Viral Hepatitis Type Research Articles

Current perspectives of viral hepatitis.

Viral hepatitis represents a major danger to public health, and is a globally leading cause of death. The five liver-specific viruses: Hepatitis A virus, hepatitis B virus, hepatitis C virus, hepatitis D virus, and hepatitis E virus, each have their own unique epidemiology, structural biology, transmission, endemic patterns, risk of liver complications, and response to antiviral therapies. There remain few options for treatment, in spite of the increasing prevalence of viral-hepatitis-caused liver disease. Furthermore, chronic viral hepatitis is a leading worldwide cause of both liver-related morbidity and mortality, even though effective treatments are available that could reduce or prevent most patients' complications. In 2016, the World Health Organization released its plan to eliminate viral hepatitis as a public health threat by the year 2030, along with a discussion of current gaps and prospects for both regional and global eradication of viral hepatitis. Today, treatment is sufficiently able to prevent the disease from reaching advanced phases. However, future therapies must be extremely safe, and should ideally limit the period of treatment necessary. A better understanding of pathogenesis will prove beneficial in the development of potential treatment strategies targeting infections by viral hepatitis. This review aims to summarize the current state of knowledge on each type of viral hepatitis, together with major innovations.

COVID-19 impact on viral hepatitis in Italy: a time-series analysis

Abstract Background Worldwide there has been a sharp decrease in the number of notified cases of any type of viral hepatitis during the pandemic period. This study aims to investigate the impact of COVID-19 on viral hepatitis in Italy. Methods This was a retrospective study that analysed data extracted from the “Integrated Epidemiological System of Acute Viral Hepatitis” (SEIEVA) online platform from 1994 to 2022 in the Piedmont region of Northern Italy. Descriptive statistics were used to compare data from the pandemic period (2020-2022) to three years of pre-pandemic period (2017-2019). Second, a univariate ARIMA temporal forecast model based on the years 1994-2019 was built to predict how many cases should have been registered in the pandemic period. The Wilcoxon test was performed to detect if there was a statistically significant difference between the observed and predicted values. Results The time elapsed between the onset of symptoms and the serological test, potentially indicative of challenges related to hospital access, was delayed by a couple of days (median 7, 2-12 IQR) in the three-year period 2020-2022 compared to 2017-2019 (median 5, 3-9 IQR). The same occurred considering the time between the positive test and the epidemiological interview (median 6, 3-16 IQR vs median 4, 2-9 IQR). Although the ARIMA forecasting model confirmed a downward trend, the observed values of notified cases were lower than expected. A statistically significant difference was found between predicted and observed values (p = 0.004). Conclusions Although it is difficult to assess the impact of COVID-19 on the transmission of viral hepatitis, the results of this study suggest a lower accuracy of the surveillance. It will be important to restore the previous levels of attention and investigation, monitoring the trend in the coming years. The World Health Organization's goal is the eradication of viral hepatitis. COVID-19 may have slowed down the process. Key messages • It is important to keep up the level of attention towards viral hepatitis, which seems to have decreased following the COVID-19 pandemic. • It will be important to pay attention to the trend of notified cases in the coming years to establish more precisely the level of impact of the pandemic.

Associated Bacterial Coinfections in COVID-19-Positive Patients.

