) is one of the main concerns of blood transfusion systems. Evaluation of HCV risk factors in HCV infected blood donors is critical for donor selection and ensuring blood safety. The aim of this study was to evaluate known and putative risk factors of HCV infection in Iranian blood donors. Methods: This matched case-control study was conducted on serologically confirmed HCV positive blood donors (cases) and serologically negative HCV blood donors came back to Iranian Blood Transfusion centers over the country from November 2015 to May 2017. Cases and controls were matched by donation status and interviewed for demographic, medical, and risk histories. Penalized conditional logistic regression model with backward selection method was used in data analysis. STATA software version 13 was used for statistical analysis. Results: A total of 271 cases and 794 controls were interviewed. Age (AOR (5 year), 1.27; 1.13 - 1.42), intravenous drug abuse (AOR, 24.89; 10.2 - 60.82), religious self-flagellation (AOR, 7.02; 2.02 - 24.4), non-injecting drug abuse (AOR, 6.13; 2.49 - 15.13), history of blood transfusion (AOR, 5.22; 1.52 - 17.92), imprisonment (AOR, 4.81; 2.43 - 9.53), sharing personal razor (AOR, 4.55; 1.45 - 14.28), tattooing (AOR, 4.46; 2.37 - 8.38), extramarital sexual activity (AOR, 2.88; 1.40 - 5.87), cupping in outpatient place (AOR, 2.44; 1.08 - 5.52), tooth extraction (AOR, 2.35; 1.46 - 3.78), surgery (AOR, 1.98; 1.22 - 3.21), and intramuscular injection (AOR, 1.68; 1.06 - 2.68) found to be current independent risk factors for HCV infection demonstrated in 98.52% of cases. Conclusions: This is the first study to perform penalized conditional logistic regression model in data analyzing to control some statistical bias in the evaluation of HCV risk factors among Iranian blood donors. According to the results, intravenous drug abuse is a primary HCV risk factor. In addition, the study emphasizes on the role of other high-risk behaviors such as religious self-flagellation and high-risk procedures such as cupping in outpatient place in HCV transmission. Increasing donor education regarding HCV risk factors and more accurate donor selection needs to improve blood safety and protect recipients from potential HCV infection risk.

Association between nuclear factor kappa-light-chain-enhancer of activated B cells genetic polymorphisms and HCV susceptibility among the Chinese population under high-risk

Objective: To explore the association between nuclear factor kappa-light-chain-enhancer of activated genetic polymorphisms in B cells (NF-κB) and the HCV susceptibility, among the Chinese population. Methods: A total of 1 679 participants were enrolled; including 503 drug users and 1 176 other participants at risk under the exposure for blood. By using the logistic regression analysis, related risk factors for HCV infection among subjects were analyzed. Two NF-κB pathway variants, NF-κB1 rs72696119 and REL rs13031237 were then genotyped by TaqMan assay method. Logistic regression analysis was performed to analyze the association between gene polymorphisms and the susceptibility on HCV. Results: Among the drug users, women (OR=0.408, 95%CI: 0.308-0.767) appeared to be associated with the decreased risk for HCV infection, while factors as drug injection (OR=8.817, 95%CI: 5.577-13.937) and the duration of drug-intake >5.5 years (OR=2.891, 95%CI: 1.824-4.583) were associated with the increased risk for HCV infection. Among the participants who had been exposed to blood, women (OR=3.431, 95%CI: 2.360-4.988) were associated with the increased risk for HCV infection, while the levels of education beyond elementary school (OR=0.613, 95%CI: 0.429-0.876) were associated with the decreased risk for HCV infection. Compared to the reference NF-κB1 rs72696119 CC genotype, the carriage of GG genotype was associated with an increased risk of susceptibility on HCV (OR=1.412, 95%CI: 1.035-1.927) among the total study population. Results from the interaction analysis showed that there was no interactive effects appeared between rs72696119 and route of infection, or between rs72696119 and gender among the total population under study (all P>0.05). Conclusion: NF-κB1 polymorphism rs72696119 and related factors seemed associated with the susceptibility to HCV infection among high-risk Chinese populations.

