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1.
Infectio ; 25(4): 293-295, oct.-dic. 2021. tab, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1286725

RESUMO

Resumen La trombosis venosa cerebral (TVC) es una presentación clínica poco común del tromboembolismo venoso caracterizada por cefalea, crisis convulsivas, déficits neurológicos focales y papiledema. El diagnóstico es confirmado con Tomografía axial computarizada (TAC) de cráneo y Resonancia magnética nuclear (RMN) cerebral. La TVC tiene una relación importante con el virus de inmunodeficiencia humana (VIH), ya que los pacientes VIH positivos cursan con hiperviscosidad san guínea, alteraciones de factores anticoagulantes endógenos y riesgo de sobreinfección, entre otros; que predisponen a estados protrombóticos y lesión vascular como lo es la TVC. El tratamiento de la TVC es terapia anticoagulante, por lo general se utiliza heparina no fraccionada o heparina de bajo peso molecular para la fase aguda y anticoagulantes orales como la warfarina para el mantenimiento posterior. Reportamos el primer caso documentado de TVC en un paciente VIH positivo en Colombia.


Abstract Cerebral venous thrombosis (CVT) is a rare clinical presentation of venous thromboembolism characterized by headache, seizures, neurological deficits and papi lledema. The diagnosis is confirmed using computed tomography scan (CT scan) and magnetic resonance imaging (MRI) of the brain. CVT has an important relationship with the human immunodeficiency virus (HIV) given that HIV-positive patients may present with blood hyperviscosity, irregular levels of endogenous anticoagulation factors and risk of sepsis among others, that predispose to prothrombotic states and vascular injury such as CVT. The treatment of CVT is anticoagulant therapy, generally unfractionated heparin or low molecular weight heparin for the early phase and oral anticoagulants such as warfarin for the late phase. This case reports the first documented case of CVT in an HIV positive patient in Colombia.


Assuntos
Humanos , Masculino , Adulto , Tromboembolia Venosa , Crânio , Encéfalo , Imageamento por Ressonância Magnética , HIV , Cefaleia , Hepatite B
2.
BMC Infect Dis ; 21(1): 1028, 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34592961

RESUMO

BACKGROUND: Tanzania ranks as the fourth country in the world with respect to the number of sickle cell disease (SCD) births; it is also endemic to the human immunodeficiency virus (HIV) and the hepatitis B virus (HBV). This study was done to determine the prevalence of HIV and HBV infections among SCD patients in Dar es Salaam, Tanzania. METHODS: A multicenter hospital-based descriptive cross sectional study was carried out among participants aged ≥ 16 years with a proven diagnosis of SCD. Socio-demographic and clinical data were recorded. Blood samples were drawn for HIV and HBV diagnosis. All categorical variables were summarized into frequencies. RESULTS: There were 185/325 (56.9 %) females. The mean age (SD) was 23.0 ± 7.5 years. The prevalence of HIV was 1.8 %; the prevalence of HBV was 1.2 %. CONCLUSIONS: The prevalence of both HIV and HBV in SCD patients is no greater than in the general population of Dar es Salaam or Tanzania. For associations, a large study would be needed. From a detailed blood transfusion history of SCD patients we found no evidence that HIV or HBV infection was transmitted through blood transfusion.


Assuntos
Anemia Falciforme , Infecções por HIV , Hepatite B , Adolescente , Adulto , Anemia Falciforme/complicações , Anemia Falciforme/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Hepatite B/epidemiologia , Vírus da Hepatite B , Humanos , Masculino , Prevalência , Tanzânia/epidemiologia , Adulto Jovem
3.
Mymensingh Med J ; 30(4): 897-902, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605453

