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1.
Med Klin Intensivmed Notfmed ; 115(1): 67-78, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-31950206

RESUMO

Injuries of healthcare workers with sharp instruments are considered among the most frequent occupational accidents in hospitals. In at least half of the cases, the instruments are contaminated with blood and therefore bear an infection risk with bloodborne pathogens, such as hepatitis B, hepatitis C and human immunodeficiency virus (HIV). Needlestick injuries require besides immediate medical intervention, such as rinsing and disinfection of the wound or skin contamination, a prompt clarification of the immune status and if necessary a postexposure prophylaxis. Furthermore, follow-up examinations are required for up to 6 months after the accident. Information about the infectious state of the index person considerably facilitates the procedure. All healthcare workers should know the management of needlestick injuries. Preventive measures refer to the reduction of the number of needlestick injuries by improving work organization and usage of needle devices with safety features as well as to the reduction of infection risk by hepatitis B vaccination and wearing safety gloves.


Assuntos
Pessoal de Saúde , Ferimentos Penetrantes Produzidos por Agulha , Exposição Ocupacional , Acidentes de Trabalho , Infecções por HIV/prevenção & controle , Infecções por HIV/terapia , Hepatite B/prevenção & controle , Hepatite B/transmissão , Hepatite C/prevenção & controle , Hepatite C/transmissão , Humanos
2.
Expert Rev Clin Pharmacol ; 13(1): 7-14, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31786966

RESUMO

Introduction: The introduction of direct-acting antiviral therapy has generated tremendous interest in transplanting organs from HCV-infected donors, an option which has the potential to lower waiting times for solid organ transplantation (including kidneys). Safe, effective and pangenotypic direct-acting antiviral agents are currently available.Areas covered: We have identified studies from PubMed, EMBASE, and the Cochrane database to review risks and benefits on solid organ transplantation from HCV-exposed donors in uninfected recipients.Expert opinion: The transmission of HCV with transplantation from anti-HCV positive kidneys without viremia is extremely uncommon whereas recent evidence (five clinical studies, n = 94 patients) shows the absence of HCV infection in HCV-naïve recipients who received kidneys from HCV RNA-positive donors and underwent early DAAs. The evidence regarding non-kidney solid organ transplantation from HCV-infected donors is more limited. One report showed the occurrence of dialysis-dependent kidney failure due to glomerulonephritis induced by acute HCV after liver transplant from a NAT-positive donor into an HCV-naïve recipient. Transplantation of kidneys and other solid organs from HCV-viremic donors into uninfected recipients has the potential to become the standard of care resulting in lower waitlist mortality. Further studies are needed urgently to establish clinical practice guidelines on this topic.


Assuntos
Antivirais/administração & dosagem , Hepatite C/tratamento farmacológico , Doadores de Tecidos , Hepatite C/prevenção & controle , Hepatite C/transmissão , Humanos , Transplante de Órgãos/métodos , Listas de Espera
3.
Unfallchirurg ; 123(1): 36-42, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31243487

RESUMO

BACKGROUND: Needlestick injuries (NSI) of healthcare personnel (HCP) are work-related accidents with a risk of transmission of blood-borne human immunodeficiency virus (HIV), hepatitis B and C viruses (HBV, HCV). Along with preventive measures to avoid accidental NSI, preventing the risk and diagnosis of an infection from NSI are given a high priority. Thus, follow-up monitoring of NSI is of great interest. OBJECTIVE: Evaluation of the follow-up monitoring after NSI with respect to early recognition of transmission of HIV, HCV and HBV as well as adherence and psychological burden of HCP. METHODS: Clinical and serological investigations of the injured HCP including determining the individual risk of infection in the situation of NSI, analysis of accident protocols by the accident insurance consultant and use of a self-developed standardized questionnaire. RESULTS: No virus transmissions from NSI were found during the observation period (23 March 2014 until 31 October 2017). A total of 112 NSI with infectious index patients (HIV 35.7%, HCV 54.5%, HBV 2.7%, coinfection 7.1%) and 3 incidents from unknown index patients were analyzed. Of the index patients six received the first diagnosis of a blood-borne infection (2 HCV infections, 4 HIV infections) after NSI. In nearly all incidents (98.3%) the HCP took measures to disinfect and flush the injury and 85.1% of the HCP exposed to HIV or unknown infection risk undertook postexposure prophylaxis (HIV-PEP) within 2 h and another 12.8% within 10 h. Follow-up examination was attended by 97.4% of the HCP, three quarters of the HCP felt concerned following NSI and 12.2% were very concerned. CONCLUSION: Through adequate management and follow-up of NSI low transmission rates can be achieved after exposure to blood-borne viruses within the occupational environment.


