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Shamshirian A, Alizadeh-Navaei R, Pourfathollah AA, Alipoor R, Mohseni AR. Seroprevalence and geographical distribution of hepatitis C virus in Iranian patients with thalassemia: a systematic review and meta-analysis. J LAB MED 2019; 43:45-55. [DOI: 10.1515/labmed-2018-0150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
AbstractBackgroundThalassemia as a hereditary hemoglobinopathy is the most common monogenic disease worldwide. Patients with thalassemia require regular blood transfusion, which provides the risk for the transmission of hepatitis C virus (HCV) as the most common post-transfusion infection in such patients, and this rate is very diverse in different parts of the world. We aimed to determine the prevalence of HCV among patients with thalassemia in Iran.MethodsIn this study, we searched for articles on the prevalence of HCV among Iranian thalassemia patients in English and Persian databases up to 2017. Heterogeneities were assessed by using anI-square (I2) test. Prevalence and 95% confidence interval (CI) were calculated using the random effects model.ResultsIn total, 37 studies with 9185 patients were included in the meta-analysis. The prevalence of HCV among Iranian thalassemia patients was 17.0% (95% CI: 14.5–19.8). The rate of prevalence among male and female subjects was 17.4% (95% CI: 13.8–21.9) and 16.8% (95% CI: 13.2–21.1), respectively.ConclusionsWe found that the prevalence of HCV among Iranian thalassemia patients declined over time and the Iranian Blood Transfusion Organization has had a reasonable performance in HCV screening.
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Hossain MS, Raheem E, Sultana TA, Ferdous S, Nahar N, Islam S, Arifuzzaman M, Razzaque MA, Alam R, Aziz S, Khatun H, Rahim A, Morshed M. Thalassemias in South Asia: clinical lessons learnt from Bangladesh. Orphanet J Rare Dis 2017; 12:93. [PMID: 28521805 PMCID: PMC5437604 DOI: 10.1186/s13023-017-0643-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 04/27/2017] [Indexed: 12/20/2022] Open
Abstract
Thalassemias are emerging as a global public health concern. Due to remarkable success in the reduction of childhood mortality by controlling infectious diseases in developing countries, thalassemias are likely to be a major public health concern in the coming decades in South Asia. Despite the fact that Bangladesh lies in the world’s thalassemia belt, the information on different aspects (epidemiology, clinical course, mortality, complications and treatment outcomes) of thalassemias is lacking. In this comprehensive review, the aim is to to depict the epidemiological aspects of thalassemias, mutation profile and current treatment and management practices in the country by sharing the experience of dealing with 1178 cases over 2009–2014 time periods in a specialized thalassemia treatment centre. We have also discussed the preventative strategies of thalassemias from the context of Bangladesh which could be effective for other developing countries.
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Affiliation(s)
- Mohammad Sorowar Hossain
- Biomedical Research Foundation, House #7, Apartment# 1A, Road# 1/B, Banani, Chairman Bari, Dhaka-1213, Bangladesh. .,Faculty of Basic Sciences, Bangladesh University of Health Sciences, Dhaka, Bangladesh. .,School of Environmental Science and Management, Independent University, Dhaka, Bangladesh.
