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2.
BMC Infect Dis ; 20(1): 736, 2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028232

RESUMO

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.


Assuntos
Segurança do Sangue , Infecções por HIV/diagnóstico , Infecções por HTLV-I/diagnóstico , Hepatite B/diagnóstico , Hepatite C/diagnóstico , Adolescente , Adulto , Doadores de Sangue/estatística & dados numéricos , Feminino , Infecções por HIV/epidemiologia , Infecções por HTLV-I/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Reação Transfusional/diagnóstico , Reação Transfusional/epidemiologia , Reação Transfusional/virologia , Adulto Jovem
3.
Medicine (Baltimore) ; 99(41): e22650, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031326

RESUMO

RATIONALE: Hepatitis B virus (HBV) reactivation caused by immunosuppressive therapy or chemotherapy is well known. The administration of direct-acting antiviral agents (DAAs) to treat hepatitis C virus (HCV) infection has also been reported to cause HBV reactivation. We report a rare case of HBV reactivation in a patient with HCV infection after DAA therapy. PATIENT CONCERNS: In 1996, a 53-year-old female was identified as infected with HCV at a medical check-up, following which she visited our hospital. She was infected with HCV genotype 2b, and at follow up in 1997, was found to be hepatitis B surface antigen (HBsAg) and antibody against HBsAg negative, antibody against HBV core positive. She then experienced malignant lymphoma in 2001 at 58 years of age. Complete remission was achieved following chemotherapy and autologous peripheral blood stem cell transplantation. In 2014, she remained negative for HBsAg and antibody against HBsAg but positive for antibody against HBV core. In 2015, 12 weeks of sofosbuvir and ribavirin treatment for HCV was started. Serum HCV RNA levels rapidly decreased, and HCV elimination was confirmed at 24 weeks after cessation of DAA treatment. Acute hepatitis B developed at 15 weeks post- sustained virological response without any symptoms and physical examination findings. DIAGNOSES: This case is speculated to represent HBV reactivation induced by DAA treatment in a patient with previously resolved HBV, based on virologic and clinical status. Genome sequencing revealed the HBV genotype as A2. INTERVENTIONS: The patient was treated with nucleotide analog for HBV reactivation once a day. OUTCOMES: Serum HBV-DNA levels decreased, and serum liver enzymes improved following initiation of nucleotide analog treatment. Also, adverse events of nucleotide analog treatment were not observed. LESSONS: Although the risk may be very low, DAA therapy can cause HBV reactivation in chronic hepatitis C patients with prior HBV infection. Thus, those patients must be closely monitored for serum HBV DNA levels during and after DAA treatment.


Assuntos
Antivirais/efeitos adversos , Vírus da Hepatite B/isolamento & purificação , Hepatite C/tratamento farmacológico , Ribavirina/efeitos adversos , Sofosbuvir/efeitos adversos , Feminino , Hepatite B/virologia , Humanos , Pessoa de Meia-Idade , Recidiva
4.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2451-2454, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018502

RESUMO

A mathematically identical ordinary differential equations (ODEs) model was derived from a multiscale partial differential equations (PDEs) model of hepatitis c virus infection, which helps to overcome the limitations of the PDE model in clinical data analysis. We have discussed about basic properties of the system and found the basic reproduction number of the system. A condition for the local stability of the uninfected and the infected steady states is presented. The local stability analysis of the model shows that the system is asymptotically stable at the disease-free equilibrium point when the basic reproduction number is less than one. When the basic reproduction number is greater than one endemic equilibrium point exists, and the local stability analysis proves that this point is asymptotically stable. Numerical sensitivity analysis based on model parameters is performed and therefore the result describes the influence of each parameter on the basic reproduction number.


Assuntos
Hepacivirus , Hepatite C , Número Básico de Reprodução , Análise de Dados , Humanos
5.
J Stud Alcohol Drugs ; 81(5): 556-560, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-33028465

RESUMO

People who use drugs (PWUD) face concurrent public health emergencies from overdoses, HIV, hepatitis C, and COVID-19, leading to an unprecedented syndemic. Responses to PWUD that go beyond treatment--such as decriminalization and providing a safe supply of pharmaceutical-grade drugs--could reduce impacts of this syndemic. Solutions already implemented for COVID-19, such as emergency safe-supply prescribing and providing housing to people experiencing homelessness, must be sustained once COVID-19 is contained. This pandemic is not only a public health crisis but also a chance to develop and maintain equitable and sustainable solutions to the harms associated with the criminalization of drug use.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por HIV/epidemiologia , Hepatite C/epidemiologia , Pneumonia Viral/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Sindemia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/prevenção & controle , Criminosos , Overdose de Drogas/complicações , Overdose de Drogas/epidemiologia , Overdose de Drogas/prevenção & controle , Serviços Médicos de Emergência , Infecções por HIV/complicações , Infecções por HIV/prevenção & controle , Hepatite C/complicações , Hepatite C/prevenção & controle , Habitação , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/complicações , Pneumonia Viral/prevenção & controle , Prescrições , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Estados Unidos/epidemiologia , United States Public Health Service
6.
BMC Infect Dis ; 20(1): 742, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33036558

