Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.646
Filtrar
1.
West Afr J Med ; 37(3): 260-267, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32476120

RESUMO

BACKGROUND: HIV has direct and indirect effects on the liver, just as hepatitis B and C viral infections are both hepatotropic viruses. Co-infection is an emerging clinical problem among HIV infected individuals, therefore its prevalence and impact on hepatic functions in children requires evaluation. METHODS: A cross sectional hospital-based study was conducted among HIV infected children and adolescents aged 2 months to 18 years on antiretroviral therapy at the University of Abuja Teaching Hospital from October 2017 to March 2018. Determination of hepatitis B surface antigen, antibody to hepatitis C, liver function tests and liver sizes were carried out on the children. RESULTS: Of a total of 153 subjects recruited, 89(58.2%) were males, 69 (45.1%) were adolescents and 117(76.5%) from lower socio-economic class. Hundred and forty (91.5%) subjects were mono-infected, 7(4.6%) had co-infection with HBsAg, 1(0.7%) had HBsAg/HBeAg, 6(3.9%) had HCV, while none had triple infection. No under-five had co-infection with HBV and no variable had significant association with HBV coinfection. There was however significant association of HCV co-infection with age (p=0.00), blood transfusion (p=0.03), and religion (p=0.01) and all the infected were less than 10 years. The mean values for alanine transaminase, aspartate transaminase, alkaline phosphatase, liver sizes of the mono and co-infected were all within normal and none had severe or life threatening hepatotoxicity. CONCLUSION: The prevalence and impact of HIV co-infection on liver function in this study was low. Use of liver biopsy, the gold standard for assessing disease severity in liver conditions may also be required for in-depth assessment.


Assuntos
Terapia Antirretroviral de Alta Atividade , Coinfecção/epidemiologia , Infecções por HIV/tratamento farmacológico , Hepatite B/complicações , Hepatite C/complicações , Adolescente , Alanina Transaminase/sangue , Criança , Pré-Escolar , Estudos Transversais , Feminino , Infecções por HIV/sangue , Infecções por HIV/epidemiologia , Hepacivirus/isolamento & purificação , Hepatite B/sangue , Hepatite B/epidemiologia , Antígenos de Superfície da Hepatite B , Vírus da Hepatite B/isolamento & purificação , Hepatite C/sangue , Hepatite C/epidemiologia , Humanos , Lactente , Testes de Função Hepática , Masculino , Nigéria/epidemiologia , Prevalência
2.
BMC Infect Dis ; 20(1): 395, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32503443

RESUMO

BACKGROUND: Tanzania has a high prevalence (7.17%) of chronic hepatitis B infection. Mother to Child transmission is very common, resulting in high rate of chronic infections. Currently, there is no screening program for HBV in pregnant women. This study investigated the prevalence and risk factors for chronic HBV infection in pregnant women in a tertiary hospital in Mwanza, Tanzania. METHODS: Seven hundred and forty-three women attending antenatal care and/or delivering at the Bugando Medical Centre were enrolled. All answered a questionnaire on sociodemographic and other risk factors and were tested for HBsAg using a rapid test. In HBsAg positive mothers, maternal blood and umbilical cord blood samples collected after delivery were analyzed for serological (HBsAg, HBeAg and anti-HBe) and virologic (HBV-DNA viral load and genotype) markers. All their babies were vaccinated within 24 h of delivery. The children were followed up at 3 years of age. Data was analyzed using the Mann-Whitney U-test, independent sample T-test and logistic regression. RESULTS: Of the 743 participants, 22 (3%) were positive for HBsAg, and 2 (9%) had detectable HBe-antigen. Low condom use was the only statistically significant risk factor for chronic HBV infection (OR = 3.514, 95%CI = 1.4-8.0). Of 14 maternal blood samples genotyped, 10 (71%) were genotype A and 4 (29%) were genotype D. HBV-DNA was detected in 21/22 samples, with a median of 241 IU/ml (range: 27.4-25.9 × 107 IU/ml). Five (33%) of 15 available cord blood samples were positive for HBsAg and 10 (67%) were negative. At follow-up, one child showed chronic HBV infection characteristics, one had anti-HBs level of 7 mIU/ml and 5/7(71%) had protective anti-HBs levels (> 10 mIU/ml). CONCLUSION: This cohort of pregnant women showed a lower-intermediate prevalence of HBV of 3%. In the 3 years follow-up only 1 out of 7 children showed evidence of chronic HBV infection. The child's mother with high viral load (25.9 × 107 IU/ml), was positive for HBeAg with a high degree of sequence similarity suggesting vertical transmission. These results highlight a need for improved diagnosis and treatment of HBV infection in pregnant women in Tanzania, in order to prevent vertical transmission.