CV diagnosis and direct-acting antiviral agents -based treatment for HIV/HCV co-infected patients in a primary care setting in Maputo, Mozambique

Background: Direct-acting antiviral agents (DAAs) treatment has been associated with high rates of sustained virological response at week 12 after treatment completion (SVR12) and a good safety profile in HIV + /HCV + individuals in clinical trials. We aimed to assess the HCV diagnosis and DAA-based treatment feasibility in a Minister of Health (MoH) primary care setting in Maputo, Mozambique. Methods & Materials: We included for analysis the active cohort of HIV-positive adults enrolled for HIV care between March 2015-July 2017 in MSF supported MoH HIV clinic in a primary health centre in Maputo, Mozambique. Results: Among 1486 active patients enrolled between March 2015-July 2017, 1334 (90%) were screened for HCV antibodies (OraQuick HCV Rapid Antibody Test, OraSure Technologies, Bethlehem, USA): 81 (6%) patients tested antibodies positive, among them 83% had viral load (VL) detectable. GNT 1a was detected in 90% of cases, 8% were GNT 4, and 2% were GNT 3. Among patiens with HCV VL detectable, 87% were men, with a mean age of 37 years old, and 90% had a history of injectable drugs abuse. The fibrosis score by Fibroscan® was F0-F1 for 82% of patients, F2-F3 for 10%, F3-F4 for 8%. A total of 21 HIV/HCV patients were initiated on DAAs from December 2016 up to October 2017 and 15 of them completed treatment. All patients were on antiretroviral treatment at HCV treatment initiation, 35% on second line regimen (with Lopinavir/ritonavir). No severe side effects were reported. No defaulters or treatment discontinuation in this cohort. VL follow-up 12 weeks after the end of treatment was done for 4 patients: 3 patients with SVR12 achieved and one failure. Conclusion: This is the first experience of HCV treatment with DAAs in the primary care setting in public health sector in Mozambique. Injectable drugs use appears as main risk factor for HCV infection. A more comprehensive package of care with targeted testing, harm reduction interventions and treatment need to be offered to most at risk population. Inclusion of HCV routine diagnosis followed by access to treatment by new DAAs in primary HIV care setting in Maputo, mozambique, is feasible.

Prevalence and Risk Factors of Hepatitis B and C Virus Infections Among Patients Undergoing Hemodialysis in Kurdistan, Iraq

Background and Objectives: Hepatitis B and C viral (HBV, HCV) infections are major the health problems worldwide. Patients undergoing hemodialysis (HD) are more vulnerable to acquire such infections than the general population. The current study aimed at assessing the prevalence and risk factors of HBV and HCV infections among patients undergoing hemodialysis in Kurdistan, Iraq. Methods: The current cross sectional study was carried out at five governmental dialysis units in Kurdistan, Iraq; most of the current study patients were recruited from 10 August 2015 to 11 February 2016. All the participants were clinically evaluated and detailed history of blood transfusion, duration of HD, and all the other parameters were also noted. Hepatitis B surface antigens (HBsAgs) and anti-HCV antibodies (anti-HCV Ab) were measured and seropositive HCV samples were subjected to polymerase chain reaction (PCR) for confirmation. Data regarding the serological status of such patients and potential risk factors were collected and analyzed. Results: A total of 510 patients undergoing HD were enrolled in the study. The overall prevalence of HBV, HCV, and coinfection in the studied subjects was 1.8%, 9.2%, and 0.2%, respectively. HBV and HCV infections were independently associated with age and history of HD (P = 0.005). HBV vaccination was a strong protective factor against HBV infection (P = 0.001), but the rate of fully vaccinated patients (77%) was still suboptimal. Other risk factors for HCV infection were the duration of HD, history of kidney transplantation, and history of dental and surgical procedures. Conclusions: The prevalence of HBV and HCV infections in the patients undergoing HD in the centers in Kurdistan was low to moderate. HBV vaccination was an efficient protective measure. The factors associated with viral hepatitis within HD units were highly suggestive for nosocomial transmission. Strict adherence to infection control measures and more effective follow-up procedures may reduce the prevalence of the studied infections.

Profile of hepatitis B and C virus infection in prisoners in Lubuk Pakam correctional facilities

Prisoners in correctional facilities are predisposed to chronic viral infections because of their high-risk behaviors or unsafe lifestyle. The economic and public health burden of chronic hepatitis B and C and its sequelae need to be addressed, such as by finding the risk factors and therefore reducing the spread of HCV and HBV infection in prisons. This study aimed to see the profile of Hepatitis B and C Virus Infection in prisoners in Lubuk Pakam Correctional Facilities. This cross-sectional study was in Lubuk Pakam Correctional Facilities in 2016. From 1114 prisoners in Lubuk Pakam correctional facility, we randomly examined 120 prisoners for HBV and HCV serology markers. From 120 prisoners, six prisoners were HBV positive, 21 prisoners were HCV positive and one prisoner positive for both HCV and HBV infection. The most common risk factors for prisoners getting HBV infection are tattoos and free sex (36.4% and 36.4%, respectively). The most common risk factors for HCV infection in prisoners are tattoos and free sex (40% and 35%, respectively).