RESUMO

BACKGROUND: The surge of methamphetamine use has been a complicating factor compounding the steeply increasing number of drug overdose deaths in the U.S. Infection from blood-borne viruses including hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV, related to methamphetamine use continue to grow. This study aims to examine the risk factors associated with HBV, HCV and HIV among people who used methamphetamine. METHODS: People who ever used methamphetamine were identified from five National Health and Nutrition Examination Survey (NHANES) cohorts, 2007 to 2016. The outcome was either positive or negative for blood-borne viruses as identified from laboratory tests. Weighted statistics for the combined ten years of data were calculated by multiplying the weighted variable for laboratory measurements by 0.2. We examined the association of sexual activities (sexual partners, sexual identity), drug use behaviors (poly-drug use, injection drug use, frequency of drug use, age started using methamphetamine), demographics, and socio-economic status with blood-borne viruses using bivariate and multivariable logistic regression models. RESULTS: There were 1132 participants representing approximately 11,996,319 persons who ever used methamphetamine in the U.S. Blood-borne viruses' positive rate was 13.0 per 100,000. Multivariable logistic regression analyses showed significant associations of blood-borne infections with age 40-49 years (vs. age 20-29 years, adjusted odds ratio 4.77, 95% CI 1.11-20.55), age 50-59 years (vs. age 20-29 years, 10.25, 2.40-43.82), living within poverty index 1-1.9 (vs. poverty index > = 2, 2.55; 1.19-5.49), living below the poverty threshold (vs. poverty index > = 2, 2.55; 1.11-5.86), having lower than high school education (vs. equal or higher than high school education, 3.13; 1.51-6.46), sexual identity as other than heterosexual (vs. heterosexual, 5.60; 1.72-18.28), using methamphetamine and heroin and cocaine (vs. using methamphetamine alone, 4.24; 1.06-16.92), injection drug use (vs. no injection drug use, 3.15; 1.61-6.16), and started using methamphetamine at age above 25 (vs. started using methamphetamine at age between 10 and 17, 2.09; 1.01-4.35). CONCLUSIONS: Among people who use methamphetamine, those who use polysubstance, or who inject substances, are in urgent need for vaccination and interventions to avoid further harm from blood borne infections.


Assuntos
Infecções por HIV/epidemiologia , HIV-1/imunologia , HIV-2/imunologia , Hepacivirus/imunologia , Vírus da Hepatite B/imunologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Metanfetamina , Abuso de Substâncias por Via Intravenosa , Adulto , Estudos de Coortes , Estudos Transversais , Feminino , Infecções por HIV/virologia , Hepatite B/virologia , Hepatite C/virologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Razão de Chances , Fatores de Risco , Assunção de Riscos , Testes Sorológicos , Comportamento Sexual , Parceiros Sexuais , Adulto Jovem
7.
Medicine (Baltimore) ; 99(36): e22005, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899048

RESUMO

The purpose of this study was to acquire the epidemic trend of age-standardized reported incidence and to analyze the age effect, period effect, and cohort effect on the reported incidence of hepatitis C in Jilin Province, China.We collected the annual reported incidence data of hepatitis C by gender (2008-2017). Annual percentage change and annual average percentage change were calculated by joinpoint Poisson regression analysis. The age effect, period effect, and cohort effect on the incidence of hepatitis C were estimated by an age-period-cohort model, and the relative risk was determined.Joinpoint regression analysis showed that the age-standardized reported incidence of hepatitis C indicated a declining trend integrally. Among people aged 30 to 44 (youth), the incidence trend declined the fastest, while trends declined the slowest among women and the overall population aged over 66 (elderly people) and men aged 45 to 65 (middle-aged group). The results of the age-period-cohort model showed that the reported incidence increased first and then decreased with age. Throughout the period, the risk of hepatitis C also increased first and then decreased. Compared with the median birth cohort of the same age group, the birth cohort of the patients with the highest incidence of hepatitis C was in the 1930s, followed by the 1940s and 1950s. The birth cohort of the patients with the lowest incidence was in the 1980s, followed by the 1970s and 1960s.Although the overall reported incidence trend of hepatitis C is declining and the risk of the young birth cohort is low, many factors affecting infection and testing with hepatitis C still exist in China. We should focus on high-risk population management and formulate corresponding public health strategies to accelerate the implementation of the global health strategy to eliminate hepatitis C published by the World Health Organization.