Assuntos
Hepatite B Crônica/diagnóstico , Adolescente , Adulto , Estudos Transversais , DNA Viral/genética , DNA Viral/metabolismo , Feminino , Genótipo , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Antígenos E da Hepatite B/sangue , Vírus da Hepatite B/genética , Vírus da Hepatite B/isolamento & purificação , Hepatite B Crônica/epidemiologia , Hepatite B Crônica/virologia , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Cuidado Pré-Natal , Prevalência , Tanzânia/epidemiologia , Centros de Atenção Terciária , Carga Viral , Adulto Jovem
3.
MMWR Morb Mortal Wkly Rep ; 69(21): 647-650, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32463810

RESUMO

An estimated 257 million persons worldwide have chronic hepatitis B virus (HBV) infection (1). CDC recommends HBV testing for persons from countries with intermediate to high HBV prevalence (≥2%), including newly arriving refugees (2). Complications of chronic HBV infection include liver cirrhosis and hepatocellular carcinoma, which develop in 15%-25% of untreated adults infected in infancy or childhood (3). HBV-infected patients require regular monitoring for both infection and sequelae. Several studies have evaluated initial linkage to HBV care for both refugee and nonrefugee immigrant populations (4-9), but none contained standardized definitions for either linkage to or long-term retention in care for chronic HBV-infected refugees. To assess chronic HBV care, three urban sites that perform refugee domestic medical examinations and provide primary care collaborated in a quality improvement evaluation. Sites performed chart reviews and prospective outreach to refugees with positive test results for presumed HBV infection during domestic medical examinations. Linkage to care (29%-53%), retention in care (11%-21%), and outreach efforts (22%-71% could not be located) demonstrated poor access to initial and ongoing HBV care. Retrospective outreach was low-yield. Interventions that focus on prospective outreach and addressing issues related to access to care might improve linkage to and retention in care.


Assuntos
Continuidade da Assistência ao Paciente/estatística & dados numéricos , Hepatite B/diagnóstico , Hepatite B/terapia , Refugiados/estatística & dados numéricos , Retenção nos Cuidados/estatística & dados numéricos , Adulto , Cidades , Feminino , Vírus da Hepatite B/isolamento & purificação , Humanos , Laboratórios , Masculino , Programas de Rastreamento , Avaliação de Programas e Projetos de Saúde , Estados Unidos , Adulto Jovem
4.
Life Sci ; 252: 117663, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32302624

RESUMO

AIMS: Interleukin-35 (IL-35) is a new member of the interleukin-12 family and is composed of the P35 and EB virus-inducible gene 3 subunits. The aims of this study were to examine the roles of IL-35 in the exhaustion of HBV-specific CTLs, as little as known on the subject. MAIN METHODS: The relative levels of serum HBV markers were detected using automated biochemical techniques. The HBV DNA copies were measured by RT-qPCR. The expression of inhibitory receptors and the cell cytokines on the surface of CTLs were determined by flow cytometry. The pSTAT1-pSTAT4 protein levels expression was determined by flow cytometry, confocal microscopy and Western blot. KEY FINDINGS: Our results showed that IL-35 can activate the Janus kinase 1 (JAK1)/tyrosine kinase 2 (TYK2)/signal transducer and activator of transcription 1 (STAT1)/STAT4 pathway in CTLs in vitro. Interferon-γ and tumor necrosis alpha-α expression increased in CTLs in the presence of a JAK/STAT-pathway blocker. In addition, we evaluated the expression of the exhaustion-associated molecules programmed death-1, cytotoxic T lymphocyte-associated protein-4, and lymphocyte activation gene-3 in CTLs after adding the JAK-STAT inhibitor The results showed that the expression of exhaustion-associated molecules on the CTL surface decreased after blocking the JAK-STAT pathway. IL-35 inhibited the function of HBV-specific CTLs through the JAK1/TYK2/STAT1/STAT4 pathway, and the function of CTLs was recovered after blocking the JAK/STAT pathway. SIGNIFICANCE: These data provide a new experimental basis for immunotherapy for chronic hepatitis B.


Assuntos
Antígenos E da Hepatite B/imunologia , Hepatite B Crônica/imunologia , Interleucinas/imunologia , Linfócitos T Citotóxicos/virologia , Adulto , Citocinas/imunologia , Feminino , Vírus da Hepatite B/imunologia , Vírus da Hepatite B/isolamento & purificação , Humanos , Janus Quinases/metabolismo , Masculino , Fatores de Transcrição STAT/metabolismo , Transdução de Sinais/imunologia , Linfócitos T Citotóxicos/imunologia
5.
Arch Virol ; 165(6): 1279-1288, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32240369