Background and Objectives: The aim of this study was to identify specific rhino- and oropharyngeal microbiological pathogens as well as associated comorbidities that favor SARS-CoV-2 infection and corelate them. Materials and Methods: This prospective clinical study enrolled 61 patients (28 COVID-19-positive and 33 controls) who were tested for other comorbidities and co-existence of associated oral pathogenic microbiota. Results: A total of 247 bacterial isolates were identified in the bacterial cultures in both groups. Viral hepatitis type A was more prevalent in the COVID-19-positive group (p = 0.026), as was the presence of oral candidiasis (p = 0.006). In the control group, a moderate direct relationship was observed between the Beta hemolytic streptococcus group G and dermatitis, and strong direct relationships were observed between the Beta hemolytic streptococcus group G and external otitis, Streptococcus pyogenes and dental alveolitis, and Streptococcus pyogenes and chronic lymphocytic leukemia. In the test group, strong direct relationships were observed between Hemophilus influenzae and pulmonary thromboembolism; Staphylococcus aureus and autoimmune thyroiditis; post-viral immunosuppression, chronic coronary syndrome, and hypernatremia; Beta hemolytic streptococcus group C and rheumatoid polyneuropathy; Beta hemolytic streptococcus group G and hyperkalemia, hypothyroidism, secondary anemia, and splenomegaly; and active oral candidiasis and SARS-CoV-2 viral pneumonia. The following relationships were strong, but inverse: Beta hemolytic streptococcus group G and acute respiratory failure, and active oral candidiasis and SARS-CoV-2 viral bronchopneumonia. Conclusions: Briefly, COVID-19-positive patients have the predisposition to build up associated comorbidities and coinfections, which can be the expression of the immune burden that this virus generates to the host.

Current Therapy of Chronic Viral Hepatitis B, C and D.

The majority of chronic viral hepatitis cases are induced via infection with the hepatitis B virus (HBV), hepatitis C virus (HCV), or hepatitis D virus (HDV). These patients are at increased risk for progressive liver disease leading to cirrhosis as well as hepatocellular carcinoma (HCC). HBV infection is well controlled by the currently available nucleosides as well as nucleotides, and the development of cirrhosis can be prevented. Additionally, it has been shown that HBV-induced liver fibrosis can regress during successful antiviral treatment; however, a "functional cure", i.e., loss of HBsAg, is a rare event when these drugs are used. Therefore, novel therapeutic strategies are aiming at the selective suppression of HBsAg levels in combination with immunostimulation. The development of directly acting antivirals (DAAs) has revolutionized HCV therapy, as almost all patients can be cured via this treatment. Additionally, DAA therapy has few, if any, side effects, and is generally well tolerated by patients. HDV remains the most challenging type of chronic viral hepatitis. Although novel therapeutic options have recently been approved, response rates are still less favorable compared to HBV and HCV. This review discusses current and future options for the treatment of chronic HBV, HCV, and HDV infection.

A study for the changes of lipid profile in sera of patients infected with viral hepatitis type B and C infections

الهدف الرئيسي من التهاب الكبد الفيروسي B و C هو الكبد ، وهو أهم عضو في التمثيل الغذائي للدهون والبروتينات الدهنية. التهاب الكبد يؤدي إلى تعطيل الدهون. درسنا في هذه الدراسة مستويات الكوليسترول والدهون الثلاثية والبروتين الدهني عالي الكثافة والبروتين الدهني منخفض الكثافة في مصل 33 مريضاً بفيروس التهاب الكبد B و 30 مريضاً بفيروس التهاب الكبد C مقابل 31 شخصاً أصحاء كمجموعة ضابطة. تم فحص الارتباطات بين معاملات الدهون ومؤشرات التهاب الكبد (البيليروبين الكلي والمباشر ، الألبومين ، ألانين ترانس أميناز ، الأسبارتاتي ، والفوسفاتيز القلوي) إحصائياً. وجد أن الكوليسترول والبروتين الدهني منخفض الكثافة ينخفضان بشكل ملحوظ في كلا المجموعتين من المرضى بينما انخفضت الدهون الثلاثية في مرضى التهاب الكبد الفيروسي. أظهر اختبار معامل سبيرمان ارتباطًا معنويًا بانخفاض الدهون الثلاثية مع زيادة البيليروبين (الكلي والمباشر) وزيادة الألبومين ، وانخفاض البروتين الدهني عالي الكثافة مع زيادة البيليروبين المباشر في مرضى التهاب الكبد B. في مرضى التهاب الكبد الوبائي ، وجد أن الكوليسترول ينخفض ​​بشكل ملحوظ مع ألانين ترانساميناز وزيادة البيليروبين المباشرة ، والدهون الثلاثية مع البيليروبين المباشر ، والبروتين الدهني منخفض الكثافة مع زيادة إنزيم الأسبارتات. تكشف هذه النتائج بوضوح أن مرضى التهاب الكبد B و C يصابون بنقص شحميات الدم وترتبط شدته بشكل إيجابي بتطور التهاب الكبد. نقترح أن يتم فحص مرضى التهاب الكبد B و C ، وخاصة أولئك الذين يعانون من مراحل مزمنة ، لمعرفة تركيزات الدهون في الدم والحفاظ على مستوياتها عند المستويات المرغوبة لتجنب مخاطر العديد من الاضطرابات المرتبطة بهذه الاضطرابات ، والأهم من ذلك ، للتخفيف. المرضى في مراحل متقدمة من عدوى فيروس التهاب الكبد B و C.