| | - Enayetur Raheem
- Biomedical Research Foundation, House #7, Apartment# 1A, Road# 1/B, Banani, Chairman Bari, Dhaka-1213, Bangladesh
| | - Tanvira Afroze Sultana
- Biomedical Research Foundation, House #7, Apartment# 1A, Road# 1/B, Banani, Chairman Bari, Dhaka-1213, Bangladesh
| | - Shameema Ferdous
- Biomedical Research Foundation, House #7, Apartment# 1A, Road# 1/B, Banani, Chairman Bari, Dhaka-1213, Bangladesh
| | - Nusrat Nahar
- Thalassemia Foundation Hospital, Dhaka, Bangladesh
| | | | - Mohammad Arifuzzaman
- Biomedical Research Foundation, House #7, Apartment# 1A, Road# 1/B, Banani, Chairman Bari, Dhaka-1213, Bangladesh
| | - Mohammad Abdur Razzaque
- Biomedical Research Foundation, House #7, Apartment# 1A, Road# 1/B, Banani, Chairman Bari, Dhaka-1213, Bangladesh.,Trinity College, Dublin, Ireland
| | - Rabiul Alam
- Biomedical Research Foundation, House #7, Apartment# 1A, Road# 1/B, Banani, Chairman Bari, Dhaka-1213, Bangladesh
| | - Sonia Aziz
- Department of Economics & Business, Moravian College, Bethlehem, USA
| | | | - Abdur Rahim
- Thalassemia Foundation Hospital, Dhaka, Bangladesh
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Echeverría N, Moreno P, Cristina J. Molecular Evolution of Hepatitis C Virus: From Epidemiology to Antiviral Therapy (Current Research in Latin America). HUMAN VIROLOGY IN LATIN AMERICA 2017:333-359. [DOI: 10.1007/978-3-319-54567-7_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2025]
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Gómez-Gutiérrez C, Chávez-Tapia NC, Ponciano-Rodríguez G, Uribe M, Méndez-Sánchez N. Prevalence of hepatitis C virus infection among patients undergoing haemodialysis in Latin America. Ann Hepatol 2015; 14:807-814. [PMID: 26436352 DOI: 10.5604/16652681.1171751] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Hepatitis C infection is a worldwide problem. The global prevalence of the hepatitis C virus (HCV) averages 3%. Moreover, its prevalence among patients undergoing haemodialysis (HD) varies worldwide, ranging from as low as 1% to up to 70%. There are few data on its prevalence in developing countries, and even less information is available on HD patients. A literature review revealed that the prevalence of HCV infection among patients undergoing HD in Latin America ranges from 4.2 to 83.9%, with most data stemming from Argentina, Brazil, Mexico, Peru, Chile, Venezuela and Cuba. The most common genotype was genotype 1, and subtype 1b was the most frequent. The risk factors associated with this condition were the duration of the HD treatment and blood transfusion before hepatitis C screening. In addition, HCV RNA detection by polymerase chain reaction is crucial for the diagnosis of HCV infection in HD patients. Trials using combinations of new oral antiviral drugs, such as sofosbuvir and combo (ombitasvir, paritaprevir, ritonavir and dasabuvir), should be the next step in the improvement of care among HD patients with HCV, because these therapeutic agents apparently do not require dose adjustment according to renal function. Finally, information on this subgroup of patients remains unavailable in some countries; therefore, additional studies are needed to determine the prevalence trend of HCV infection in these populations.
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Affiliation(s)
| | | | | | - Misael Uribe
- Liver Research Unit. Medica Sur Clinic & Foundation, Mexico City, Mexico
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Jafroodi M, Davoudi-Kiakalayeh A, Mohtasham-Amiri Z, Pourfathollah AA, Haghbin A. Trend in Prevalence of Hepatitis C Virus Infection among β-thalassemia Major Patients: 10 Years of Experience in Iran. Int J Prev Med 2015; 6:89. [PMID: 26445636 PMCID: PMC4587076 DOI: 10.4103/2008-7802.164832] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 04/13/2015] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) is the leading cause of transfusion transmitted infections (TTIs) among patients with β-thalassemia major. A high prevalence of HCV was reported among these patients. The aim of this study is seeking the trend of the prevalence of HCV infection among the patients with b-thalassemia major in Guilan province, Northern Iran over a 10-year period. METHODS A retrospective study was conducted on 1113 patients with b-thalassemia major in the Guilan province, northern Iran from 2002 to 2012, using multiple data sources. A blood sample was taken from each patient, and a questionnaire regarding demographic data and risk factors was completed for them. Enzyme-linked immunosorbent assay and recombinant immunoblot assay for HCV were performed in all cases. A stepwise forward logistic regression analysis was done. RESULTS The prevalence of hepatitis C infection among β-thalassemia major patients was 13.6%. The risk of hepatitis C among β-thalassemia major patients was greater before screening program for HCV (odds ratio = 9.6, 95% confidence interval: 2.3-40.5). In addition, the prevalence of anti-HCV seropositivity was decreased dramatically among patients who have received transfusions after implementation of blood donor screening for HCV. There were no positive HCV cases in the patients younger than 10 years. CONCLUSIONS The risk of TTIs including HCV can be reduced by implementing screening program for healthy blood.