RESUMO

Mother-to-child transmission of hepatitis B virus (HBV) is the main route of transmission in Asia, and characterization of HBV quasispecies is needed to further understand virus evolution and adaptation. To understand changes in HBV during mother-to-child transmission, we enrolled nine pairs of mothers and children in the study, including a set of twins. Three groups were infected with HBV genotype C, and six groups were infected with HBV genotype B. The full-length HBV genome was amplified by PCR from serum samples before antiviral treatment, the whole viral genomes from each pair were sequenced, and the complexity and diversity of the quasispecies were analyzed. The entropy of transmitted HBV in children was found to be lower than their mothers, suggesting that there was a bottleneck effect during HBV transmission from the mother to the child. Selective evolution was shown by calculating πN and πS in the whole genomes, and the highest values were obtained for the X gene, which plays a role in viral replication and immune escape. All genotype C patients and only one genotype B pair had a πN/πS greater than 1 ratio, indicating that positive selection had occurred. In addition, quasispecies were found to be different between the twin children despite having the same mother, indicating that virus evolution is host-specific.


Assuntos
Vírus da Hepatite B/genética , Hepatite B Crônica/transmissão , Hepatite B Crônica/virologia , Transmissão Vertical de Doença Infecciosa , Quase-Espécies , Transativadores/genética , Adulto , Criança , Pré-Escolar , China , DNA Viral/sangue , Evolução Molecular , Feminino , Genoma Viral , Genótipo , Vírus da Hepatite B/classificação , Vírus da Hepatite B/isolamento & purificação , Especificidade de Hospedeiro/genética , Humanos , Lactente , Recém-Nascido , Masculino , Mães , Mutação , Filogenia , Reação em Cadeia da Polimerase , Gêmeos , Adulto Jovem
6.
PLoS One ; 15(4): e0232121, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32339207

RESUMO

Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third most common cause of cancer mortality worldwide. Infection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) is the most predominant cause of HCC. Concerns arise for the presence of additional risk factors, as there is still a large proportion of patients without HBV or HCV infection. Previous studies have reported that higher intake of fruits and vegetables and reduced consumption of red/processed meat might play a protective role in HCC etiology, though the nationwide proof is limited. Hence, we studied multiple risk factors including food habit, lifestyle, and clinical implications of HCC patients in Bangladeshi. Demographic, clinical, and biochemical data, as well as data on food habits, were collected in this study. Our results indicated that a high intake of rice (AOR 4.28, 95% CI 1.48 to 14.07, p = 0.011), low intake of fruits (AOR = 4.41 95% CI 1.48-15.46; p = 0.012), leafy vegetables (AOR = 2.80, 95% CI 1.32-6.08; p = 0.008), and fish (AOR = 4.64 95% CI 2.18-10.23; p<0.001) increased the HCC risk. Moreover, a high intake of eggs (AOR = 2.07 95% CI 0.98-4.43; p = 0.058) also showed an increased risk. Roti, non-leafy vegetables, red meat, and tea were found to have no association with HCC risk. This study revealed that food habit patterns and lifestyle may have a profound effect on HCC development among Bangladeshi patients in addition to well established risk factors.


Assuntos
Carcinoma Hepatocelular/epidemiologia , Comportamento Alimentar , Hepatite B/complicações , Hepatite C/complicações , Estilo de Vida , Neoplasias Hepáticas/epidemiologia , Bangladesh/epidemiologia , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/virologia , Estudos de Casos e Controles , Feminino , Hepacivirus/isolamento & purificação , Hepatite B/virologia , Vírus da Hepatite B/isolamento & purificação , Hepatite C/virologia , Humanos , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/virologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco
7.
Gene ; 742: 144585, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32173542

RESUMO

The association between rs738409 (C>G, I148M) with patatin-like phospholipase domain-containing 3 (PNPLA3) gene and the risk of hepatocellular carcinoma (HCC) was controversial in different ethnic populations. Our study aimed to explore the effect of PNPLA3 rs738409 on the risk of HCC and persistent infection of Hepatitis B virus (HBV) in a Chinese HBV-related population, and further evaluate its role in HCC risk among Asians. First, we performed a case-control study by recruiting 786 HBV-related HCC cases, 695 HBV persistent carriers and 719 HBV natural clearance subjects. PNPLA3 rs738409 was genotyped by MassARRAY platform. Second, we conducted a systematic review and meta-analysis on Asians to further validate our results. Our case-control study demonstrated that PNPLA3 rs738409 was not associated with HCC risk or persistent HBV infection (All P > 0.05). The subsequent meta-analysis included 13 Asian studies with 9,802 subjects. Results showed that PNPLA3 rs738409 might increase HCC risk among healthy subjects (pooled odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.11-1.95), but it had no influence on the development of HCC among HBV-related subjects (pooled OR = 1.07, 95%CI = 0.89-1.30). Our case-control study highlights that PNPLA3 rs738409 is probably not associated with the risk of HCC or persistent HBV infection in a Chinese HBV-related population. Besides, our systematic review and meta-analysis on Asians further suggest that PNPLA3 rs738409 may confer an increased risk of HCC among healthy people, but contribute little to the development of HCC among HBV-related subjects. Future studies are required to confirm these results.