Hepatitis C virus spread from HIV-positive to HIV-negative men who have sex with men.

The aim of this study was to evaluate the potential transmission of HCV strains between HIV-positive men who have sex with men (MSM) and HIV-negative MSM. Since 2000, an ongoing epidemic of HCV infections is observed among HIV-positive MSM in high-income countries. However, HCV infections in HIV-negative MSM are investigated to a lesser extent due to the lack of follow-up in this population and only limited information is available on the risk of HCV transmission between HIV-positive MSM and HIV-negative MSM. We enrolled 49 MSM of which 43 were HIV-positive and 6 HIV-negative, including 4 being enrolled or waiting for enrolment in a preexposure prophylaxis (PrEP) program. All patients were diagnosed with acute HCV infection at the Infectious Disease Unit at the Hospices Civils de Lyon from 2014 to 2016. Risk factors for HCV infection were similar in both groups and included IV or nasal drug use, and rough sex practices. Typing and phylogenetic cluster analysis of HCV variants were performed by NS5B sequencing. Several clusters of infections were identified (genotype 1a: 3 clusters and 1 pair; genotype 4d: 1 cluster and 2 pairs), suggesting that several transmission events occurred within the study population. Every HCV strain identified in HIV-negative MSM was included in a cluster with HIV-positive MSM. Chronological analysis of contagiousness suggested the transmission of HCV from HIV-positive to HIV-negative patients. We conclude that recommendations for HCV surveillance should not be confined to HIV-positive MSM but should be extended to HIV-negative MSM with similar risk factors.

Prevalence and risk factors of HCV infection in a prison setting in Uttar Pradesh, India

Hepatitis C virus (HCv) is the main cause of progressive liver diseases and has become a global public health problem. HCv infection is more frequently detected in inmates and the main risk factor associated with HCv infection in the prison populations is intravenous drug use (IVDU).

Seroprevalence and clinico-epidemiological correlates of hepatitis c infection in pregnancy at a booking antenatal clinic, federal medical centre, Yenagoa

Background: World health organization estimated that approximately 170 million people are infected with Hepatitis C virus with about 130 million being carriers, three to four million persons are newly infected in each year and more than 350,000 people estimated to die from Hepatitis C-related liver diseases in each year worldwide. The seroprevalence rates of Hepatitis C in pregnancy change as indicated by the endemicity of a given zone with high rates generally among economically constraint countries in Asia and Africa. The general objective is to determine the seroprevalence and clinicoepidemiological correlates of Hepatitis C viral antibodies in pregnancy in Yenagoa. The specific objectives are (1) To find out the seroprevalence of HCV in pregnant women that present in clinic. (2) To identify known risk factors for HCV infections in pregnant women. (3) To make evidence based recommendations on screening protocols for our obstetric population.Methodology: This is a descriptive cross sectional study. Two hundred and twenty (220) consecutive healthy pregnant women attending the antenatal booking clinic of the hospital who met the inclusion criteria were recruited into this study after pretest counselling and obtaining consent from them. This was tested for anti HCV antibody with commercially available in vitro diagnostic kits (one step test strips). Data was collected via a structured interviewer administered questionnaire. Data entry and analysis was done using SPSS (statistical package for social sciences) 22 statistical package (SPSS Inc., Illinois, U.S.A). Univariate analysis for categorical variables was performed using chi-square. P value less than 0.05 was taken as being significant.Results: The mean age of the pregnant women studied was 28.8 years ± 5.2 while the mean parity was 1.20 ± 1.16. 220 pregnant women who came for antenatal booking were recruited into this study. The seroprevalence of Hepatitis C viral (anti-HCV) antibodies is 2.7% (n=6).There was no significant association with respect to a history of jaundice or contact with a jaundiced patient, multiple sexual partners, female circumcision, previous blood transfusion, intravenous drug abuse or sharing of sharps, previous surgery, episiotomies or dilatation and curettage (p>0.05).Conclusion: The seroprevalence of 2.7% of Hepatitis C virus infection may not justify universal screening. However, seropositive pregnant women could be counselled on modification of lifestyle like avoiding excessive alcohol intake and preventing further spread of the disease. Multidisciplinary management with risk based screening, antenatal surveillance and postpartum care of seropositive pregnant women is also advocated.Keywords: Hepatitis C virus infection, anti-hepatitis C antibodies, Hepatitis in pregnancy

Anti-HCV immunoblot indeterminate results in blood donors: non-specific reactivity or past exposure to HCV?