Incidence and risk factors of Chronic Viral Hepatitis type C in persons deprived of their liberty in the Social Rehabilitation Center (CERESO) of the state of Veracruz

Incidence and risk factors of Chronic Viral Hepatitis type C in persons deprived of their liberty in the Social Rehabilitation Center (CERESO) of the state of Veracruz

A novel strategy against hepatitis B virus: Glycyrrhetnic acid conjugated multi-component synergistic nano-drug delivery system for targeted therapy.

It is well known that Glycyrrhetnic acid (GA) has significant liver-targeting and anti-inflammatory effects. Syringopicroside (SYR) and Hydroxytyrosol (HT), the active components of the Chinese herb Syringa oblata Lindl, have earned great reputation for their potential in preventing or treating viral hepatitis type B. Therefore, we loaded SYR and HT into GA-conjugated PEG-PLGA, so that they could target the liver in additional to exerting their own pharmacological effects in a synergistic. However, the in vivo targeting and the low bioavailability of SYR and HT pose a huge challenge. Therefore, we synthesized GA-conjugated multi-component nano-drug delivery system (SH-GPP). SH-GPP had a regular spherical shape with a uniform size distribution of 110.5 ± 3.18nm. We further evaluated the effects of SH-GPP in vitro and in vivo. In the in vivo experiment, we evaluated the following parameters: the serum ALT and AST values; liver tissue homogenate MDA and SOD; HE staining of the pathological liver sections; and the liver coefficient. In the in vitro studies, the following parameters were evaluated: cellular uptake of SH-GPP; wound healing/scratch assay; cellular apoptosis; cell cycle; HBsAg; and HBeAg content. SH-GPP had better anti-hepatitis B effect than Syringopicroside and hydroxytyrosol (SH) and NPP alone. The targeting ability of GA enabled HT and SYR in GPP to reach the liver accurately, and played a synergistic role to maximize their therapeutic effects. This study provides a novel strategy against hepatitis B virus, and also provides a feasible scheme for improving the low bioavailability of the active components of traditional Chinese medicine.

Effect of SARS-CoV-2 Infection on HBV-Infected Patients

Background: Hepatic manifestations of COVID-19 are prevalent in individuals infected with viral hepatitis type B (HBV). Objectives: The current study aims to determine the extent of the HBV reactivation depending on the immune impact on patients infected with SARS-CoV-2. Materials and Methods: One hundred forty-one hospitalized cases were divided into patients infected with HBV with/without SARS-CoV-2 diagnosed by automatic fluorescent immunoassay system COVID-19 Ab (IgM/IgG). Next, HBV reactivation was assessed using hepatitis B surface antigen (HBsAg), HBcAb (IgM), HBeAg, and HBeAb ELISA test. Results: The results showed significant differences in HBV reactivation patients with SARS-CoV-2 at P < 0.05. Out of 141 HBV patients, 115 (1, 80, and 34) had positive COVID-19 in IgM, IgG, and IgM with IgG, respectively. The results of reactivation test showed 34.07% of patients have HBV reactivation. Conclusions: The HBV reactivation patients had been recorded in acute and chronic cases of HBV patients, where no severe cases were recorded compared with the advanced cases of the disease who received immunosuppressive therapy and biological treatment. Therefore, it is necessary to consider the special care of persons exposed to infection with SARS-CoV-2 to patients infected with viral hepatitis, in particular, advanced cases of the disease and their stages of treatment as it leads to liver dysfunction and life-threatening complications.