Assuntos
Infecções por HIV , Hepatite B , Hepatite C , Ferimentos Penetrantes Produzidos por Agulha , Patógenos Transmitidos pelo Sangue , Infecções por HIV/transmissão , Hepatite B/transmissão , Hepatite C/transmissão , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional , Estudos Prospectivos
4.
Mayo Clin Proc ; 95(2): 243-254, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31883694

RESUMO

OBJECTIVES: To summarize patient notifications resulting from unsafe injection practices by health care personnel in the United States and describe recommended actions for prevention and response. PATIENTS AND METHODS: We examined records of events involving communications to groups of patients, conducted from January 1, 2012, through December 31, 2018, in which bloodborne pathogen testing was recommended or offered because of potential exposure to unsafe injection practices by health care personnel in the United States. Information compiled included: health care setting(s), type of unsafe injection practice(s), number of patients notified, number of outbreak-associated infections, and whether evidence suggesting bloodborne pathogen transmission prompted the notification. We compared these numbers with a similar review conducted from January 1, 2001, through December 31, 2011. RESULTS: From 2012 through 2018, more than 66,748 patients were notified as part of 38 patient notification events. Twenty-one involved exposures in non-hospital settings. Twenty-five involved syringe and/or needle reuse in the context of routine patient care; 11 involved drug tampering by a health care provider. The majority of events (n=25) were prompted by identification of unsafe injection practices alone, absent any documented infections at the time of notification. Outbreak-associated hepatitis B virus and/or hepatitis C virus infections were documented for 11 of the events; 8 involved patient-to-patient transmission, and 3 involved provider-to-patient transmission. CONCLUSIONS: Since 2001, nearly 200,000 patients in the United States were notified about potential exposure to blood-contaminated medications or injection equipment. Facility leadership has an obligation to ensure adherence to safe injection practices and to respond properly if unsafe injection practices are identified.


Assuntos
Comunicação , Infecção Hospitalar/epidemiologia , Reutilização de Equipamento/estatística & dados numéricos , Controle de Infecções/métodos , Injeções/efeitos adversos , Erros Médicos/estatística & dados numéricos , Seringas , Patógenos Transmitidos pelo Sangue , Infecção Hospitalar/etiologia , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/transmissão , Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Hepatite B/epidemiologia , Hepatite B/transmissão , Hepatite C/epidemiologia , Hepatite C/transmissão , Humanos , Estados Unidos/epidemiologia
5.
Georgian Med News ; (295): 114-118, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31804211

RESUMO

Nosocomial transmission of hepatitis C virus (HCV) is well established, however the role of dental care in HCV transmission has been speculated but particularly difficult to quantify. This study investigated the potential for nosocomial transmission of HCV in dental clinics in a high HCV prevalence, middle-income country.  Dental health care workers (DHCWs) in 13 clinics in 3 cities were invited to participate. After informed consent was obtained, the DHCWs were asked to provide a blood sample to test for anti-HCV and complete a questionnaire that included questions on risk behaviors. A second sample of dental clinics was recruited to conduct environmental testing for HCV RNA. Among the 244 DHCWs invited to participate in the study, 196 (80.3%) enrolled including 115 doctors, 49 nurses and 32 dental residents. The seroprevalence of anti-HCV among DHCWs was 4%. Of the 46 private dental clinics invited to participate, 37 (80.4%) dental clinics agreed to allow the environmental study. Overall, 23 (62.2%) clinics had HCV RNA detected in at least one location. The most frequently contaminated location was the suction unit with HCV RNA retrieved from 14 (37.8%) clinics, followed by contaminated samples from the general dental room in 9 (24.3%) clinics. Given that HCV RNA can be viable for up to six weeks, without fastidious attention to infection control procedures, patients may be exposed to contaminated dental equipment and nosocomial transmission can occur.