Assuntos
Grupo com Ancestrais do Continente Asiático/genética , Carcinoma Hepatocelular/genética , Hepatite B Crônica/genética , Lipase/genética , Neoplasias Hepáticas/genética , Proteínas de Membrana/genética , Adulto , Idoso , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/virologia , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença , Vírus da Hepatite B/isolamento & purificação , Hepatite B Crônica/patologia , Hepatite B Crônica/virologia , Humanos , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/virologia , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Medição de Risco , Fatores de Risco
8.
BMC Infect Dis ; 20(1): 194, 2020 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-32138677

RESUMO

BACKGROUND: Hepatitis B virus disease is a potentially life-threatening liver infection and a major global health problem. It causes chronic infection and puts people at high risk of death from cirrhosis and liver cancer. WHO estimated 257 million people are living with hepatitis B virus (HBV) infection and in 2015 alone HBV resulted in to 887,000 deaths globally. We determined the prevalence and associated factors of hepatitis B virus infection among Antenatal Care (ANC) attendees in Gamawa Local Government Area, Bauchi State. METHODS: We conducted a descriptive cross-sectional, health facility-based study between March and April 2018. We used systematic random sampling technique to recruit 210 pregnant women aged 15-49 years. With a structured questionnaire, we interviewed the respondents and collected blood sample to test for hepatitis B surface antigen. We calculated frequencies, means, proportions, and tested for associations using Epi Info 7.2 and Microsoft Excel. RESULTS: The mean age of respondents was 24.5 ± 6.0 years; 112 (53%) of whom were younger than 25 years. All were married, 183 (87%) had no formal education and up to 190 (90%) were employed. Overall, 14 (6.7%) tested positive for HBsAg; women aged ≥35 years had the highest prevalence (10%). None with tertiary education tested positive and women married before 18 years had 13 (6.2%) prevalence. CONCLUSIONS: The prevalence of HBsAg among pregnant women in Gamawa LGA was 6.7% which is quite lower than the national prevalence reported. We recommended improved surveillance of HBV infection and screening of women attending ANC.


Assuntos
Vírus da Hepatite B/isolamento & purificação , Hepatite B/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Cuidado Pré-Natal/estatística & dados numéricos , Adolescente , Adulto , Instituições de Assistência Ambulatorial , Estudos Transversais , Feminino , Hepatite B/diagnóstico , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/imunologia , Humanos , Pessoa de Meia-Idade , Nigéria/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos , Inquéritos e Questionários , Adulto Jovem
9.
PLoS One ; 15(3): e0229911, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32155208

RESUMO

BACKGROUND: The unique characteristics of long-term care facilities (LTCFs) including host factors and living conditions contribute to the spread of contagious pathogens. Control measures are essential to interrupt the transmission and to manage outbreaks effectively. AIM: The aim of this systematic review was to verify the causes and problems contributing to transmission and to identify control measures during outbreaks in LTCFs. METHODS: Four electronic databases were searched for articles published from 2007 to 2018. Articles written in English reporting outbreaks in LTCFs were included. The quality of the studies was assessed using the risk-of-bias assessment tool for nonrandomized studies. FINDINGS: A total of 37 studies were included in the qualitative synthesis. The most commonly reported single pathogen was influenza virus, followed by group A streptococcus (GAS). Of the studies that identified the cause, about half of them noted outbreaks transmitted via person-to-person. Suboptimal infection control practice including inadequate decontamination and poor hand hygiene was the most frequently raised issue propagating transmission. Especially, lapses in specific care procedures were linked with outbreaks of GAS and hepatitis B and C viruses. About 60% of the included studies reported affected cases among staff, but only a few studies implemented work restriction during outbreaks. CONCLUSIONS: This review indicates that the violation of basic infection control practice could be a major role in introducing and facilitating the spread of contagious diseases in LTCFs. It shows the need to promote compliance with basic practices of infection control to prevent outbreaks in LTCFs.


