Risk Factors For Hepatitis C Virus Transmission Research Articles

Hepatitis C Infection in Hemodialysis Patients, 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 centres 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 Centre 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., from four centres in the western region of KSA, (72.3%) and that by Huraib et al., in their multi-centre 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-centres, 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-centres is paramount.

Sociodemographic Profile, Genotype, and Response to Therapy in Hepatitis C Virus Infection: A Brief Report from Himachal Pradesh

Introduction Hepatitis C virus (HCV) infection is a major cause of liver disease worldwide. There is no data on sociodemographic profile, risk factors, genotype, and response to therapy of HCV infection from Himachal Pradesh. Methods In this single-center study, we retrospectively analyzed data from HCV-infected patients treated with new oral direct-acting antiviral drugs from September 2019 to March 2022. Data on the sociodemographic profile of HCV-infected patients, along with risk factors for its transmission, HCV genotype, and response to therapy, was analyzed. Results A total of 189 patients were included, with a mean age of 30.9 ± 13.8 years. Most were males and were students. Predominant risk factor for HCV transmission was intravenous drug use (61.4%), tattooing (11.7%), and hemodialysis (11.1%). A majority of the patients were students (72%). The predominant genotype was GT 3. Most (95.2%) patients were without cirrhosis, so sofosbuvir plus daclatasvir for 12 weeks was the most common regimen used. Sustained virological response was achieved in 94.7% of patients. Conclusion This study, alarmingly, shows that intravenous drug users and tattooing are important risk factors for HCV infection in Himachal Pradesh. Further, students were the most frequently infected group.

Hepatitis C virus risk among young people who inject drugs.

BackgroundInjection drug use (IDU) is the leading risk factor for hepatitis C virus (HCV) transmission in the U.S. While the general risk factors for HCV transmission are known, there is limited work on how these factors interact and impact young people who inject drugs (YPWID).MethodsProject data were drawn from a study of 539 New York City (NYC) residents ages 18-29 who were recruited via Respondent-Driven Sampling and, reported past-month non-medical use of prescription opioids and/or heroin. Analyses are based on a subsample of 337 (62%) who reported injecting any drug in the past 12 months. All variables were assessed via self-report, except HCV status, which was established via rapid antibody testing. Integrating the observed statistical associations with extant literature on HCV risk, we also developed a qualitative system dynamics (SD) model to use as a supplemental data visualization tool to explore plausible pathways and interactions among key risk and protective factors for HCV.ResultsResults showed a 31% HCV antibody prevalence with an overall incidence of 10 per 100 person-years. HCV status was independently correlated with having shared cookers with two or more people (AOR = 2.17); injected drugs 4–6 years (AOR = 2.49) and 7 or more years (AOR = 4.95); lifetime homelessness (AOR = 2.52); and having been incarcerated two or more times (AOR = 1.99). These outcomes along with the extant literature on HCV risk were used to develop the qualitative SD model, which describes a causal hypothesis around non-linearities and feedback loop structures underlying the spread of HCV among YPWID.ConclusionsDespite ongoing harm reduction efforts, close to a third of YPWID in the community sample have been exposed to HCV, have risks for injection drug use, and face challenges with structural factors that may be preventing adequate intervention. The qualitative SD model explores these issues and contributes to a better understanding of how these various risk factors interact and what policies could potentially be effective in reducing HCV infections.

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.

Risk factors for HCV transmission in HIV-positive men who have sex with men in México.