RESUMO

Hepatitis B virus infection is an important cause of liver disease. Hepatitis B Virus may present with varying degree of severity. In older children, 5-10% cases leading to chronic liver disease, cirrhosis and hepatocellular carcinoma. This descriptive cross sectional study was done to assess the prevalence of Hepatitis B Virus infection among hospitalized children with liver disease in pediatric department of Mymensingh Medical College Hospital, Bangladesh from December 2015 to October 2016. All the children of both sexes having age between six months to twelve years admitted in the pediatric ward with acute or chronic liver disease were included in this study by purposive sampling. A written consent was obtained from legal guardian of children before inclusion. Ethical clearance was obtained from competent authority. A detailed history was taken from parents in each case according to pre-designed questionnaire about demography of the patients and the risk factors of the liver disease. A thorough clinical examination and available relevant investigations like serological testing for HBV infection was done in all patients. We had figure out the seropositivity of HBV among patients having liver disease by doing HBsAg and Anti-HBc IgM. Progress of the patient was monitored by daily clinical examinations and by investigating HBsAg and Anti-HBc IgM. Finally data analysis was done by SPSS version 21.0. Among total 100 patients most (44%) patients were in 7-10 years old and most (62%) of the participants were male. Acute liver disease was 58% cases and chronic liver disease was 42% cases. HBsAg was positive in 1 case among acute liver disease and 5 cases among chronic cases. Total 6 (six) patients were found positive for HBsAg. Anti HBc IgM was positive in 4 patients among acute liver disease. Among these Anti HBc IgM positive (4) patients only one had both HBsAg and Anti HBc IgM positive. So, four patients were confirming suffered from acute viral hepatitis because they had anti HBc IgM positive. On the contrary 5 patients suffered from chronic hepatitis by hepatitis B because they were only HBsAg positive. So, in this study 9 patients (9%) were confirming suffered from HBV infection. Possible transmission factors of hepatitis B were history of (H/O) blood transfusion/trauma/parenteral injection, H/O umbilical sepsis, H/O maternal illness/infection during pregnancy. HBV still is a major cause of morbidity. All the children with liver disease should be routinely tested for HBV.


Assuntos
Carcinoma Hepatocelular , Hepatite B , Neoplasias Hepáticas , Criança , Estudos Transversais , Feminino , Hepatite B/epidemiologia , Vírus da Hepatite B , Hospitais , Humanos , Lactente , Masculino , Gravidez , Prevalência
4.
World J Gastroenterol ; 27(36): 6025-6038, 2021 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-34629817

RESUMO

Elimination of viral hepatitis in sub-Saharan Africa by 2030 is an ambitious feat. However, as stated by the World Health Organization, there are unprecedented opportunities to act and make significant contributions to the elimination target. With 60 million people chronically infected with hepatitis B virus (HBV) of whom 38800 are at risk of developing highly fatal hepatocellular carcinoma (HCC) every year, sub-Saharan Africa faces one of the greatest battles towards elimination of viral hepatitis. There is a need to examine progress in controlling the disproportionate burden of HBV-associated HCC in sub-Saharan Africa within the context of this elimination target. By scaling-up coverage of hepatitis B birth dose and early childhood vaccination, we can significantly reduce new cases of HCC by as much as 50% within the next three to five decades. Given the substantial reservoir of chronic HBV carriers however, projections show that HCC incidence and mortality rates in sub-Saharan Africa will double by 2040. This warrants urgent public health attention. The trends in the burden of HCC over the next two decades, will be determined to a large extent by progress in achieving early diagnosis and appropriate linkage to care for high-risk chronic HBV infected persons.


Assuntos
Carcinoma Hepatocelular , Hepatite B , Hepatite Viral Humana , Neoplasias Hepáticas , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/prevenção & controle , Pré-Escolar , Hepatite B/diagnóstico , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Vírus da Hepatite B , Humanos , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/prevenção & controle
5.
World J Gastroenterol ; 27(36): 6053-6063, 2021 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-34629819

RESUMO

Hepatitis B virus (HBV) infection is one of the main causes of morbidity and mortality worldwide. Most children acquire the infection perinatally or during early childhood and develop a chronic hepatitis characterized by a high viral replication and a low-inflammation phase of infection, with normal or only slightly raised aminotransferases. Although a conservative approach in children is usually recommended, different therapies exist and different therapeutic approaches are possible. The main goals of antiviral treatment for children with chronic HBV infection are to suppress viral replication and to warn the disease progression to cirrhosis and hepatocellular carcinoma, although these complications are rare in children. Both United States Food and Drug Administration (US-FDA) and European Medicines Agency (EMA) have approved interferon alfa-2b for children aged 1 year and older, pegylated interferon alfa-2a and lamivudine for children aged 3 years and older, entecavir for use in children aged 2 years and older, and adefovir for use in those 12 years of age and older. Tenofovir disoproxil fumarate is approved by EMA for children aged 2 years and older and by US-FDA for treatment in children aged 12 years and older. Finally, EMA has approved the use of tenofovir alafenamide for treatment of children aged 12 years and older or for children weighing more than 35 kg independent of age. This narrative review will provide the framework for summarizing indications to antiviral therapy in the management of chronic HBV infection in children and adolescents.


