Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 10.472
Filtrar
1.
Artículo en Alemán | MEDLINE | ID: mdl-33326051

RESUMEN

BACKGROUND: In 2016, the World Health Organization (WHO) released a strategy to eliminate hepatitis B, C, and D and defined indicators to monitor the progress. The Robert Koch Institute organized an interdisciplinary working meeting in 2019 to identify data sources and gaps. OBJECTIVES: The objectives were to network, to create an overview of the data sources available in Germany on hepatitis B and C, and to discuss how to construct indicators. MATERIALS AND METHODS: We extracted the WHO indicators relevant for Germany and determined how they can be constructed on the basis of available data. Stakeholders from public health services, clinics, laboratories, health insurance companies, research institutes, data holders, and registries attended a workshop and discussed methods of constructing the indicators for which data are lacking. Data sources and data were evaluated and prioritized with regard to their quality and completeness. RESULTS: Indicators on prevalence, incidence, prevention, testing and diagnosis, treatment, cure, burden of sequelae, and mortality for the general population can be constructed using secondary data such as diagnosis, health service, and registry data, data from laboratories and hospitals as well as population-based studies. Data sources for vulnerable groups are limited to studies among drug users, men who have sex with men, and about HIV coinfected patients. Data for migrants, prisoners, and sex workers are largely lacking as well as data on burden of disease from chronic viral hepatitis in the general population. CONCLUSIONS: We identified data sources, their limitations, and methods for construction for all selected indicators. The next step is to convert the ideas developed into concrete projects with individual stakeholders.


Asunto(s)
Hepatitis B , Hepatitis C , Hepatitis Viral Humana , Minorías Sexuales y de Género , Alemania/epidemiología , Hepatitis B/diagnóstico , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Hepatitis C/diagnóstico , Hepatitis C/epidemiología , Hepatitis C/prevención & control , Homosexualidad Masculina , Humanos , Masculino
2.
J Viral Hepat ; 28(1): 80-88, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32929826

RESUMEN

The interaction between existing chronic liver diseases caused by hepatitis B virus (HBV) infection and COVID-19 has not been studied. We analysed 70 COVID-19 cases combined with HBV infection (CHI) to determine the epidemiological, clinical characteristics, treatment and outcome. We investigated clinical presentation, imaging and laboratory parameters of COVID-19 patients of seven hospitals from Jan 20 to March 20, 2020. Multivariate analysis was used to analyse risk factors for progression of patients with COVID-19 combined with HBV infection. Compared with COVID-19 without HBV infection (WHI) group, patients with dual infection had a higher proportion of severe/critically ill disease (32.86% vs. 15.27%, P = .000), higher levels of alanine aminotransferase (ALT), aspartate transaminase (AST) and activated partial thromboplastin (APTT) [50(28-69)vs 21(14-30), P = .000; 40(25-54) vs 23(18-30), P = .000; 34.0(27.2-38.7) vs 37.2(31.1-41.4), P = .031]. The utilization rates of Arbidol and immunoglobulin were significantly higher than those in the co-infected group [48.57% vs. 35.64%, P < .05; 21.43% vs. 8.18%, P < .001], while the utilization rate of chloroquine phosphate was lower (1.43% vs 14.00%, P < .05) in the co-infected patients group. Age and c-reactive protein (CRP) level were independent risk factors for recovery of patients with COVID-19 combined with HBV infection. The original characteristics of COVID-19 cases combined with HBV infection were higher rate of liver injury, coagulation disorders, severe/critical tendency and increased susceptibility. The elderly and patients with higher level of CRP were more likely to experience a severe outcome of COVID-19.


Asunto(s)
/epidemiología , Hepatitis B/epidemiología , Hepatitis B/patología , Adulto , /terapia , China/epidemiología , Coinfección/complicaciones , Coinfección/epidemiología , Coinfección/patología , Coinfección/terapia , Femenino , Hepatitis B/complicaciones , Hepatitis B/terapia , Virus de la Hepatitis B , Humanos , Hígado/lesiones , Hígado/patología , Hígado/fisiopatología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Resultado del Tratamiento
3.
PLoS One ; 15(12): e0242502, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33290386

RESUMEN

BACKGROUND: The timely administration of vaccines is considered to be important for both individual and herd immunity. In this study, we investigated the timeliness of the diphtheria-tetanus-whole cell pertussis-hepatitis B-Haemophilus influenzae type b (pentavalent) vaccine, scheduled at 6, 10 and 14 weeks of age in the Lao People's Democratic Republic. We also investigated factors associated with delayed immunization. METHODS: 1162 children aged 8-28 months who had received the full course of the pentavalent vaccine at different levels of the health care system were enrolled. Vaccination dates documented in hospital records and/or immunisation cards were recorded. Age at vaccination and time intervals between doses were calculated. Predictors for timely completion with the pentavalent vaccine at 24 weeks were assessed by bivariate and multivariable analyses. RESULTS: Several discrepancies in dates between vaccination documents were observed. In general, vaccination with the pentavalent vaccine was found to be delayed, especially in health care settings below the provincial hospital level. Compared to the central hospital level, less participants who were vaccinated at the district/health center level received the third dose by 16 (48% at the central hospital level vs. 7.1% at the district and 12.4% at the health center level) and 24 weeks of age (94.4% at the central hospital level vs 64.6% at the district-outreach and 57.4% at the health center level) respectively. In logistic regression analyses, lower education level of the mother as well as vaccination by outreach service, were independently associated with delayed completion of vaccination. CONCLUSION: We observed a general delay of vaccination, especially at lower ranked facilities, which correlated with indicators of poor access to health services. This highlights the need for further improving health equity in rural areas. Age-appropriate vaccination should become a quality indicator for the national immunization programme. In addition, we recommend further training of the health care staff regarding the importance of reliable documentation of dates.