Assuntos
Hepatite C/epidemiologia , Adulto , Idoso , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade
8.
Value Health ; 23(9): 1137-1141, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32940230

RESUMO

OBJECTIVES: Hepatitis C virus (HCV) antivirals have been shown to be highly effective with minimal adverse effects, but they are costly. Little is known about the national spending on this drug class in either Canada or the United States, 2 countries with different drug pricing regulations. Thus the objective of this study was to compare drug expenditure on HCV medications in the United States and Canada. METHODS: This was a retrospective cross-sectional study using the IQVIA National Sales Perspectives (United States) and Geographic Prescription Monitor (Canada) databases, which contains prescription transactions from American and Canadian pharmacies. All prescription claims for the period between January 1, 2014, and June 30, 2018, were used to describe HCV antiviral expenditure in both countries. RESULTS: The United States and Canada spent $59.7 billion and $2.8 billion on HCV medications, respectively. Population-adjusted HCV medication costs were higher in the United States ($1 million per 100 000 population) compared with Canada ($0.4 million per 100 000 population). CONCLUSIONS: Although the rates of HCV infection are similar in the 2 countries, these findings highlight the differences in both the reimbursement utilization policy for HCV treatments in the countries and the major differences in drug pricing policies. As policies to reduce drug spending in the United States are explored, this article highlights the potential cost implications of implementing Canadian index pricing.


Assuntos
Antivirais/economia , Custos de Medicamentos/estatística & dados numéricos , Hepatite C/tratamento farmacológico , Canadá , Estudos Transversais , Política de Saúde , Humanos , Estudos Retrospectivos , Estados Unidos
9.
Medicine (Baltimore) ; 99(35): e21825, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871904

RESUMO

OBJECTIVE: To conduct a meta-analysis evaluating the effect of combining traditional Chinese medicine (TCM) with Western medicine in treating hepatitis C, and to provide an evidence-based medical strategy. METHODS: Randomized controlled trials (RCTs) comparing the effect of pegylated interferon (Peginterferon) combined with ribavirin (PR) alone and its combination with TCM were manually retrieved from the Weipu Information Resources System (VIP), Wan Fang Database, PubMed, and the Chinese Journal Full Text Database (CNKI). Studies meeting the inclusion criteria were selected and analyzed using the Review Manager 5.3 software. Suitable tests were also performed to determine the quality, heterogeneity, and sensitivity of the studies included in the meta-analysis. RESULTS: Twenty-eight RCTs met the inclusion criteria. The combination therapy or intervention group showed significantly greater HCV-RNA negative rate post-treatment compared to the monotherapy or the control group (P < .05). In addition, the serum levels of the liver function indicators alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin (ALB) were significantly improved after the combination therapy compared to PR alone (P < .05), while total bilirubin (TB) and r-glutamyltransferase (GGT) levels were not affected by TCM (P > .05). Finally, the parameters of liver fibrosis were also reduced by the combination therapy more effectively than the monotherapy. CONCLUSION: The combination of TCM and PR can improve the Comprehensive Clinical Efficacy of hepatitis C and have a better negative rate of HCV-RNA with a better benefit in the liver function. The effect of TCM + PR is better than that of PR alone in treating hepatitis C.


Assuntos
Antivirais/uso terapêutico , Hepatite C/terapia , Medicina Tradicional Chinesa , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Bilirrubina/sangue , Terapia Combinada , Quimioterapia Combinada , Hepacivirus/genética , Humanos , Interferon-alfa/uso terapêutico , Cirrose Hepática/tratamento farmacológico , Polietilenoglicóis/uso terapêutico , RNA Viral/sangue , Proteínas Recombinantes/uso terapêutico , Ribavirina/uso terapêutico , Albumina Sérica , gama-Glutamiltransferase/sangue
10.
BMC Infect Dis ; 20(1): 655, 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32894072