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Affiliation(s)
- Maryam Jafroodi
- Department of Hematology/Oncology, Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Davoudi-Kiakalayeh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran ; Department of Neurobiology, Care Science and Society (NVS), H1, Division of Family Medicine, Karolinska Institutet, Sweden, Iran
| | - Zahra Mohtasham-Amiri
- Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Akbar Pourfathollah
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Azade Haghbin
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
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Lopez L, Flichman D, Mojsiejczuk L, Gonzalez MV, Uriarte R, Campos R, Cristina J, Garcia-Aguirre L. Genetic variability of hepatitis B virus in Uruguay: D/F, A/F genotype recombinants. Arch Virol 2015; 160:2209-17. [PMID: 26100402 DOI: 10.1007/s00705-015-2477-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 05/29/2015] [Indexed: 12/22/2022]
Abstract
Hepatitis B virus (HBV) infection is a serious global health problem. Approximately 2 billion people worldwide have been infected, and approximately 350 million individuals currently suffer from HBV-induced chronic liver infection, which causes 600,000 deaths annually from chronic hepatitis, cirrhosis and hepatocellular carcinoma. HBV is classified in eight genotypes (A-H), and two more have been proposed (I-J). In this paper, complete genome sequences of nine Uruguayan HBV are reported. Five samples belong to genotype F1b and one to genotype A2. Three HBV recombinants were detected: A1/F1b, A2/F1b and D3/F1b. The following mutations were detected: a G1896A substitution, a 33-nucleotide deletion from position 2896 to 2928 in the Pre-S1 region involving Pre-S1 residues 3-13, a 33-nt deletion in the Pre-S1 region involving nt 2913-2945 and Pre-S1 residues 9-19. More F genotypes strains than expected were detected in this study, supporting the hypothesis that there are more people of indigenous origin than declared in our population. Also, one third of the samples analyzed were recombinants. This cannot be explained by the low HBV prevalence in Uruguay, but a high HBV infection rate in drug addicts and dialysis patients could act in favor of multiple-genotype HBV infections that could lead to recombination.
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Affiliation(s)
- L Lopez
- Laboratorio de Virología Molecular, Facultad de Ciencias, Centro de Investigaciones Nucleares, Udelar, Montevideo, Uruguay
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Arroyave Ospina JC, Alvarez Flórez CM, Correa Arango G, Balcázar Morales N, Arbeláez Montoya MP, Navas Navas MC. Infección por el virus de la hepatitis C en individuos transfundidos antes de 1994 en Antioquia, Colombia. ACTA ACUST UNITED AC 2014. [DOI: 10.22516/25007440.435] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Introducción: la infección por el virus de la hepatitis C es un problema de salud pública. Según datos de la Organización Mundial de la Salud, se estiman 184 millones de casos de infección por VHC en el mundo. El principal factor de riesgo en países en desarrollo corresponde a la transfusión de componentes sanguíneos. En Colombia, en 1993, se reglamentó el tamizaje serológico en los bancos de sangre para diferentes agentes infecciosos, incluido el VHC; sin embargo, los datos de infección por VHC en la población transfundida antes de esta fecha es limitada.
Objetivo: describir la frecuencia de infección por el VHC en una población de individuos transfundidos antes de 1994 en Antioquia.
Materiales y Métodos: un total de 166 individuos transfundidos antes de 1994 aceptaron participar en el estudio. A partir de las muestras de suero se realizó la detección de anticuerpos totales contra el VHC (anti-VHC) mediante prueba de ELISA y en las muestras positivas se determinó la presencia del genoma viral por RT-PCR de la región no codificante 5’.
Resultados y conclusiones: en el población de estudio se encontró una frecuencia de anticuerpos anti-VHC de 6,6% (11/166) y presencia del genoma del VHC en 7/11 de las muestras; el genotipo 1 se identificó en 4 de las muestras. No se encontró asociación de otros factores de riesgo diferentes a transfusión en los individuos con marcadores de infección por el VHC. Este estudio aporta datos a la epidemiología de la infección por el VHC en Colombia.