Asunto(s)
Vacuna contra Difteria, Tétanos y Tos Ferina/administración & dosificación , Vacunas contra Haemophilus/administración & dosificación , Vacunas contra Hepatitis B/administración & dosificación , Programas de Inmunización/organización & administración , Inmunización/estadística & datos numéricos , Vacunas Combinadas/administración & dosificación , Preescolar , Difteria/epidemiología , Difteria/prevención & control , Escolaridad , Femenino , Infecciones por Haemophilus/epidemiología , Infecciones por Haemophilus/prevención & control , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Hospitales , Humanos , Esquemas de Inmunización , Lactante , Laos/epidemiología , Modelos Logísticos , Masculino , Población Rural , Tétanos/epidemiología , Tétanos/prevención & control , Población Urbana , Tos Ferina/epidemiología , Tos Ferina/prevención & control
4.
BMC Infect Dis ; 20(1): 957, 2020 Dec 14.
Artículo en Inglés | MEDLINE | ID: mdl-33317454

RESUMEN

BACKGROUND: Chronic Sedentary lifestyles have been linked to increased odds of stress, elevated anxiety and diminished wellbeing, inducing cytokine production and predispose to hypertension and other cardiovascular diseases. In endemic areas, Plasmodium falciparum and hepatitis B virus (HBV) infections can trigger pro-inflammatory cytokine responses. However, the impact of these infections on cytokine response profiles in individuals engaged in chronic sedentary activities is unknown. This study was aimed at addressing these concerns using a predominantly sedentary population of traders in the Tamale metropolis of Ghana. METHOD: Four hundred respondents were categorized, based on their number of working years (< or ≥ 5 years) and number of working hours per day (< or ≥ 10 h), into sedentary (≥5 years + ≥ 10 h) and non-sedentary (≥ 5 years + < 10 h, < 5 years + ≥ 10 h and <  5 years + < 10 h) groups. The participants were tested for P. falciparum and HBV infections using polymerase chain reaction. Blood pressure and cytokines responses were measured. Associations and comparison analysis between variables were determined, and test statistics with p < 0.05 were considered statistically significant. RESULTS: Infection status included: un-infected (93.5%), P. falciparum mono-infected (1.0%), HBV mono-infected (3.0%) or P. falciparum /HBV co-infected (2.5%). Majority of the participants, 57.0% (n = 228) were involved in chronic sedentary life style. That notwithstanding, sedentary lifestyle was independent of the infection groups (χ2 = 7.08, p = 0.629). Hypertension was diagnosed in 53.8% of respondents and was independent of infection status (X 2 = 6.33, p = 0.097). Pro-inflammatory (TNF-α, IL-1ß, IL-6, IL-8 and IL-12) and anti-inflammatory (IL-10, IL-7 and IL-13) cytokine responses were similar among individuals with different sedentary working time and between hypertensive and non-hypertensive individuals (p > 0.05 for all comparisons). Among individuals with different infection status, pro-inflammatory (TNF-α; p = 0.290, IL-1ß; p = 0.442, IL-6; p = 0.686, IFN-γ; p = 0.801, IL-8; p = 0.546, IL-12; p = 0.154) and anti-inflammatory (IL-10; p = 0.201, IL-7; p = 0.190, IL-13; p = 0.763) cytokine responses were similar. CONCLUSION: Our data suggest that asymptomatic infections of P. falciparum and HBV together with a high prevalence of hypertension did not have any significant impact on cytokine response profiles among predominantly sedentary traders in the Tamale metropolis of Ghana.


Asunto(s)
Enfermedades Asintomáticas/epidemiología , Coinfección/epidemiología , Citocinas/sangre , Virus de la Hepatitis B/genética , Hepatitis B/epidemiología , Malaria Falciparum/epidemiología , Plasmodium falciparum/genética , Conducta Sedentaria , Adolescente , Adulto , Coinfección/parasitología , Coinfección/virología , Estudios Transversales , Femenino , Ghana/epidemiología , Hepatitis B/sangre , Hepatitis B/virología , Humanos , Malaria Falciparum/sangre , Malaria Falciparum/parasitología , Masculino , Persona de Mediana Edad , Autoinforme , Adulto Joven
5.
Rev Soc Bras Med Trop ; 54: e00892020, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33338106

RESUMEN

INTRODUCTION: Viral hepatitis is a major public health problem. It is necessary to understand the epidemic, verifying the combination of biological and demographic characteristics. METHODS: This is an analytical ecological and epidemiological study. Confirmed case data from the Notification Disease Information System (SINAN) were used. RESULTS: From 2009-2018, SINAN confirmed 404,003 viral hepatitis cases in Brazil, with 12.49%, 37.06%, and 48.28% cases of hepatitis A, B, and C, respectively. CONCLUSIONS: In Brazil, 4,296 deaths were associated with viral hepatitis, of which 36.66% were associated with acute hepatitis B. The proportional distribution of cases varied among the five Brazilian regions.