RESUMO

BACKGROUND: People who use drugs including people who inject drugs (PWUD/ID), sex workers (SWs) and men who have sex with men (MSM) are at increased risk of HIV and viral hepatitis infection. Limited epidemiological data on the infections exists in key populations (KPs) in South Africa. We investigated the prevalence of hepatitis B (HBV), hepatitis C (HCV) and HIV and selected risk factors among these KPs to inform effective responses. METHODS: We used convenience sampling to recruit a targeted 3500 KPs accessing HIV-related health services across Cape Town (SWs, MSM, PWUD/ID), Durban (SWs, PWUD/ID), Pietermaritzburg (SWs), Mthatha (SWs), Port Elizabeth (SWs), Johannesburg (MSM) and Pretoria (MSM and PWUD/ID) into a cross-sectional survey. An interviewer questionnaire to assess socio-demographic characteristics, drug use and sexual risk practices, was administered. HBV surface antigen (HBsAg); HCV antibody, viral load and genotype, and HIV antibody, was tested. RESULTS: Among the 3439 people included in the study (1528 SWs, 746 MSM, 1165 PWUD/ID) the median age was 29 years, most participants were black African (60%), and 24% reported homelessness. 82% reported substance use in the last month, including alcohol (46%) and heroin (33%). 75% were sexually active in the previous month, with condom use at last sex at 74%. HIV prevalence was 37% (highest among SWs at 47%), HBsAg prevalence 4% (similar across KPs) and HCV prevalence was 16% (highest among PWUD/ID at 46%). CONCLUSIONS: HBV, HCV and HIV pose a health burden for KPs in South Africa. While HIV is key for all included KPs, HCV is of particular importance to PWUD/ID. For KPs, HBV vaccination and behavioural change interventions that support consistent condom and lubricant access and use are needed. Coverage of opioid substitution therapy and needle and syringe services, and access to HCV treatment for PWUD/ID need to be expanded.


Assuntos
Infecções por HIV/epidemiologia , HIV/imunologia , Hepacivirus/genética , Hepacivirus/imunologia , Vírus da Hepatite B/imunologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Adulto , Estudos Transversais , Feminino , Genótipo , Anticorpos Anti-HIV/sangue , Infecções por HIV/tratamento farmacológico , Infecções por HIV/etiologia , Infecções por HIV/prevenção & controle , Hepatite B/etiologia , Antígenos de Superfície da Hepatite B/sangue , Hepatite C/etiologia , Anticorpos Anti-Hepatite C/sangue , Homossexualidade Masculina , Humanos , Masculino , Prevalência , Estudos Prospectivos , Fatores de Risco , Profissionais do Sexo , Minorias Sexuais e de Gênero , África do Sul/epidemiologia , Abuso de Substâncias por Via Intravenosa/complicações , Carga Viral , Adulto Jovem
11.
BMC Public Health ; 20(1): 1393, 2020 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-32919467

RESUMO

BACKGROUND: Seine-Saint-Denis is a deprived departement (French administrative unit) in the North-East of Paris, France, hosting the majority of South Asian migrants in France. In recent years, the number of migrants from Pakistan, which has a high prevalence of hepatitis C globally, increased. As a corollary, this study addressed the high proportion of Pakistani patients in the infectious diseases clinic of a local hospital, diagnosed with hepatitis C, but also hepatitis B and Human Immunodeficiency Virus (HIV). It explored genealogies and beliefs about hepatitis and HIV transmission, including community, sexual and blood risk behaviours. The aim was to understand the ways these risk factors reduce or intensify both en route and once in France, in order to devise specific forms of community health intervention. METHODS: The study took place at Avicenne University-Hospital in Seine-Saint-Denis, and its environs, between July and September 2018. The design of the study was qualitative, combining semi-structured interviews, a focus group discussion, and ethnographic observations. The sample of Pakistani participants was selected from those followed-up for chronic hepatitis C, B, and/or HIV at Avicenne, and who had arrived after 2010 in Seine-Saint-Denis. RESULTS: Thirteen semi-structured interviews were conducted, until saturation was reached. All participants were men from rural Punjab province. Most took the Eastern Mediterranean human smuggling route. Findings suggest that vulnerabilities to hepatitis and HIV transmission, originating in Pakistan, are intensified along the migration route and perpetuated in France. Taboo towards sexuality, promiscuity in cohabitation conditions, lack of knowledge about transmission were amongst the factors increasing vulnerabilities. Participants suggested a number of culturally-acceptable health promotion interventions in the community, such as outreach awareness and testing campaigns in workplaces, health promotion and education in mosques, as well as web-based sexual health promotion tools to preserve anonymity. CONCLUSIONS: Our findings highlight the need to look at specific groups at risk, related to their countries of origin. In-depth understandings of such groups, using interdisciplinary approaches such as were employed here, can allow for culturally adapted, tailored interventions. However, French colour-blind policies do not easily permit such kinds of targeted approach and this limitation requires further debate.