The significance of anti-HCV immunoblot (IB) indeterminate results can be difficult to determine. We analysed results for blood donors tested on the MP Diagnostics HCV Blot 3.0 IB assay to determine whether indeterminate results representing past exposure to HCV could be distinguished from those due to non-specific reactivity. Results for all donors tested by IB during the study period (July 2010 to December 2013) were included in this study. Of 131 donors tested by IB, 34 (26.0%) were negative, 38 (29.0%) were indeterminate, and 59 (45.0%) were positive. There was no significant difference in IB band reactivity strength between indeterminate and positive donors. The PRISM HCV chemiluminescent immunoassay (ChLIA) sample to cut-off (s/co) ratio distribution for the indeterminate donors was significantly higher than for those with biological false reactivity (P=0·037), but significantly lower than for donors who were IB positive/HCV RNA negative (P<0·001) or IB not tested/HCV RNA positive (P<0·001). Of donors available for follow-up, 53.1% of the indeterminate group disclosed a putative risk factor for HCV infection compared to 39.4% (P<0·001) for the IB-negative group, 76.6% (P=0·065) for the IB-positive group and 83.4% (P<0·001) for the HCV RNA-positive group. The results of this study indicate that PRISM ChLIA s/co ratios >2·00 with IB indeterminate results predict exposure to HCV, particularly in the presence of putative risk factors for HCV infection. These findings may be applied to optimizing counselling of donors with indeterminate HCV results.

FEATURES OF CIRCULATION OF HEPATITIS C VIRUS IN KHABAROVSK REGION

Aim. Study the intensity of circulation of HCV in Khabarovsk Region and genetic variants of the virus circulating in the region. Materials and methods. 940 sera samples obtained from individuals with unestablished risk factors for HCV infection in polyclinic of the Far-Eastern Regional Centre for Prophylaxis and Control of AIDS (Khabarovsk) were studied. Individuals of the following age groups were included into the study: 1 - 4, 5 - 9,10 - 14,15 - 19,20 - 29, 30 - 39, 40 - 49, 50 - 59, older than 60 years; each group included approximately 100 individuals. Anti-HCV was determined in all the samples, HCV RNA was determined in samples positive for anti-HCV. Phylogenetic analysis with a time scale for the detected genovariants of HCV was carried out for reconstruction of the history of prevalence of HCV in Khabarovsk Region. Trees were constructed using BEAST vl.8.2 program by 2 genome sequences - core (1043 bp) and NS5B (389 bp). Results. The mean prevalence of anti-HCV among the examined individuals was 9.3% (87/940). The proportion of individuals with a current HCV-infection (presence of HCV RNA) was 4.2% (39/940). A sharp increase of HCV prevalence was observed beginning from the age group 20 - 29, where frequency of anti-HCV was 13.1% (13/99) that is 6 times higher compared with the previous age group of 15 - 19 (2,2%, p

Prevalence and Risk Factors of HCV Infection among Haemodialysis Patients at Dialysis Centers in Khartoum State - Sudan

Prevalence and Risk Factors of HCV Infection among Haemodialysis Patients at Dialysis Centers in Khartoum State - Sudan

Skin Manifestations of Hepatitis C in Chronic Renal Disease Patient

Hepatitis C virus is a single stranded RNA virus. It is a major cause of acute and chronic hepatitis. The mode of infection is usually through intravenous drug abuse or transfusion of infected blood or blood products. Health care workers are at risk for needle stick and other with high-risk sexual behavior is also considered a major risk factor for HCV infection. The incidence of new cases of acute HCV infection has sharply decreased in the United States during the past decade, but the prevalence remains high with approximately 2.7 million Americans infected with the virus. Chronic HCV infection progresses in roughly 75% of patients after acute infection by the virus. Chronic HCV infection is slowly progressive disease and results in severe morbidity in 20-30% of infected persons.

Prevalence of Hepatitis C Virus Infection and Its Risk Factors among Patients Attending Rwanda Military Hospital, Rwanda.