Asunto(s)
Hepatitis B , Hepatitis Viral Humana , Brasil/epidemiología , Estudios Epidemiológicos , Hepatitis B/epidemiología , Hepatitis Viral Humana/epidemiología , Humanos , Incidencia
6.
BMC Infect Dis ; 20(1): 925, 2020 Dec 04.
Artículo en Inglés | MEDLINE | ID: mdl-33276727

RESUMEN

BACKGROUND: Not all men who have sex with men (MSM) at risk for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) infection currently receive sexual healthcare. To increase the coverage of high-quality HIV/STI care for MSM, we developed a home-care programme, as extended STI clinic care. This programme included home sampling for testing, combined with treatment and sexual health counselling. Here, we pilot implemented the programme in a hospital setting (HIV-positive MSM) to determine the factors for the successful implementation of STI home sampling strategies. METHODS: Healthcare providers from the HIV hospital treatment centre (Maastricht) were invited to offer free STI sampling kits (syphilis, hepatitis B, [extra]genital chlamydia and gonorrhoea laboratory testing) to their HIV-positive MSM patients (March to May 2018). To evaluate implementation of the program, quantitative and qualitative data were collected to assess adoption (HIV care providers offered sampling kits to MSM), participation (MSM accepted the sampling kits) and sampling-kit return, STI diagnoses, and implementation experiences. RESULTS: Adoption was 85.3% (110/129), participation was 58.2% (64/110), and sampling-kit return was 43.8% (28/64). Of the tested MSM, 64.3% (18/28) did not recently (< 3 months) undergo a STI test; during the programme, 17.9% (5/28) were diagnosed with an STI. Of tested MSM, 64.3% (18/28) was vaccinated against hepatitis B. MSM reported that the sampling kits were easily and conveniently used. Care providers (hospital and STI clinic) considered the programme acceptable and feasible, with some logistical challenges. All (100%) self-taken chlamydia and gonorrhoea samples were adequate for testing, and 82.1% (23/28) of MSM provided sufficient self-taken blood samples for syphilis screening. However, full syphilis diagnostic work-up required for MSM with a history of syphilis (18/28) was not possible in 44.4% (8/18) of MSM because of insufficient blood sampled. CONCLUSION: The home sampling programme increased STI test uptake and was acceptable and feasible for MSM and their care providers. Return of sampling kits should be further improved. The home-care programme is a promising extension of regular STI care to deliver comprehensive STI care to the home setting for MSM. Yet, in an HIV-positive population, syphilis diagnosis may be challenging when using self-taken blood samples.


Asunto(s)
Infecciones por Chlamydia/epidemiología , Chlamydia/genética , Gonorrea/epidemiología , Seropositividad para VIH/epidemiología , VIH , Virus de la Hepatitis B/inmunología , Hepatitis B/epidemiología , Homosexualidad Masculina , Tamizaje Masivo/métodos , Neisseria gonorrhoeae/genética , Minorías Sexuales y de Género , Manejo de Especímenes/métodos , Sífilis/epidemiología , Treponema pallidum/inmunología , Adulto , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/microbiología , Consejo , Gonorrea/diagnóstico , Gonorrea/microbiología , Seropositividad para VIH/virología , Personal de Salud , Hepatitis B/diagnóstico , Hepatitis B/virología , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Parejas Sexuales , Sífilis/diagnóstico , Sífilis/microbiología
7.
Pan Afr Med J ; 36: 352, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33224418

RESUMEN

Introduction: HIV, hepatitis B and hepatitis C pose a public health challenge in sub-Saharan Africa and there are only few studies on co-infection of these viruses done in rural areas in Northern Nigeria. This study provides a rural perspective on HIV-hepatitis co-infection in a Northern Nigerian community. Methods: this cross-sectional study was carried out amongst people living with HIV/AIDS (PLWHA) in a rural community hospital over a three-month period. Socio-demographic data and other relevant information were obtained from the participants and case notes using an interviewer-administered questionnaire. Hepatitis B surface antigen and antibody to Hepatitis C virus were assayed from serum using enzyme-linked immunosorbent assay (ELISA) kits developed by LabACON®. Chi-square test was used to compare categorical variables and logistic regression modelling was used to determine correlates of co-infection in the population. Results: a total of 281 individuals participated in the study. The prevalence of Hepatitis B co-infection, Hepatitis C co-infection and triple infection was 6.0%, 14.6% and 1.1% respectively. Using Chi-square test, none of the socio-demographic characteristics, WHO Clinical Stage, viral suppression had significant association with Hepatitis B co-infection, however marital status was significantly associated with Hepatitis C co-infection and level of education was significantly associated with triple infection (p < 0.05). Logistic regression modelling generated no significant results. Conclusion: co-infection of viral hepatitis (particularly Hepatitis C) in PLWHA is common in rural Northern Nigeria, and significant correlates include lack of formal education and being married. There is need for provider-initiated routine counselling and screening of PLWHA for viral hepatitis, with adequate follow-up and treatment of co-infected individuals and Hepatitis B vaccination for those without co-infection.


Asunto(s)
Infecciones por VIH/epidemiología , Hepatitis B/epidemiología , Hepatitis C/epidemiología , Población Rural/estadística & datos numéricos , Adolescente , Adulto , Anciano , Niño , Coinfección/epidemiología , Estudios Transversales , Femenino , Hepatitis B/diagnóstico , Antígenos de Superficie de la Hepatitis B/sangre , Hepatitis C/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Nigeria/epidemiología , Encuestas y Cuestionarios , Adulto Joven
8.
PLoS One ; 15(11): e0242748, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33237972

RESUMEN

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide. Despite curative surgical resection, high recurrence of HCC after surgery results in poor patient survival. To develop prognostic markers is therefore important for better prevention and therapy of recurrent HCC to improve patient outcomes. Deletion mutations over the pre-S1 and pre-S2 gene segments of hepatitis B virus (HBV) have been closely associated with recurrence of HCC after curative surgical resection. In this study, we applied a next-generation sequencing-based approach to further evaluate the association of pre-S deletion regions with HCC recurrence. We demonstrated that the pre-S2 deletion (nucleotide 1 to 54) was the most predominant deletion regions of pre-S gene in plasma of HBV-related HCC patients. Moreover, patients with the pre-S2 deletion (nucleotide 1 to 54) exhibited a significantly higher risk of HCC recurrence after curative surgical resection than those without. The pre-S2 deletion (nucleotide 1 to 54) in plasma represented a prognostic factor that independently predicted HCC recurrence with greater performance than other clinicopathological and viral factors. Our data suggest that detection of the pre-S2 deletion (nucleotide 1 to 54) in plasma may be a promising noninvasive strategy for identifying patients at high risk for HCC recurrence after curative surgical resection.