Assuntos
Hepatite B Crônica , Hepatite B , Neoplasias Hepáticas , Adolescente , Antivirais/efeitos adversos , Criança , Pré-Escolar , Hepatite B/tratamento farmacológico , Vírus da Hepatite B/genética , Hepatite B Crônica/diagnóstico , Hepatite B Crônica/tratamento farmacológico , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Estados Unidos/epidemiologia
6.
Trials ; 22(1): 701, 2021 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-34649610

RESUMO

INTRODUCTION: Hepatitis B-related compensated liver cirrhosis is related to a higher risk of hepatocellular carcinoma, and antiviral therapy is the preferred method. As the pathological mechanisms of liver fibrosis are complex, drugs developed for a single target are difficult to be effective in clinical practice, so there are no chemical drugs or biological drugs with clear efficacy available for clinical application at present. Traditional Chinese medicine is a kind of medical science that has been gradually formed during thousands of years and continuously enriched by the people of all ethnic groups in China. Traditional Chinese medicine shows curative effects in the treatment of liver diseases, especially in the field of liver fibrosis prevention and treatment. This study aims to test the integrative medicine (Chinese medicine plus antiviral therapy) effective on lowing hepatocellular carcinoma risk among patients with hepatitis-related compensated liver cirrhosis. METHODS AND ANALYSIS: This is a multi-center randomized controlled trial, and a total of 5 hospitals and 802 patients will be involved in. All the subjects are randomly allocated to the YinQiSanHuang Jiedu decoction (YQSHD) group (n = 401) or the placebo group (n = 401). The YQSHD group receives YQSHD granule with entecavir (ETV), and the placebo group receives YQSHD placebo with ETV. The treatment period will last for 52 weeks, and the follow-up period for 52 ± 2 weeks. The primary outcome measure is the annual incidence of HCC. Outcomes will be assessed at baseline and after treatment. The objective of this trial is "the integrative of YQSHD with ETV reduce the annual incidence of HCC to 1%." ETHICS AND DISSEMINATION: The protocol has been approved by the Medical Ethics Committee of Guang'anmen Hospital, China (No.2019-006-KY), and the other centers in the trial will not begin recruiting until the local ethical approval has been obtained. Trial final results will be disseminated via publication. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1900021532 . Registered on February 26, 2019.


Assuntos
Carcinoma Hepatocelular , Medicamentos de Ervas Chinesas , Hepatite B , Neoplasias Hepáticas , Antivirais/efeitos adversos , Carcinoma Hepatocelular/tratamento farmacológico , Método Duplo-Cego , Medicamentos de Ervas Chinesas/efeitos adversos , Hepatite B/diagnóstico , Hepatite B/tratamento farmacológico , Humanos , Cirrose Hepática/diagnóstico , Cirrose Hepática/tratamento farmacológico , Neoplasias Hepáticas/tratamento farmacológico , Estudos Multicêntricos como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
7.
Clin Lab ; 67(10)2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34655197

RESUMO

BACKGROUND: Development and progression of HBV-related acute-on-chronic liver failure (HBV-ACLF) are associated with inflammatory responses. We aimed to explore the utility of blood cell count-derived inflammatory markers (white blood cell, neutrophil-to-lymphocyte ratio, red cell distribution width, and monocyte-to-lymphocyte ratio [MLR]) as prognostic index in HBV-ACLF patients. METHODS: A total of 160 HBV-ACLF patients were included in this retrospective study. Univariate and multivariate analyses were performed to identify predictors of poor outcomes, and the performance of these predictors was evaluated by receiver operating characteristic curve analysis. RESULTS: Fifty-six patients died within 28 days after admission. MLR was markedly higher in non-survivors than in survivors. Moreover, MLR was an independent predictor for 28-day mortality. CONCLUSIONS: This retrospective study found that MLR is a simple and accurate prognostic index for mortality in HBV-ACLF patients and can serve as a screening tool for prediction of poor outcomes in these patients.