Assuntos
Infecção Hospitalar/prevenção & controle , Surtos de Doenças/prevenção & controle , Controle de Infecções/organização & administração , Instituições Residenciais/organização & administração , Infecção Hospitalar/epidemiologia , Higiene das Mãos/organização & administração , Higiene das Mãos/normas , Higiene das Mãos/estatística & dados numéricos , Hepacivirus/isolamento & purificação , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Hepatite B/transmissão , Hepatite B/virologia , Vírus da Hepatite B/isolamento & purificação , Hepatite C/epidemiologia , Hepatite C/prevenção & controle , Hepatite C/transmissão , Hepatite C/virologia , Humanos , Higiene/normas , Controle de Infecções/normas , Controle de Infecções/estatística & dados numéricos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Influenza Humana/transmissão , Influenza Humana/virologia , Assistência de Longa Duração/organização & administração , Assistência de Longa Duração/normas , Assistência de Longa Duração/estatística & dados numéricos , Orthomyxoviridae/isolamento & purificação , Orthomyxoviridae/patogenicidade , Instituições Residenciais/normas , Instituições Residenciais/estatística & dados numéricos , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/prevenção & controle , Infecções Estreptocócicas/transmissão , Streptococcus pyogenes/isolamento & purificação
11.
Arch Virol ; 165(4): 913-922, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32078045

RESUMO

Little information is available regarding the prevalence of viral hepatitis in Central West Argentina. This study aims to give new information regarding HBV and HCV prevalence, genotypes, and risk factors in Central West Argentina and the suitability of dried blood spot (DBS) sampling for HBV and HCV screening. METHODS: A total of 622 individuals were included; the mean age was 36.6 ± 14.3 years and 55.4% were females. HBV and HCV markers were detected using serological and molecular analysis, and risk factors were evaluated using statistical analysis. RESULTS: Using serum samples, the HBsAg prevalence was 1.8%, the rate of HBV exposure (anti-HBc positivity) was 5.3%, and the rate of HBV immunity was 34.9%. HBV DNA was found in four out of 11 HBsAg+ samples, and the viruses in three of these samples were classified as genotypes A1, A2 and F2a. Multivariate analysis showed that anti-HBs positivity was associated with the level of schooling and history of HBV vaccination. The anti-HCV prevalence was 2.6%, and HCV RNA was found in 11 samples, seven of which contained viruses of genotypes 1a (n = 2), 1b (n = 3) and 2 (n = 2). The sensitivity of the DBS assay for HBsAg, anti-HBc, and anti-HCV was 100%, 66.6%, and 75%, respectively, and the specificity was above 98% for all markers when compared to serum. CONCLUSION: A low rate of HBV immunity was observed, demonstrating the importance of HBV vaccination. High HCV prevalence was found, and HCV 1b was closely related to other Argentinian isolates. Finally, the performance of DBS testing in this population needs more optimization to increase its sensitivity and specificity.


Assuntos
Hepacivirus/isolamento & purificação , Vírus da Hepatite B/isolamento & purificação , Hepatite B/epidemiologia , Hepatite B/virologia , Hepatite C/epidemiologia , Hepatite C/virologia , Adulto , Argentina/epidemiologia , Estudos Transversais , Feminino , Genótipo , Hepacivirus/classificação , Hepacivirus/genética , Hepatite B/sangue , Hepatite B/diagnóstico , Anticorpos Anti-Hepatite B/sangue , Vírus da Hepatite B/classificação , Vírus da Hepatite B/genética , Hepatite C/sangue , Hepatite C/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Filogenia , Prevalência , Adulto Jovem
13.
PLoS One ; 15(1): e0227776, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31917810

RESUMO

BACKGROUND: Coinfections of HIV patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) are mayor public health problems, contributing to the emerging burden of HIV-associated hepatic mortality. Coinfection rates vary geographically, depending on various factors such as predominant transmission modes, HBV vaccination rates, and prevalence of HBV and HCV in the general population. In South America, the epidemiology of coinfections is uncertain, since systematic studies are scarce. Our study aimed to analyze rates of HBV and HCV infection in people living with HIV attending centers of the public and private health system in Chile. METHODS: We performed a cross-sectional study including a public university hospital and a private health center in Santiago, Metropolitan Region in Chile. Serum samples were used to determine serological markers of hepatitis B (HBsAg, anti-HBs, anti-HBc total, HBeAg, anti-HBe) and anti-HCV. Demographic, clinical and laboratory data were obtained from medical records. RESULTS: 399 patients were included (353 from public, 46 from private health center). Most (92.8%) were male, with a median age of 38.3 years; 99.4% acquired HIV through sexual contact (75.0% MSM); 25.7% had AIDS and 90.4% were on ART. In 78.9%, viral loads were <40 cps/mL; the median CD4 cell count was 468 cells/mm3. According to their serological status, 37.6% of patients were HBV naïve (susceptible), 6.5% were vaccinated, 43.6% had resolved HBV infection, and 5.8% were chronically infected. The rate of vaccination was 4.5% in the public and 21.7% in the private system. HCV coinfection was found in 1.0% of all patients. CONCLUSION: HBV coinfection rate was within the range of other South American countries, but lower than in non-industrialized regions in Asia and Africa. A low percentage of patients were HBV vaccinated, especially within the public system. HCV coinfection rate was very low, most probably due to the rareness of injecting drug use.


Assuntos
Infecções por HIV/complicações , Hepatite B/complicações , Hepatite C/complicações , Adulto , Chile/epidemiologia , Coinfecção/sangue , Coinfecção/complicações , Coinfecção/epidemiologia , Estudos Transversais , Feminino , HIV/isolamento & purificação , Infecções por HIV/sangue , Infecções por HIV/epidemiologia , Hepacivirus/isolamento & purificação , Hepatite B/sangue , Hepatite B/epidemiologia , Vírus da Hepatite B/isolamento & purificação , Hepatite C/sangue , Hepatite C/epidemiologia , Hospitais Privados , Hospitais Públicos , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
14.
Am J Clin Oncol ; 43(1): 20-27, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31633514

RESUMO

OBJECTIVES: The objective of this study was to establish a reliable and effective nomogram for predicting prognosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) with postoperative adjuvant transarterial chemoembolization (TACE). PATIENTS AND METHODS: A derivation cohort of 370 HCC patients treated with postoperative TACE in the Eastern Hepatobiliary Surgery Hospital from January 2009 to December 2012 were retrospectively analyzed. Univariate and multivariate analysis were performed by Cox regression and independent prognostic factors for overall survival were determined to construct the nomogram. Concordance index (C-index), calibration curve and decision curve analysis were performed to evaluate the capability of the nomogram and the established nomogram was compared with TNM stage and Barcelona Clinic Liver Cancer (BCLC) stage to identify the superior model. The results were validated in a validation cohort of 123 HCC patients in the same center. RESULTS: Multivariate analysis indicated that γ-glutamyl transferase, α-fetoprotein, tumor number, tumor size, satellite lesions, microvascular invasion, and HBV-DNA were independent prognostic factors for overall survival in the derivation cohort, and all these factors were selected into the nomogram. The C-index was 0.755 for survival prediction of the nomogram, which was significantly higher than the TNM stage (0.636, P<0.001) and BCLC stage (0.594, P<0.001). A fair uniformity and a superior net benefit with wide range threshold probabilities were showed in the calibration curves and decision curve analysis. In the validation cohort, the C-index of the nomogram (0.785) also had a higher predictive accuracy than TNM stage (0.744, P=0.019) and BCLC stage (0.616, P<0.001). CONCLUSIONS: The nomogram with accurate and reasonable performance was proposed for predicting survival of HBV-related HCC with postoperative adjuvant TACE.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Hepatocelular/patologia , Quimioembolização Terapêutica/mortalidade , Hepatectomia/mortalidade , Hepatite B/complicações , Neoplasias Hepáticas/patologia , Nomogramas , Carcinoma Hepatocelular/terapia , Carcinoma Hepatocelular/virologia , Quimioterapia Adjuvante , Terapia Combinada , Feminino , Seguimentos , Hepatite B/virologia , Vírus da Hepatite B/isolamento & purificação , Humanos , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/virologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
15.
Int J Infect Dis ; 90: 138-144, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31682960

RESUMO

BACKGROUND: Previous studies in the Central African Republic (CAR) have reported the presence of hepatitis B virus (HBV) recombinant genotype E/D and a suspicion of immune escape mutants (IEMs), without further investigation into their impact on prevention and diagnosis. Consequently, this study investigated HBV mutations among hepatitis B surface antigen (HBsAg)-positive patients attending Institut Pasteur de Bangui in the CAR. METHODS: Sera from a total of 118 HBsAg-positive patients with no previous history of HBV treatment or vaccination at the Institut Pasteur de Bangui, were sampled between 2017 and 2019. Subsequently, the region spanning the surface and polymerase genes of HBV was amplified by PCR and sequenced. HBV sequences were genotyped/subgenotyped by phylogenetic analysis and serotyped based on predicted amino acid residues at positions s122, s127, s140, s159, and s160. They were then analyzed for HBV IEMs and polymerase mutations. RESULTS: The region spanning the surface and polymerase genes was successfully amplified and sequenced for 51 samples. Of the HBV sequences, 49 were genotype E and two were genotype A subgenotype A1; these were serotyped as ayw4 and ayw1, respectively. Potential IEMs sY100C, sA128V, and sM133T, and several polymerase mutants were identified. CONCLUSIONS: This study raises awareness of the need for further studies to be conducted on a large scale to better understand HBV mutations for improved disease control and prevention strategies in the country.


Assuntos
DNA Polimerase Dirigida por DNA/genética , Vírus da Hepatite B/imunologia , Hepatite B/virologia , Proteínas Virais/genética , Adolescente , Adulto , Sequência de Bases , República Centro-Africana/epidemiologia , Feminino , Genótipo , Hepatite B/sangue , Hepatite B/epidemiologia , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/classificação , Vírus da Hepatite B/genética , Vírus da Hepatite B/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Filogenia , Reação em Cadeia da Polimerase , Adulto Jovem
17.
Gastroenterology ; 158(1): 215-225.e6, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31574268

RESUMO

BACKGROUND & AIMS: There have been conflicting results from studies comparing the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infection treated with tenofovir disoproxil fumarate (TDF) vs those treated with entecavir. We compared the effects of TDF vs entecavir on HCC risk in a large cohort of patients with chronic HBV infection in China. METHODS: We performed a retrospective study of consecutive adults with chronic HBV infection who initially received treatment with entecavir or TDF, for at least 6 months, from January 2008 through June 2018. Patients who had cancers or liver transplantation before or within the first 6 months of treatment were excluded. Propensity score weighting and 1:5 matching were used to balance the clinical characteristics between the 2 groups. Fine-Gray model was used to adjust for competing risk of death and liver transplantation. RESULTS: We analyzed data from 29,350 patients (mean age, 52.9 ± 13.2 years; 18,685 men [63.7%]); 1309 were first treated with TDF (4.5%) and 28,041 were first treated with entecavir (95.5%). TDF-treated patients were younger (mean age, 43.2 years vs 53.4 years) and a lower proportion had cirrhosis (38 patients [2.9%] vs 3822 patients treated with entecavir [13.6%]). At a median follow-up time of 3.6 years after treatment began (interquartile range, 1.7-5.0 years), 8 TDF-treated patients (0.6%) and 1386 entecavir-treated patients (4.9%) developed HCC. Patients' clinical characteristics were comparable after propensity score weighting. TDF treatment was associated with a lower risk of HCC than entecavir treatment after propensity score weighting (weighted subdistribution hazard ratio, 0.36; 95% confidence interval 0.16-0.80; P = .013) and 1:5 matching (weighted subdistribution hazard ratio, 0.39; 95% confidence interval 0.18-0.84; P = .016). CONCLUSIONS: In a retrospective analysis of 29,350 patients with chronic HBV infection in China, treatment with TDF was associated with a lower risk of HCC than treatment with entecavir, over a median follow-up time of 3.6 years.


Assuntos
Antivirais/administração & dosagem , Carcinoma Hepatocelular/prevenção & controle , Guanina/análogos & derivados , Hepatite B Crônica/tratamento farmacológico , Neoplasias Hepáticas/prevenção & controle , Tenofovir/administração & dosagem , Adulto , Assistência ao Convalescente , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/virologia , China/epidemiologia , Progressão da Doença , Feminino , Guanina/administração & dosagem , Vírus da Hepatite B/isolamento & purificação , Hepatite B Crônica/patologia , Hepatite B Crônica/virologia , Humanos , Incidência , Fígado/efeitos dos fármacos , Fígado/patologia , Fígado/virologia , Cirrose Hepática/epidemiologia , Cirrose Hepática/prevenção & controle , Cirrose Hepática/virologia , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/virologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
18.
Int J Infect Dis ; 92: 13-18, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31863879

RESUMO

OBJECTIVES: Egypt ranks first regarding the prevalence of hepatitis C virus (HCV) infection. Many patients have concomitant diseases like kidney disorders requiring hemodialysis, a procedure carrying the hazard of transmitting other hepatitis viruses. The purpose of this study was to investigate for occult hepatitis B virus (HBV), SEN virus (SENV), and torque teno virus (TTV) among chronic HCV patients on maintenance hemodialysis to identify their impacts. METHODS: A total of 325 hemodialysis patients were enrolled and divided into two groups based on HCV RNA testing results. Blood samples were collected before hemodialysis. Sera were tested for hepatitis B core antibodies (anti-HBc) and hepatitis B surface antibodies (anti-HBs) using ELISA. HBV, SENV, and TTV DNA were detected by PCR. The serum alanine aminotransferase (ALT) level was measured. RESULTS: Anti-HBc and HBV DNA were detected in 73.1% and 50.8% of group 1 versus 36.4% and 22.6% of group 2. The serum ALT level was higher in group 1 than group 2. SENV was detected in 11.5% of group 1 versus 8.2% of group 2. TTV was detected in 29% of group 1 versus 27% of group 2. CONCLUSIONS: There is an increased prevalence of occult HBV in our locality among chronic HCV patients undergoing hemodialysis. The existence of SENV and TTV viremia has no clinical impact.