In Rwanda, the prevalence of viral hepatitis (HCV) is poorly understood. The current study investigated the prevalence and risk factors of HCV infection in Rwanda. A total of 324 patients attending Rwanda Military Hospital were randomly selected and a questionnaire was administered to determine the risk factors. Blood was collected and screened for anti-HCV antibodies and seropositive samples were subjected to polymerase chain reaction method. Hematology abnormalities in the HCV infected patients were also investigated. Anti-HCV antibody and active HCV infection were found in 16.0% and 9.6% of total participants, respectively. Prevalence was highest (28.4%; 19/67) among participants above 55 years and least (2.4%; 3/123) among younger participants (18–35 years). There was a significant (P = 0.031) relationship between place of residence and HCV infection with residents of Southern Province having significantly higher prevalence. The hematological abnormalities observed in the HCV infected patients included leukopenia (48.4%; 15/52), neutropenia (6.5%; 2/52), and thrombocytopenia (25.8%; 8/52). The HCV infection was significantly higher in the older population (>55 years) and exposure to injection from traditional practitioners was identified as a significant (P = 0.036) risk factor of infection. Further studies to determine the factors causing the high prevalence of HCV in Rwanda are recommended.

A COMPARATIVE STUDY OF EFFICACY BETWEEN THIRD GENERATION ELISA AND FOURTH GENERATION TRI-DOT TEST TO DETECT SEROPREVALENCE OF HEPATITIS-C INFECTION IN PATIENTS ON HAEMODIALYSIS

Introduction: The detection of anti-HCV antibodies is based on the use of third generation Enzyme Immunoassay (EIA) that detects antibodies directed against various HCV epitopes. HCV TRI-DOT test is a rapid, protein A immunofiltration assay for the qualitative detection of anti HCV antibodies in serum or plasma with a sensitivity of 100% and specificity of 91.5%. The study was conducted to compare the efficacy between 3rd generation ELISA and 4th generation TRI-DOT test to detect the seroprevalence of HCV and to assess the risk factors associated with HCV infection in the patients who are on haemodialysis. Material and Methods: The study was conducted to compare the efficacy between 3rd generation ELISA and 4th generation TRI-DOT test to detect the seroprevalence of HCV and to assess the risk factors associated with HCV infection in the patients who are on haemodialysis. Sera of 150 adult CRF patients on &gt;2 months haemodialysis tested by TRIDOT test and then by ELISA. Demographic data of all included patients reviewed for risk factors. Statistical analysis was performed by the SPSS program for Windows, version 17.0. Results: Out of 150 cases, 17 were found seropositive for HCV by TRI-DOT test and 16 were found seropositive for HCV by ELISA. One hundred and one patients were males and 49 were females. Maximum positive patients fell in 36-55 years age group. Duration of haemodialysis, mean blood transfusion, number of dialysis centre changed found almost double in HCV reactive patients than in non reactive. Sensitivity of HCV TRI-DOT is 100% and specificity is 99.3%, positive predictive value is 94.1% and negative predictive value is 100% in comparison of ELISA. Conclusion: Seroprevalence of Hepatitis C in haemodialysis patients in our institute is 10.7%. Risk factors for HCV infection in haemodialysis patients included duration of haemodialysis, number of haemodialysis centre changed, number of blood transfusion unit transfused, male gender and middle age. The sensitivity of HCV TRI-DOT is equal to HCV ELISA but the specificity is slightly less.

Hepatitis C seropositivity and RNA detection among Type2 Diabetic patients in Sulaimani Governorate-Iraqi Kurdistan Region

The current study included 421 cases (221 with type 2 diabetic) and (200 non-diabetics- control group). ELISA and conventional PCR techniques were used for detection of anti-HCV antibodies and HCV-RNA respectively. The percentage rates of HCV seropositivity were (9.5%) among type 2 diabetic patients that were significantly higher (p &lt; 0.05) compared to controls. Moreover, HCV-RNA detection was more frequent among diabetic patients (5.88%), although no significant differences found with non-diabetic cases (p &gt; 0.05). No significant effects of sex found among positive results (p &gt; 0.05). Duration of diabetes, residence, the job type, the patient’s education level, history of jaundice, smoking and alcohol consumption showed significant effects (p &lt; 0.05) on the percentage rates of HCV infection among type 2 diabetic patients. It was concluded that these parameters are a risk factor for HCV infection among Type 2 Diabetic patients. Moreover, diabetes itself can consider as a risk factor for HCV infection.