Treatment and follow up of children with chronic hepatitis C in Albania.

BACKGROUND: Treatment of Hepatitis C in children has a better outcome than in adults, and for this reason the treatment had different views. However, in pediatric age hepatitis C is seen to have an evolution towards chronicity. Today is a normal option to treat chronic hepatitis C as early as possible according to certain criteria. The aim of this study is to show the results of treatment with interferon and ribavirin and the follow-up of children diagnosed with chronic hepatitis C in our service. PATIENTS AND METHODS: This is a prospective study which has included children 3 up to 15 years old (13 boys and 4 girls) diagnosed with chronic hepatitis C. All patients underwent a certain protocol, including liver biopsy prior to treatment. Treatment consisted in use for 48 weeks of INF α-2b, 3 MIU/m2 three times a week s/c and ribavirin 15 mg/kg orally divided bid. Two patients were treated with PEGINF α-2b with dose 1.5 mcg/kg once a week s/c and ribavirin 15 mg/kg. After the treatment all patients have stayed under our control for an average period of 24 weeks. RESULTS: At the end of the treatment we detected a patient with HCV-RNA positive. End Treatment Viral Response was 94%. Six months later we found three patients who showed relapse of disease. Sustained Viral Response was approximately 83% CONCLUSION: The combination therapy of interferon with Ribavirin in treatment of children with chronic hepatitis C provides a higher SVR when treatment is initiated at the earliest stages of hepatic changes. Side effects of therapy are insignificant in comparison with results obtained.

Trends in prevalence of hepatitis B virus infection among Albanian blood donors, 1999-2009.

BACKGROUND: Hepatitis B virus (HBV) was among the first virus known to be transmitted by blood and blood productions. The objective of this study is to determine the trend of hepatitis B virus in blood donors. MATERIALS AND METHODS: In this study 79274 blood donors were retrospectively evaluated for HBsAg. The donors were selected using personal questionnaire, physical examination and testing blood before donation. Blood banks records are used as source of information. The blood donors samples were analyzed for the presence of hepatitis B surface antigen (HBsAg) by commercial available kits ELISA method, third generation (from Abbott laboratory, Germany). A sample was considered as HBsAg positive when found twice repeatedly reactive. Reactive samples were not confirmed with addition tests. RESULTS: In the evaluation data, we found out that from 79274 of the total healthy blood donors, 15983 were voluntary donors, 52876 were family replacement donors and 10424 commercial blood donors. The prevalence of HBsAg in blood donors was 7.9%. It was increased steadily from 5.9% in 1999 to 9.1% in 2006 and decreased in 7.9% in 2009. According to blood donors status the HBsAg prevalence was 10.5% in commercial blood donors, 8.1% in voluntary donors and 8.6% in family replacement donors. The prevalence of anti-HBc in blood donors was 59.1%. CONCLUSION: The prevalence of HBsAg was lower in voluntary non remunerate blood donors than commercial donors and family replacement blood donors. In FDs the prevalence was higher than VDs but lower than CDs. So, it is important to encourage the voluntary blood donors to become regularly blood donors.

Trends in the prevalence of transfusion-transmissible infections among blood donors in Albania.

BACKGROUND: The objective of this study is to determine the trend of transfusion transmitted infection in blood donors. METHODS: In this study 52727 blood donors were retrospectively evaluated for markers of hepatitis B, C, HIV(1/2), and syphilis. To screen the blood donors for HIV(1/2)(HIV(1/2) Ag/Ab COMBO, ABBOTT Laboratory, Delkenheim, Germany), the microparticle enzyme immunoassay (MEIA) method was used. For HBsAg and anti-HCV third generation MEIA kits (ABBOTT Laboratory, Delkenheim, Germany) were used and for the syphilis RPR test the Biokit SA (Barcelona, Spain) was used. RESULTS: A total of 52,727 donors were tested within the five year period, of which 15 (0.03%), 3531 (6.7%), 323 (0.6%), and 35 (0.07%) were positive for HIV, HBV, HCV, and syphilis, respectively. The prevalence of TTI in blood donors was 7.4%. It increased steadily from 5.1% in 2004 to 8.3% in 2006, stayed in same level in 2007, and decreased to 8.1% in 2008. Distribution of transfusion-transmissible infection (TTI) based on donor status was 13.8% in first time commercial remunerated blood donors, 9.4% in first time voluntary blood donors, and 9.7% in family replacement blood donors. CONCLUSIONS: Our results in this study showed that family replacement donors are more likely to transmit transfusion-transmissible infections (TTIs) than voluntary donors, but are safer than commercial blood donors. So blood transfusion services should work on replacement of family blood donors with voluntary non-remunerated blood donors.