Assuntos
Vírus da Hepatite B , Hepatite C Crônica/virologia , Diálise Renal , Torque teno virus , Adulto , Alanina Transaminase/sangue , Egito , Ensaio de Imunoadsorção Enzimática , Feminino , Hepacivirus , Anticorpos Anti-Hepatite B/sangue , Vírus da Hepatite B/isolamento & purificação , Hepatite C Crônica/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Prevalência , Torque teno virus/isolamento & purificação
19.
Anal Chim Acta ; 1095: 162-171, 2020 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-31864618

RESUMO

This research proposes two methods for hepatitis B diagnosis including rapid testing and electrochemical assay. For the first method, a multiplex hepatitis B test strip was fabricated to serve as a rapid test for hepatitis B screening. It was developed to simultaneously test three essential serological markers of hepatitis B virus infection including hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (Anti-HBs) and hepatitis B core antibody (Anti-HBc). Gold nanoparticles (GNPs) were used as the signal generator on the test strip. Furthermore, a part of a paper network was incorporated on the strip for the gold-silver enhancement process. This paper network helped in decreasing the analysis time of enhancement and makes the enhancement process easier for rapid testing. The developed test strip was specific for each serological marker. The detection limits of HBsAg, Anti-HBs and Anti-HBc were obtained at 0.5, 0.3 and 0.1 µg mL-1, respectively. For the second method, electrochemical impedance spectroscopy (EIS) was applied for HBsAg detection. This method was proposed for quantitative hepatitis B detection. Anti-HBs antibodies were immobilized on a carbon screen printed electrode (SPCE) via the N-ethyl-N'-(3-(dimethylamino)propyl)carbo-diimide/N-hydroxy succinimide (EDC/NHS) couple reaction which reacted with the carboxyl group of the BSA cross-linked film on the electrode. The electrode modification process was characterized by EIS. A linear relationship between delta charge transfer resistance (ΔRct) and HBsAg concentration was obtained in the range of 5-3000 ng mL-1 with a detection limit of 2.1 ng mL-1. This work is appropriate for quantitative analysis because it is a simple and low-cost method to implement as the SPCE is disposable. Therefore, we hope that this research will be useful to improve hepatitis B detection in the future.


Assuntos
Espectroscopia Dielétrica/métodos , Anticorpos Anti-Hepatite B/análise , Antígenos de Superfície da Hepatite B/análise , Vírus da Hepatite B/isolamento & purificação , Hepatite B/diagnóstico , Imunoensaio/métodos , Animais , Anticorpos Imobilizados/imunologia , Anticorpos Monoclonais Murinos/imunologia , Biomarcadores/análise , Cabras , Hepatite B/sangue , Anticorpos Anti-Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/imunologia , Imunoensaio/instrumentação , Limite de Detecção , Camundongos , Coelhos
20.
Dis Markers ; 2019: 2046825, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31814857

RESUMO

Background and Aim: Aspartate aminotransferase-to-platelet ratio index (APRI) is widely used in the assessment of fibrosis and cirrhosis, especially in patients with chronic hepatitis. However, the prognostic value of APRI in patients with chronic hepatitis with regard to the prediction of hepatocellular carcinoma (HCC) occurrence remains controversial. The objective of this meta-analysis is to investigate the association between APRI and HCC risk on the basis of cohort studies. Methods: We systematically reviewed PubMed, EMBASE, Web of Science, and Chinese National Knowledge Infrastructure databases for relevant cohort studies up to May 1, 2019. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) for total and subgroup analyses were calculated with Stata 12.0 software for the assessment of the relationship between APRI and HCC risk. Results: A total of 13 studies, involving 8897 patients, were included in the meta-analysis, of which 11 explored the association between pretreatment APRI and HCC risk and four reported the relationship between posttreatment APRI and HCC risk. Pooled results showed that an elevated level of pretreatment APRI was associated with increased HCC risk (HR = 2.56, 95% CI: 1.78-3.68). When stratified by hepatitis type, high pretreatment APRI predicted HCC development in patients with chronic hepatitis B (CHB) and C (CHC) but not in alcoholic liver cirrhosis (ALC). In the subgroup analyses of study region, cut-off value, sample size, and analysis method, the relationship between high pretreatment APRI and increased HCC risk was significant. Meanwhile, patients with a high level of posttreatment APRI suffered from high HCC risk (HR = 3.69, 95% CI: 2.52-5.42). Conclusion: Results revealed a significant association between elevated APRI and HCC development in patients with chronic hepatitis, suggesting that APRI might serve as a valuable predictor for HCC risk in patients with chronic hepatitis.


Assuntos
Aspartato Aminotransferases/metabolismo , Plaquetas/patologia , Carcinoma Hepatocelular/patologia , Hepatite B Crônica/complicações , Hepatite C Crônica/complicações , Neoplasias Hepáticas/patologia , Carcinoma Hepatocelular/enzimologia , Carcinoma Hepatocelular/etiologia , Estudos de Coortes , Hepacivirus/isolamento & purificação , Vírus da Hepatite B/isolamento & purificação , Hepatite B Crônica/virologia , Hepatite C Crônica/virologia , Humanos , Neoplasias Hepáticas/enzimologia , Neoplasias Hepáticas/etiologia , Prognóstico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA