overview of the Hepatitis C control plan in Qatar

Since the development and approval of new direct-acting antiviral (DAA) drugs, chronic hepatitis C virus (HCV) infection is now considered a curable disease. However, the emphasis on DAA therapies might disregard other preventive measures, and limits the strategy for a clinical cure rather than comprehensive disease control. The Qatar National plan for HCV control was launched in December 2014 to prioritize and proactively manage HCV with the ultimate aim of eliminating viral hepatitis. The plan is based on four pillars: primary prevention, early detection, clinical management, and continuous monitoring. This report describes the activities undertaken in Qatar to prepare for the programme and the early results of its initial phase, given the fact that countries with comprehensive HCV plans are providing better access to care and prevention

Assessment of hepatitis B immunization programme among school students in Qatar

Background: In 2010, Qatar adopted the target of reducing hepatitis B prevalence to < 1% in children by 2015. The World Health Organization Region for the Eastern Mediterranean is identified with intermediate hepatitis B virus [HBV] endemicity, ranging from 2% to 7%. It is estimated that 4.3 million individuals are living with HBV infection in the Region.

Aims: This study was conducted to assess hepatitis B seroprevalence in children, hepatitis B vaccination coverage, potential exposure to risk factors, and knowledge among parents/guardians about hepatitis B infection.

Methods: We carried out this cross-sectional study in Qatar during the academic year 2015/16. Multistage cluster sampling was used to select a nationally representative sample of 2735 grade 1 school students aged . 5 years. Blood was collected by finger prick and tested using the point-of-care test/rapid test. A self-administered, precoded questionnaire was used to assess parent/guardian knowledge about HBV and collect information on the childfs HBV vaccination coverage.

Results: All blood samples were HBsAg negative. Qataris had a vaccination card and were totally vaccinated but 17.7% of non-Qataris did not hold a vaccination card and most parents/guardians were not aware of the vaccination status of their children. Children were exposed to various hepatitis B risk practices. Knowledge about hepatitis B among parents/ guardians was low.

Conclusions: Qatar has averted the hepatitis B threat and maintained high vaccination coverage for children

Clinical Application of AIMS65 Scores to Predict Outcomes in Patients with Upper Gastrointestinal Hemorrhage

BACKGROUND/AIMS: To evaluate the ability of the recently proposed albumin, international normalized ratio (INR), mental status, systolic blood pressure, age >65 years (AIMS65) score to predict mortality in patients with acute upper gastrointestinal bleeding (UGIB). METHODS: AIMS65 scores were calculated in 251 consecutive patients presenting with acute UGIB by allotting 1 point each for albumin level 1.5, alteration in mental status, systolic blood pressure or =65 years. Risk stratification was done during the initial 12 hours of hospital admission. RESULTS: Intensive care unit (ICU) admission, endoscopic therapy, or surgery were required in 51 patients (20.3%), 64 (25.5%), and 12 (4.8%), respectively. The predictive accuracy of AIMS65 scores > or =2 was high for blood transfusion (area under the receiver operator characteristic curve [AUROC], 0.59), ICU admission (AUROC, 0.61), and mortality (AUROC, 0.74). The overall mortality was 10.3% (n=26), and was 3%, 7.8%, 20%, 36%, and 40% for AIMS65 scores of 0, 1, 2, 3, and 4, respectively; these values were significantly higher in those with scores > or =2 (30.9%) than in those with scores or =2 predict high in-hospital mortality.

Circulating adhesion molecules in orthotopic liver transplantation: relation to clinical course

Intercellular adhesion molecules [ICAMs] constitute an integral part of the immune reactions in various clinical conditions. Soluble forms shed or released from effector cells retain ligand-binding activity and their measurement in body fluids has proved as useful markers of cellular and endothelial reactivity. In this work, circulating soluble intercellular adhesion molecule-1 [sICAM-1], soluble vascular cell adhesion molecule [sVCAM-1], soluble E and P-selectins [sE- and sP-selectins] were measured by enzyme immuno-assay [EIA] in the serum of 27 liver transplant recipients who received cadaveric grafts within the previous 13 years and who were showing different clinical courses. 13 patients were having stable graft function [Stable group] and 14 showing evidence of chronic rejection +/- viral pathology [Unstable group]. 12 patients with hepatitis C virus [HCV] cirrhosis still on the waiting list for liver transplantation were also included [Pre-transplant group], in addition to 15 healthy subjects matched for age and sex [Control group]. A significant increase in sICAMs was noted in all patient groups as compared to controls except those stable non-viral cases who showed sICAM levels comparable to the control subjects. Patients transplanted for non-viral aetiology had their levels markedly lower than viral cases, whether stable or unstable. Stable cases showing viral recurrence had their sICAM levels comparable to the pre-transplanted cases with an insignificant increase in the unstable group. We could conclude that sICAM levels can be used to monitor graft integrity in the non-viral cases but their use in patients transplanted for viral causes would not be justified