Assuntos
Insuficiência Hepática Crônica Agudizada , Hepatite B Crônica , Hepatite B , Insuficiência Hepática Crônica Agudizada/diagnóstico , Contagem de Células Sanguíneas , Hepatite B/complicações , Hepatite B/diagnóstico , Vírus da Hepatite B , Hepatite B Crônica/complicações , Hepatite B Crônica/diagnóstico , Humanos , Prognóstico , Curva ROC , Estudos Retrospectivos
8.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 52(5): 772-777, 2021 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-34622591

RESUMO

Objective: To analyze the behavioral factors influencing of new hepatitis B virus (HBV) infection in diabetic patients, so as to provide evidence for reducing the risk of new HBV infection in diabetic patients. Methods: A nested case-control study was conducted to follow up and observe 4 586 diabetic patients. The 114 diabetic patients who newly developed HBV infection during the follow-up period were selected as the case group, and 228 diabetic patients who did not develop HBV infection in the same period were selected as the control group from the cohort population at a matching ratio of 1∶2 according to the age ±2 years. Questionnaire surveys and laboratory examinations were conducted in the cohort. The contents of the questionnaire included family history of hepatitis B, history of trauma, history of receiving/donating blood, individual-related behavioral characteristics, diabetes severity, and behavior related to diabetes treatment and management. In addition, the blood samples of the cohort were tested for hepatitis B surface antigen (HBsAg) by enzyme-linked immunosorbent assay (ELISA). The conditional logistic regression model was used to analyze the related behavioral factors affecting new HBV infection in diabetic patients. Results: The median ages of the HBV group and the control group were 64 years old and 66 years old, respectively. There was no statistically significant difference in the composition of sex, age, ethnicity, occupation and amount of formal education between the two groups ( P>0.05). Multivariate analysis showed that diabetic patients with a family history of hepatitis B ( OR=13.052, 95% CI: 3.799 to 44.847) had a higher risk of new HBV infection, while diabetic patients who used blood collection/injection devices in a standardized way ( OR=0.189, 95% CI: 0.082 to 0.436), safety locking blood glucose needles ( OR=0.142, 95% CI: 0.073 to 0.276) and venous blood collection needles ( OR=0.019, 95% CI: 0.001 to 0.262) and self-testing of blood sugar at home ( OR=0.466, 95% CI: 0.222 to 0.980) had a lower risk of new HBV infection. Conclusion: Family history of hepatitis B is an independent factor that increases the risk for new HBV infection in diabetic patients. During the process of long-term blood glucose management of diabetic patients, standardized use of blood collection/injection devices, use of safer types of blood sampling lancet, and self-testing of blood glucose help can reduce the risk of HBV infection.


Assuntos
Diabetes Mellitus , Hepatite B , Estudos de Casos e Controles , Diabetes Mellitus/epidemiologia , Hepatite B/complicações , Vírus da Hepatite B/genética , Humanos , Pessoa de Meia-Idade , Fatores de Risco
9.
Science ; 374(6564): 182-188, 2021 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-34618559
11.
Pan Afr Med J ; 39: 174, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34584600

RESUMO

Introduction: sub-Saharan Africa bears a high prevalence for hepatitis B virus (HBV) infection. This analysis aims at elucidating the exposure to HBV across different age groups in Mbeya Region in Tanzania and determines prevalences of hepatitis C (HCV) and hepatitis delta antigen (HDV) infections. Methods: plasma samples from children and adults with defined HIV status were analysed for HBV, HCV and HDV markers.\. Results: hepatitis B (HBs)-antigen positivity was 8.3% (3/36) in the 0 to 5 years age group, 13.3% (8/60) in the 6 to 7 years, 17.2% (10/58) in the 8 to 14 years and 13.3% (8/60) in the 15 to 18 years age groups. In adults 5.0% of samples were HBs-antigen positive. Overall, 17.1% were HIV-1 positive. Adults infected with HIV-1 were significantly more often HBs-antigen positive (7.5%) than HIV-1 negative adults (4.5%; p<0.05). A serological sub-study including 174 adults showed that both total anti-HBs and total anti-HBc positivity increased with age in HBs-antigen negative participants. Across all age groups, HCV antibodies were found in 9 individuals, HDV antibodies in 3 individuals. Conclusion: children presented a high prevalence of HBs-antigen carriers, with lower levels in the younger children. Among adults, the overall prevalence of HBs-antigen was lower than in children, either corresponding to clearance of HBV over time or due to a die-off effect. HBs-antigen positive adults had higher frequencies of anti-HBc- and anti-HBe-antibodies, indicating better immunological control of HBV infection than children. This supports claims that HBV infections in Africa are mostly acquired in childhood and to a large extent cleared again by adulthood. One in 20 adults remains chronically infected, emphasising the importance of HBV vaccination strategies.


Assuntos
Hepatite B/epidemiologia , Hepatite C/epidemiologia , Hepatite D/epidemiologia , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Infecções por HIV/epidemiologia , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Anticorpos Anti-Hepatite C/sangue , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Prevalência , Tanzânia/epidemiologia , Adulto Jovem
12.
Pan Afr Med J ; 39: 175, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34584601

RESUMO

Introduction: viral infection caused by hepatitis B virus is the most frequent transfusion-transmitted viral infection. Although the search for hepatitis B surface antigen (HBsAg) in blood banks has significantly reduced the risk for transfusion-transmitted virus infection, there is still a residual transfusion risk of transmission from donors with occult hepatitis B. Blood bags containing aHBc with or without aHBs and viral DNA can cause infections and represent a threat to transfusion safety when aHBc levels are undetectable. The purpose of this study is to determine the residual risk for transfusion-transmitted hepatitis B virus at the Central Hospital of Yaoundé (CHY) as well as at the St Martin de Porres's Catholic Hospital (SMPCH) in Yaoundé, Cameroon. Methods: we conducted a cross-sectional study among blood donors at the Central Hospital of Yaoundé (CHY) and the St Martin de Porres's Catholic Hospital. In these subjects the search for aHBc and/or the aHBs was conducted by immunochromatography. HBV DNA test was performed on blood samples tested positive for aHBc and/or aHBs by Polymerase Chain Reaction (PCR) technique using specific primers. Results: out of a total of 193 blood donors negative for HIV, HBV (HBsAg), HCV serological markers and treponema infections, the overall seroprevalence of aHBc and/or aHBs was 9,84% (19/193). Out of a total of 19 potentially infected donors, HBV DNA was detected in 03 individuals, including 02 aHBc carriers and 01 carrier of both aHBc and aHBs, reflecting a prevalence of occult hepatitis B of 15,79% (3/19) [IC 95% =3,38%-39,58%] and a residual risk for transfusion-transmitted hepatitis B virus of 1,55% (3/193) [IC 95% =0,32%-4,48%]. Conclusion: this study shows that the residual risk for transfusion-transmitted hepatitis B virus is low. However, it is recommended to screan blood donors for aHBc and/or aHBs.


Assuntos
Doadores de Sangue , Seleção do Doador/métodos , Antígenos de Superfície da Hepatite B/sangue , Hepatite B/transmissão , Adolescente , Adulto , Segurança do Sangue/métodos , Transfusão de Sangue/normas , Camarões , Estudos Transversais , DNA Viral/sangue , Feminino , Hepatite B/sangue , Hepatite B/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Medição de Risco , Estudos Soroepidemiológicos , Adulto Jovem
13.
Ann Surg ; 274(4): 556-564, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34506310

RESUMO

OBJECTIVES: The aim of this study was to assess the 1-year safety and effectiveness of HBV Nucleic Acid Test positive (HBV NAT+) allografts in seronegative kidney transplant (KT) and liver transplant (LT) recipients. SUMMARY BACKGROUND DATA: Despite an ongoing organ shortage, the utilization of HBV NAT+ allografts into seronegative recipients has not been investigated. METHODS: From January 2017 to October 2020, a prospective cohort study was conducted among consecutive KT and LT recipients at a single institution. Primary endpoints were post-transplant HBV viremia, graft and patient survival. RESULTS: With median follow-up of 1-year, there were no HBV-related complications in the 89 HBV NAT+ recipients. Only 9 of 56 KTs (16.1%) and 9 of 33 LTs (27.3%) experienced post-transplant HBV viremia at a median of 185 (KT) and 269 (LT) days postoperatively. Overall, viremic episodes resolved to undetected HBV DNA after a median of 80 days of entecavir therapy in 16 of 18 recipients. Presently, 100% of KT recipients and 93.9% of LT recipients are HBV NAT- with median follow-up of 13 months, whereas 0 KT and 8 LT (24.2%) recipients are HBV surface antigen positive indicating chronic infection. KT and LT patient and allograft survival were not different between HBV NAT+ and HBV NAT- recipients (P > 0.05), whereas HBV NAT+ KT recipients had decreased waitlist time and pretransplant duration on dialysis (P < 0.01). CONCLUSIONS: This is the largest series describing the transplantation of HBV NAT+ kidney and liver allografts into HBV seronegative recipients without chronic HBV viremia or decreased 1-year patient and graft survival. Increasing the utilization of HBV NAT+ organs in nonviremic recipients can play a role in decreasing the national organ shortage.


Assuntos
Seleção do Doador , Doença Hepática Terminal/cirurgia , Hepatite B/diagnóstico , Falência Renal Crônica/cirurgia , Transplante de Rim , Transplante de Fígado , Adulto , Idoso , Aloenxertos/virologia , Doença Hepática Terminal/mortalidade , Doença Hepática Terminal/virologia , Feminino , Sobrevivência de Enxerto , Humanos , Falência Renal Crônica/mortalidade , Falência Renal Crônica/virologia , Masculino , Pessoa de Meia-Idade , Taxa de Sobrevida , Resultado do Tratamento
14.
Medicine (Baltimore) ; 100(38): e27231, 2021 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-34559118

RESUMO

BACKGROUND: Hepatitis B cirrhosis with hyperalphafetoproteinemia is the intermediate stage of liver cirrhosis progressing to hepatocellular carcinoma (HCC), there is no effective way to treat precancerous lesions of liver in modern medicine. In recent decades, clinical and experimental evidence shows that Chinese medicine (CM) has a certain beneficial effect on Hepatitis B Cirrhosis. Therefore, this trial aims to evaluate the efficacy and safety of a CM erzhu jiedu recipe (EZJDR) for the treatment of Hepatitis B Cirrhosis with Hyperalphafetoproteinemia. METHODS: We designed a randomized, double blind, placebo-controlled clinical trial. A total of 72 patients of Hepatitis B Cirrhosis with hyperalphafetoproteinemia were randomized in 2 parallel groups. Patients in the control group received placebo granules similar to the EZJDR. In the EZJDR group, patients received EZJDR twice a day, after meals, for 48 weeks. The primary efficacy measures were changes in serum alpha-fetoprotein (AFP) and alpha-fetoprotein alloplasm (AFP-L3); The secondary indicators of efficacy are changes in liver function indicators, HBV-DNA level; Liver stiffness measurement (LSM); Hepatic portal vein diameter; T lymphocyte subgroup indexes during treatment. All data will be recorded in case report forms and analyzed by Statistical Analysis System software. Adverse events will also be evaluated. RESULTS: The results showed that EZJDR can significantly inhibit the levels of AFP and AFP-L3 in patients with hepatitis B cirrhosis and hyperalphafetoproteinemia and have good security. ETHICS AND DISSEMINATION: The study protocol was approved by the Medical Ethics Committee of Shuguang Hospital, affiliated with University of Traditional Chinese Medicine, Shanghai (NO.2018-579-08-01). TRIAL REGISTRATION: This trial was registered on Chinese Clinical Trial Center (NO.ChiCTR1800017165).


Assuntos
Proteínas de Transferência de Ésteres de Colesterol/deficiência , Erros Inatos do Metabolismo Lipídico/tratamento farmacológico , Erros Inatos do Metabolismo Lipídico/etiologia , Medicina Tradicional Chinesa/normas , Distribuição de Qui-Quadrado , Método Duplo-Cego , Fibrose/complicações , Fibrose/tratamento farmacológico , Hepatite B/complicações , Hepatite B/tratamento farmacológico , Humanos , Medicina Tradicional Chinesa/métodos , Medicina Tradicional Chinesa/estatística & dados numéricos , Placebos
15.
Pan Afr Med J ; 39: 138, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34527154

RESUMO

Introduction: hepatitis B virus (HBV) is one of the commonest causes of acute and chronic liver diseases worldwide. HBV can be transmitted by exposure to infected blood and human secretions through sharp injuries and splashes. Health workers are among the most high-risk groups because they regularly interact with patients. A seroprevalence survey conducted in Uganda in 2014 found a higher prevalence of HBV in Gulu Municipality compared to the rest of Uganda. Methods: a cross-sectional study was conducted among health workers in Gulu Regional Hospital. A stratified random sampling was used. Knowledge ratings and Likert scale were used to score knowledge, attitudes and risks of HBV infections in a qualitative assessment. Ethical approval was obtained and SPSS was used for data analysis. A p-value less than 0.05 was considered significant. Results: one hundred and twenty-six (126) respondents participated; 65 (51.6%) were male, 80 (63.5%) were aged 20-29 years, 74 (58.7%) were not married, 86 (68.3%) had a work experience of 0-9 years, 64 (50.8%) had good knowledge, 90(71.4%) had positive attitude, 114 (90.5%) had high to very high pre-exposure risks, and 75 (59.5%) had moderate to high exposure and post-exposure risks. There was no significant difference in knowledge (X 2= 13.895; p = 0.178) and work experience (X 2= 21.196; p = 0.097) among the health workers. Conclusion: there is a high pre-exposure, exposure and post-exposure risks of HBV infection among health workers in Gulu Hospital. There is need to augment awareness on HBV infection and design strategies to strengthen and implement infection control measures including HBV vaccination among health workers.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Hepatite B/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Hepatite B/transmissão , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/prevenção & controle , Prevalência , Estudos Soroepidemiológicos , Inquéritos e Questionários , Uganda/epidemiologia , Adulto Jovem
16.
BMC Cancer ; 21(1): 1063, 2021 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-34583662

RESUMO

BACKGROUND: Transarterial chemoembolization (TACE) is an effective treatment for patients with hepatocellular carcinoma (HCC). However, the impact of hepatitis B viral (HBV) infection and body mass index (BMI) on TACE is controversial. The present study aimed to compare the influence of HBV and high BMI on TACE outcomes in advanced HCC. METHODS: Based on HBV infection history and BMI, patients were assigned to different subgroups. Blood samples were collected and analyzed by an enzyme-linked immunosorbent assay (ELISA) kit. The primary endpoint was progression-free survival (PFS) and the overall survival (OS) in the population. RESULTS: Compared to overweight combined HBV patients who received TACE, people with normal weight or no viral infection had significantly better OS and PFS. Sex, age, portal vein tumor thrombus, BCLC, ECOG, and tumor diameter are the main risk factors affecting PFS and OS. Except for the postoperative fever, no significant difference was detected in adverse reactions. Irrespective of TACE, the average expression of HMGB1 in hepatitis or obesity patients was higher than that in normal individuals and did not show upregulation after TACE. Patients without overweight or HBV infection had a low expression of serum HMGB1 that was substantially upregulated after TACE. CONCLUSIONS: In this study, overweight combined HBV infection patients had shorter PFS and OS than other HCC patients. Thus, HBV and BMI maybe two factors affecting the efficacy of TACE via upregulated HMGB1.


Assuntos
Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica/métodos , Hepatite B/complicações , Neoplasias Hepáticas/terapia , Sobrepeso/complicações , Fatores Etários , Índice de Massa Corporal , Carcinoma Hepatocelular/mortalidade , Quimioembolização Terapêutica/efeitos adversos , Feminino , Proteína HMGB1/sangue , Hepatite B/sangue , Hepatite B/mortalidade , Vírus da Hepatite B , Humanos , Estimativa de Kaplan-Meier , Neoplasias Hepáticas/mortalidade , Masculino , Pessoa de Meia-Idade , Sobrepeso/sangue , Sobrepeso/mortalidade , Veia Porta , Intervalo Livre de Progressão , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Trombose/complicações , Resultado do Tratamento
17.
Arch Virol ; 166(11): 3075-3084, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34468889

RESUMO

Occult hepatitis B virus (OBI) infection is defined by the presence of viral DNA in the liver and/or serum in absence of hepatitis B surface antigen (HBsAg). While multiple studies have identified mutations that are associated with OBI, only a small portion of these mutations have been functionally characterized in vitro. Using complementary in silico approaches, the effects of OBI-associated amino acid mutations on HBV protein function in HBV/HIV-positive ART-naïve South Africans were evaluated. Two OBI-associated mutations in the PreS1 region, one in the PreS2 region, and seven in the surface region of subgenotype A1 sequences were identified as deleterious. In subgenotype A2 sequences, 11 OBI-associated mutations in the PreS1 region, seven in the PreS2 region, and 31 in the surface region were identified as deleterious. In the polymerase region, 14 OBI-associated mutations in subgenotype A1 and 71 OBI-associated mutations in subgenotype A2 were identified as deleterious. This study utilized in silico approaches to characterize the likely impact of OBI-associated mutations on viral function, thereby identifying and prioritizing candidates and reducing the significant cost associated with functional studies that are essential for mechanistic studies of the OBI phenotype.


Assuntos
Vírus da Hepatite B/genética , Hepatite B/virologia , Mutação , Simulação por Computador , DNA Viral/sangue , Genótipo , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/química , Vírus da Hepatite B/patogenicidade , Humanos , África do Sul
18.
J Investig Med High Impact Case Rep ; 9: 23247096211043712, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34477014

RESUMO

Patients chronically infected with hepatitis B virus (HBV) may travel to areas with high endemicity of malaria. The overlap between malaria and HBV infection can be clinically severe and present a diagnostic challenge as both diseases manifest similar symptoms. This case describes a fatal case of a 43-year-old man with chronic HBV infected with Plasmodium falciparum malaria that presents as acute kidney injury (AKI) and jaundice following a trip to malaria-endemic region. Despite administering antimalarial and 6 courses of renal replacement therapy, the patient's clinical condition did not improve, leading to septic shock, multi-organ dysfunction, and eventually, death. AKI and jaundice are commonly seen in severe P. falciparum malaria, as well as acute exacerbation of chronic HBV. This case emphasizes the importance to consider malarial screening when evaluating sick returning travelers, even in those with underlying chronic HBV. Given the severity of coinfection, prompt identification of this overlap can avert the rapid deterioration of severe malaria by early administration of intravenous artesunate and renal replacement therapy.


Assuntos
Injúria Renal Aguda , Antimaláricos , Hepatite B , Icterícia , Malária , Injúria Renal Aguda/etiologia , Adulto , Antimaláricos/uso terapêutico , Hepatite B/complicações , Hepatite B/diagnóstico , Hepatite B/tratamento farmacológico , Humanos , Icterícia/tratamento farmacológico , Icterícia/etiologia , Malária/tratamento farmacológico , Masculino
19.
Med J Malaysia ; 76(5): 719-724, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34508381

RESUMO

This case series is to create awareness among clinicians on the importance of Hepatitis B screening prior to administration of chemotherapeutic agents and immunosuppressant in preventing Hepatitis B reactivation (HBVr). We also highlight the importance of identifying patients who are at risk of HBVr and when to initiate antiviral prophylaxis based on the current evidence-based guidelines. The case series consists of four patients seen in Hospital Selayang, Malaysia who developed fulminant liver failure secondary to chemotherapeutic agents or immunosuppressant induced HBVr. HBVr is likely to be of increasing clinical significance as potent immunosuppressive regimens are used more widely across all medical specialties. Clinicians should be made aware of the potential risk of patients developing fulminant liver failure following HBVr and its association with high morbidity and mortality. In the era of inexpensive Hepatitis B blood screening tests and safe potent antivirals, there is now a paradigm shift to make the test compulsory to screen all patient prior to initiation of chemotherapeutic agents or immunosuppressive therapy. Antiviral prophylaxis may be offered to more patients who are at risk of HBVr and the duration of both prophylaxis and subsequent monitoring may be extended until 6 to 18 months following completion of treatment.


Assuntos
Hepatite B , Imunossupressores , Antivirais/efeitos adversos , Hepatite B/induzido quimicamente , Vírus da Hepatite B , Humanos , Imunossupressores/efeitos adversos , Ativação Viral
20.
J Investig Med High Impact Case Rep ; 9: 23247096211045450, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34521227

RESUMO

Genomic variants of the hepatitis B virus (HBV) preS/S protein are well-known to occur. Typically, immunity is gained through recovered HBV infection or by immunization. Very rarely, there are certain mutations that may enable HBV escape from the immune detection. PreS/S mutants may present with unpredictable pathobiologic, clinical, and transmittable implications. Standard laboratory testing for genomic HBV variants is not routinely performed by reference guidelines. s-variant HBV management remains challenging. Herein is a case of s-variant chronic HBV infection in a 55-year-old man. Diagnosis and treatment are described.


Assuntos
Vírus da Hepatite B , Hepatite B , Variação Genética , Hepatite B/diagnóstico , Antígenos de Superfície da Hepatite B , Vírus da Hepatite B/genética , Humanos , Sistema Imunitário , Masculino , Pessoa de Meia-Idade
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