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Hussein E. Blood donor recruitment strategies and their impact on blood safety in Egypt. Transfus Apher Sci 2013; 50:63-7. [PMID: 24325889 DOI: 10.1016/j.transci.2013.11.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Revised: 10/30/2013] [Accepted: 11/01/2013] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Because of the high incidence of HCV, blood safety presents a serious challenge in Egypt. Given the constrained economy which limits the implementation of nucleic acid amplification technology, proper recruitment of blood donors becomes of paramount importance. To evaluate the effectiveness of blood donor recruitment strategies, the seroprevalence of positive infectious markers among blood donors was studied. MATERIALS AND METHODS Donors' records covering the period from 2006-2012 were reviewed. Blood donations were screened for HCV antibodies, HBs antigen (HBsAg), HIV-1 and 2 and syphilis antibodies. RESULTS Of 308,762 donors, 63.4% were voluntary donors (VD). VD of 2011-2012 were significantly younger than family replacement donors (RD) .The overall prevalences of HCV antibodies, HBsAg, HIV and syphilis antibodies were 4.3%, 1.22%, 0.07%, and 0.13%, respectively. All tested markers (except HIV) were significantly higher among RD, when compared to VD (P<0.0001). A consistent steady trend for decrease in HCV seropositivity was observed in RD and VD from 8.9% and 4.2% to 3.8% and 1.5%, respectively. A trend for decrease in HBsAg was demonstrated in VD from 1.2% to 0.53%. CONCLUSION The decreasing trends in HCV antibody and HBs antigen is promising and may reflect the improved donor selection criteria.
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Affiliation(s)
- Eiman Hussein
- Departments and Institutions, Cairo University Blood Bank, Clinical Pathology Department, Cairo University, Cairo, Egypt(1).
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Onuigbo MAC, Onuigbo NTC. De novo HBV infection in a Mayo Clinic hemodialysis population: economic impact of reduced HBV testing and a call for changes in current US CDC guidelines on HBV testing protocols. Hemodial Int 2013; 16 Suppl 1:S32-8. [PMID: 23036034 DOI: 10.1111/j.1542-4758.2012.00748.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Hemodialysis (HD) exposes end-stage renal disease patients to significantly higher risks for Hepatitis B Virus (HBV) infection, a major public health scourge. Therefore, current US CDC guidelines, last revised in 2001, call for monthly HbsAg tests. The charge to Medicare per HbsAg test is $100. In an economic analysis, we hypothesized that in the new environment of Medicare Fee Bundling, this is unwise and wasteful if de novo HBV infection rate among HD patients is <1%. We determined de novo HBV infection rate among a Mayo Clinic HD cohort, July 2000-July 2010. A retrospective analysis of all relevant medical records of the cohort was completed to identify de novo HBV infection. Nine hundred sixty-five HD patients were analyzed. One case of de novo HBV infection was identified in a 54-year old known IV drug user, a previous Hepatitis C carrier. This translates to a de novo HBV case incidence rate of 0.1%. De novo HBV infection among HD patients in the US, 2000-2010, is only 0.1%. In the early 1970s, rates were as high as 30%. We recommend 3-monthly HbsAg testing, but to continue current monthly testing for IV drug users and other high-risk groups. Huge cost savings would result, without any compromise of quality outcomes. With over 500,000 HD patients, this represents a mind-boggling $40 billion savings in Medicare charges over 10 years. The US CDC should revise these outdated guidelines, last revised in 2001, to fall in line with current clinical realities on the ground.
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El-Faramawy AAM, El-Rashidy OF, Tawfik PH, Hussein GH. Transfusion transmitted hepatitis: where do we stand now? A one center study in upper egypt. HEPATITIS MONTHLY 2012; 12:286-91. [PMID: 22690237 PMCID: PMC3360939 DOI: 10.5812/hepatmon.852] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Revised: 02/01/2012] [Accepted: 03/02/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND Despite progress made in the prevention of transfusion-transmitted infections (TTI) over the last few years, they continue to be a problem in many parts of the world, particularly in multitransfused patients. OBJECTIVES The aim of this study was to estimate the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and to evaluate the screening and vaccination program among our cohort of multitransfused children from Qena, Upper Egypt. PATIENTS AND METHODS One-hundred children suffering from diseases requiring repeated blood transfusions were included in the study. They were classified into group 1, which included 67 children with thalassemia, and group 2, which included 33 children with hemophilia. Screening for hepatitis B surface antigen, hepatitis B surface antibody, hepatitis B core antibody and antibody to HCV was done using a second-generation enzyme-linked immunosorbent assay technique. RESULTS Only 12% of all patients were either acutely or chronically infected with HBV. 46% were immune due to previous vaccination, whereas 39% of patients were not protected from HBV infection. HCV antibodies were positive in 45% of cases. Seventy-eight patients had a complete hepatitis B vaccination in the form of three doses as documented by birth certificate. Thirty-six patients mentioned history suggestive of hepatitis. The prevalence of the studied hepatitis markers was similar in both the thalassemia and hemophilia groups of children. CONCLUSIONS Transfusion-transmitted hepatitis is still a major problem for multitransfused children in Egypt. More effort is required to reduce the infection rate through proper screening of blood and blood products, strict emphasis on receiving the vaccine, regular follow-up for those children with a hepatitis B antibody titer, and providing booster doses for those in need.