Protection of Ducklings from Duck Hepatitis A Virus Infection with ELPylated Duck Interferon-α.

Duck viral hepatitis type I (DVH I) is a lethal disease in ducklings caused by duck hepatitis A virus (DHAV). Although the commercial vaccine is available for vaccination of one-day-old ducklings or breeder ducks, the disease is still prevalent due to the delayed immune response in ducklings and variable maternal antibody levels in breeder duck flocks. To explore the feasibility of duck interferon-α (DuIFN-α) for control of DVH I, DuIFN-α was expressed as an elastin-like polypeptide (ELP) fusion protein (ELP-DuIFN-α) in E. coli and purified by inverse phase transition cycling (ITC). After detection of its cytotoxicity, bioactivity, plasma stability and serum half-life, the protective efficacy of ELP-DuIFN-α against DHAV-1 infection of embryos or ducklings was evaluated using different treatment routes at different infection times. The results show that ELP-DuIFN-α was correctly expressed and purified to more than 90% purity after two cycles of ITC. The purified fusion protein had a specific anti-DHAV-1 activity of 6.0 × 104 IU/mg protein, significantly extended plasma stability and serum half-life without overt cytotoxicity. After allantoic injection with ELP-DuIFN-α pre-infection, co-infection or post-infection with DHAV-1, 5/5, 5/5 or 4/5 embryos survived from the virus challenge. After intramuscular injection or oral administration with ELP-DuIFN-α, 3/5 or 4/5 ducklings survived from co-infection with DHAV-1. After oral administration with ELP-DuIFN-α pre-infection, co-infection or post-infection with DHAV-1, 3/5, 4/5 or 4/5 ducklings survived from the virus challenge, and the relative transcription levels of interferon-stimulated genes were significantly higher than the normal control group and virus challenge control group (p < 0.01). These experimental data suggest that ELP-DuIFN-α can be used as a long-lasting anti-DHAV-1 reagent.

Alterações hepáticas em Gallus gallus domesticus no Brasil

ABSTRACT: The occurrence and the frequency of hepatic changes in chickens, including broiler (BC), layer (LC) and backyard chickens (BYC) were investigated. The retrospective and prospective study (2006-2021) was conducted with a total of 300 cases of liver disorders. Industrial poultry (BC and LC) were frequently affected (88%) and noninfectious changes were the most diagnosed (69%). Considering etiology or conditions, the hepatic changes were classified as follows: degenerative changes (42%), bacterial (28%), metabolic (15%), toxic (8%), viral (3%), neoplastic (2%), protozoal diseases (1.5%) and circulatory disorders (0.5%). Regarding the type of bird, degenerative, toxic changes and viral hepatitis were more frequent in BC. Circulatory and metabolic disorders, as well as bacterial hepatitis, were more frequently diagnosed in LC. Neoplastic and protozoal hepatitis occurred more frequently in BYC. The macroscopic examination in association with histopathology enabled the diagnosis of the hepatic changes in 59% of the cases. Considering bacterial hepatitis in commercial poultry, the etiological diagnosis is highly important, in view of the risk for public health, despite the obvious importance due to the productivity losses and condemnation at processing.