Asunto(s)
Secuencia de Bases , Carcinoma Hepatocelular , Virus de la Hepatitis B/genética , Hepatitis B , Neoplasias Hepáticas , Recurrencia Local de Neoplasia , Eliminación de Secuencia , Proteínas Virales/genética , Adulto , Anciano , Carcinoma Hepatocelular/epidemiología , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/cirugía , Carcinoma Hepatocelular/virología , Femenino , Hepatitis B/epidemiología , Hepatitis B/genética , Hepatitis B/virología , Humanos , Neoplasias Hepáticas/epidemiología , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/cirugía , Neoplasias Hepáticas/virología , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/epidemiología , Recurrencia Local de Neoplasia/genética , Recurrencia Local de Neoplasia/cirugía
9.
PLoS One ; 15(11): e0242278, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33206693

RESUMEN

BACKGROUND: The available data concerning hepatitis B virus (HBV) infection in Uganda are limited, particularly in the case of people living with HIV/AIDS (PLWH). HBV is not routinely tested when starting antiretroviral therapy (ART). We aimed to determine the prevalence, the correlates of the risk of HBV infection, and the association with outcomes of ART among PLWH attending a busy HIV clinic in a referral hospital in Northern Uganda. PATIENTS AND METHODS: From April to June 2016, a random sample of 1000 PLWH attending the outpatients' clinic of St. Mary's Hospital, Gulu, Uganda were systematically selected to undergo a rapid hepatitis B surface antigen (HBsAg) test after administering a questionnaire in this cross-sectional study. HIV care parameters were obtained from client files. Multivariate logistic regression and general linear model were used for the analysis. RESULTS: 950 of the 985 evaluable patients (77% females; mean age 42.8 years) were receiving ART. The overall prevalence of HBsAg was 7.9% (95% confidence interval [CI] 6.2-9.6%), and was significantly lower among the females (6.8% vs 11.7%; p = 0.020). The factors independently associated with higher HBV infection were having lived in an internally displaced persons' camp (adjusted odds ratio [aOR] 1.76, 95% CI 1.03-2.98; p = 0.036) and having shared housing with HBV-infected people during childhood (aOR 3.30, 95% CI 1.49-7.32; p = 0.003). CD4+ T cell counts were significantly lower in HBV patients (p = 0.025), and co-infection was associated with a poorer CD4+ T cell response to ART (AOR 0.88; 95% CI 0.79-0.98; p = 0.030). CONCLUSIONS: The observed prevalence of HBV among the PLWH may be underestimated or a signal of HBV decline in the region. The factors favouring horizontal HBV transmission identified suggest extending HBV screening and vaccine prophylaxis among PLWH.


Asunto(s)
Coinfección/complicaciones , Infecciones por VIH/complicaciones , Hepatitis B/complicaciones , Hepatitis B/epidemiología , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Uganda/epidemiología
10.
Pan Afr Med J ; 36: 362, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33235639

RESUMEN

Introduction: viral hepatitis B remains a major public health problem around the world, especially in underdeveloped and developing countries. Cameroon shows a grate variability in prevalence of this infection in the country and even within different populations groups. The aim of this study was to determine the prevalence and factors associated with viral hepatitis B infection in the rural area of Dschang. Methods: we conducted a cross-sectional community-based study, involving 551 participants of both genders recruited by a voluntary sampling technique. The biological diagnosis of HBsAg was done by the Immunochromatographic method (PKL® kit of PARAMEDICAL srl laboratories). Positive cases were confirmed by ELISA method (reagent Kit from DIALAB Laboratories). Results: results show a Viral Hepatitis B prevalence of 5.08% (95% CI: 3.2-6.9). University students were the most infected (11/88) with a positivity rate of 12.50% (95%CI: 5.6-19.4). Only 29/551 participants (5.26%) had received at least one dose of vaccine against the disease and were less infected (3.44%) than the others (5.17%). Age (p=0.000), level of education (p=0.013), occupation (p = 0.002), belief in the traditional healing of hepatitis B (p=0.000) and knowledge about the disease and its contamination roads (p=0.049) were associated with viral hepatitis B. Conclusion: there is a need of intensifying awareness, education, routine screening and vaccination of the population, especially in schools and university milieu to better counteract the infection with hepatitis B virus in our local Communities.


Asunto(s)
Antígenos de Superficie de la Hepatitis B/sangre , Vacunas contra Hepatitis B/administración & dosificación , Hepatitis B/epidemiología , Población Rural/estadística & datos numéricos , Adolescente , Adulto , Camerún/epidemiología , Estudios Transversales , Femenino , Hepatitis B/diagnóstico , Humanos , Masculino , Tamizaje Masivo/métodos , Prevalencia , Factores de Riesgo , Estudios Seroepidemiológicos , Vacunación/estadística & datos numéricos , Adulto Joven
11.
Artículo en Inglés | MEDLINE | ID: mdl-33142883