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Affiliation(s)
| | | | - Perihan Hamdy Tawfik
- The Clinical Pathology Department, Faculty of Medicine, Ain Shams, University, Cairo, Egypt
| | - Galal Helmy Hussein
- The Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Transfusion Transmitted Hepatitis: Where Do We Stand Now? A One Center Study in Upper Egypt. HEPATITIS MONTHLY 2012. [DOI: 10.5812/hepatmon.5986] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Prevalence and incidence of hepatitis C virus in hemodialysis patients in British Columbia: Follow-up after a possible breach in hemodialysis machines. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2011; 20:e19-23. [PMID: 20514154 DOI: 10.1155/2009/641941] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Accepted: 09/04/2008] [Indexed: 01/20/2023]
Abstract
BACKGROUND A possible breach of the transducer protector in specific dialysis machines was reported in June 2004 in British Columbia (BC), which led to testing of hemodialysis patients for hepatitis C virus (HCV), hepatitis B virus (HBV) and HIV. This testing provided an opportunity to examine HCV incidence, prevalence and coinfection with HBV and HIV, and to compare anti-HCV and HCV polymerase chain reaction (PCR). METHODS The results of hemodialysis patients who were dialyzed on the implicated machines (65% of BC dialysis patients), and tested for HCV, HBV and HIV, between June 1, 2004, and December 31, 2004, were reviewed and compared with available previous results. RESULTS Of 1286 hemodialysis patients with anti-HCV and/or HCV-PCR testing, 69 (5.4%) tested positive. Two HCV genotype 4 seroconversions were identified. HCV incidence rate on dialysis was 78.8 cases per 100,000 person-years. Younger age, history of renal transplant and past HBV infection were associated with HCV infection. No occult infection was identified using HCV-PCR. INTERPRETATION Hemodialysis patients had three times the HCV prevalence rate of the general BC population, and more than 20 times the incident rate of the general Canadian population. One of the two seroconversions occurred before the testing campaign; the patient was likely infected during hemodialysis in South Asia. The other was plausibly a late seroconversion following renal transplant in South Asia. Nosocomial transmission cannot be ruled out because both patients were dialyzed in the same centre. Baseline and annual anti-HCV testing is recommended. HCV-PCR should be considered at baseline for persons with HCV risk factors, and for returning travellers who received dialysis in HCV-endemic countries to identify HCV infection occurring outside the hemodialysis unit.
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Vidja PJ, Vachhani JH, Sheikh SS, Santwani PM. Blood transfusion transmitted infections in multiple blood transfused patients of Beta thalassaemia. Indian J Hematol Blood Transfus 2011; 27:65-9. [PMID: 22654294 DOI: 10.1007/s12288-011-0057-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2010] [Accepted: 02/09/2011] [Indexed: 11/30/2022] Open
Abstract
Transfusion Transmitted Infection (TTI) continue to be a problem in many parts of world and multi-transfused patients of beta thalassaemia major are at a particularly increased risk of TTI. This study is aimed to estimate the prevalence of blood TTI in multiple blood transfused patients of beta thalassaemia major. Cross-sectional study of 200 multi-transfused patients of beta thalassaemia major, who were interviewed using a structured questionnaire and history was taken regarding sero-status of HIV (Human Immunodeficiency Virus), HBV (Hepatitis B Virus), HCV (Hepatitis C Virus) infection from their case papers. This study was conducted at the department of Pathology, M.P. Shah medical college, Jamnagar and Thalassemia ward, G.G. Hospital, Jamnagar (Gujarat, India) from March to May 2010. Out of 200 multiple blood transfused patients 7% patients were infected with TTI. Total 9 male patients and 5 female patients were infected with TTI. The seroreactivity for HIV was 3% (06/200); 1% (02/200) were males and 2% (04/200) were females. The seroreactivity for HBV was 2% (04/200) all were males. The seroreactivity for HCV was 2% (04/200); 1.5% (03/200) were males and 0.5% (01/200) was female. HIV, HBV, HCV infections are most prevalent TTI among multiple blood transfused patients of beta thalassemia major, and remains a major health problem for these patients.
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Affiliation(s)
- Prakash J Vidja
- Department of Pathology, M.P.Shah Medical College, Jamnagar, 361008 Gujarat India
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The association of infection and clinical severity in sickle cell anaemia patients. Trans R Soc Trop Med Hyg 2011; 105:121-6. [PMID: 21216418 DOI: 10.1016/j.trstmh.2010.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Revised: 11/12/2010] [Accepted: 11/12/2010] [Indexed: 11/20/2022] Open
Abstract
Sickle cell anaemia (SCA) patients have a high risk of infection. We retrospectively investigated the prevalence of infection among SCA patients from Bahia, Brazil. A total of 1415 SCA patients were studied between 1995 and 2009: 190 (13.4%) had hepatitis C virus (HCV), 67 (4.7%) had human T-lymphotropic virus type I (HTLV-I), 44 (3.1%) had hepatitis B virus (HBV), 40 (2.8%) had Chagas' disease, 11 (0.8%) had human immunodeficiency virus (HIV), and 5 (0.4%) had syphilis. Patients with HCV infection had a higher risk of hospitalisation (OR=1.52, 95% Cl: 1.07-2.17, P=0.020), bone disorders (OR=1.94, 95% Cl: 1.15-3.27, P=0.011), stroke (OR=2.17, 95% Cl: 1.12-4.14, P=0.017), painful crisis (OR=1.61, 95% Cl: 1.17-2.22, P=0.004) and leg ulcers (OR=1.61, 95% Cl: 1.04-3.03, P=0.031). Patients with HBV infection had a higher risk for bone disorders (OR=4.90, 95% Cl: 2.08-11.54, P<.010), stroke (OR=3.01, 95% Cl: 1.29-6.04, P=0.007), painful crisis (OR=3.51, 95% Cl: 1.62-7.63, P<0.001), acute chest syndrome (ACS) (OR=2.66, 95% Cl: 1.34-5.28, P=0.004), leg ulcers (OR=6.60, 95% Cl: 3.37-12.91, P<.001) and vaso-occlusive crisis (OR=6.34, 95% Cl: 1.96-20.66, P<0.001). Patients with HTLV-I infection had a high risk for bone disorders (OR=2.94, 95% Cl: 1.28-6.74, P=0.011), respiratory failure (OR=2.66, 95% Cl: 1.26-5.51, P=0.012), leg ulcers (OR=3.27, 95% Cl: 1.69-6.11, P<.001), painful crisis (OR=1.82, 95% Cl: 1.07-3.13, P=0.025) and ACS (OR=1.85, 95% Cl: 1.10-3.41, P<.047). SCA patients with HCV infection had increased triglycerides and low-density lipoprotein cholesterol (P=0.036; P=0.027), iron serum (P=0.016) and ferritin (P=0.007). These results reveal important roles for these infections in SCA patients' clinical outcomes, and studies are warranted to determine the mechanisms utilised by these agents and their involvement in disease severity.
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Paniagua R, Villasís-Keever A, Prado-Uribe MDC, Ventura-García MDJ, Alcántara-Ortega G, Ponce de Leon SR, Cure-Bolt N, Rangel-Frausto S. Elevated Prevalence of Hepatitis B in Mexican Hemodialysis Patients. A Multicentric Survey. Arch Med Res 2010; 41:251-4. [DOI: 10.1016/j.arcmed.2010.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Accepted: 04/23/2010] [Indexed: 11/25/2022]
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Moreno P, Alvarez M, López L, Moratorio G, Casane D, Castells M, Castro S, Cristina J, Colina R. Evidence of recombination in Hepatitis C Virus populations infecting a hemophiliac patient. Virol J 2009; 6:203. [PMID: 19922637 PMCID: PMC2784780 DOI: 10.1186/1743-422x-6-203] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Accepted: 11/18/2009] [Indexed: 12/20/2022] Open
Abstract
Background/Aim Hepatitis C virus (HCV) infection is an important cause of morbidity and mortality in patients affected by hereditary bleeding disorders. HCV, as others RNA virus, exploit all possible mechanisms of genetic variation to ensure their survival, such as recombination and mutation. In order to gain insight into the genetic variability of HCV virus strains circulating in hemophiliac patients, we have performed a phylogenetic analysis of HCV strains isolated from 10 patients with this kind of pathology. Methods Putative recombinant sequence was identified with the use of GARD program. Statistical support for the presence of a recombination event was done by the use of LARD program. Results A new intragenotypic recombinant strain (1b/1a) was detected in 1 out of the 10 hemophiliac patient studied. The recombination event was located at position 387 of the HCV genome (relative to strain AF009606, sub-type 1a) corresponding to the core gene region. Conclusion Although recombination may not appear to be common among natural populations of HCV it should be considered as a possible mechanism for generating genetic diversity in hemophiliacs patients.
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Affiliation(s)
- Pilar Moreno
- Laboratorio de Virología Molecular, Centro de Investigaciones Nucleares, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay.
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Seroprevalencia de infección por virus de la hepatitis B y por virus de la inmunodeficiencia humana en una población de pacientes con múltiples transfusiones en cuatro hospitales, Colombia, Sur América. BIOMEDICA 2009. [DOI: 10.7705/biomedica.v29i2.25] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Elghannam DM, Aly RM, Goda EF, Eltoraby EE, Farag RE. Clinical significance of antibody to hepatitis B core antigen in multitransfused hemodialysis patients. Asian J Transfus Sci 2009; 3:14-7. [PMID: 20041091 PMCID: PMC2798778 DOI: 10.4103/0973-6247.45256] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND In spite of the progress made in the prevention of transfusion transmitted infections over the last few years, transmission of HBV infection through transfusion of HBsAg negative blood has been documented. OBJECTIVES To assess the frequency and clinical significance of anti-HBc in multitransfused hemodialysis patients. MATERIALS AND METHODS One hundred and forty-three hemodialysis patients who had been receiving blood regularly with an average of 39.4 +/- 7.579 months on hemodialysis were enrolled in this study. HBV markers (HBsAg, anti-HBc, anti-HBs) were measured in these patients and in 100 healthy controls by the ELISA technique. The following data were obtained for all patients: socio demographic data, number of blood transfusions and some laboratory investigations. RESULTS In our patients, anti-HBc was positive in 9%, anti HBs in 7%, coexistant HbsAg/anti-HBc in 2.8% and anti HBc/anti HBs in 18.9%, meanwhile no patients were positive for HBsAg alone. In patients with only positive anti-HBc, the levels of anti-HBc were significantly related to abnormal results of liver function. In patients with positive anti-HBs/anti-HBc (n = 27), 18 patients had abnormal liver function, and 9 patients had normal liver function with no significant difference between them. CONCLUSIONS This study suggests that hepatitis B prevalence in our multitransfused hemodialysis patients is far in excess of that anticipated on the basis of HBsAg prevalence. Absence of HBsAg in the blood of hemodialyzed patients may not be sufficient to ensure lack of circulating HBV, and isolated positivity of anti-HBc may be a possible indicator of active hepatitis B infection.
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Affiliation(s)
- Doaa M. Elghannam
- Department of Clinical Pathology and of Internal Medicine, Mansoura University, Mansoura- Egypt
| | - Rabab M. Aly
- Department of Clinical Pathology and of Internal Medicine, Mansoura University, Mansoura- Egypt
| | - Enas F. Goda
- Department of Clinical Pathology and of Internal Medicine, Mansoura University, Mansoura- Egypt
| | - Ehab E. Eltoraby
- Department of Clinical Pathology and of Internal Medicine (Renal Dialysis Unit), Mansoura University, Mansoura- Egypt
| | - Raghda E. Farag
- Department of Tropical Medicine, Mansoura University, Mansoura- Egypt
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Wicker S, Cinatl J, Berger A, Doerr HW, Gottschalk R, Rabenau HF. Determination of risk of infection with blood-borne pathogens following a needlestick injury in hospital workers. ACTA ACUST UNITED AC 2008; 52:615-22. [PMID: 18664514 DOI: 10.1093/annhyg/men044] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Our paper measures the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) in patients at the University Hospital of Frankfurt/Main, and correlates the prevalence with risk factors for exposure to and infection of healthcare workers (HCWs). Individual risk assessments were calculated for exposed HCWs. METHODS Survey of patients admitted to a German University Hospital. Markers for HBV, HCV and HIV were studied and evaluated statistically. Data on needlestick injuries (NSIs) among HCWs were correlated with the prevalence of infectious patients. RESULTS The HBV, HCV and HIV prevalence among patients at the University Hospital were 5.3% (n = 709/13 358), 5.8% (n = 1167/20 163) and 4.1% (n = 552/13 381), respectively. Our results indicate that the prevalence of blood-borne infections in patients was about nine times higher for HBV, approximately 15 times higher for HCV and approximately 82 times higher for HIV than in the overall German population. The highest risk of acquiring a blood-borne infection via NSI was found in the department of internal medicine due to increased prevalence of blood-borne pathogens in patients under treatment. CONCLUSIONS While accidental NSIs were most frequent in surgery, the nominal risk of blood-borne virus infection was greatest in the field of internal medicine. The study underlines the importance of HBV vaccinations and access to HIV-post-exposure prophylaxis for HCWs as well as the use of anti-needlestick devices.
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Affiliation(s)
- Sabine Wicker
- Occupational Health Service, University Hospital, Johann Wolfgang Goethe University of Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany.
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Ferreira MRMN, Lonardoni MVC, Bertolini DA. Hepatitis C: serological and molecular diagnosis and genotype in haemophilic patients at the Regional Hemocenter of Maringá, Maringá PR Brazil. Haemophilia 2008:HAE1676. [PMID: 18355265 DOI: 10.1111/j.1351-8216.2008.01676.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Prior to the process of viral inactivation in the 1980s most haemophilic patients were infected with hepatitis C virus, currently one of the disease's main causes. The prevalence of infection by hepatitis C virus in haemophilic patients enrolled in the Hemocenter of the Regional University Hospital maintained by the State University of Maringá is evaluated from social and epidemiologic data and from serum and molecular tests. Possible association between haemophilia's type and severity, type of treatment, data of start of treatment and hepatic enzyme rates of Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) was verified. Sixty-nine haemophilic patients, 82.6% with haemophilia A and 17.4% with haemophilia B, in the 1 - 67 years age bracket, average age 22 years, were investigated. Whereas anti-HCV was investigated with third generation immunoenzymatic test and confirmed by HCV-RNA, LiPA technique determined genotypes. HCV-prevalence infection reached 37.7% and 21.7% respectively when antibody anti-HCV and HCV-RNA detection and associated significantly (p<0.05) with type of treatment, date of start of treatment and ALT and AST hepatic enzyme rates are taken into account. HCV genotype 1 predominated (53.3%) followed by genotype 3 (40.0%) and genotype 2 (6.7%). HCV predominance is high in haemophilic patients although infection has not been reported in patients under the age of 17.
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Affiliation(s)
- M R M N Ferreira
- Course of After-graduation in Sciences of the Health, State University of Maringá, Maringá, PR, Brazil
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Batey RG. Controversies in and challenges to our understanding of hepatitis C. World J Gastroenterol 2007; 13:4168-76. [PMID: 17696244 PMCID: PMC4250614 DOI: 10.3748/wjg.v13.i31.4168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Discovered in 1989, the hepatitis C virus (HCV) continues to cause significant morbidity and mortality world-wide despite a huge research commitment to defining and understanding the virus and the disease it causes. This paper discusses a number of areas where progress in the management of the HCV have not kept pace with the scientific understanding of the HCV. It is suggested that in the fields of HCV prevention and providing access to treatment, practice falls short of what could be achieved. The role of alcohol in the pathogenesis of HCV liver injury is discussed. Discrimination against those with HCV infection and particularly those in prison settings fails to match good clinical practice. The complicated processes of sharing information between specialty groups is also discussed in an attempt to optimise knowledge dissemination in this field.
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Affiliation(s)
- Robert G Batey
- Drug and Alcohol Clinical Services, Hunter New England Area Health Services, Newcastle, New South Wales, Australia.
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