The Impacts of Viral Hepatitis on Liver Enzymes and Bilrubin

Viral hepatitis is an infection that causes liver inflammation and damage. Several different viruses cause hepatitis, including hepatitis A, B, C, D, and E. The hepatitis A and E viruses typically cause acute infections. The hepatitis B, C, and D viruses can cause acute and chronic infections. Hepatitis A causes only acute infection and typically gets better without treatment after a few weeks. The hepatitis A virus spreads through contact with an infected person’s stool. Protection by getting the hepatitis A vaccine. Hepatitis E is typically an acute infection that gets better without treatment after several weeks. Some types of hepatitis E virus are spread by drinking water contaminated by an infected person’s stool. Other types are spread by eating undercooked pork or wild game. Hepatitis B can cause acute or chronic infection. Recommendation for screening for hepatitis B in pregnant women or in those with a high chance of being infected. Protection from hepatitis B by getting the hepatitis B vaccine. Hepatitis C can cause acute or chronic infection. Doctors usually recommend one-time screening of all adults ages 18 to 79 for hepatitis C. Early diagnosis and treatment can prevent liver damage. The hepatitis D virus is unusual because it can only infect those who have a hepatitis B virus infection. A coinfection occurs when both hepatitis D and hepatitis B infections at the same time. A superinfection occurs already have chronic hepatitis B and then become infected with hepatitis D. The aim of this study is to find the effect of each type of viral hepatitis on the bilirubin (TB , DSB) , and liver enzymes; AST, ALT, ALP,GGT among viral hepatitis patients. 200 patients were selected from the viral hepatitis units in the central public health laboratory in Baghdad city, all the chosen cases were confirmed as a positive samples , they are classified into four equal group each with fifty individual and with a single serological viral hepatitis type either; anti-HAV( IgM ) , HBs Ag , anti-HCV ,or anti-HEV(IgM ). All patients were tested for; serum bilirubin ( TB ,D.SB ) , AST , ALT , ALP , GGT. Another fifty quite healthy and normal person was selected as a control group for comparison. . Liver enzymes and bilirubin changes are more pronounced in HAV, HEV than HCV and HBVAST and ALT lack some sensitivity in detecting HCV ,HBV and mild elevations of ALT or AST in asymptomatic patients can be evaluated efficiently by considering ,hepatitis B, hepatitis C. ALT is generally a more sensitive indicator of acute liver cell damage than AST, It is relatively specific for hepatocyte necrosis with a marked elevations in viral hepatitis. Liver enzymes and bilirubin changes are more pronounced in HAV, HEV than HCV and HBV.AST and ALT lack some sensitivity in detecting HCV ,HBV and mild elevations of ALT or AST in asymptomatic patients can be evaluated efficiently by considering ,hepatitis B, hepatitis C. ALT is generally a more sensitive indicator of acute liver cell damage than AST, It is relatively specific for hepatocyte necrosis with a marked elevations in viral hepatitis.

Transmitted Water Disease, Assessment of Immunopathogenesis of Chronic Hepatitis B and The Carrier State of Disease

The transmission of viral hepatitis type B (HBV) is of significant public health concern. The infection result depends on how well the virus interacts with the host and in particular, on the ability to respond inherently and adaptively to the humoral and cellular immunity. The purpose of this study is to evaluate clinical, immunology and tracer status (viral). This study showed the relationship between the immune and chronic conditions of Iraqi patients who are chronic hepatitis virus B or HBV carriers. The study included (111) chronically-viral hepatitis type (b) and (112) hepatitis virus surface antigen type (b) healthy carriers from out of patients. The result of this study proved that a non-significant correlation was observed between cellular immune response (CD4 and CD8) among chronic hepatitis B patients. For CD8+ lymphocytes: there was a highly significant decrease (P&lt;0.001) in the percentage means of the CD8+ cells in CHB patients, as compared with the carrier groups. For CD4+ lymphocytes: there was a slight decrease in the percentage of these lymphocytes in the peripheral blood of the patients, as compared with the carrier groups, a non-significant importance was recorded between them. The percentage of cytotoxic T-lymphocyte CD8+ was significantly decreased in CHB patients as compared to the carrier group. One of the deciding factors for the form of infection, and the immune response, which developed in accordance with a number of other biochemical factors and genes is chronic hepatitis B immunopathogénesis and carrier condition with the level of cellular immunity.

In silico Analysis of a Novel Peptide Vaccine against Hepatitis B Virus (HBV)

Background : Hepatitis B is a potentially life-threatening liver infection caused by the Hepatitis B virus (HBV). It is a major global health problem and the most serious type of viral hepatitis. It can cause chronic liver disease and puts people at high risk of death from cirrhosis of the liver and liver cancer. HBV is found in highest concentrations in blood and in lower concentrations in other body fluids.&#x0D; Methods: Target protein was retrieved from the swissprot database. Epitopes were predicted using the BCEPRED server. After running the BLAST algorithm for the target protein, the template with the best identity was selected. After modeling, target protein is verified by using the swiss model workspace and after this process the obtained target protein is allowed to interact with the MHC which is studied by using patchdock, finally these results were viewed by using the deepview tool.&#x0D; Results: The target protein for vaccine development was downloaded from the SwissProt database. Its SwissProt ID was p29178. The protein was isolated from hepatitis B virus genotype G. The virus was isolated from the United States of America. The length of the target protein was found to be 195 amino acids. To confirm that the target protein could be used for vaccine development, the Presence of epitopes in the protein was confirmed using the BCEPRED tool. Results from the SAVS server showed 95.80 of the residues of the protein had an average 3D-1D score greater than 0.2. The protein attained a pass with an ERRAT value of 90.299.&#x0D; Conclusion: The present investigation recognized the promising complex formed between the HBV peptide and MHC molecules. All the downloaded MHC molecules were found to interact with the target protein through the formation of hydrogen bonds. Since these interactions are necessary during an immune response to invading pathogens, the target protein would ultimately trigger an immune response if it is administered as a vaccine for Hepatitis B virus genotype G.

Differences in Incidence of Acute Viral Hepatitis between Foreigners and Autochthonous Population in Italy.

Background: In European countries, the prevalence of HBV and HCV in refugees and migrants tends to reflect the prevalence in their countries of origin. The aim of this study is to analyse acute viral hepatitis cases diagnosed in Italy among foreign citizens and to compare incidence rates in foreigners and Italians. Methods: We analysed the cases of each viral hepatitis type among foreigners. Standardised incidence rates were compared between natives and foreigners. Results: Between 2004 and 2019, 15,872 cases of acute viral hepatitis were notified by 10 Italian regions, 14.8% among foreign citizens. Until 2012, the percentage increased gradually, while a fluctuating trend set in from 2013 onwards; in 2019, 23.9% of cases were foreigners. Data from the SEIEVA surveillance show higher standardised incidence rates of hepatitis A and B among foreign citizens; no significant difference emerged between Italians and foreigners in terms of their hepatitis C incidence. Conclusions: foreign citizens have an increased incidence of hepatitis A and B. Regarding hepatitis A, vaccination is strongly recommended to foreigners travelling to their countries of origin. Screening tests for hepatitis B and C infection should be offered to newly arrived migrants from high prevalence countries, or having specific risk factors.

Evaluation the Level of Interleukin 2 and 6’ Receptors in Hepatitis-C Patients in Wasit Province / Iraq

Viral hepatitis type C, is a disease happened due to entering of Hepatitis C virus the body and reaching theliver. It will multiplication and stimulates the patient’s immune system to attack the infected cells, thereforewill caused the liver inflammation. Our study included (35) HCV patient’s blood samples and had beencompared with (30) control’s blood samples. When the interleukin 2 receptors’ and interleukin 6receptors’level and some of a biochemical test (ALT, AST, ALP, TSB) had been measured. We observed a significantincreasing (P&lt;0.05) in the value of biochemical parameters (ALT, AST, ALP, TSB) of patients compared tohealthy. Also there was a significant increasing (P&lt;0.05) in Interleukin 2&amp;6 receptors in patients comparedto healthy. From the results a presence of a direct correlation had been indicated between the interleukin-2receptors and (ALT, AST), and reversed correlation between Interleukin 2 receptors and (TSB, ALP)apresence of a direct correlation indicated between the interleukin-6 receptors and (ALT, TSB), and reversedcorrelation between Interleukin-6 receptors and (AST, ALP)Hepatitis C virus, HCV, Interleukin-2, Interleukin-6, Interleukin-2 Receptors, Interleukin-6Receptors, IL6, IL2, IL2Rs, IL6Rs.