Assuntos
Emigração e Imigração , Infecções por HIV/prevenção & controle , Promoção da Saúde , Hepatite B/prevenção & controle , Hepatite C/prevenção & controle , Assunção de Riscos , Migrantes , Adulto , Cultura , Grupos Étnicos , França , Conhecimentos, Atitudes e Prática em Saúde , Hepacivirus , Hepatite B Crônica/prevenção & controle , Hepatite C Crônica/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão , Pesquisa Qualitativa , Fatores de Risco , Comportamento Sexual , População Suburbana , Adulto Jovem
12.
Artigo em Alemão | MEDLINE | ID: mdl-32930821

RESUMO

In February 2019, the fourth expert meeting on rapid diagnostic tests (RDTs) for sexually transmitted infections (STI) was held at the Robert Koch Institute (RKI) in Berlin. Novel technical developments and new aspects of RDT applications were discussed by representatives from the German STI Society (DSTIG); RKI; the Paul Ehrlich Institute; national reference centers for HIV, HBV, and HCV; and reference laboratories for Chlamydia, gonococci, and Treponema pallidum.As a result of this meeting, we present a revision of the joint statement on STI diagnostics with RDTs from 2017. The Regulation (EU) 2017/746 of the European Parliament and of the Council on in vitro diagnostic medical devices became effective in May 2017 and includes more stringent regulatory requirements for RDTs, mainly concerning conformity of manufacturing processes and performance characteristics of class D in vitro diagnostics (detection of HIV, HBV, HCV, and T. pallidum). Some RDTs for HIV, HCV, and T. pallidum have been evaluated in clinical studies and/or were WHO prequalified and may be used in low-threshold services. Among them are some HIV RDTs available and approved for self-testing. In addition, some HBV RDTs based on detection of HBs antigen (HBsAg) received WHO prequalification. However, false negative results may occur in samples with low HBsAg levels, as for instance in HIV-coinfected patients receiving antiretroviral therapy. For Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG), antigen-based RDTs still do not allow reliable detection of infection. Only PCR-based CT/NG RDTs possess sufficient diagnostic accuracy to be used as point-of-care tests. Rapid PCR tests for NG, however, do not provide any information about antimicrobial resistance.


Assuntos
Chlamydia , Infecções por HIV/diagnóstico , Hepatite C/diagnóstico , Doenças Sexualmente Transmissíveis/diagnóstico , Berlim , Alemanha , Vírus da Hepatite B , Humanos , Neisseria gonorrhoeae , Treponema pallidum
13.
BMC Infect Dis ; 20(1): 664, 2020 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-32907538

RESUMO

BACKGROUND: Hepatitis C virus (HCV) infection and type 2 diabetes mellitus (T2DM) are two major public health problems associated with increasing complications and mortality rates worldwide. The objective of this study is to evaluate the prevalence of hepatitis C virus (HCV) infection in diabetic patients and to investigate the influence of several epidemiological and clinical factors on HCV infection. METHOD: A total number of one hundred and eighty diabetic patients were recruited for this study. Consented subjects made up of 71(39.4%) males and 109(60.56%) females were recruited for the study. While one-Hundred (100) Non-Diabetics (Controls) were also recruited for the study. Structured questionnaires were administered to the consented participants to obtain relevant data. Sera samples were assayed for antibodies to HCV using an enzyme linked immunosorbent assay [Inteco Diagnostic Limited]. ELISA technique. RESULT: Overall prevalence of HCV infection among diabetes patients assayed was 13.3% out of which 8(11.3%) was obtained from the male subjects compared to 16 (14.7%) seropositivity recorded among the females (P = 0.511; P > 0.05). Considering age distribution, Subjects aged 41-50 years recorded, 9 (22.5%) positivity (P = 0.238; P > 0.05).Considering educational status of subjects screened, 22 (14.9%) positivity was rescored among subjects who have attained tertiary status of education.(P = 0.574;P > 0.05).Risk factors considered showed that, 7 (18.9%) seropositive subject were alcoholic consumers(P value = 0.2621;P > 0.05) while 5 (8.9%) recorded history of sharing sharp objects P = 0.2427;P > 0.05). CONCLUSION: Our study shows a slightly higher prevalence of hepatitis C infection in type 2 diabetics. This call for urgent routine screening exercise among diabetic patients for HCV infection. This study also emphasizes the need for public enlightenment on the association between HCV infection and T2DM, to avert possible complications among diabetic patients.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Hepacivirus/imunologia , Hepatite C/epidemiologia , Centros de Atenção Terciária , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Comorbidade , Ensaio de Imunoadsorção Enzimática , Feminino , Hepatite C/virologia , Anticorpos Anti-Hepatite C/sangue , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
14.
Value Health ; 23(8): 1003-1011, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32828211