RESUMEN

The correct immunization of the inmate population minimizes the risk of transmission of vaccine-preventable diseases in prisons. The objective of this study was to evaluate the vaccine coverage of long-term prisoners in the Spanish penitentiary system through a retrospective longitudinal study. One-thousand and five prisoners were selected, who were imprisoned from 2008 and 2018 in three Spanish prisons. Their degree of immunization was evaluated as related to hepatitis A (HAV), hepatitis B (HBV), tetanus, diphtheria, pneumococcus and seasonal flu. The state of vaccination of the prisoners with a serological diagnosis of HBV, hepatitis C (HCV) and human immunodeficiency virus (HIV) was also evaluated. The vaccination coverage obtained for hepatitis B was 52.3%, and for tetanus-diphtheria, it was 71.9%. However, for hepatitis A and pneumococcus infection, it was insignificant (<2% of the prisoners). Vaccination against seasonal flu was lower than 16%. The HCV and HIV-positive inmates were not correctly vaccinated either. The insufficient level of immunization obtained reflects the lack of interest and marginalization of this population by the penitentiary system and the health authorities. The lack of reliable records is combined with the lack of planned strategies that promote stable and well-defined programs of active vaccination.


Asunto(s)
Hepatitis B , Prisioneros , Prisiones , Cobertura de Vacunación , Adulto , Femenino , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
12.
BMC Infect Dis ; 20(1): 847, 2020 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-33198649

RESUMEN

BACKGROUND: Hepatitis B virus (HBV), Human Immunodeficiency virus (HIV) and Tuberculosis (TB) are common infections in South Africa. We utilized the opportunity of care provision for HIV-TB co-infected patients to better understand the relationship between these coinfections, determine the magnitude of the problem, and identify risk factors for HBV infection in HIV infected patients with and without TB in KwaZulu-Natal, South Africa. METHODS: This retrospective cohort analysis was undertaken in 2018. In-care HIV infected patients were included in the analysis. Results from clinical records were analysed to determine the prevalence, incidence, persistence and factors associated with HBsAg positivity in HIV-infected patients with or without TB co-infection. RESULTS: A total of 4292 HIV-infected patients with a mean age of 34.7 years (SD: 8.8) were included. Based on HBsAg positivity, the prevalence of HBV was 8.5% (363/4292) [95% confidence interval (CI): 7.7-9.3] at baseline and 9.4% (95%CI: 8.6-10.3%) at end of follow-up. The HBV incidence rate was 2.1/100 person-years (p-y). Risk of incident HBV infection was two-fold higher among male patients (HR 2.11; 95% CI: 1.14-3.92), while severe immunosuppression was associated with a greater than two-fold higher risk of persistent infection (adjusted risk ratio (RR) 2.54; 95% CI 1.06-6.14; p = 0.004. Additionally, active TB at enrolment was associated with a two-fold higher risk of incident HBV infection (aHR 2.38; 95% CI: 0.77-7.35). CONCLUSION: The provision of HIV care and treatment in high HBV burden settings provide a missed opportunity for HBV screening, immunization and care provision.


Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Coinfección/epidemiología , VIH , Virus de la Hepatitis B/inmunología , Hepatitis B/diagnóstico , Hepatitis B/epidemiología , Mycobacterium tuberculosis/aislamiento & purificación , Tuberculosis/epidemiología , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Infecciones Oportunistas Relacionadas con el SIDA/virología , Adulto , Fármacos Anti-VIH/uso terapéutico , Coinfección/virología , Femenino , Estudios de Seguimiento , Hepatitis B/virología , Antígenos de Superficie de la Hepatitis B/inmunología , Humanos , Incidencia , Masculino , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Sudáfrica/epidemiología , Tuberculosis/diagnóstico , Tuberculosis/microbiología , Adulto Joven
13.
PLoS One ; 15(11): e0242658, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33227013

RESUMEN

BACKGROUND: Hepatitis B imposes a major public health problem with an increased risk of occupational exposure among unvaccinated health care workers. This study was conducted to determine the Hepatitis B vaccination status, along with the knowledge, attitude, and practice regarding Hepatitis B, among preclinical medical students of a medical college in Nepal. MATERIALS AND METHODS: This descriptive study was conducted among preclinical students of a medical college in Kathmandu, Nepal from 6th July to 14th July 2020. The whole sampling technique was used. Data were collected using a pretested, self-administered questionnaire which was emailed to individuals and analyzed with the statistical package for social sciences version-22. RESULTS: A total of 181 students participated in the study out of 198, giving a response rate of 91.4%. Among the study participants, only 67 (37%) were fully vaccinated against Hepatitis B while 71 (39.2%) were never vaccinated. For the majority (74.6%) of the non-vaccinated participants, the main reason for not getting vaccination was a lack of vaccination programs. Half the study participants (n = 92, 50.8%) had good knowledge, attitude and practice regarding hepatitis B. The median knowledge, attitude and practice scores towards Hepatitis B were 61.00 (57.00-66.00), 20(18.00-21.00) and 21(19.00-23.00) respectively. CONCLUSIONS: The majority of preclinical medical students were not fully vaccinated against Hepatitis B and only half of them had acceptable knowledge, attitude and practice towards Hepatitis B, which makes them vulnerable to the infection. This might represent the situation of not only Nepal, but also all South Asian countries, and creates concern about whether students take the vaccination programs seriously. Since unavailability of vaccination program is the main cause of non-vaccination, we strongly recommend the provision of the Hepatitis B vaccination program to the preclinical medical students.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Vacunas contra Hepatitis B/uso terapéutico , Hepatitis B/prevención & control , Estudiantes de Medicina , Encuestas y Cuestionarios , Vacunación , Adulto , Estudios Transversales , Femenino , Hepatitis B/epidemiología , Humanos , Masculino , Nepal/epidemiología
14.
Biomed Environ Sci ; 33(10): 735-744, 2020 Oct 20.
Artículo en Inglés | MEDLINE | ID: mdl-33228832