Assuntos
Clínicas Odontológicas , Hepacivirus , Hepatite C , Pessoal de Saúde , Hepatite C/transmissão , Anticorpos Anti-Hepatite C , Humanos , Transmissão de Doença Infecciosa do Profissional para o Paciente , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos
7.
Przegl Epidemiol ; 73(2): 167-178, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31385675

RESUMO

OBJECTIVE: The aim of this article was to analyze the epidemiological situation of HCV in Poland in 2017, based on data collected as part of epidemiological surveillance. MATERIAL AND METHODS: The analysis was carried out based on: 1) individual data collected as part of epidemiological interviews with persons diagnosed with HCV infection in 2017, 2) diagnosis rate from bulletins "Infectious diseases and poisonings in Poland" for the years 2011-2017 and 3) data about deaths due to hepatitis C from the Demographic Surveys and Labour Market Department of the Central Statistical Office. RESULTS: In 2017, the diagnosis rate of HCV infection stayed on high level: 10.44 per 100,000 (4010 cases were reported). Stabilization of hepatitis C epidemiological situation was observed in the following issues: 1) diagnosis rate reported in men and women remained at a similar level (10.55 vs. 10.33 per 100,000); 2) diagnosis rate still showed variation depending on the voivodship (from 4.09 to 18.48 per 100,000) and the location of residence (urban/rural, 12.7 vs. 7.0 per 100,000); 3) the percentage of hospitalization accompanying the new cases of HCV infection has shown downward trend (36% in 2017); 4) the decreasing hepatitis C mortality trend was continued (175 cases of death in 2017); 5) the most common possible transmission route were still medical procedures. In 2017, the outbreak of HCV infection in the Lubelskie was registered. (8 patients, 291 exposed persons, with whom computer tomography with a contrast from multi-dose packaging was conducted, using an automatic injection device). CONCLUSIONS: Epidemiological situation of hepatitis C since 2015 is stable. The role of medical care in the transmission of HCV infections in Poland is worrying.


Assuntos
Hepatite C/epidemiologia , Sistema de Registros , Adolescente , Adulto , Distribuição por Idade , Idoso , Criança , Pré-Escolar , Feminino , Hepatite C/mortalidade , Hepatite C/prevenção & controle , Hepatite C/transmissão , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , População Rural , Distribuição por Sexo , População Urbana , Adulto Jovem
8.
J Immunoassay Immunochem ; 40(5): 528-539, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31378189

RESUMO

Introduction: Hepatitis C virus (HCV) infects about 0.5% to 2.3% of the world population with most of the cases occurring in developing countries. It is primarily transmitted through transfusion of blood and blood products. There exists dearth of information on burden and circulation of HCV and their attendant health challenges in Nigeria. This study was therefore designed to determine the seroprevalence rate and risk of HCV transmission among blood donors in Lagos State Nigeria. Methodology: Blood samples were collected between January 2002 and December 2006 from 3,002 consenting (Male = 2,922; Female = 80; Age range = 18-63; Median age = 32 years) donors in five selected public hospitals' blood donation centers between 2002 and 2006. Sera was tested for anti-HCV by ELISA technique. Demographic and other relevant information were obtained by a semi-structured questionnaire to assess risk factors for HCV transmission. Results: This study found an overall rate of 3.1% for anti-HCV among the blood donors sampled. Highest rate of 6.0% for HCV was found among participants age ranged ≥50 years and lowest in the age group 40-49 years. Prevalence of HCV was higher in female (6.3%) than in male (3.0%) and was 0.21 times less risky in female compared to their male counterparts (OR = 1.29, 95%CI 0.11-1.31). By location, MSCH had the highest HCV rate (3.9%) and lowest (2.1%) in GHOA. Sharing of sharps for tattoo/tribal markings had a statistical association (p = .0379) with HCV infection. However, no significant difference was found by gender (CI = 0.99-2.01; p = .1002), age (CI = 0.79-1.55; p = .1001) and location (p = .5326). Conclusion: The relatively high prevalence of HCV infection detected and the risk of transmission among blood donors in this study are of public health importance. Hence, the institution of appropriate measures to stem down the trend of HCV circulation among this population in Nigeria is therefore advocated.


Assuntos
Doadores de Sangue , Hepacivirus/imunologia , Hepacivirus/isolamento & purificação , Hepatite C/sangue , Hepatite C/transmissão , Adulto , Feminino , Hepatite C/epidemiologia , Hepatite C/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Fatores de Risco , Estudos Soroepidemiológicos , Adulto Jovem
9.
Indian J Med Res ; 149(5): 633-640, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31417031

RESUMO

Background & objectives: Individual donation nucleic acid testing (ID-NAT) is considered as sensitive technology to assess blood safety from viral transfusion-transmissible infections (TTIs) in blood donors. The present study was aimed to analyze the results of ID-NAT for three years (2013-2015) with special reference to different types of donors and their age ranges in a tertiary care centre in north India. Methods: The results of ID-NAT for three years were retrospectively analyzed at our centre. A total of 168,433 donations were tested with ID-NAT, of which 10,467 were tested with Procleix® Ultrio® reagents and 157,966 were tested with Procleix®UltrioPlus® reagents, and the results were compared with those of serology to calculate the NAT yield in voluntary, replacement, first-time and repeat donors. Results: A combined NAT yield was observed as one in 1031 out of 167,069 seronegative donations with HBV yield as one in 1465, HCV yield as one in 3885 and HIV-1 as one in 167,069. Yield for co-infection (HCV and HBV) was one in 41,767. A high NAT yield was observed in replacement donors (1 in 498) as compared to voluntary donors (1 in 1320). Interpretation & conclusions: Addition of NAT to serology improved the blood safety in our centre interdicting possibility of 150 TTIs annually. It has also reemphasized the safety of voluntary over replacement donors. The results also highlight the need of proper counselling, notification and referral guidelines of NAT yield donors in our country and other countries which lack them.


Assuntos
Doadores de Sangue , Segurança do Sangue , Reação Transfusional/genética , Infecções por HIV/sangue , Infecções por HIV/transmissão , Infecções por HIV/virologia , HIV-1/isolamento & purificação , HIV-1/patogenicidade , Hepacivirus/isolamento & purificação , Hepacivirus/patogenicidade , Hepatite B/sangue , Hepatite B/transmissão , Hepatite B/virologia , Vírus da Hepatite B/isolamento & purificação , Vírus da Hepatite B/patogenicidade , Hepatite C/sangue , Hepatite C/transmissão , Hepatite C/virologia , Humanos , Índia/epidemiologia , Centros de Atenção Terciária , Reação Transfusional/prevenção & controle , Reação Transfusional/virologia
10.
BMC Infect Dis ; 19(1): 724, 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31420017

RESUMO

BACKGROUND: Hepatitis C virus (HCV) is a leading cause of chronic liver disease. As yet there is no approved vaccine protects against contracting hepatitis C. HCV seriously affects many people's health in the world. METHODS: In this article, an epidemiological model is proposed and discussed to understand the transmission and prevalence of hepatitis C in mainland China. This research concentrates on hepatitis C data from Chinese Center for Disease Control and Prevention (China's CDC). The optimal parameters of the model are obtained by calculating the minimum chi-square value. Sensitivity analyses of the basic reproduction number and the endemic equilibrium are conducted to evaluate the effectiveness of control measures. RESULTS: Vertical infection is not the most important factor that causes hepatitis C epidemic, but contact transmission is. The proportion of acute patients who are transformed into chronic patients is about 82.62%. The possibility of the hospitalized patients who are restored to health is about 76.24%. There are about 92.32% of acute infected are not treated. The reproduction number of hepatitis C in mainland China is estimated as approximately 1.6592. CONCLUSION: We find that small changes of transmission infection rate of acutely infected population, transmission infection rate of exposed population, transition rate for the acutely infected, and rate of progression to acute stage from the exposed can achieve the purpose of controlling HCV through sensitivity analysis. Finally, based on the results of sensitivity analysis, we find out several preventions and control strategies to control the Hepatitis C.


Assuntos
Hepatite C/prevenção & controle , Hepatite C/transmissão , Controle de Infecções , China/epidemiologia , Epidemias , Feminino , Hepatite C/epidemiologia , Humanos , Modelos Teóricos , Prevalência
11.
Transpl Infect Dis ; 21(5): e13144, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31291501

RESUMO

Post-transplant lymphoproliferative disorder (PTLD) is an uncommon, but well-described complication after liver transplantation. Most recently, Hepatitis C virus (HCV) has been implicated in the development of PTLD. A HCV-negative 62-year-old man with autoimmune hepatitis received a HCV nucleic acid amplification test-positive liver graft from a 73-year-old brain-dead donor (D+/R-). After his recovery from the operation, the patient was treated for HCV and achieved an undetectable viral load. He was readmitted 6 months after transplant with a spontaneous perisplenic hematoma, weight loss, failure to thrive, low-grade fevers, and abnormal liver function tests. He had a rapid clinical deterioration and expired shortly after admission. His liver biopsy demonstrated EBV-negative monomorphic B-cell PTLD. Our case is the first to report an aggressive early-onset EBV-negative monomorphic B-cell PTLD in a HCV D+/R- liver transplant. This case illustrates the paucity of knowledge on HCV seroconversion and its involvement in EBV-negative monomorphic B-cell PTLD development.


Assuntos
Linfócitos B/patologia , Hepatite C/transmissão , Transplante de Fígado/efeitos adversos , Transtornos Linfoproliferativos/diagnóstico , Soroconversão , Transplantes/virologia , Infecções por Vírus Epstein-Barr , Herpesvirus Humano 4 , Humanos , Transtornos Linfoproliferativos/virologia , Masculino , Pessoa de Meia-Idade , Doadores de Tecidos , Carga Viral
12.
Cells ; 8(7)2019 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-31269695

RESUMO

Background: The aim of the study was to investigate the intra-host variability through next-generation-sequencing (NGS) of the NS5A-gene in nosocomial transmission-clusters observed in two Italian hospitals among hepatitis C virus (HCV)-genotype-1b infected patients. Methods: HCV-sequencing was performed by Sanger-sequencing (NS3 + NS5A + NS5B) and by NGS (NS5A, MiSeq-Illumina) in 15 HCV-1b infected patients [five acute with onco-hematologic-disease and 10 (4/6 acute/chronic) with ß-thalassemia]. Resistance-associated-substitutions (RAS) were analysed by Geno2pheno-algorithm. Nucleotide-sequence-variability (NSV, at 1%, 2%, 5%, 10% and 15% NGS-cutoffs) and Shannon entropy were estimated. Phylogenetic analysis was performed by Mega6-software and Bayesian-analysis. Results: Phylogenetic analysis showed five transmission-clusters: one involving four HCV-acute onco-hematologic-patients; one involving three HCV-chronic ß-thalassemia-patients and three involving both HCV-acute and chronic ß-thalassemia-patients. The NS5A-RAS Y93H was found in seven patients, distributed differently among chronic/acute patients involved in the same transmission-clusters, independently from the host-genetic IL-28-polymorphism. The intra-host NSV was higher in chronic-patients versus acute-patients, at all cutoffs analyzed (p < 0.05). Even though Shannon-entropy was higher in chronic-patients, significantly higher values were observed only in chronic ß-thalassemia-patients versus acute ß-thalassemia-patients (p = 0.01). Conclusions: In nosocomial HCV transmission-clusters, the intra-host HCV quasispecies divergence in patients with acute-infection was very low in comparison to that in chronic-infection. The NS5A-RAS Y93H was often transmitted and distributed differently within the same transmission-clusters, independently from the IL-28-polymorphism.


Assuntos
Infecção Hospitalar/virologia , Hepacivirus/genética , Hepatite C/virologia , Proteínas não Estruturais Virais/genética , Talassemia beta/terapia , Doença Aguda , Adulto , Substituição de Aminoácidos , Antivirais/farmacologia , Antivirais/uso terapêutico , Transfusão de Sangue , Doença Crônica , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/transmissão , Farmacorresistência Viral/genética , Feminino , Genótipo , Hepacivirus/patogenicidade , Hepatite C/tratamento farmacológico , Hepatite C/transmissão , Sequenciamento de Nucleotídeos em Larga Escala , Interações Hospedeiro-Patógeno/genética , Interações Hospedeiro-Patógeno/imunologia , Humanos , Interferons/genética , Interferons/imunologia , Masculino , Pessoa de Meia-Idade , Filogenia , Polimorfismo de Nucleotídeo Único , Talassemia beta/genética , Talassemia beta/imunologia
13.
Artigo em Inglês | MEDLINE | ID: mdl-31269774

RESUMO

Hepatitis C remains a significant public health threat. However, the main routes of transmission have changed since the early 1990s. Currently, drug use is the main source of hepatitis C virus (HCV) infection, and some measures have been successively implemented and additional studies have been published. However, the factors correlating with HCV infection failed to clearly define. Our study pooled the odds ratios (ORs) with 95% confidence intervals (CIs) and analyzed sensitivity by searching data in the PubMed, Elsevier, Springer, Wiley, and EBSCO databases. Publication bias was determined by Egger's test. In our meta-analysis, HCV-infected and non-HCV-infected patients from 49 studies were analyzed. The pooled ORs with 95% CIs for study factors were as follows: Injecting drug use 10.11 (8.54, 11.97); sharing needles and syringes 2.24 (1.78, 2.83); duration of drug use >5 years 2.39 (1.54, 3.71); unemployment 1.50 (1.22, 1.85); commercial sexual behavior 1.00 (0.73, 1.38); married or cohabiting with a regular partner 0.88 (0.79, 0.98), and sexual behavior without a condom 1.72 (1.07, 2.78). This study found that drug users with histories of injecting drug use, sharing needles and syringes, drug use duration of >5 years, and unemployment, were at increased risk of HCV infection. Our findings indicate that sterile needles and syringes should be made available to ensure safe injection. In view of that, methadone maintenance treatment can reduce or put an end to risky drug-use behaviors, and should be scaled up further, thereby reducing HCV infection.


Assuntos
Usuários de Drogas/estatística & dados numéricos , Hepatite C/epidemiologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Hepatite C/transmissão , Humanos , Uso Comum de Agulhas e Seringas/estatística & dados numéricos , Fatores de Risco , Assunção de Riscos , Trabalho Sexual/estatística & dados numéricos , Fatores Socioeconômicos , Fatores de Tempo , Sexo sem Proteção/estatística & dados numéricos
14.
PLoS One ; 14(5): e0217811, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31150518

RESUMO

Sharing of injection drug use paraphernalia is a dyadic process linked to the transmission of HIV and hepatitis C virus (HCV). Despite this, limited research exists identifying specific dyadic interpersonal factors driving injecting partners' engagement in needle/syringe and ancillary injecting equipment sharing among young adults. Using semi-structured in-depth interview data collected between 2014 and 2015 from twenty-seven people who inject drugs (PWID), we applied an inductive approach to identify key injection drug-related interpersonal factors and developed a conceptual model integrating the findings based on interdependence theory. Interactions between injecting partners resulted in varying levels of injecting-related trust, cooperation, intimacy, and power. These factors interacted to collectively influence the type and level of risk perceived and enacted by injecting partners. The relationship between these injecting-related interpersonal factors, on the one hand, and risk perception on the other was dynamic and fluctuated between actions that protect the self (person-centered) and those that protect the partnership (partnership-centered). These findings indicate that the interpersonal context exerts substantial influence that shapes risk perception in all types of injecting partnerships. Partnership-focused prevention strategies should consider the dynamics of trust, cooperation, intimacy, and power, in characterizing dyadic risk perceptions and in understanding risky injecting practices among PWID.


Assuntos
Infecções por HIV/psicologia , Hepatite C/psicologia , Dependência de Heroína/psicologia , Abuso de Substâncias por Via Intravenosa/psicologia , Adulto , Feminino , HIV/patogenicidade , Infecções por HIV/transmissão , Infecções por HIV/virologia , Hepacivirus/patogenicidade , Hepatite C/transmissão , Hepatite C/virologia , Heroína , Dependência de Heroína/virologia , Humanos , Relações Interpessoais , Masculino , Uso Comum de Agulhas e Seringas , Fatores de Risco , Assunção de Riscos , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Abuso de Substâncias por Via Intravenosa/virologia , Confiança/psicologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-31159479

RESUMO

BACKGROUND: Hepatitis C virus (HCV) among young suburban people who inject drugs (PWID) is a growing epidemic in the United States, yet little is known about the factors contributing to increased exposure. The goal of this study was to explore and assess HCV knowledge and attitudes about treatment and identify risk behaviors among a cohort of young suburban PWID. Methods: We conducted interviews with New Jersey (NJ) service providers and staff from the state's five syringe service programs to inform a semistructured survey addressing HCV knowledge, treatment, and risk factors among young suburban PWID. We then used this survey to conduct qualitative interviews with 14 young suburban PWID (median age 26 years) in NJ between April and May 2015. Data were analyzed using a modified grounded theory approach and coded to identify thematic relationships among respondents. Results: Most participants had substantial gaps in several aspects of HCV knowledge. These included: HCV transmission, HCV symptoms, and the availability of new direct-acting antiviral therapy. Participants also downplayed the risk of past and current risk behaviors, such as sharing drug paraphernalia and reusing needles, which also reflected incomplete knowledge regarding these practices. Conclusion: Young suburban PWID are not receiving or retaining accurate and current HCV information. Innovative outreach and prevention messages specifically tailored to young suburban PWID may help to disseminate HCV prevention and treatment information to this population.


Assuntos
Hepacivirus/isolamento & purificação , Hepatite C/epidemiologia , Assunção de Riscos , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adulto , Feminino , Hepatite C/psicologia , Hepatite C/transmissão , Humanos , Conhecimento , Masculino , New Jersey , Inquéritos e Questionários , Adulto Jovem
16.
Cent Eur J Public Health ; 27(2): 170-172, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31241295

RESUMO

OBJECTIVE: We described an impressive cluster of hepatitis C in a single family. Of nine members of the family, six - the mother and five daughters - were affected by chronic hepatitis, hepatitis C virus (HCV) genotype 1b, of which two were co-infected with hepatitis B virus (HBV). Sharing a non-disposable injection equipment for intramuscular medical care was the most likely route of contagion. Twenty years after the first observation, we performed a follow up of this family. METHODS: The clinical history was updated, and the members of the family underwent a clinical evaluation, extensive liver laboratory tests, and whole serology for hepatitis C and B. Protein chain reaction for HCV RNA was performed when indicated. The eight spouses of the offspring and their eight children underwent the same evaluation. RESULTS: The main findings of this study are the favourable outcome of the two members of the family mono-infected by HCV, treated with peginterferon and ribavirin (sustained response and free of liver disease), in contrast with the ominous outcome of the two members co-infected with HCV and HBV, who evolved to decompensated cirrhosis, with hepatocellular carcinoma in one case, ultimately leading to death. A further feature is the absence of transmission of HCV to the spouses and to the third generation of children of this family, consistent with the assumption that sexual and vertical transmission is unlikely. CONCLUSIONS: A thorough epidemiological investigation of the two first generations of this family, the study of their spouses and children, and the twenty years of follow up provided a strong presumption that the infection with HCV had occurred within this family through the promiscuous use of the same inadequately sterilized glass syringe for intramuscular therapies, as was a common practice during the fifties and sixties worldwide and still is in some part of the world.


Assuntos
Família , Hepacivirus/isolamento & purificação , Hepatite C Crônica/transmissão , Hepatite C/transmissão , Uso Comum de Agulhas e Seringas/efeitos adversos , Antivirais/uso terapêutico , Criança , Transmissão de Doença Infecciosa , Feminino , Seguimentos , Hepatite C/tratamento farmacológico , Hepatite C Crônica/sangue , Hepatite C Crônica/diagnóstico , Humanos , Cirrose Hepática/tratamento farmacológico , Ribavirina/uso terapêutico
17.
BMC Infect Dis ; 19(1): 393, 2019 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-31068138

RESUMO

BACKGROUND: Human immunodeficiency virus, hepatitis B virus and hepatitis C virus are among the greatest threats to blood safety for the recipient. They are also the leading cause of death, chronic and life-threatening abnormalities. Therefore, this study was aimed to assess the Sero-prevalence of HIV, Hepatitis B and C virus among blood donors at the University of Gondar Comprehensive Specialized Hospital. METHODS: A retrospective cross-sectional study was used to estimate the seroprevalence of HIV, Hepatitis B and C virus among blood donors at the University of Gondar Comprehensive Specialized Hospital from May-July 2018. Screening of HIV, HBV, and HCV was done by using the Enzyme-Linked ImmunoSorbent Assay. Records of 5983 first time blood donors were collected and reviewed by using a checklist from registration book. Data was entered in statistical package EP Info version 3.5.1, and data cleaned and analyzed using the statistical package SPSS version 16.0. RESULTS: Of 5983 blood donors, 85.5% (5118/5983) donors were males and 14.5% (865/5983) were females. The median age was 27 years and the highest blood donations age category was between 20 to 51.2% (29/5983) followed by 30 to 39 years of age, 21.6% (1295/5983). The prevalence of HIV, HBV and HCV infections were 2.5% (95% CI: 1.07-2.398), 4.1% (95% CI: 0.461-1.053) and 1.6% (95% CI: 0.845-3.354), respectively. HIV infection was significantly associated with gender (p = 0.021, x2 = 5.358) and HCV infection with age group (p = 0.003, x2 = 17.673). Of all donated blood, 8.2% (489/5983) had serological evidence for at least one of the screened pathogens and 58 (0.96%) of them had multiple infections. CONCLUSIONS: This study showed a significant prevalence of HIV, HBV, and HCV among blood donors, 2.5% (147/5983), 4.1% (244/5983) and 1.6% (98/5983), respectively. Therefore, strict selection of blood donors with an emphasis on getting voluntary blood donors, and highly sensitive and specific tests for screening of blood donors for HIV, HBV, and HCV using standard methods are highly recommended to ensure the safety of blood for the recipient.


Assuntos
Infecções por HIV/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Adolescente , Adulto , Doadores de Sangue/estatística & dados numéricos , Segurança do Sangue , Transfusão de Sangue , Estudos Transversais , Etiópia/epidemiologia , Feminino , Infecções por HIV/transmissão , Hepatite B/transmissão , Hepatite C/transmissão , Hospitais Especializados/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Estudos Soroepidemiológicos
18.
J Res Health Sci ; 19(1): e00435, 2019 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31133625

RESUMO

BACKGROUND: Transmitting blood-borne diseases is alarming in places with high prevalence of people who inject drugs. This study aimed to determine the prevalence of drug injection and its related predictors among prisoners with a history of tattooing in Iran. STUDY DESIGN: Cross-sectional study. METHODS: By using a census sampling, 5493 prisoners with a history of tattooing of 11988 prisoners participated for hepatitis B and C bio-behavioral surveillance surveys (BSS) in prisons of Iran, during 2015-2016 from 55 prisons in 19 provinces were assessed. The data for the BSS were collected using face-to-face checklist-based interviews. Weighted prevalence and the association between variables and history of drug injection were determined using Chi-square test and adjusted odds ratio (AOR) was estimated through multivariate logistic regression test using survey package. RESULTS: The mean age of participants was 33.9 ±8.3 yr. Most of them were male (96.4%) and had a history of drug use (85.4%). The prevalence of drug injection among drug users was 20.2%, of which 33.9% had a history of shared injection. The prevalence of drug injection among prisoners with a history of tattooing is associated with male gender (P=0.047), age ≥35 yr (P<0.001), being single (P=0.002), being divorced/widow (P=0.039), and a history of imprisonment (P<0.001). CONCLUSION: The prevalence of drug injection increases in the presence of other high-risk behaviors. It is necessary to initiate harm reduction programs and preventive interventions in groups with multiple high-risk behaviors.


Assuntos
Prisões , Assunção de Riscos , Abuso de Substâncias por Via Intravenosa , Tatuagem , Adulto , Fatores Etários , Estudos Transversais , Feminino , Hepatite B/transmissão , Hepatite C/transmissão , Humanos , Injeções Intravenosas/estatística & dados numéricos , Irã (Geográfico)/epidemiologia , Modelos Logísticos , Masculino , Estado Civil , Uso Comum de Agulhas e Seringas/efeitos adversos , Uso Comum de Agulhas e Seringas/estatística & dados numéricos , Razão de Chances , Prevalência , Prisioneiros , Fatores de Risco , Fatores Sexuais , Abuso de Substâncias por Via Intravenosa/complicações , Abuso de Substâncias por Via Intravenosa/epidemiologia
19.
Arch Virol ; 164(7): 1761-1770, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31065852

RESUMO

The distribution of hepatitis C virus (HCV) genotypes/subtypes varies among different populations. Here, we investigated HCV infection and its genotype distribution in injection drug users (IDUs) in Guangdong Province of China. A total of 318 IDUs from two prisons were recruited. The genotypes/subtypes of HCV in IDUs were determined by phylogenetic analysis using E1 and/or NS5B gene sequences. Our previous data on blood donors (BDs) with no history of drug use were used as control population data for comparison. Our results showed that the prevalence of HCV 3b (20.9% vs. 3.6%, P = 3.4E-9) and 6a (57.0% vs. 39.8%, P = 1.2E-5) was higher in IDUs than in BDs. In contrast, the prevalence of HCV 1b (43.4% vs. 5.6%, P = 9.8E-23) in BDs was higher than in IDUs. Phylogeographic analysis indicated that HCV 3b migrated from Yunnan to Guangdong Province and became endemic, with further transmission to other regions of China. The trend of HCV 3b dissemination in China in IDUs requires further attention, and a strategy for prevention and therapy is needed.


Assuntos
Usuários de Drogas/estatística & dados numéricos , Hepacivirus/classificação , Hepacivirus/genética , Hepatite C/epidemiologia , Adulto , Anticorpos Antivirais/sangue , China/epidemiologia , Feminino , Genótipo , Hepacivirus/isolamento & purificação , Hepatite C/transmissão , Humanos , Masculino , Filogeografia , Prisioneiros/estatística & dados numéricos , RNA Viral/genética , Abuso de Substâncias por Via Intravenosa , Proteínas do Envelope Viral/genética , Proteínas não Estruturais Virais/genética
20.
Am J Nurs ; 119(5): 15, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31033542

RESUMO

Direct-acting antivirals can effectively treat recipients who become HCV positive.


Assuntos
Hepatite C/tratamento farmacológico , Transplante de Órgãos , Obtenção de Tecidos e Órgãos/métodos , Seleção do Doador , Hepatite C/transmissão , Humanos
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