RESUMO

OBJECTIVES: The prevalence of hepatitis is high in emergency department (ED) attendees in the United Kingdom, with a prevalence of up to 2% for hepatitis B (HBV) HBsAg, and 2.9% for hepatitis C (HCV) RNA. The aim of this paper is to perform an economic evaluation of opt-out ED-based HCV and HBV testing. METHODS: A Markov model was developed to analyze the cost-effectiveness of opt-out HCV and HBV testing in EDs in the UK. The model used data from UK studies of ED testing to parameterize the HCV and HBV prevalence (1.4% HCV RNA, 0.84% HBsAg), test costs, and intervention effects (contact rates and linkage to care). For HCV, we used an antibody test cost of £3.64 and RNA test cost of £68.38, and assumed direct-acting antiviral treatment costs of £10 000. For HBV, we used a combined HBsAg and confirmatory test cost of £5.79. We also modeled the minimum prevalence of HCV (RNA-positive) and HBV (HBsAg) required to make ED testing cost-effective at a £20 000 willingness to pay per quality-adjusted life-year threshold. RESULTS: In the base case, ED testing was highly cost-effective, with HCV and HBV testing costing £8019 and £9858 per quality-adjusted life-year gained, respectively. HCV and HBV ED testing remained cost-effective at 0.25% HCV RNA or HBsAg prevalence or higher. CONCLUSIONS: Emergency department testing for HCV and HBV is highly likely to be cost-effective in many areas across the UK depending on their prevalence. Ongoing studies will help evaluate ED testing across different regions to inform testing guidelines.


Assuntos
Serviço Hospitalar de Emergência/organização & administração , Hepatite B/diagnóstico , Hepatite C/diagnóstico , Programas de Rastreamento/organização & administração , Análise Custo-Benefício , Serviço Hospitalar de Emergência/economia , Custos Hospitalares , Humanos , Cadeias de Markov , Programas de Rastreamento/economia , Programas de Rastreamento/métodos , Modelos Econométricos , Reino Unido
15.
Medicine (Baltimore) ; 99(34): e21799, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846815

RESUMO

Hepatitis B (HBV) and hepatitis C (HCV) viruses are hepatotropic and lymphotropic viruses that can proliferate either in lymphocytes and monocytes or hepatocytes.The aim of this study was to evaluate the seroprevalence of HBV, HCV, and human immunodeficiency virus (HIV) in patients with plasma cell disorders. We also aimed to compare patients with plasma cell disorders and chronic lymphocytic leukemia (CLL) in terms of HBV, HCV, and HIV seropositivity.This is a retrospective study. The patients who had patient file in the Multiple Myeloma Outpatient Unit of our hospital and were followed in our outpatient unit between January 1, 2012 and September 15, 2019, with diagnoses of either of the plasma cell disorders were included in the study. In addition, 272 CLL patients who were admitted to the Leukemia Outpatient Unit of our hospital were also enrolled in the study. The 2 disease groups were compared in terms of HBV, HCV, and HIV seropositivity.A statistically significant relationship was found between disease groups according to hepatitis B surface antigen (P < .05). Hepatitis B positivity were found to be more common in CLL patients. There was also a statistically significant relationship between the disease groups in terms of hepatitis B e antigen positivity (P = .001).We found that hepatitis B surface antigen positivity rate in CLL patients was higher than in patients with plasma cell disorders. Seroprevalence of HBV, HCV, and HIV was found to be very low in patients with plasma cell disorders.


Assuntos
Soroprevalência de HIV , Antígenos da Hepatite B/sangue , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Leucemia Linfocítica Crônica de Células B/epidemiologia , Paraproteinemias/epidemiologia , Idoso , Comorbidade , Feminino , Infecções por HIV/sangue , Infecções por HIV/imunologia , Hepatite B/sangue , Antígenos da Hepatite B/imunologia , Antígenos do Núcleo do Vírus da Hepatite B/sangue , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/sangue , Antígenos de Superfície da Hepatite B/imunologia , Antígenos E da Hepatite B/sangue , Anticorpos Anti-Hepatite C/sangue , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/epidemiologia , Plasmócitos/patologia , Estudos Retrospectivos , Estudos Soroepidemiológicos
16.
Rev Assoc Med Bras (1992) ; 66(7): 908-912, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32844950

RESUMO

Hepatocellular carcinoma in patients with hepatitis C in the absence of cirrhosis is uncommon. We demonstrate the importance of morphofunctional magnetic resonance imaging (MRI) with a hepatospecific contrast agent by describing an asymptomatic female patient with HCV, who presented with a nodule detected on ultrasound. She underwent inconclusive computed tomography, presenting no signs of chronic liver disease. MRI with hepatospecific contrast providing functional information combined with the superior tissue contrast inherent to this method stands out for its greater accuracy with the possibility of not resorting to invasive diagnostic methods. With increasing experience and the dissemination of this new diagnostic modality in the medical field, its use and other potential benefits of morphofunctional MRI with hepatospecific contrast agents may be established, benefiting patients with challenging focal liver lesions.