RESUMEN

Objective: Despite the remarkable progress in efforts to control disease spread, the nationwide elimination of hepatitis B in China is still hindered by the persistently high rate of hepatitis B virus (HBV) infection in Western China. This study aimed to evaluate the strategy of hepatitis B prevention and control in Western China and identify potential areas and strategies for improvement. Methods: Susceptible population vaccination, health education, professional training of doctors, and other prevention and control measures have been implemented in Wuwei city since 2010. Data were obtained from three representative cross-sectional serosurveys conducted in 2010, 2013, and 2015. The serum samples were subjected to enzyme-linked immunosorbent assays to detect the following seromarkers: HBV surface antigen (HBsAg), antibody against hepatitis B surface antigen (anti-HBs), and antibody against hepatitis B core antigen (anti-HBc). Estimates of variance were determined using Taylor series linearization methods. Results: The three serosurveys revealed decreases in the prevalence of HBsAg (7.19% in 2010 vs. 6.51% in 2013 vs. 5.87% in 2015) and anti-HBc positivity (43.89% vs. 32.87% vs. 28.46%) and an increase in the prevalence of anti-HBs positivity (49.07% vs. 53.66% vs. 53.72%) over time. From 2010 to 2015, the legally reported incidence of hepatitis B in Wuwei city decreased from 686.53/100,000 to 53.72/100,000. Notably, persistently high HBsAg-positive rates (above 5.40%) were observed among subjects aged 20-69 years old in the three serosurveys; the prevalence of HBsAg was above 1% among children younger than 10 years old. Furthermore, rural subjects had higher rates of HBsAg and anti-HBc positivity than their urban counterparts (6.04% vs. 4.83% and 30.26% vs. 20.35%, respectively) in 2015 but had a lower rate of anti-HBs positivity (49.68 vs. 55.18%). Multivariate regression analysis showed that age, urban and rural areas, and education level were the main factors affecting HBV infection. Conclusion: Although vaccine-based prevention and control measures reduced the rate of HBV infection in Wuwei City over time, the hepatitis B infection rate in children younger than 10 years was still higher than the national average level. Therefore, the prevention and control of mother-to-child transmission and the management of the infected should be the focus of future prevention and control work.


Asunto(s)
Control de Enfermedades Transmisibles/estadística & datos numéricos , Virus de la Hepatitis B/aislamiento & purificación , Hepatitis B/prevención & control , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , China/epidemiología , Control de Enfermedades Transmisibles/métodos , Estudios Transversales , Femenino , Hepatitis B/sangre , Hepatitis B/epidemiología , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Seroepidemiológicos , Adulto Joven
15.
Afr Health Sci ; 20(2): 579-586, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33163019

RESUMEN

Background: The health of people living with HIV/AIDS becomes progressively worse when co-infected with hepatitis B virus (HBV) and hepatitis C virus (HCV), resulting in shortened life span. The modes of transmission of HIV, HBV and HCV are similar. Objective: To determine the prevalence of HBV and HCV co-infection in HIV patients. Method: This was a retrospective study of serology test results for hepatitis B surface antigen (HBsAg) and antibodies to HCV (anti-HCV) of HIV positive patients registered from 2008-2013 (6years) at the University of Nigeria Teaching Hospital. Adult patients with confirmed HIV seropositivity were included. Ethical approval was obtained and confidentiality of the patient information was maintained. Laboratory records were reviewed to obtain HBsAg, anti-HCV, and CD4 T-lymphocyte results. Prevalence was determined by the number of positive results over total number of patients tested. Chi-square test was used to determine relationships and p<0.05 was considered to be statistically significant. Results: 4663 HIV patient records were included comprising 3024 (65%) females and 1639 (35%) males. Serology results showed 365/4663 (7.8%) tested HBsAg-positive only; 219/4663 (4.7%) tested anti-HCV-positive only; and 27/4663 (0.58%) tested both HBsAg and anti-HCV-positive. Correlation of age and sex were statistically significant with HBV and HCV (p<0.05) but not CD4 count (p>0.05). Conclusion: HBV co-infection was more prevalent than HCV, and triple infection was also observed. Screening for these viral infections in the HIV population is necessary for early identification to enable appropriate, holistic management of these patients.


Asunto(s)
Coinfección/epidemiología , Infecciones por VIH/epidemiología , Hepacivirus/aislamiento & purificación , Virus de la Hepatitis B/aislamiento & purificación , Hepatitis B/epidemiología , Anticuerpos contra la Hepatitis C/sangre , Hepatitis C/epidemiología , Adulto , Recuento de Linfocito CD4 , Coinfección/virología , Ensayo de Inmunoadsorción Enzimática , Femenino , VIH/genética , Infecciones por VIH/sangre , Hepacivirus/genética , Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/análisis , Antígenos de Superficie de la Hepatitis B/sangre , Virus de la Hepatitis B/genética , Hepatitis C/sangre , Humanos , Masculino , Persona de Mediana Edad , Nigeria/epidemiología , Prevalencia , ARN Viral/análisis , Estudios Retrospectivos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
16.
BMC Infect Dis ; 20(1): 839, 2020 Nov 12.
Artículo en Inglés | MEDLINE | ID: mdl-33183254

RESUMEN

BACKGROUND: Hepatitis B virus (HBV) infection is a public health problem in Togo and transmission to the child occurs mainly during childbirth. The objective of this study was to estimate the prevalence of HBV among childbearing women and infants born to HBV positive mothers in Togo. METHODS: A national cross-sectional study was carried out in six cities in Togo in the six health regions in Togo. Mother-child pairs were recruited from immunization centers or pediatric wards in Lomé, Tsévié, Atakpamé, Sokodé, Kara and Dapaong in 2017. Women aged 18 and over with one child of at least 6 months old were included. A standardized questionnaire was used for data collection and HBV screening was performed using Determine® rapid tests. The prevalence of HBV, defined by a positive HBV surface antigen (HBsAg), was estimated in mothers and then in infants of mothers who were positive for HBsAg. Logistic regression model was performed to identify risk factors for HBsAg positivity in mothers. RESULTS: A total of 2105 mothers-pairs child were recruited. The median age of mothers and infants was 29 years, interquartile range (IQR) [25-33] and 2.1 years, IQR [1-3] respectively. About 35% of women were screened for HBV during antenatal care and 85% of infants received three doses of HBV immunization. Among mothers, the prevalence of HBV was 10.6, 95% confidence interval (95% CI) [9.4-12.0%], and 177 had detectable HBV viral load (> 10 IU/mL). Among mothers with positive HBsAg, three infants also had positive HBsAg, a prevalence of 1.3, 95% CI [0.2-3.8%]. In multivariable analysis, HIV-infection (aOR = 2.19; p = 0.018), having at least three pregnancies (aOR = 1.46; p = 0.025) and living in Tsévié (aOR = 0.31; p < 0.001) compared to those living in Lomé, were associated to HBV infection in mothers. CONCLUSION: In this study, one out of 10 childbearing women were infected with HBV, but less than 2% of infant born to HBV positive mothers under 5 years' old who received immunization under the Expanded Program on Immunization were infected. Improving antenatal screening and providing targeted interventions in babies could help eliminate HBV in Togo.


Asunto(s)
Virus de la Hepatitis B/inmunología , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , Vacunación , Adulto , Preescolar , Estudios Transversales , Femenino , VIH , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Infecciones por VIH/virología , Hepatitis B/virología , Antígenos de Superficie de la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/inmunología , Virus de la Hepatitis B/genética , Humanos , Lactante , Masculino , Embarazo , Complicaciones Infecciosas del Embarazo/virología , Atención Prenatal , Prevalencia , Togo/epidemiología , Adulto Joven
17.
BMC Infect Dis ; 20(1): 806, 2020 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-33129259

RESUMEN

BACKGROUND: This study aimed at determining the prevalence of and risk factors for hepatitis B virus (HBV) and hepatitis C virus (HCV) among incarcerated people who inject drugs (PWID) in Iran in 2015-16. METHODS: The required data was collected from a database provided by Iranian national bio-behavioral surveillance surveys (BBSSs) on 11,988 prisoners selected from among 55 prisons in 19 provinces in 2015-16. The data on demographics and behavioral variables were collected through interviews and the status of exposure to HBV and HCV were determined using ELISA blood test. A total of 1387 individuals with a history of drug injection in their lifetime were enrolled into the study. Data were analyzed using the survey package in Stata/SE software, Version 14.0. Univariate and multivariate logistic regression tests were used to investigate the relationships between risk factors and outcomes. RESULTS: The mean age of the incarcerated PWID was 36.83 ± 8.13 years. Of all the studied subjects, 98.46% were male and 50.97% were married. The prevalence of HCV and HBV among the subjects were 40.52 and 2.46%, respectively. The prevalence of HCV was associated with age ≥ 30 years, being single, illiteracy and low level of education, prison term> 5 years, history of piercing, and extramarital sex in lifetime (P < 0.05). CONCLUSIONS: The prevalence of HCV is alarmingly high. In general, it is recommended to adopt measures to screen and treat patients with HCV and vaccinat incarcerated PWID without a history of vaccination against HBV.


Asunto(s)
Hepatitis B/epidemiología , Hepatitis C/epidemiología , Prisioneros , Abuso de Sustancias por Vía Intravenosa/complicaciones , Adulto , Estudios Transversales , Femenino , Hepacivirus , Hepatitis B/complicaciones , Hepatitis B/prevención & control , Virus de la Hepatitis B , Hepatitis C/complicaciones , Hepatitis C/prevención & control , Humanos , Irán/epidemiología , Modelos Logísticos , Masculino , Prevalencia , Prisioneros/estadística & datos numéricos , Prisiones , Factores de Riesgo , Vacunas contra Hepatitis Viral/administración & dosificación
18.
PLoS One ; 15(10): e0241226, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33108365

RESUMEN

INTRODUCTION: The hepatitis B vaccine is the backbone of hepatitis B prevention. All health care workers must receive a full-dose (3-dose vaccine series) to achieve >90% protection against hepatitis B virus. There is limited evidence available on vaccination coverage of HBV among health care workers in Ethiopia. Therefore, the objective of this study was to estimate the national full-dose hepatitis B vaccination coverage and the associated factors among health care workers in Ethiopia. METHODS: Studies were retrieved from PubMed, EMBASE, Web of Science, SCOPUS, CINAHL, and Google Scholar by using a combination of search terms with Boolean operators. The quality of each study was evaluated independently by three authors using the modified Newcastle-Ottawa Scale (NOS) for cross-sectional studies. Statistical analyses were performed using STATA™ Version 14 software. Meta-analysis was carried out using a random-effects (DerSimonian and Laird) method. The heterogeneity test was conducted by using I-squared (I2) statistics. Leave-one-out sensitivity analysis was performed. RESULTS: A total of 15 articles with 5734 participants were included in this systematic review and meta-analysis. The pooled prevalence of full-dose hepatitis B virus vaccination coverage among health care workers in Ethiopia was 20.04% (95% CI: 13.83, 26.26); I2 = 98.9%). Being male sex (p = 0.002), having work experience of less than 5 years (p < 0.001), educational level of diploma and below (p = 0.003), health care providers who received training on infection prevention (p < 0.001), and those who had a history of exposure to blood and body fluids (p = 0.001), were factors significantly associated with full-dose hepatitis B virus vaccination. CONCLUSION: The national full-dose hepatitis B vaccination coverage among health care workers was low. Training of health care workers in infection prevention, particularly in hepatitis B and testing and providing hepatitis B vaccination for newly recruited staff and every 5 years for those long-term workers were recommended to increase the uptake of the vaccine.


Asunto(s)
Vacunas contra Hepatitis B/administración & dosificación , Virus de la Hepatitis B/aislamiento & purificación , Hepatitis B/prevención & control , Cobertura de Vacunación/estadística & datos numéricos , Vacunación/estadística & datos numéricos , Etiopía/epidemiología , Hepatitis B/epidemiología , Humanos , Prevalencia
19.
BMC Infect Dis ; 20(1): 736, 2020 Oct 07.
Artículo en Inglés | MEDLINE | ID: mdl-33028232

RESUMEN

BACKGROUND: Blood transfusion is associated with potential risks of transfusion-transmitted infections (TTIs). Different strategies are needed to monitor blood safety and screen the donors' efficacy, such as evaluation of the prevalence and trends of TTIs. This study was conducted to evaluate the prevalence and trends of TTIs, including hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and human T-cell lymphotropic virus (HTLV 1/2), and the impact of the donors' characteristics such as age, sex, and donor status on the prevalence of TTIs in blood donors in seven large provinces of Iran from 2010 to 2018. METHODS: This study was conducted on the data collected from all blood donations in seven Iranian Blood Transfusion Centers including Ardabil, Alborz, Guilan, West Azarbaijan, North, Razavi, and South Khorasan from April 2010 to March 2018. Demographic characteristics, number of donations, donor status, and screening and confirmatory serological results of all blood donations were collected from Iranian Blood Transfusion Organizations (IBTO) national database. The prevalence and trend of HBV, HCV, HIV, and HTLV 1/2 infections were reported according to the donation year and donor's characteristics. RESULTS: The analysis of the prevalence and trend of TTIs in 3,622,860 blood donors showed a significant decreasing trend in first-time and regular donors. Additionally, compared to first- time donors, regular donors made safer blood donations with lower risks of HBV, HIV, HCV and HTLV 1/2 (P < 0.0001). Although the prevalence of HTLV 1/2 and HBV was higher in females, TTIs had a significant decreasing trend in males and females. Finally, it was found that the prevalence of HBV and HTLV 1/2 increased with age up to 40-49 years and then decreased thereafter. CONCLUSIONS: The decreasing trends of TTIs in Iranian donors during 9 years may indicate that the various strategies implemented by IBTO have been effective in recent years. Other factors such as a decrease in the prevalence of specific TTIs in the general population might have also contributed to these declines.


Asunto(s)
Seguridad de la Sangre , Infecciones por VIH/diagnóstico , Infecciones por HTLV-I/diagnóstico , Hepatitis B/diagnóstico , Hepatitis C/diagnóstico , Adolescente , Adulto , Donantes de Sangre/estadística & datos numéricos , Femenino , Infecciones por VIH/epidemiología , Infecciones por HTLV-I/epidemiología , Hepatitis B/epidemiología , Hepatitis C/epidemiología , Humanos , Irán/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Reacción a la Transfusión/diagnóstico , Reacción a la Transfusión/epidemiología , Reacción a la Transfusión/virología , Adulto Joven
20.
PLoS One ; 15(10): e0239951, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33002081

RESUMEN

Sri Lanka has a low-level HIV epidemic. This study aims to provide evidence on HIV, syphilis and hepatitis B (HBV) prevalence, sexual risk behaviours and utilisation of HIV prevention interventions among female sex workers (FSW) in the cities Colombo, Galle, and Kandy. Using respondent-driven sampling (RDS), we recruited a total of 458 FSW in Colombo, 360 in Galle and 362 in Kandy from November 2017 to March 2018. Participants provided biological specimens for testing for infections and completed a behavioural questionnaire. We found no HIV nor HBV infections in Galle and Kandy, and low HIV (0.4%) and HBV surface antigen (0.6%) prevalence in Colombo. FSW in Colombo had higher positivity on Treponema pallidum-particle agglutination test (8.4%) compared to Galle (2.0%) and Kandy (2.5%). About two thirds of FSW heard of HIV in each of the cities. Around 90% of FSW used condom at last sex with a client in both Colombo and Galle, but considerably less in Kandy (57.1%). However, lower proportion of FSW used condoms every time during sex with clients in the past 30 day: 22.9% of FSW in Colombo, 26.6% in Kandy and 68.4% in Galle. Across cities, 17.5%-39.5% of FSW reported being tested for HIV in the past 12 months or knowing HIV positive status. The commonest reasons for never testing for HIV was not knowing where to test (54.2% in Colombo, 41.8% in Galle, 48.1% in Kandy) followed by inconvenient testing location (23.7% in Colombo and 31.1% in Kandy). HIV has not yet been firmly established among FSW in three cities in Sri Lanka, but the vulnerability towards HIV and STIs is substantial. HIV interventions should be intensified by expanding community-based HIV testing approaches, increasingawareness of HIV risks and addressing socio-structural vulnerabilities of FSW to HIV.


Asunto(s)
Seropositividad para VIH/epidemiología , Hepatitis B/epidemiología , Trabajadores Sexuales/estadística & datos numéricos , Sífilis/epidemiología , Serodiagnóstico del SIDA/estadística & datos numéricos , Adolescente , Adulto , Femenino , Humanos , Persona de Mediana Edad , Sri Lanka , Serodiagnóstico de la Sífilis/estadística & datos numéricos , Sexo Inseguro/estadística & datos numéricos
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA