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1.
BMC Infect Dis ; 19(1): 1022, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31791273

RESUMO

BACKGROUND: Few countries in sub-Saharan Africa know the magnitude of their HIV epidemic among people who inject drugs (PWID). This was the first study in Mozambique to measure prevalence of HIV, HBV, and HCV, and to assess demographic characteristics and risk behaviors in this key population. METHODS: We used respondent-driven sampling (RDS) to conduct a cross-sectional behavioral surveillance survey of PWID in two cities of Mozambique lasting six months. Participants were persons who had ever injected drugs without a prescription. Participants completed a behavioral questionnaire and provided blood specimens for HIV, hepatitis B surface antigen (HBsAg) and hepatitis C virus antibody (anti-HCV) testing. We performed RDS-adjusted analysis in R 3.2 using RDSAT 7.1 weights. RESULTS: We enrolled 353 PWID in Maputo and 139 in Nampula/Nacala; approximately 95% of participants were men. Disease prevalence in Maputo and Nampula/Nacala, respectively, was 50.1 and 19.9% for HIV, 32.1 and 36.4% for HBsAg positivity, and 44.6 and 7.0% for anti-HCV positivity. Additionally, 8% (Maputo) and 28.6% (Nampula/Nacala) of PWID reported having a genital sore or ulcer in the 12 months preceding the survey. Among PWID who injected drugs in the last month, 50.3% (Maputo) and 49.6% (Nampula/Nacala) shared a needle at least once that month. Condomless sex in the last 12 months was reported by 52.4% of PWID in Maputo and 29.1% in Nampula/Nacala. Among PWID, 31.6% (Maputo) and 41.0% (Nampula/Nacala) had never tested for HIV. In multivariable analysis, PWID who used heroin had 4.3 (Maputo; 95% confidence interval [CI]: 1.2, 18.2) and 2.3 (Nampula/Nacala; 95% CI: 1.2, 4.9) greater odds of having HIV. CONCLUSION: Unsafe sexual behaviors and injection practices are frequent among PWID in Mozambique, and likely contribute to the disproportionate burden of disease we found. Intensified efforts in prevention, care, and treatment specific for PWID have the potential to limit disease transmission.


Assuntos
Usuários de Drogas/estatística & dados numéricos , Infecções por HIV/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adolescente , Adulto , Idoso , Cidades/epidemiologia , Estudos Transversais , Epidemias , Feminino , Infecções por HIV/sangue , Soropositividade para HIV/epidemiologia , Hepatite B/sangue , Antígenos de Superfície da Hepatite B/análise , Antígenos de Superfície da Hepatite B/sangue , Antígenos de Superfície da Hepatite B/imunologia , Hepatite C/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Moçambique/epidemiologia , Vigilância da População/métodos , Prevalência , Assunção de Riscos , Estudos Soroepidemiológicos , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto Jovem
2.
Rev Chilena Infectol ; 36(5): 576-584, 2019 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-31859798

RESUMO

BACKGROUND: Chile is a low-endemic HBV country, but countries with the highest migratory flow to Chile have an intermediate-high endemicity. In order to avoid vertical transmission of HBV, immunoprophylaxis (IP) in the newborn (NB) is a key factor. AIM: To identify HBsAg prevalence in pregnant immigrants and Chilean pregnant women with risk behaviors (RB) and to asses IP use in the NB. MATERIAL AND METHODS: Prospective HBsAg screening cohort of immigrant and Chilean pregnant women with RB, between July 1, 2017 and June 30, 2018 in CABL. IP of all NB of reactive HBsAg mothers was assessed. RESULTS: 1,415 HBsAg samples, 1,265 immigrants and 150 Chileans with RB. 37 reactive HBsAg. Two false positive. HBsAg prevalence in immigrant pregnant women was 2.7% and 0.66% in Chileans with RB (p < 0.05). 91.1% came from Haiti, with a prevalence of 3.5% in our region. All NB (36) received IP with a median of administration of 3:02 h. CONCLUSIONS: The prevalence in immigrant pregnant women was higher than that reported in the general population and in Chilean women with RB. We proposed the need for universal screening in pregnancy, especially in pregnant women from countries with intermediate-high endemicity.


Assuntos
Emigrantes e Imigrantes , Antígenos de Superfície da Hepatite B/análise , Hepatite B/epidemiologia , Hepatite B/transmissão , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Programas de Rastreamento/métodos , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Chile/epidemiologia , Feminino , Vírus da Hepatite B/isolamento & purificação , Humanos , Recém-Nascido , Masculino , Gravidez , Complicações Infecciosas na Gravidez/virologia , Estudos Prospectivos , Fatores de Risco , Assunção de Riscos , Estudos Soroepidemiológicos , Fatores de Tempo , Vacinação/métodos , Adulto Jovem
3.
BMC Infect Dis ; 19(1): 917, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664923

RESUMO

BACKGROUND: Hepatitis B virus is one of the major public health concerns globally. It is highly infectious and can be transmitted from person to person through vertically or horizontally via contaminated body fluids. Despite the provision of an effective vaccine, it remains a major problem worldwide, particularly among the developing countries. METHODS: Online electronic databases including PubMed, Google Scholar, Science Direct, African Index Medicus, African Journals Online, and WHO Afro Library were searched and published articles from 2010 to June 8, 2019, were considered. Both authors independently screened articles and extracted the data. Funnel-Plots and Egger's test statistics were used to determine the presence of small-study effects and publication bias. The pooled prevalence of HBV was analyzed using the random-effects model. The possible sources of heterogeneity was analyzed through subgroup analysis, sensitivity analysis, and meta-regression. RESULTS: The overall pooled prevalence of HBV was 6% and among subgroups, pregnant women, healthcare workers, and HIV positive patients accounted for 5% for each group. Relatively low prevalence (4%) was obtained among blood donors. The Egger's test statistics (p = 0.747) indicated the absence of publication bias. In addition, from the sensitivity analysis, there was no influence on the overall effect estimate while removing a single study at a time. The level of heterogeneity was reduced among pregnant women, HIV positive and studies with unknown sampling techniques. After conducting meta-regression, province, study group, screening method, and quality of papers were identified as sources of heterogeneity. CONCLUSIONS: The overall pooled prevalence of HBV in Ethiopia was high. Strengthening and scaling up of the scope of the existing vaccination program and implementing novel approaches including screen-and-treat could be implemented to reduce the burden of the disease. Generally, the study can provide current prevalence estimate of HBV that could vital for intervention to tackle the disease.


Assuntos
Vírus da Hepatite B/isolamento & purificação , Hepatite B/epidemiologia , Doadores de Sangue , Estudos Transversais , Países em Desenvolvimento , Ensaio de Imunoadsorção Enzimática , Etiópia/epidemiologia , Feminino , Soropositividade para HIV/epidemiologia , Pessoal de Saúde , Hepatite B/prevenção & controle , Hepatite B/transmissão , Antígenos de Superfície da Hepatite B/análise , Vacinas contra Hepatite B , Humanos , Masculino , Gravidez , Gestantes , Prevalência , Vacinação
4.
Biosens Bioelectron ; 142: 111556, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31377574

RESUMO

Nowadays, nanomaterials with enzymatic properties have aroused wide interest because of their special advantages, such as catalytic activity, simple preparation method and high stability. We introduced new nanoenzymes to a label-free electrochemical immunosensor for Hepatitis B surface antigen (HBs Ag) detection. In this study, PtPd nanocubes@MoS2 nanoenzymes (PtPd NCs@MoS2) were prepared by loading PtPd nanocubes (PtPd NCs) on molybdenum disulfide nano-sheet (MoS2) through in situ redox polymerization. The prepared nanoenzymes exhibited enhanced peroxidase-like activity than separate MoS2 and PtPd NCs. The catalytic process of PtPd NCs@MoS2 is in agreement with the Michaelis-Menten kinetic equation. PtPd NCs@MoS2 were used for sensitive detection of HBs Ag, which is ascribed to their superior peroxidase activity, good conductivity and high specific surface area and synergistic amplification for current signals. Compared with the detection limit of colorimetric method (3.3 pg/mL), the electrochemical method (10.2 fg/mL) shows a lower detection limit and a wider linear range from 32 fg/mL to 100 ng/mL, so it is more suitable for quantitative analysis of Hepatitis B. In summary, the prepared immunosensor provides a better opportunity for early diagnosis of Hepatitis B and also has further applications in biosensing and medical diagnostics.


Assuntos
Dissulfetos/química , Antígenos de Superfície da Hepatite B/sangue , Molibdênio/química , Nanoestruturas/química , Paládio/química , Platina/química , Anticorpos Imobilizados/química , Técnicas Biossensoriais/métodos , Técnicas Eletroquímicas/métodos , Hepatite B/sangue , Hepatite B/diagnóstico , Antígenos de Superfície da Hepatite B/análise , Vírus da Hepatite B/isolamento & purificação , Humanos , Imunoensaio/métodos , Limite de Detecção , Nanoestruturas/ultraestrutura
5.
Gut ; 68(12): 2206-2213, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31462554

RESUMO

OBJECTIVE: Although most patients with chronic hepatitis B (CHB) reach effective virological suppression with long-term nucleos(t)ide analogues (NA) therapy, some might not need to continue treatment for life. In this randomised, controlled, phase IV trial, we evaluated off-therapy outcomes in patients after discontinuing long-term NA therapy. DESIGN: Patients who had received NA therapy for ≥1 year and achieved virological suppression (hepatitis B e antigen (HBeAg) seroconversion combined with undetectable hepatitis B virus (HBV) DNA ≥12 months in HBeAg-positive patients or undetectable HBV DNA ≥36 months in HBeAg-negative patients) were randomised 2:1 to stop or continue NA therapy for 72 weeks. Sustained disease remission (HBeAg negative, HBV DNA <2000 IU/mL and normal alanine aminotransferase (ALT)) was evaluated at 72 weeks after stopping NA therapy. RESULTS: Among 67 enrolled patients, sustained disease remission was observed in 13/45 (29%) stop versus 18/22 (82%) continue patients. Hepatitis B surface antigen (HBsAg) loss occurred in two patients (one in each group). The median HBsAg decline from randomisation to week 72 was similar in both groups (0.2 (0.0-0.4) vs 0.1 (0.0-0.2) log IU/mL in stop vs continue patients). Among patients who stopped, 15/45 (33%) had virological or biochemical relapse and 17/45 (38%) were retreated according to predefined criteria. A total of 11/18 (61%) pretreatment HBeAg-positive versus 6/27 (22%) HBeAg-negative patients required retreatment (p=0.01). Fourteen (31%) patients developed ALT >10× upper limit of normal (ULN) and another 7 (16%) had ALT >5× ULN. No patients experienced liver decompensation or died. CONCLUSION: The findings of this prospective study suggest limited benefit of stopping NA therapy in chronic hepatitis B. TRIAL REGISTRATION NUMBER: NCT01911156.


Assuntos
Hepatite B Crônica/tratamento farmacológico , Nucleosídeos/análogos & derivados , DNA Viral/análise , Feminino , Seguimentos , Antígenos de Superfície da Hepatite B/análise , Antígenos E da Hepatite B/análise , Vírus da Hepatite B/genética , Vírus da Hepatite B/imunologia , Hepatite B Crônica/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Nucleosídeos/uso terapêutico , Estudos Prospectivos , Resultado do Tratamento
6.
BMC Public Health ; 19(1): 901, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286924

RESUMO

BACKGROUND: To determine the treatment behaviors among a community-based cohort of chronic hepatitis B virus (HBV)-infected persons and to examine the disease progression among non-antiviral-treated HBV-infected cases after 5 years of follow-up. METHODS: We conducted a community-based prospective study on people with chronic HBV infection in mainland China from 2009 to 2014. In 2009, we recruited participants who were identified as HBV infected in 2006 in a national sero-survey. A face-to-face follow-up investigation was completed in 2014, and the personal information, the clinical diagnosis provided at the last hospital visit, the HBV antiviral treatment history, and the insurance type was collected for each patient for analysis. Multivariable logistic regression was used to identify factors that are associated with active medical care- seeking and antiviral treatments. RESULTS: Among the 2422 chronic HBV-infected patients recruited in 2009, 1784 (73.7%) were followed-up to 2014, and 638 (35.8%) had sought medical care in hospitals; among them, 140 (21.9%) received antiviral treatments. The lowest medical care-seeking rate (26%) was in participants over 50-year old. We determined that the frequency of medical care-seeking was higher among those participants living in urban areas (aRR = 1.3, 95% CI:1.0-1.6), those in 0-19-year old (aRR = 1.5, 95% CI:1.1-2.1), 20-39-year old (aRR = 2.2, 95% CI:1.7-3.0) and 40-49-year old (aRR = 1.5, 95% CI:1.1-2.0), and persons with insurance of the type Urban residents' basic medical insurance (URBMI) or Commercial health insurance (CHI) (aRR = 2.5, 95% CI:1.7-3.6) and New Rural Cooperative Medical System (NRCMS) (aRR = 1.9, 95% CI:1.4-2.6). Patients were more likely to receive antiviral treatment if they were 20-39-year old (aRR = 0.4, 95% CI:0.3-0.7), had insurance of the type URBMI or CHI (aRR = 2.6, 95% CI:1.1-6.3) or NRCMS (aRR = 3.0, 95% CI:1.3-6.9) and were treated at prefecture and above-level hospitals (aRR = 2.0, 95% CI:1.4-3.0). Among non-antiviral-treated HBV-infected cases, we found the annual rates for HBsAg sero-clearance, progress to cirrhosis and HCC were 1.0, 0.6 and 0.2%, respectively. CONCLUSION: The rates of medical care-seeking and antiviral treatment were low among community-based chronic HBV-infected persons, thus we recommend improving the insurance policies for HBV-infected persons to increase the antiviral treatment rate, and conducting extensive education to promote HBV-infected patients actively seeking medical care from hospitals.


Assuntos
Hepatite B Crônica/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adolescente , Adulto , Antivirais/uso terapêutico , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/virologia , Criança , Pré-Escolar , China/epidemiologia , Progressão da Doença , Feminino , Seguimentos , Antígenos de Superfície da Hepatite B/análise , Vírus da Hepatite B , Hepatite B Crônica/tratamento farmacológico , Hepatite B Crônica/virologia , Humanos , Lactente , Recém-Nascido , Seguro Saúde/estatística & dados numéricos , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/virologia , Masculino , Pessoa de Meia-Idade , Motivação , Estudos Prospectivos , População Urbana/estatística & dados numéricos , Adulto Jovem
7.
Med Sci Monit ; 25: 4665-4674, 2019 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-31230063

RESUMO

BACKGROUND High rates of HBeAg and/or HBsAg seroconversion or clearance have been achieved in chronic hepatitis B (CHB) patients receiving pegylated interferon (pegIFN) in addition to ongoing nucleos(t)ide analogue (NUC) treatment. In the present study, we aimed to evaluate HBsAg kinetics to predict HBeAg seroconversion and HBsAg clearance in these patients. MATERIAL AND METHODS A total of 33 HBeAg-positive and 17 HBeAg-negative patients were enrolled between January 2010 and January 2018. At the end of pegIFN treatment, 9 of 50 patients achieved HBsAg clearance, and 9 of 33 HBeAg-positive patients achieved HBeAg seroconversion. RESULTS The cutoff value of 0.41 log10 IU/mL in HBsAg decline at week 12 had a positive predictive value (PPV) of 58.3% and a negative predictive value (NPV) of 94.6% for HBsAg clearance. The cutoff value of 1.94 log10 IU/mL in HBsAg decline at week 24 had a PPV of 80.0% and an NPV of 97.5% for HBsAg clearance. The cutoff value of 0.47 log10 IU/mL in HBsAg decline at week 12 had a PPV of 83.3% and an NPV of 85.2% for HBeAg seroconversion. The cutoff value of 1.29 log10 IU/mL in in HBsAg decline at week 24 had a PPV of 85.7% and an NPV of 88.5% for HBeAg seroconversion. CONCLUSIONS Early HBsAg drop has a high predictive value for HBsAg clearance and HBeAg seroconversion in patients who were treated with combination therapy of pegIFN and NUCs.


Assuntos
Antígenos de Superfície da Hepatite B/análise , Hepatite B Crônica/tratamento farmacológico , Adulto , Antivirais/uso terapêutico , Biomarcadores Farmacológicos/sangue , DNA Viral/sangue , Feminino , Guanina/análogos & derivados , Antígenos de Superfície da Hepatite B/sangue , Antígenos de Superfície da Hepatite B/metabolismo , Antígenos E da Hepatite B/sangue , Antígenos E da Hepatite B/metabolismo , Vírus da Hepatite B/genética , Hepatite B Crônica/sangue , Humanos , Interferon alfa-2/farmacocinética , Interferon alfa-2/farmacologia , Interferon-alfa/farmacologia , Masculino , Pessoa de Meia-Idade , Polietilenoglicóis/farmacologia , Proteínas Recombinantes/farmacologia , Soroconversão , Resultado do Tratamento
8.
Virologie (Montrouge) ; 23(1): 23-34, 2019 Feb 01.
Artigo em Francês | MEDLINE | ID: mdl-31131827

RESUMO

Hepatitis B virus (HBV) infects approximately 257 million individuals worldwide. Recent advances in the virology and diagnosis of HBV infection are summarized in this review article. A novel classification of the different phases of chronic HBV infection, proposed by the European Association for the Study of the Liver (EASL), is presented. New diagnostic and monitoring tools are now available, including rapid diagnostic tests for hepatitis B surface antigen (HBsAg) detection, HBsAg quantification assays, an HBV core-related antigen (HBcrAg) quantification test, and HBV RNA quantification testing. Their clinical utility under study is discussed in this review.


Assuntos
Técnicas e Procedimentos Diagnósticos/tendências , Vírus da Hepatite B/fisiologia , Hepatite B/diagnóstico , Monitorização Fisiológica/tendências , Virologia/tendências , Biomarcadores/análise , Biomarcadores/sangue , DNA Viral/análise , DNA Viral/sangue , Hepatite B/complicações , Hepatite B/patologia , Hepatite B/virologia , Antígenos do Núcleo do Vírus da Hepatite B/análise , Antígenos do Núcleo do Vírus da Hepatite B/sangue , Antígenos do Núcleo do Vírus da Hepatite B/genética , Antígenos de Superfície da Hepatite B/análise , Antígenos de Superfície da Hepatite B/sangue , Antígenos de Superfície da Hepatite B/genética , Antígenos E da Hepatite B/análise , Antígenos E da Hepatite B/sangue , Antígenos E da Hepatite B/genética , Vírus da Hepatite B/genética , Hepatite B Crônica/diagnóstico , Hepatite B Crônica/patologia , Hepatite B Crônica/virologia , Humanos , Monitorização Fisiológica/métodos , Virologia/legislação & jurisprudência , Virologia/métodos
9.
Artif Cells Nanomed Biotechnol ; 47(1): 455-461, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30836779

RESUMO

Hepatitis B virus (HBV) infection is one of the major health issues in the world presently with high tendency of leading to hepatocarcinoma, cirrhosis, and liver cancer, especially if not properly managed. It has been estimated that there are about 2 billion people with a serological profile of HBV infection, and 360 million patients worldwide living with chronic HBV-associated liver disease, hence the need to find an efficient and precise diagnosis technique to drive a robust treatment for Hepatitis B virus cannot be over emphasized. The emergence of analytical device like biosensor which combines biological and physicochemical element to detect HBV in screened samples has been very helpful in providing a timely intervention to tame this virus. This review focuses on the current state of biosensor researches with respect to various in-depth application of gold nanoparticle for the detection of hepatitis B virus (HBV).


Assuntos
Técnicas Biossensoriais/métodos , Ouro/química , Vírus da Hepatite B/isolamento & purificação , Nanopartículas Metálicas/química , Nanotecnologia/métodos , Antígenos de Superfície da Hepatite B/análise , Vírus da Hepatite B/imunologia
10.
Artif Cells Nanomed Biotechnol ; 47(1): 469-474, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30686057

RESUMO

Hepatitis B virus (HBV) infection is one of the major health issues in the world presently with high tendency of leading to hepatocarcinoma, cirrhosis and liver cancer, especially if not properly managed. It has been estimated that there are about 2 billion people with a serological profile of HBV infection, and 360 million patients worldwide living with chronic HBV-associated liver disease, hence the need to find an efficient and precise diagnosis technique to drive a robust treatment for Hepatitis B virus cannot be over emphasized. The emergence of analytical device like biosensor which combines biological and physicochemical element to detect HBV in screened samples has been very helpful in providing a timely intervention to tame this virus. This review focuses on the current state of biosensor researches with respect to various in-depth application of gold nanoparticle for the detection of HBV.


Assuntos
Ouro/química , Vírus da Hepatite B/isolamento & purificação , Nanopartículas Metálicas , Nanotecnologia/métodos , Técnicas Biossensoriais , Antígenos de Superfície da Hepatite B/análise , Vírus da Hepatite B/imunologia , Humanos
11.
Int J Infect Dis ; 78: 130-139, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30466898

RESUMO

OBJECTIVE: In rural areas of China with highly endemic for hepatitis B virus (HBV) infection, protective efficacy was observed in adulthood when a one-dose HBV vaccine booster was administered to high-risk children born to mothers who were positive for hepatitis B surface antigen (HBsAg). The aim of this study was to estimate the cost-effectiveness of an HBV vaccine booster in this specific group of children when given at 10 years of age. METHODS: Two potential strategies were considered: strategy 1 was a one-dose booster given if the child was negative on HBsAg screening; strategy 2 was a one-dose booster given if the child was negative on both HBsAg plus anti-HBs screening. A decision tree combined with a Markov model was developed to simulate the booster intervention process and to simulate the natural history of HBV infection in a cohort of 10-year-old children who were born to HBsAg-positive mothers. The model was calibrated based on multiple selected outcomes. Costs and quality-adjusted life years (QALYs) were measured from a societal perspective. Cost-effectiveness ratios (CERs) of the different strategies were compared in both base-case and one-way sensitivity analyses. RESULTS: Compared to the current practice of 'no screening and no booster', both strategy 1 and strategy 2 were cost-saving, with CERs estimated at US$ -6961 and US$ -6872 per QALY gained, respectively. In the one-way sensitivity analysis for strategy 1, all the CERs were found to be less than US$ -5000 per QALY gained after considering the uncertainty of all the variables, including vaccination protective efficacy, natural history, behavior, and various costs and utility weights. In a 'worst case' scenario (all parameter values simultaneously being at the worst), the CER of strategy 1 increased to US$ 3263 per QALY gained, which was still less than the GDP per capita of China in 2016 (US$ 8126). CONCLUSIONS: A hepatitis B vaccine booster given to children born to HBsAg-positive mothers in rural China would be cost-effective and could be considered in HBV endemic areas.


Assuntos
Antígenos de Superfície da Hepatite B/análise , Vacinas contra Hepatite B/administração & dosagem , Adolescente , Adulto , Criança , Pré-Escolar , Análise Custo-Benefício , Feminino , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Anticorpos Anti-Hepatite B/sangue , Vacinas contra Hepatite B/imunologia , Humanos , Imunização Secundária , Lactente , Masculino , Mães , Anos de Vida Ajustados por Qualidade de Vida , Saúde da População Rural
12.
Int J Infect Dis ; 79: 47-49, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30496851

RESUMO

Hepatitis C virus (HCV) treatment with direct-acting antivirals (DAA) can be associated with reactivation of hepatitis B (HBV). We report a case of a kidney transplant recipient who had a fatal severe HBV reactivation during treatment for chronic hepatitis C with DAA. Diagnosis of HBV reactivation was delayed due to undetectable surface antigen (HBsAg) by standard assays. The latter was explained by the presence of HBsAg escape mutants. The case illustrates the relevance of HBV-DNA testing in transplant recipients with previous exposure to HBV, even in the absence of HBsAg, and particularly when liver test abnormalities are present.


Assuntos
Coinfecção , Vírus da Hepatite B/fisiologia , Hepatite B/virologia , Hepatite C Crônica/complicações , Hepatite C Crônica/tratamento farmacológico , Ativação Viral , Antivirais/uso terapêutico , Evolução Fatal , Hepatite B/complicações , Antígenos de Superfície da Hepatite B/análise , Humanos , Transplante de Rim , Masculino , Pessoa de Meia-Idade , Transplantados
13.
Ann Saudi Med ; 38(6): 413-419, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30531175

RESUMO

BACKGROUND: Globally, about 300 million people are infected with hepatitis B virus (HBV). Among the effective approaches to fight HBV infection is immunization. In 1989, an obligatory hepatitis B vaccine program was launched in Saudi Arabia. OBJECTIVE: Assess hepatitis B surface antibody (anti-HBs) levels among the medical students before and after receiving booster doses of HBV vaccine. DESIGN: Cross-sectional. SETTING: Taibah University. SUBJECTS AND METHODS: Students born between 1993 and 1995 were recruited in this study from the Occupational Health Clinic. Students were screened for anti-HBs levels using chemiluminescent microparticle immunoassay (CMIA) before and after booster HBV vaccine doses. MAIN OUTCOME MEASURES: Anti-HBs levels before and after booster doses. SAMPLE SIZE: 335. RESULTS: About half of participants (n=164, 49%) had protective anti-HBs levels ( greater than or equal 10 mIU/mL) to the original primary series of HBV vaccine and received no booster doses. The reimaining 171 (51%) participants were at risk of HBV infection since their anti-HBs levels were less than 10 mIU/mL, despite having received the original primary HBV vaccine. The levels of anti-HBs were higher in female than in male students (P less than .001). In addition, female students showed a stronger humoral immune response to the booster vaccine than male students (P less than .001). When participants were given the three boosters, most participants (98.3%) showed anti-HBs levels of greater than or equal 10 mIU/mL. The results also showed a strong correlation between pre-booster and post-booster anti-HBs levels in the greater than or equal 10 mIU/mL group (r2= 0.52, P less than .001) but not in less than 10 mIU/mL group (r2= 0.003, P=.53). CONCLUSION: A considerable portion of the participants (about 51%) were at risk of HBV infection since their anti-HBs levels were less than 10 mIU/mL. Booster doses significantly trigger memory immune response and this ensured their protection against the virus. Pre-booster anti-HBs level are a good predictive of post-booster anti-HBs levels in greater than or equal 10 mIU/mL group. LIMITATIONS: The sample size was small. Shortage of collaborators. CONFLICT OF INTEREST: None.


Assuntos
Anticorpos Anti-Hepatite B/análise , Antígenos de Superfície da Hepatite B/análise , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/imunologia , Hepatite B , Adulto , Relação Dose-Resposta a Droga , Feminino , Hepatite B/epidemiologia , Hepatite B/imunologia , Hepatite B/prevenção & controle , Humanos , Imunidade Humoral/imunologia , Imunização Secundária/métodos , Memória Imunológica/efeitos dos fármacos , Memória Imunológica/imunologia , Masculino , Medição de Risco , Arábia Saudita/epidemiologia , Fatores Sexuais , Estudantes de Medicina/estatística & dados numéricos
14.
Ulster Med J ; 87(3): 177-180, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30559541

RESUMO

PURPOSE: The rate of progression of acute Hepatitis B (HBV) to chronic disease is quoted as <10%. The purpose of this study was to determine the rate of progression from acute to chronic HBV in Northern Ireland (NI), assessing the influence of age, gender and biochemical parameters. METHODS: All "acute" HBV cases diagnosed in NI between 2011 and 2015 were reviewed. Inclusion criteria: 1). positive HBsAg and positive HBV core IgM; 2). in the absence of positive HBV core IgM, positive HBsAg with a recent negative HBsAg. Patient age, HBsAg, HBV core IgM, peak bilirubin and peak ALT were recorded, along with date and result of repeat HbsAg testing. Mann-Whitney U test was used to compare mean age, peak ALT and bilirubin between clearing and non-clearing groups. Fisher's exact test was used to compare progression to chronicity according to gender and age less than or greater than 50yrs. RESULTS: Of 80 identified cases, 4 incorrectly categorised cases were excluded. Of the remaining 76, (15 female (mean age 37.27yr), 61 male (mean age 47.39yr)) follow-up data was available for 71 patients (15 female (mean age 37.27yr), 56 male (48.59yr)). All female patients cleared HBV. 42 of 61 males cleared HBV (p=0.0313).Overall the chronicity rate was 18.42% The mean age of those clearing the virus was 43.88 years, versus 55.64 years for those going on to develop chronic HBV (Mann-Whitney U test, z= -2.68, p=0.0037). Clearance rate was 83.72% in patients aged <50yrs and 63.64% in patients 50yrs (p=0.0068).Mean peak ALT (U/L) and peak bilirubin (µmol/L) for the clearing group were 2130 and 174 respectively compared to 656 and 100 for the non-clearing group (z= -3.51, p=0.0002, z= -2.35, p=0.009). CONCLUSION: Our results suggest a higher than expected rate of progression from acute to chronic HBV with a significantly higher risk for those over 50yrs. This suggests a need to revise information provided to older patients with acute HBV regarding the likelihood of progression.


Assuntos
Progressão da Doença , Hepatite B Crônica , Hepatite B , Doença Aguda , Adolescente , Adulto , Fatores Etários , Idoso , Feminino , Soropositividade para HIV/complicações , Hepatite B/complicações , Hepatite B/epidemiologia , Anticorpos Anti-Hepatite B/análise , Antígenos de Superfície da Hepatite B/análise , Humanos , Imunoglobulina M/análise , Incidência , Masculino , Pessoa de Meia-Idade , Irlanda do Norte/epidemiologia , Adulto Jovem
15.
Biosens Bioelectron ; 122: 58-67, 2018 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-30240967

RESUMO

Detection of the Hepatitis-B surface antigen at the attomolar level is demonstrated using antibody functionalized liquid gated ZnO nanorods field effect transistor (FET) biosensor with vertical electrode configuration. The sensor is operated in heterodyne mode at high frequency to overcome the problem of Debye screening effect in physiological analyte. Enhanced penetration of the electric field lines through the nanorods enables significant improvement in the limit of detection and sensitivity compared to that of the conventional lateral electrode configuration. The combined effect of the probable change in the threshold voltage and the carrier mobility for vertical electrode configuration lead to a sensitivity of around 75% at 1 fM (which is an enhancement by 200%) and a detection limit of 20 aM with a dynamic range from 20 aM to 1 pM. The detection limit which is achieved with the proposed label free sensor in physiological analyte using antibodies is lowered by more than three orders of magnitude compared to the existing reports.


Assuntos
Anticorpos Imobilizados/química , Técnicas Biossensoriais/instrumentação , Antígenos de Superfície da Hepatite B/sangue , Hepatite B/sangue , Nanotubos/química , Óxido de Zinco/química , Eletrodos , Desenho de Equipamento , Antígenos de Superfície da Hepatite B/análise , Humanos , Limite de Detecção , Nanotubos/ultraestrutura , Transistores Eletrônicos
16.
Mikrochim Acta ; 185(10): 458, 2018 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-30218157

RESUMO

A composite consisting of graphene oxide and gold nanorods (GO-GNRs) was designed for the trace determination of hepatitis B surface antigen (HBsAg) using surface enhanced Raman spectroscopy (SERS). GO contains numerous carboxy and hydroxy groups on its surface and therefore can serve as the substrate for decoration with GNRs and for immobilizing antibody against HBsAg. The GNRs (carrying the SERS probe 2-mercaptopyridine) exhibit high SERS activity, and this improves the sensitivity of the biosensor. The antibody on the GO-GNRs binds HBsAg with high specificity, and it results in excellent selectivity. The SERS signal (measured at 1002 cm-1) increases in the 1-1000 pg·mL-1 HBsAg concentrations range, and the limit of detection is 0.05 pg·mL-1 (at an S/N ratio of 3). The immunoassay achieves the sensitive and selective determination of HBsAg in serum and expands the potential application of GO-GNR based SERS tag in clinical research. Graphical abstract A novel graphene oxide-gold nanorod (GO-GNRs) based surface-enhanced Raman scattering (SERS) tag for immunoassay was designed. It allows for sensitive and selective determination of HBsAg in serum. The method is expected to expand the potential application in the environment, in medicine and in food analysis.


Assuntos
Ouro/química , Grafite/química , Antígenos de Superfície da Hepatite B/análise , Imunoensaio/métodos , Nanotubos/química , Óxidos/química , Análise Espectral Raman , Humanos , Modelos Moleculares , Conformação Molecular , Propriedades de Superfície
18.
ACS Appl Mater Interfaces ; 10(34): 28412-28419, 2018 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-30080381

RESUMO

Hepatitis B virus (HBV) infection is a major worldwide health issue causing serious liver diseases, including liver cirrhosis and hepatocellular carcinoma. Monitoring the serum hepatitis B surface antigen (HBsAg) level is pivotal to the diagnosis of HBV infection. In this study, we describe multidimensional conductive nanofilm (MCNF)-based field-effect transistor (FET) aptasensor for HBsAg detection. The MCNF, composed of vertically oriented carboxylic polypyrrole nanowires (CPPyNW) and graphene layer, is formed using electropolymerization of pyrrole on the graphene surface and following acid treatment. The amine-functionalized HBsAg-binding aptamers are then immobilized on the CPPyNW surface through covalent bonding formation (i.e., amide group). The prepared aptasensor presents highly sensitive to HBsAg as low as 10 aM among interfering biomolecules with various deformations. Moreover, the MCNF-based aptasensor has great potential for practical application in the noninvasive real-time diagnosis because of its improved sensing ability to the human serum and artificial saliva.


Assuntos
Antígenos de Superfície da Hepatite B/análise , Carcinoma Hepatocelular , DNA Viral , Hepatite B , Vírus da Hepatite B , Humanos , Neoplasias Hepáticas , Nanoestruturas
20.
Chin Med J (Engl) ; 131(15): 1813-1818, 2018 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-30058578

RESUMO

Background: Cytokines play an important role in occurrence and recovery of hepatitis B virus (HBV) infection. The aim of this study was to investigate the changes of cytokines concentration and its correlation to alanine aminotransferase (ALT), HBV deoxyribonucleic acid (HBV-DNA), hepatitis B envelope antigen (HBeAg), and HBV surface antigen (HBsAg) in the development of chronic hepatitis B (CHB). Methods: Thirteen healthy individuals (HI), 30 chronic HBV-infected patients in immune tolerant (IT) phase, and 55 CHB patients were enrolled between August 2015 and May 2017. The peripheral blood samples were collected from all individuals. The levels of interferon (IFN)-α2, interleukin (IL)-10, transforming growth factor (TGF)-ß1, HBV-DNA, HBsAg, and HBeAg and liver function were measured. The quantitative determinations of cytokines levels, including IFN-α2, IL-10, and TGF-ß1 were performed using Luminex multiplex technology. The correlation of cytokines to ALT, HBV-DNA, HBsAg, and HBeAg was analyzed by linear regression analysis. Results: IFN-α2 levels were similar between HI and IT groups (15.35 [5.70, 67.65] pg/ml vs. 15.24 [4.07, 30.73] pg/ml, Z = -0.610, P = 0.542), while it elevated significantly in CHB group (35.29 [15.94, 70.15] pg/ml vs. 15.24 [4.07, 30.73] pg/ml; Z = -2.522, P = 0.012). Compared with HI group (3.73 [2.98, 11.92] pg/ml), IL-10 concentrations in IT group (5.02 [2.98, 10.11] pg/ml), and CHB group (7.48 [3.10, 18.00] pg/ml) slightly increased (χ2 = 2.015, P = 0.365), and there was no significant difference between IT and CHB group (Z = -1.419, P = 0.156). The TGF-ß1 levels among HI (3.59 ± 0.20 pg/ml), IT (3.62 ± 0.55 pg/ml), and CHB groups (3.64 ± 0.30 pg/ml) were similar (χ2 = 2.739, P = 0.254). In all chronic HBV-infected patients (including patients in IT and CHB groups), the elevation of IFN-α2 level was significantly associated with ALT level (ß= 0.389, t = 2.423, P = 0.018), and was also negatively correlated to HBV-DNA load (ß = -0.358, t = -2.308, P = 0.024), HBsAg (ß = -0.359, t = -2.288, P = 0.025), and HBeAg contents (ß = -0.355, t = -2.258, P = 0.027). However, when both ALT level and cytokines were included as independent variable, HBV-DNA load, HBsAg, and HBeAg contents were only correlated to ALT level (ß = -0.459, t = -4.225, P = 0.000; ß = -0.616, t = -6.334, P = 0.000; and ß = -0.290, t = -2.433, P = 0.018; respectively). Conclusions: IFN-α2 elevation was associated with ALT level in patients with chronic HBV infection. However, in CHB patients, only ALT level was correlated to HBV-DNA, HBsAg and HBeAg contents.


Assuntos
Alanina Transaminase/sangue , Citocinas/sangue , Antígenos de Superfície da Hepatite B/análise , Hepatite B Crônica/imunologia , Adulto , Antígenos de Superfície , Estudos de Casos e Controles , DNA Viral , Feminino , Hepatite B , Antígenos E da Hepatite B , Vírus da Hepatite B , Hepatite B Crônica/sangue , Humanos , Masculino , Adulto Jovem
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