Assuntos
Carcinoma Hepatocelular , Hepatite C , Neoplasias Hepáticas , Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/virologia , Meios de Contraste , Feminino , Hepatite C/complicações , Humanos , Cirrose Hepática , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/virologia , Imagem por Ressonância Magnética
17.
BMC Infect Dis ; 20(1): 632, 2020 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-32847527

RESUMO

BACKGROUND: Viral relapse is a major concern in hepatitis C virus (HCV) antiviral therapy. Currently, there are no satisfactory methods to predict viral relapse, especially in the era of direct acting antivirals in which the virus often quickly becomes undetectable using PCR-based approaches that focus on a small viral region. Next-generation sequencing (NGS) provides an alternative option for viral detection in a genome-wide manner. However, owing to the overwhelming dominance of human genetic content in clinical specimens, direct detection of HCV by NGS has a low sensitivity and hence viral enrichment is required. METHODS: Based on template-dependent multiple displacement amplification (tdMDA), an improved method for whole genome amplification (Wang et al., 2017. Biotechniques 63, 21-27), we evaluated two strategies to enhance the sensitivity of NGS-based HCV detection: duplex-specific nuclease (DSN)-mediated depletion of human sequences and HCV probe-based capture sequencing. RESULTS: In DSN-mediated depletion, human sequences were significantly reduced in the two HCV serum samples tested, 65.3% → 55.6% → 33.7% (#4727) and 68.6% → 56% → 21% (#4970), respectively for no normalization, self- and driver-applied normalization. However, this approach was associated with a loss of HCV sequences perhaps due to its micro-homology with the human genome. In capture sequencing, HCV-mapped sequencing reads occupied 96.8% (#4727) and 22.14% (#4970) in NGS data, equivalent to 1936x and 7380x enrichment, respectively. Capture sequencing was then applied to ten serum samples collected at the end of HCV antiviral therapy. Interestingly, the number of HCV-mapped reads was significantly higher in relapsed patients (n = 5) than those from patients with sustained virological response (SVR) (n = 5), 102.4 ± 72.3 vs. 2.6 ± 0.55, p = 0.014. CONCLUSIONS: Our data provides concept evidence for a highly sensitive HCV detection by capture sequencing. The abundance difference of HCV sequencing reads at the end of HCV antiviral therapy could be applied to predict treatment outcomes.


Assuntos
Antivirais/uso terapêutico , Hepacivirus/genética , Hepatite C/diagnóstico , Hepatite C/tratamento farmacológico , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Feminino , Genoma Viral/genética , Hepatite C/sangue , Humanos , Masculino , RNA Viral/sangue , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Resposta Viral Sustentada
18.
BMC Infect Dis ; 20(1): 634, 2020 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-32847528

RESUMO

BACKGROUND: People who inject drugs (PWID) have increased risk of acquiring blood-transmitted chronic viral infections such as Hepatitis B (HBV), Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV) as well as increased risk of acquiring bacterial infections. We aimed to identify and describe bacteraemic episodes, their recurrence rates, predictive and prognostic factors amongst hospitalised PWID. METHODS: In this retrospective cohort study, we included 257 hospitalised PWID during 2000-2006 with follow up at the Department of Infectious Diseases, Hvidovre Hospital, Denmark. Data collection included comorbidity (HBV-, HCV-, HIV-, and psychiatric comorbidities), social information (contact to an addiction treatment centre, homelessness), opioid substitution treatment (OST), treatment completion and microbiology findings. There was a 10-years follow-up regarding mortality. RESULTS: The study identified 257 patients classified as PWID. Of these, 58 (22.6%) had at least one episode of bacteraemia during their first hospital admission. Recurrence was found in 29 (50.0%) of the bacteraemia cases. Staphylococcus aureus was the dominant microorganism of both first and recurrent episodes with 24 (41.4%) and nine (31.4%) of cases, respectively. A psychiatric diagnose was significantly associated with a lower risk of bacteraemia in the multivariate analysis (OR: 0.29, [95%CI: 0.11-0.77], P = 0.01). Mortality was significantly higher in patients with bacteraemia (17.2% vs. 3.0%, P < 0.01, OR: 6.67 [95%CI: 2.33-20], P < 0.01). CONCLUSIONS: In hospitalised PWID, bacteraemia was found in 22.6% and was associated with at higher mortality. The most common microorganism of bacteraemia was S. aureus. Psychiatric comorbidity was significantly associated with a lower risk of bacteraemia.