PurposeIn the last two decades transmission of hepatitis C virus (HCV) in HIV positive men who have sex with men (MSM) has been reported globally. Chemsex and specific sexual practices have been identified as risk factors. Our study aimed to identify risk factors for HCV transmission in MSM living with HIV attending in Mexico.MethodsWe conducted a case-control study from April to December 2019 at the Hospital de Infectología “La Raza” National Medical Center, in Mexico City. A case was defined as an HIV-infected MSM with positive HCV-antibody test. For each case, 3 controls were included, defined as HIV infected MSM with negative HCV-antibody test. A self-questionnaire covering sexual practices and other risk factors for HCV transmission was applied. Bivariate analysis was performed to obtain odds ratio (OR) using Chi-square test. Independent risk factors were identified in a subsequent analysis performing a logistic regression model.ResultsA total of 324 patients participated in the study, 81 cases and 243 controls. Median age was 30.5 years (IQR: 18–52) and 28.8 years (IQR: 21–45) in the case and control group, respectively. Most prevalent HCV genotype was 1a (79%). In the logistic regression model, sharing straw during cocaine inhalation (OR: 9.03; 95% CI; 1.35–13.52; P = 0.003), sharing sex toys (OR: 17.53, 95% CI; 6.85–44.86; P = 0.002), and ethyl chloride use for chemsex (OR: 2.26; 95% CI; 1.29–5.56; P = 0.037) were significant risk factors for HCV infection.ConclusionThis study identifies risk factors for HCV transmission in Mexico in HIV positive MSM in congruence with the findings of many studies performed worldwide. This is the first study that indicates a possible association between ethyl chloride use in chemsex and HCV infection. Assessment of local populations for risk factors for HCV transmission may help to develop specifically targeted behavioral interventions to reduce HCV transmission.

A Systematic Review of Risk Factors for Hepatitis C Virus Infection Among Low-Risk Population in India

Identification of risk factors for hepatitis C virus (HCV) transmission will help in targeted screening of people who are at risk for HCV. Indian studies, published between January 1989 and June 2020, were systematically reviewed to identify the relevant studies. We searched electronic databases including PubMed/Medline, Embase, Scopus, and Google scholar to identify the original data published in English language. The full-text studies, published in any form, which reported data on risk factors for HCV transmission among low-risk population were selected. The studies which exclusively included high-risk groups were excluded. Data were extracted from 31,176 participants included in 25 studies (median [range] 40 [7-20,113). The participants were HCV infected patients who visited the hospital (n=10), community population (n=6), pregnant women (n=5), blood donors (n=2), people with diabetes mellitus (n=1), army recruits (n=1), or slum dwellers (n=1). These studies provided data on blood transfusion, use of unsafe injections, minor or major surgery, unsafe dental procedures, tattooing, body piercing, obstetrical procedures, unsafe shaving, intravenous drug use, and unsafe sexual practices as risk factors for HCV transmission. Unsafe injections, body piercing, unsafe dental procedure, unsafe shaving, and tattooing were identified as major risk factors for reported by HCV population participants.More data are needed to identify the risk factors for HCV in Indian population. Risk-factor-targeted screening may increase the yield and reduce the cost of HCV screening in India.

Prevalence, Genotypic Distribution and the associated Risk Factors of Hepatitis C Infection in Pakistan Pediatric Patients

Hepatitis C virus (HCV) is an important contributor to chronic morbidity and mortality in developing countries. The study’s objective was to determine the genotype distribution and risk factors associated with the transmission of HCV infections in pediatric patients. Rapid screening and confirmation by the enzyme-linked immunosorbent assay (ELISA) were used to analyze 585 pediatric blood specimens hospitalized and visited the outpatient department of the largest tertiary care hospital in Pakistan. Detection and genotyping of HCV RNA were performed using a real-time polymerase chain reaction (RT-PCR). Demographic data and a history of risk factors were gathered through a survey questionnaire. HCV RNA was detected in 323 (72.4%) cases which showed viral load ranging from Log10 IU/mL < 3 to > 6 IU/mL. HCV genotype 3a was detected in 256 (79.3%) cases while type 3b and 1a was observed in 36 (11.1%) and 31 (9.6%) patients, respectively. HCV positivity was significantly associated with the cases from rural areas [p = 0.005; odds ratio (OR) 1.65; 95% CI 1.16-2.23] and also significantly associated with low-income group [p < 0.001; OR 5.75; 95% CI 3.90-8.40]. The primary risk factors associated with HCV transmission in children were family history (p = 0.002), blood transfusion (p = 0.03), surgical procedures (p = 0.02), and history of injections (p = 0.05). HCV genotype 3a is the most common genotype in children. The main risk factors for HCV transmission in children are blood transfusion, surgical procedures, and injection practices by informal health care providers.

S1091 Barriers to Hepatitis C Virus Testing According to Latest CDC Recommendations Among Trainees of Internal Medicine and Family Medicine at a Single Tertiary Academic Medical Center

Introduction: Hepatitis C virus (HCV) infection is a major source of morbidity and mortality in the United States. Chronic HCV infections affect approximately 2.4 million Americans. In 2020, the CDC, USPSTF, and AASLD/IDSA recommend one-time opt-out testing for HCV in all adults aged 18 to 79 years irrespective of risk factors. We sought to measure Internal Medicine (IM) and Family Medicine (FM) residents’ perspective of HCV screening guidelines and barriers to routine testing. Methods: This survey was conducted at a single tertiary care academic health center comprised of IM and FM training programs. An electronic anonymous 41-question survey was distributed among the trainees between May to June 2021. We received a total of 32 (28.5%) responses out of 112 (70 IM and 42 FM) resident physicians using Redcap distribution tool for obtaining the responses. Results: Thirty-two (21 IM and 11 FM) surveys were completed. Seventeen (53%) trainees were aware of the current CDC recommendations for HCV testing and less than five (15.6%) residents reported routine testing for HCV based on CDC recommendations. The most common barriers for routine testing were competing priorities (41%), insufficient time (37%) and patient refusal (16%) (Figure 1a). The most common facilitators for routine testing were Electronic Medical Records reminders (31%), knowledge about current guidelines (25%), institutional ease of ordering (12.5%) and reminders from attending physicians (12.5%) (Figure 1b). Many of the residents fail to obtain history regarding risk factors for HCV transmission during their encounters (see Figure 1c). Majority of the residents strongly agreed to positive statements about HCV screening (Figure 1d). There were no significant differences in the knowledge about HCV screening among internal medicine and family medicine residents in the program (see Table 1). Conclusion: There are gaps in knowledge regarding testing for HCV according to CDC recommendations among IM and FM residents. A small proportion of trainees were performing routine testing. While competing priorities and lack of time remain significant barriers to testing, electronic medical record reminders and knowledge about current guidelines facilitate testing.Figure 1.: Results graph representing responses obtained from trainees from Internal Medicine and Family Medicine at a single tertiary medical center.Table 1.: Demographic Characteristics of the respondent trainees and HCV Testing awareness among trainees.

A cross sectional study of the risk factors of hepatitis C infection in North Egypt.

Hepatitis C is a viral infection that has been declared as a global health problem by the World Health Organization. Egypt has the highest prevalence of hepatitis C virus (HCV) which results in a high morbidity and mortality from chronic liver disease, cirrhosis, and even hepatocellular carcinoma. Cities have lower rates of infection than rural areas. Studies about the abnormally high prevalence of HCV in Egypt ascribed that to the governmental campaign to treat Schistosoma. However, these treatment campaigns have stopped more than 35years ago, which means that some other modes of transmission must have been involved. The objective of this work is to study the main reasons of HCV prevalence in the Egyptian Delta valley. A questionnaire-based study was conducted by members of the HCV Fighters project. Responses were collected from 949 volunteers (451 HCV patients and 498 healthy volunteers as control). The data were analyzed using SPSS version 19.0. The two-sample proportion test was used for statistical comparison between groups. The most probable risk factors of HCV transmission in Egypt included regular visits to dental clinics (55.2%), previous surgical operations (54.4%), former blood transfusion (52%), intrafamilial HCV infection (45.9%) and history of bilharzial infection (44.3%). Increasing public awareness about modes of transmission and risk factors of HCV infection is a must, especially within family members of HCV patients. Strict commitment to proper medical care precautions by health care practitioners is required.

Phylogenetic Analysis of NS5B Region of Hepatitis C Genotype 3a Virus among Different Risk Groups in Iran

Background: Hepatitis C virus (HCV) is a major cause of liver diseases. Transmission of HCV, as a blood-borne virus, is a major concern for the safety of blood products. In Iran, intravenous drug abuse is a major risk factor for HCV transmission. Recently a change in the distribution of HCV genotype among Iranian blood donors has been reported, and genotype 3a is reported as the most frequent genotype. Also, genotype 3a is the dominant genotype among IDUs. Objective: To investigate the association between HCV genotype 3a circulating in the community, sequences of HCV genotype 3a were analyzed among different risk groups in Iran. Methods: In this cross-sectional study, a partial sequence of the NS5B region of the HCV genome was isolated from 58 blood donors, 48 intravenous drug users (IDUs), and 31 patients with inherited bleeding disorders (IBDs) infected with HCV genotype 3a were included. The published sequence data were obtained from the Gen Bank database and were compared to construct the phylogenetic trees. Results: Of 58 blood donors infected with subtype 3a, 31 (53.5%) reported the risk of intravenous drug abuse. In the phylogenetic tree, no separate cluster was formed to differentiate between HCV sequences in blood donors and IDUs. A cluster at the middle level was found in the phylogenetic tree formed by sequences from blood donors, IDUs, and patients with inherited bleeding disorders. Conclusions: The phylogenetic tree showed the phylogenetic mixing of genotype 3a sequences in BDs, IBD patients, and IDUs. The results confirmed the extensive transmission of IDU-related genotype 3a towards the general population.

Detection, quantification and genotype distribution of HCV patients in Lahore, Pakistan by real-time PCR.

Hepatitis C virus (HCV) is considered as "Viral Time Bomb" suggested by the World Health Organization and if it is not treated timely, it will lead towards cirrhosis and hepatocellular carcinoma (HCC). The purpose of the present research is to study possible risk factors, frequent genotypes of HCV and its association with different age groups. Suspected blood samples from HCV patients were collected from different hospitals of Lahore, Pakistan. Out of 1000 HCV suspected samples, 920 samples were found HCV positive detected by Anti-HCV ELISA, CobasR. kit. The quantification of HCV load was determined by HCV quantification kit and LINEAR ARRAY KIT (Roche) was used for genotype determination by Real-Time PCR (ABI). Statistical analysis was done by using Microsoft Excel. Out of 920 subjects, 77 subjects (8.4%) were false positive and they were not detected by nested PCR. Three PCR positive samples were untypeable. Genotype 3 was predominant in Lahore which was 83.5%, whereas type 1 and 2 were 5.1% and 0.7% respectively. There were also mixed genotypes detected, 1 and 3 were 0.4%, 2 and 3 were 1.41% and 3 and 4 were 0.2% only. Male were more infected of HCV in the age <40 years and females >40years. The major risk factor for HCV transmission is by use of unsterilized razors/blades. It is necessary to spread awareness among the general population of Pakistan about HCV transmission risk factors. Regular physical examination at least once a year is recommended, so that early detection of HCV could be done.

Daclatasvir/Sofosbuvir versus Ledipasvir/Sofosbuvir in Patients with Hepatitis C Virus Infection Genotypes 1 and 3

Background: The new direct-acting antiviral agents (DAAs) with high efficacy, low resistance, and low rate of adverse events (AEs) have shown promising outcomes for hepatitis C virus (HCV) treatment. This study assessed the efficacy and safety of Daclatasvir/Sofosbuvir (DCV/SOF) compared to Ledipasvir/Sofosbuvir (LDV/SOF) in patients with HCV infection in the real-world setting in Iran. Materials and Methods: A total of 42 patients with HCV infection were treated with either LDV/SOF (genotype 1) or DCV/SOF (genotypes 1, 3 or unknown) with or without ribavirin (RBV). Assessment of risk factors, laboratory tests, sustained virologic response at post-treatment week 12 (SVR12), and AEs were performed. Results: The highest risk factor for HCV transmission was major surgery (50.0%), followed by tattooing (40.5%), phlebotomy (40.5%), and dental surgery (40.5%). No statistically significant relationships between genotypes and risk factors were observed. In both treatment groups (LDV/SOF and DCV/SOF), all of the patients (100%) with or without cirrhosis and treatment-experience achieved SVR12. One patient with a history of failed LDV/SOF therapy achieved SVR12 following retreatment with DCV/SOF. Both treatment regimens were well-tolerated. No serious AEs or discontinuation due to AEs was observed. The most common AE across both treatment groups were fatigue (42.9%), followed by anxiety (28.6%). Numerically, more adverse events were found with the LDV/SOF regimen than with the DCV/SOF regimen. Conclusion: Our study showed an excellent safety and efficacy of DCV/SOF and LDV/SOF in Iranian patients infected with HCV. The incidence of AEs among patients treated with LDV/SOF was higher than those receiving SOF/DCV.

Seroprevalence and risk factors of hepatitis B and C viruses among diabetes mellitus patients in Duhok province, Iraqi Kurdistan.

Context:Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are major public health issues as they may progress into chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma (HCC).Aims:to identify the prevalence and risk factors of HBV and HCV among diabetic patients in Duhok province.Patients and Methods:It is a prospective study conducted in Shilan private hospital from June 2016 until December 2018. The serum of all diabetic patients was investigated by Enzyme-linked Immunosorbent Assay (ELISA) to detect HBsAg and anti-HCV. Diabetes mellitus (DM) was diagnosed according to American Diabetes Association (ADA). The results were analyzed by entering the data in Statistical Package for the Social Sciences (SPSS).Results:Three hundred seventy five DM patients were included in this study. The mean age of the patients was 54.38 ± 9.23, and the majority was female patients (65.87%). Out of 375 patients, 8 cases (2.13%) were HBV and 2 cases (0.53%) were HCV. Considering risk factors associated with HBV and HCV infections among diabetic patients, alcoholism was associated with both infections. Hemodialysis was a risk factor for HCV infection among diabetic patients but it was not associated with HBV.Conclusions:Although prevalence of HBV and HCV is higher among diabetic patients, its prevalence is low in comparison to other studies. It is recommended to screen HBsAg and anti-HCV in all alcoholic diabetic patients. Hemodialysis remains a significant risk factor for HCV transmission among diabetic patients with end stage renal disease (ESRD).

HEPATITIS C VIRUS ANTIBODIES AMONG HEMODIALYSIS PATIENTS IN MAKKAH CITY, KINGDOM OF SAUDI ARABIA

BACKGROUND: 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. MATERIALS AND METHODS: 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. RESULTS: The overall prevalence of anti-HCVamong HD patients was 49.9% according to clinical measurements and questionnaires CONCLUSION: 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 [1] and southern regions of KSA (45.5%). [2, 3] 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 [3, 4] , from four centers in the western region of KSA, (72.3%) and that by Huraib, et al [5] [6] in their multi-center study in KSA, (68%) as well as the mean national rate.[3, 7] 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 earlier by Saeed, et al [8] from Riyadh and those observed in the central region of KSA.[9]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 HDcenters is paramount

High Prevalence of Hepatitis C Virus Infection in Primitive Tribes of Eastern India and Associated Sociobehavioral Risks for Transmission: A Retrospective Analysis.

Purpose: The primitive tribal groups (PTGs) need special attention because of their low population growth: declining population size with high mortality rates. Scanty reports are available on the prevalence of hepatitis C virus (HCV) infection in primitive tribes of the country emphasizing their cultural and social practices associated with transmission of the disease.Methods: The study was conducted on 1765 tribal individuals covering 5 PTGs, namely Lodha, Saora, Khadia, Juanga, and Mankidia, from 6 districts of Odisha. Serum samples were tested for the anti-HCV antibody using commercially available enzyme immunoassays. HCV RNA was detected based on the 5′ NCR region and genotyping was done by direct sequencing of the core region. Potential risk factors for HCV transmission were collected using a questionnaire and subjected to regression analysis through SPSS, version 17.0.Results: Antibody to HCV was detected in 0%, 3.3%, 5.7%, 8.5%, and 13.4% in Saora, Lodha, Khadia, Juanga, and Mankidia tribes, respectively. HCV RNA was detected in 8.6% (11/127) of the samples tested. Genotyping of HCV isolates in all HCV RNA-positive samples revealed genotype 1b. Sharing of razors and shaving by the village barber were found to be significantly (p<0.05) associated with HCV transmission in males, whereas tattooing and multiple injections were found to be significant risk factors for females.Conclusion: This study indicated a high prevalence of HCV infection in Mankidia and Juanga tribes in comparison with the national scenario, which needs public health attention.

Prevalence and Risk Factors for Transmission and Genotype of HCV in Iraqi Patients

BACKGROUND: Hepatitis C virus (HCV) infection is a serious public health problem in the world, and about 170 million patients are chronically infected with HCV. Worldwide; different epidemiologic patterns of HCV infection have been identified.&#x0D; &#x0D; AIM OF THE STUDY: By this study, we try to know the prevalence and risk factors for HCV transmission in Iraqi patients and genotype distribution of the disease.&#x0D; &#x0D; PATIENTS &amp;amp; METHODS: In a cross sectional study of 355898 persons, 232645 males &amp;amp; 123253 females; had been enrolled for the study in Baghdad teaching hospital, Iraqi blood bank, Al-Yarmouk teaching hospital, Al-Nu&amp;#39;man teaching&amp;nbsp; Hospital and Al-Basrah teaching hospital from February 2017 to February 2019. Positive patients for hepatitis C antibody were further studied for way of transmission and viral load and genotype. History had been taken about the possible risk factor for HCV transmission which included (15) risk factors.&#x0D; &#x0D; RESULTS: A total of 355898 persons, 232645 males &amp;amp; 123253 females their Mean age at diagnosis was 47.3 (&amp;plusmn; 15.6) years, Ranged (19&amp;ndash;78) years. The mean body mass index (BMI) of the study sample was 22.9 (&amp;plusmn; 3) kg/m2, studied all screen for hepatitis C antibody 1155 discovered to be positive 650 were males and 505 were females, further study done for viral load in 746 patients and genotype in 633 patients: 356 (48%) with high viral load, 390 (52%)with low viral load and 345 (52.8%) with genotype V and 301 (46.2%) with genotype IV, while genotype II was 2 (0.3%) and III 7 (0.5%), The most common possible ways of transmission of the disease by history in this study was blood transfusion 53%, dental procedure 42%, hemodialysis 36%, caesarean section 34.5%, while injured male during shaving 33%, patient who have surgical operation 24%, Tattooing in 8%, cupping in 6.6%, IV injection in 4% heterosexual seen in 2%, renal transplant in 2%, and only 1% in needle stick injury. while the more frequent genotype is 1 then 4. Hemodialysis and improper use of IV medication had been found to be more significant in HCV male patients .The relation between possible risk factor for transmission of HCV and residence, viral load were not significant.&#x0D; &#x0D; CONCLUSION: The most common probable risk factors as single risk factor for the male was blood transfusion, and for female was caesarean section. While for two risk factors for male were Blood transfusion and Hemodialysis and for female were Caesarean section &amp;amp; Dental procedure and for both gender were hemodialysis &amp;amp; dental procedure. &#x0D; &#x0D; While for three risk factors for both gender were surgery, barbers, and dental procedure. In our study we had found the prevalence of HCV in our Iraqi big sample was relatively low. The most common genotype was genotype I then genotype IV with rarity of genotype III 0 and genotype II.

The contribution of injection drug use to hepatitis C virus transmission globally, regionally, and at country level: a modelling study

WHO aims to eliminate the hepatitis C virus (HCV) as a public health threat by 2030. Injection drug use is an important risk factor for HCV transmission, but its contribution to country-level and global epidemics is unknown. We estimated the contribution of injection drug use to risk for HCV epidemics globally, regionally, and at country level. We developed a dynamic deterministic HCV transmission model to simulate country-level HCV epidemics among people who inject drugs and the general population. Each country's model was calibrated using country-specific data from UN datasets and systematic reviews on the prevalence of HCV and injection drug use. The population attributable fraction of HCV transmission associated with injection drug use was estimated-defined here as the percentage of HCV infections prevented if additional HCV transmission due to injection drug use was removed between 2018 and 2030. The model included 88 countries (85% of the global population). The model predicted 0·23% (95% credibility interval [CrI] 0·16-0·31) of the global population were injection drug users in 2017, and 8% (5-12) of prevalent HCV infections were among people who currently inject drugs. Globally, if the increased risk for HCV transmission among people who inject drugs was removed, an estimated 43% (95% CrI 25-67) of incident HCV infections would be prevented from 2018 to 2030, varying regionally. This population attributable fraction was higher in high-income countries (79%, 95% CrI 57-97) than in countries of low and middle income (38%, 24-64) and was associated with the percentage of a country's prevalent HCV infections that are among people who inject drugs. Unsafe injecting practices among people who inject drugs contribute substantially to incident HCV infections globally. Any intervention that can reduce HCV transmission among people who inject drugs will have a pronounced effect on country-level incidence of HCV. None.

Transmission of hepatitis C virus in the dialysis setting and strategies for its prevention.

Hepatitis C virus (HCV) infection is more common among hemodialysis patients than the general population and transmission of HCV in dialysis clinics has been reported. In the context of the increased morbidity and mortality associated with HCV infection in the end stage renal disease population, it is important that dialysis clinics have processes in place for ensuring recommended infection control practices, including Standard Precautions, through regular audits and training of the staff. This review will summarize the epidemiology of HCV infection and risk factors for HCV transmission among hemodialysis patients. In addition, the proper protocols are required to investigate suspected cases of HCV transmission in dialysis facilities and recommendations for prevention of HCV transmission in will be reviewed.

Descriptive epidemiology of hepatitis C in individuals referred for specialized HCV care in Newfoundland and Labrador, 1996-2014.

Despite growing awareness of the significant burden of disease caused by hepatitis C virus (HCV) infection worldwide, understanding of the epidemiology and demographic distribution of HCV infection in Canada, specifically in Atlantic Canada, is limited. Currently, data on the demographic and clinical profile of HCV-infected individuals in Newfoundland and Labrador is limited. The aim of this study is to address this knowledge gap. A retrospective cohort study of HCV-positive individuals referred for specialized care in St. John's, Newfoundland, between 1996 and 2014, was conducted. Descriptive data were obtained through chart review and access to a database consisting of individuals referred for specialized HCV care in St. John's. During the study period, 767 individuals were referred for specialized HCV care, of whom 714 were included in our analysis. These individuals represent 57.5% of HCV-positive cases identified by the province's public health department during the same time frame. HCV infection was more common among men (68.2%) and urban dwellers (74.8%). The majority of cases were HCV genotype 1 (52.1%). Intravenous and intranasal drug use were the most common self-reported risk factors for HCV transmission. High loss-to-follow-up rates were found among those referred from the province's correctional system. This study provides important insights into the demographic and clinical profile of individuals referred for HCV-related care in Newfoundland and Labrador and fills a gap in the current understanding of HCV-positive individuals in this Atlantic province. These findings can help inform future directions for HCV-related health policy, resource allocation, and clinical care initiatives in Newfoundland and Labrador and across Canada.

Systematic overview of hepatitis C infection in the Middle East and North Africa.

AIMTo assess the quality of and to critically synthesize the available data on hepatitis C infections in the Middle East and North Africa (MENA) region to map evidence gaps.METHODSWe conducted an overview of systematic reviews (SRs) following an a priori developed protocol (CRD42017076736). Our overview followed the preferred reporting items for systematic reviews and meta-analyses guidelines for reporting SRs and abstracts and did not receive any funding. Two independent reviewers systematically searched MEDLINE and conducted a multistage screening of the identified articles. Out of 5758 identified articles, 37 SRs of hepatitis C virus (HCV) infection in populations living in 20 countries in the MENA region published between 2008 and 2016 were included in our overview. The nine primary outcomes of interest were HCV antibody (anti-) prevalences and incidences in different at-risk populations; the HCV viremic (RNA positive) rate in HCV-positive individuals; HCV viremic prevalence in the general population (GP); the prevalence of HCV co-infection with the hepatitis B virus, human immunodeficiency virus, or schistosomiasis; the HCV genotype/subtype distribution; and the risk factors for HCV transmission. The conflicts of interest declared by the authors of the SRs were also extracted. Good quality outcomes reported by the SRs were defined as having the population, outcome, study time and setting defined as recommended by the PICOTS framework and a sample size > 100.RESULTSWe included SRs reporting HCV outcomes with different levels of quality and precision. A substantial proportion of them synthesized data from mixed populations at differing levels of risk for acquiring HCV or at different HCV infection stages (recent and prior HCV transmissions). They also synthesized the data over long periods of time (e.g., two decades). Anti-HCV prevalence in the GP varied widely in the MENA region from 0.1% (study dates not reported) in the United Arab Emirates to 2.1%-13.5% (2003-2006) in Pakistan and 14.7% (2008) in Egypt. Data were not identified for Bahrain, Jordan, or Palestine. Good quality estimates of anti-HCV prevalence in the GP were reported for Algeria, Djibouti, Egypt, Iraq, Morocco, Pakistan, Syria, Sudan, Tunisia, and Yemen. Anti-HCV incidence estimates in the GP were reported only for Egypt (0.8-6.8 per 1000 person-year, 1997-2003). In Egypt, Morocco, and the United Arab Emirates, viremic rates in anti-HCV-positive individuals from the GP were approximately 70%. In the GP, the viremic prevalence varied from 0.7% (2011) in Saudi Arabia to 5.8% (2007-2008) in Pakistan and 10.0% (2008) in Egypt. Anti-HCV prevalence was lower in blood donors than in the GP, ranging from 0.2% (1992-1993) in Algeria to 1.7% (2005) in Yemen. The reporting quality of the outcomes in blood donors was good in the MENA countries, except in Qatar where no time framework was reported for the outcome. Some countries had anti-HCV prevalence estimates for children, transfused patients, contacts of HCV-infected patients, prisoners, sex workers, and men who have sex with men.CONCLUSIONA substantial proportion of the reported outcomes may not help policymakers to develop micro-elimination strategies with precise HCV infection prevention and treatment programs in the region, as nowcasting HCV epidemiology using these data is potentially difficult. In addition to providing accurate information on HCV epidemiology, outcomes should also demonstrate practical and clinical significance and relevance. Based on the available data, most countries in the region have low to moderate anti-HCV prevalence. To achieve HCV elimination by 2030, up-to-date, good quality data on HCV epidemiology are required for the GP and key populations such as people who inject drugs and men who have sex with men.