Interferonogenic activity of the strain BH-3 duck hepatitis virus type I (Picornaviridae: Avihepatovirus: Avihepatovirus A)

Duck viral hepatitis type I (DVH-I) is a poorly studied contagious disease caused by RNA-containing duck (Anatinae) hepatitis virus type I (Picornaviridae: Avihepatovirus: Avihepatovirus A). This infection is widespread in many countries, including Russia, and causes significant damage to industrial duck breeding. The study of interferonogenic activity of its etiologic agent strains is of great importance in solving the problem of developing effective means to control the disease. Strain BH-3 of duck hepatitis virus type I isolated from the liver of sick ducklings was used in the study. The strain was adapted to developing 10-12 day old duck embryos, to the cell culture of chicken and duck fibroblasts and deposited in the State Collection of Viruses of the D.I. Ivanovsky Institute of Virology of FSBI «National Research Centre for Epidemiology and Microbiology named after the honorary academician N.F. Gamaleya» of the Ministry of Health of Russia. Experiments were performed using the standard tissue culture method. Data on the ability of the viral strain BH-3 to induce interferon (IFN) and its sensitivity to the action of exogenous interferon in the culture of duck fibroblasts are presented. It has been shown that the interferonogenic activity of this strain of the hepatitis virus is in direct proportion to the multiplicity of infection. The maximum induction of IFN (1 : 256 CEPD50) was observed at a dose of 1.0 TCD50/cell in 72-96 hrs after inoculation of the cell culture. Exogenous IFN at a dose of 1 : 128 completely suppressed the cytopathic effect and death of duck embryos infected with hepatitis virus at a dose of 100 TCD50/cell. The data obtained allow us to state that the vaccine strain BH-3 of duck hepatitis virus type I has a pronounced interferonogenic activity and sensitivity to the action of exogenous IFN. This may have implications for the development of effective therapeutic agents against DVH-I.

Seroprevalence of Hepatitis- A virus in North Karnataka and its changes over a 5 year period

Introduction: Worldwide, the most common type of acute viral hepatitis is hepatitis A, transmitted via the fecal-oral route occasionally leading to death due to acute fulminant hepatitis. The present study was undertaken to study the seroprevalence of HAV infection in a tertiary care hospital over a five year period. Materials and Methods: A cross-sectional study was conducted from January 2012 to December 2016 on samples of blood obtained from cases of clinically suspected hepatitis infection by IgM 'capture' assay ELISA. Results: A total of 173 cases were included in the study. The number of positive cases were 35(20.2%). The percentage positivity rate of anti HAV IgM was higher among the children tested 32(30.8%) when compared to adults tested 3(4.3%). Seasonal distribution showed maximum number of seropositive cases in the monsoon months. Conclusion: Increase in the number of samples received during 2014 and 2015 and a zero positive rate in 2015 indicates a rise in the awareness about preventive measures against hepatitis A virus infection. Uniform and well structured protocols which monitor HAV cases and assess disease load are necessary to capture and probe into the sudden rise in the seropositivity, as seen in the last four months of 2016 in this study. Keywords: Fulminant hepatitis, Feco-oral route, Hepatitis A, Sero prevalence.

Trend analysis and prediction of viral hepatitis incidence in China, 2009-2018

Objective: To explore the time series characteristics of 5 types of viral hepatitis in China and predict their incidence through effective models. Methods: The monthly incidence data of 5 types of viral hepatitis (A, B, C, D and unspecified) in China from 2009 to 2018 were collected for descriptive and time series analyses, decomposition methods were used to explore the seasonality in the form of seasonal indices and the long-term trend in the form of a linear regression model. Autoregressive integrated moving average (ARIMA) models were established for each type of viral hepatitis. Results: From 2009 to 2018, a total of 14 856 990 cases of viral hepatitis were reported, the seasonal index range of 5 types of viral hepatitis were all lower than 1, the seasonality of hepatitis E was significant, and its incidence was unimodal, but no obvious seasonality characteristics were observed for other four types of viral hepatitis. The incidences of hepatitis A, hepatitis E and unspecified hepatitis remained at lower levels, showing slow declines. Although the cases of hepatitis B accounted for the highest proportion (79.59%, 11 824 262/14 856 990) among 5 types of viral hepatitis, the decline was fastest (-0.01/100 000). The incidence of hepatitis C was on rise, and the rate of increase remained stable (0.005/100 000). The predicted incidences of 5 types of viral hepatitis in China from January 2009 to December 2018 fitted by ARIMA model were consistent with the actual incidences, and the mean absolute error percentage (MAPE) ranged from 3.756 8 to 8.068 3. Conclusions: Time series analysis on surveillance data is useful for better understanding the incidence of the viral hepatitis. The ARIMA model has good application value in the short-term prediction of viral hepatitis incidence in China.

Hepatitis B infection and intrahepatic cholestasis of pregnancy: A systematic review and meta-analysis.

Background:Viral hepatitis type B is caused by hepatitis B virus (HBV) infection. Several studies have linked HBV infection to a higher risk of developing intrahepatic cholestasis of pregnancy (ICP), although some give contradictory results. To investigate the association and estimated risk of ICP in patients with HBV infection, we conducted this meta-analysis to summarize all available evidence.Methods:This study consists of 2 meta-analyses. A literature search was performed using MEDLINE and EMBASE from inception to July 2019. The first study included studies that reported associations between HBV infection and the risk of ICP. The second analysis included studies comparing the risk of HBV infection in ICP patients with those without ICP. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using a random-effect, inverse variance method.Results:Four studies were included in both analyses. The OR of ICP in HBV-infected pregnant women compared with non-HBV pregnant women was 1.68 (95% CI 1.43–1.97; I2 = 0%). The OR of HBV infection among ICP patients compared with non-ICP patients was 1.70 (95% CI 1.44–2.01; I2 = 0%).Conclusions:Our meta-analysis demonstrates not only a higher risk of ICP among HBV-infected pregnant women but also an increased risk of HBV infection among ICP patients. These findings suggest that HBV is a high-risk factor for ICP and screening for hepatitis B in women with ICP symptoms may be beneficial.

REGISTERED OUTBREAKS OF ACUTE VIRAL HEPATITIS A IN STARA ZAGORA REGION, FOR THE PERIOD SEPTEMBER 2019 – MARCH 2020, IN THE MUNICIPALITIES BR. DASKALOVI, HRISHTENI, GALABOVO IN BULGARIA

Viral hepatitis type A is an acute infectious disease, occupying 75% of all viral hepatitis. Purpose of the study was to investigate three outbreaks, of viral hepatitis A in the municipalities of Stara Zagora region, from 09.2019-03.2020 in schools and kindergartens. Methods: We investigated all cases from viral hepatitis A, for the municipalities of Bratya Daskalovi-26, Hrishteni-19, Galabovo-21. A retrospective analysis and descriptive epidemiological methods have been used. Results: The gender distribution shows that men were affected in 56% and women in 44%. The children in the age group of 5-9 years - 49%, as well as of 1 - 4 years - 19.7% are most ill. The peak in the development of the outbreaks is in December 2019 (18%) and January 2020 (48%), which lasts until March with the so-called "Epidemic tail". Contact persons were not covered by the hepatitis A vaccine. The faecal-oral mode of transmission of infection has been proven. Specialized companies were engaged for the activities of current and final disinfection. Health educational activities aimed at improving hygiene habits have been carried out. Conclusion: To prevent the outbreaks the cases have to be timely reported; Early examination of contact persons; Applications of a vaccine on the contact persons.