Assuntos
Bacteriemia/epidemiologia , Infecções por HIV/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Transtornos Mentais/epidemiologia , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/isolamento & purificação , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Comorbidade , Dinamarca/epidemiologia , Feminino , Seguimentos , HIV/imunologia , Hepacivirus/imunologia , Vírus da Hepatite B/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Recidiva , Estudos Retrospectivos , Abuso de Substâncias por Via Intravenosa/mortalidade
19.
Braz J Infect Dis ; 24(4): 304-309, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32735876

RESUMO

BACKGROUND: Despite the emergence of more effective therapies, hepatitis C virus (HCV) infection remains a serious public health problem at the global level. Currently, this virus is classified into seven genotypes and 67 subgenotypes, which in turn are distributed heterogeneously in Brazil and worldwide. Studies have shown that this genetic divergence results in differences in the progression of chronic disease associated with HCV infection and its treatment. OBJECTIVE: The aim of this study was to report the frequency of HCV genotypes in the state of Pará, Northern Brazil, and to assess the association between genotype and different clinical and laboratory characteristics, as well as risk factors for infection. METHOD: Data from 85 medical records of untreated patients who had chronic hepatitis C infection were analyzed; the patients were evaluated at two hospitals in Belem, Pará, Brazil. RESULTS: Circulation of genotypes 1 and 3 was detected, with a higher prevalence of genotype 1 (75.3%) than genotype 3 (24.7%). In addition, there was a predominance of subgenotype 1b (60.34%) compared to 1a (20.69%) and 3a (18.97%). Reuse of needles and/or glass syringes was significantly associated with infection by HCV genotype 1 than genotype 3; however, the small number of patients infected with genotype 3 may have biased the results. No associations between genotype and the evaluated clinical and laboratory characteristics were observed. CONCLUSION: This study reinforces the differences in the distribution of HCV genotypes in Brazil and showed no association between HCV genotype and progression of chronic hepatitis C in the studied group.


Assuntos
Hepacivirus/genética , Hepatite C/epidemiologia , Brasil/epidemiologia , Genótipo , Hepatite C Crônica , Humanos , RNA Viral , Fatores de Risco
20.
PLoS Pathog ; 16(8): e1008346, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32764824

RESUMO

Viruses subvert macromolecular pathways in infected host cells to aid in viral gene amplification or to counteract innate immune responses. Roles for host-encoded, noncoding RNAs, including microRNAs, have been found to provide pro- and anti-viral functions. Recently, circular RNAs (circRNAs), that are generated by a nuclear back-splicing mechanism of pre-mRNAs, have been implicated to have roles in DNA virus-infected cells. This study examines the circular RNA landscape in uninfected and hepatitis C virus (HCV)-infected liver cells. Results showed that the abundances of distinct classes of circRNAs were up-regulated or down-regulated in infected cells. Identified circRNAs displayed pro-viral effects. One particular up-regulated circRNA, circPSD3, displayed a very pronounced effect on viral RNA abundances in both hepatitis C virus- and Dengue virus-infected cells. Though circPSD3 has been shown to bind factor eIF4A3 that modulates the cellular nonsense-mediated decay (NMD) pathway, circPSD3 regulates RNA amplification in a pro-viral manner at a post-translational step, while eIF4A3 exhibits the anti-viral property of the NMD pathway. Findings from the global analyses of the circular RNA landscape argue that pro-, and likely, anti-viral functions are executed by circRNAs that modulate viral gene expression as well as host pathways. Because of their long half-lives, circRNAs likely play hitherto unknown, important roles in viral pathogenesis.


Assuntos
Carcinoma Hepatocelular/virologia , Hepacivirus/genética , Hepatite C/complicações , Neoplasias Hepáticas/virologia , Provírus/genética , RNA Circular/genética , RNA Viral/genética , Replicação Viral , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/patologia , RNA Helicases DEAD-box/genética , RNA Helicases DEAD-box/metabolismo , Fator de Iniciação 4A em Eucariotos/genética , Fator de Iniciação 4A em Eucariotos/metabolismo , Perfilação da Expressão Gênica , Hepatite C/virologia , Humanos , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/patologia , Degradação do RNAm Mediada por Códon sem Sentido , Proteínas Virais/genética , Proteínas Virais/metabolismo
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