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Mei X, Lu H. Prevalence, diagnosis, and treatment of hepatitis C in Mainland China. Glob Health Med 2021; 3:270-275. [PMID: 34782868 PMCID: PMC8562088 DOI: 10.35772/ghm.2021.01080] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 09/30/2021] [Accepted: 10/08/2021] [Indexed: 12/13/2022]
Abstract
Infection with the hepatitis C virus (HCV) is a major cause of liver disease and hepatocellular carcinoma in China. Rapid economic development has had an enormous impact on the epidemiology and treatment of hepatitis C. The prevalence of anti-HCV antibodies in Mainland China is approximately 0.91%, and use of injected drugs has become the main route of HCV transmission in China. Reimbursement for 3 direct-acting antivirals (DAAs) has been approved by the National Medical Insurance scheme in China, which ensures the accessibility of treatment for an HCV infection. To improve the awareness of treatments for hepatitis C among medical personnel and the rate of in-hospital screening for HCV, the Chinese Medical Association has formulated guidelines for the diagnosis and treatment of hepatitis C and a process of in-hospital screening for hepatitis C in China. These efforts have standardized the screening, diagnosis, treatment, and management of hepatitis C. Based on the international strategy for micro-elimination of hepatitis C, China has also screened and treated groups at risk of hepatitis C infection, and this has reduced the number of the infected. The current review describes the status of and issues with the prevalence, diagnosis, and treatment of hepatitis C in Mainland China as part of the global effort to eliminate viral hepatitis by 2030.
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Affiliation(s)
- Xue Mei
- Department of Severe Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Hongzhou Lu
- Department of Infections Disease, Shenzhen Third People’s Hospital, Shenzhen, China
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2
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Prevalence of positivity to antibodies to hepatitis C virus among volunteer blood donors in China: a meta-analysis. Public Health 2021; 199:87-95. [PMID: 34571442 DOI: 10.1016/j.puhe.2021.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 06/17/2021] [Accepted: 07/09/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Safe blood transfusion plays an important role in the prevention of transfusion-transmissible infections, and hepatitis C virus (HCV) infection is one of the major problems associated with this procedure. This meta-analysis aimed to determine the prevalence of HCV infection in Chinese blood donors. STUDY DESIGN The study design of this study is a meta-analysis. METHODS Eligible studies were retrieved from PubMed, Embase, China National Knowledge Infrastructure, China Science and Technology Journal Database and Wanfang literature databases from 2010 to 2020. The effect measure was presented as HCV prevalence with a 95% confidence interval (CI). Q test was used to assess the heterogeneity, and the I2 statistics was determined to decide whether a random effects model or a fixed effects model should be used as the pooling method. Subgroup analyses were also conducted. RESULTS A total of 62 eligible studies, including 9,007,220 HCV blood donors, were analysed. Of the total blood donors, 35,017 were infected with HCV. The pooled HCV prevalence was 0.415% (95% CI: 0.371-0.458). The subgroup analysis revealed that the prevalence of positivity to anti-HCV antibodies was significantly different in each year (P < 0.05). However, no significant difference was observed in HCV prevalence in terms of sex. Moreover, the prevalence of positivity to anti-HCV was remarkably higher in first-time blood donors than in repeat blood donors (P < 0.05), and the rate of HCV infection among university students was significantly lower than that among soldiers (P < 0.05). CONCLUSIONS The rate of HCV infection showed a downward trend from 2010 to 2014, increased in 2015-2016, and finally decreased in 2017-2018. Thus, the prevalence of HCV infection has decreased in Chinese blood donors after comprehensive prevention and treatment.
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Bettaieb J, Chouikha A, Khedhiri M, Kharroubi G, Badreddine M, Bel Hadj Hmida N, Gharbi A, Hammemi W, Sadraoui A, Ben Yahia A, Meddeb Z, Ben Salah A, Triki H. Hepatitis C virus epidemiology in Central-West Tunisia: a population-based cross-sectional study. Arch Virol 2019; 164:2243-2253. [PMID: 31179516 DOI: 10.1007/s00705-019-04308-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 05/09/2019] [Indexed: 12/18/2022]
Abstract
This study aimed to assess the seroprevalence, viraemia and genotype distribution of hepatitis C virus (HCV) in a region in Central-West Tunisia. A door-to-door cross-sectional study was conducted on a randomly selected sample. A total of 3178 individuals aged 5 to 74 years and members of 935 families were investigated. Seroprevalence of HCV was assessed using ELISA tests. The viral load was determined by real-time RT-PCR, and HCV genotyping was conducted by amplification and sequencing in the NS5b genomic region. The global prevalence of HCV antibodies was 3.32% (95% confidence interval [CI]: 2.72-4.00). It was significantly higher in women: 4.47% vs. 2.16% in men, p = 0.001. Seroprevalence increased with age, and the highest rates were found in the 50- to 59-year-old age group (12.90%, 95% CI: 9.45-16.86), suggesting a cohort effect with very low contribution of intrafamilial transmission. Genotyping showed a predominance of subtype 1b (84.6%), with cocirculation of subtypes 2c (9.6%), 1a (1.9%), 1d (1.9%) and 2k (1.9%), similar to the previously reported genotype distribution in Tunisia and with no genetic clusters specific to the study region. These results indicate a higher endemicity of HCV infection when compared to the previously reported nationwide surveillance data. This study provides valuable data that can contribute to current strategies to eliminate hepatitis C.
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Affiliation(s)
- Jihene Bettaieb
- Department of Medical Epidemiology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Research Laboratory: "Transmission, Controle et Immunobiologie des Infections" (LR11-IPT02), Tunis, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Anissa Chouikha
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, 13 Place Pasteur BP-74, 1002, Tunis Belvedere, Tunisia. .,Research Laboratory: "Transmission, Controle et Immunobiologie des Infections" (LR11-IPT02), Tunis, Tunisia. .,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.
| | - Marwa Khedhiri
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, 13 Place Pasteur BP-74, 1002, Tunis Belvedere, Tunisia.,Research Laboratory: "Transmission, Controle et Immunobiologie des Infections" (LR11-IPT02), Tunis, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Ghassen Kharroubi
- Department of Medical Epidemiology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Research Laboratory: "Transmission, Controle et Immunobiologie des Infections" (LR11-IPT02), Tunis, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Malek Badreddine
- Department of Medical Epidemiology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Nabil Bel Hadj Hmida
- Department of Medical Epidemiology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Research Laboratory: "Transmission, Controle et Immunobiologie des Infections" (LR11-IPT02), Tunis, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Adel Gharbi
- Department of Medical Epidemiology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Research Laboratory: "Transmission, Controle et Immunobiologie des Infections" (LR11-IPT02), Tunis, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Walid Hammemi
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, 13 Place Pasteur BP-74, 1002, Tunis Belvedere, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Amel Sadraoui
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, 13 Place Pasteur BP-74, 1002, Tunis Belvedere, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Ahlem Ben Yahia
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, 13 Place Pasteur BP-74, 1002, Tunis Belvedere, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Zina Meddeb
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, 13 Place Pasteur BP-74, 1002, Tunis Belvedere, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Afif Ben Salah
- Department of Medical Epidemiology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Research Laboratory: "Transmission, Controle et Immunobiologie des Infections" (LR11-IPT02), Tunis, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.,Department of Community and Family Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Henda Triki
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, 13 Place Pasteur BP-74, 1002, Tunis Belvedere, Tunisia.,Research Laboratory: "Transmission, Controle et Immunobiologie des Infections" (LR11-IPT02), Tunis, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
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Xu R, Yu Y, Leitch ECM, Wang M, Huang K, Huang J, Tang X, Liao Q, Song D, Shan Z, Li C, Mclauchlan J, Rong X. HCV genotype 6 prevalence, spontaneous clearance and diversity among elderly members of the Li ethnic minority in Baisha County, China. J Viral Hepat 2019; 26:529-540. [PMID: 30629794 DOI: 10.1111/jvh.13062] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 11/16/2018] [Accepted: 11/25/2018] [Indexed: 01/01/2023]
Abstract
The epidemiology of hepatitis C virus varies widely across geographical regions and ethnic groups. Our previous study showed that 6 strains isolated from Baisha County, Hainan Island, China, were all new genotype 6 (gt6) subtypes which differed significantly from subtypes of other regions. In the current study, we conducted a comprehensive epidemiological survey of HCV in the Li ethnic group, native to Baisha County. Anti-HCV antibodies were detected by 2 independent ELISAs in all participants, and positive results confirmed by the recombinant immunoblot assay (RIBA) and HCV RNA viral loads were measured. Univariate chi-square test and multivariable logistic regression analyses were used to determine the risk factors for HCV infection and spontaneous clearance rates. Indeterminate RIBA results were excluded or included in analyses; consequently, findings were expressed as a range. Direct sequencing of partial regions within NS5B and E1 was employed for genotyping. Among 1682 participants, 117 to 153 were anti-HCV positive (7.0%-9.1%), with 42.7%-52.6% confirmed to have cleared infection. Anti-HCV positivity was associated with older age (≥60 years) (OR = 0.02, 95% CI 0.01-0.05, P < 0.01) and surgery (OR = 2.75, 95% CI 1.36-5.57, P < 0.01), with no significant difference found between the HCV infection group and the HCV spontaneous clearance group. The gt6 subtype distribution characteristics of Baisha County were unique, complex and diverse. The sequences did not cluster with known gt6 subtypes but formed 4 Baisha community-specific groups. HCV infection in members of the Li minority ethnic group is characterized by high prevalence rates in the elderly, high spontaneous clearance rates and broad gt6 diversity.
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Affiliation(s)
- Ru Xu
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, Guangdong, China
| | - Yongjuan Yu
- Department of Clinical Laboratory, People's Hospital of Baisha Li Autonomous County, Hainan, China
| | | | - Min Wang
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, Guangdong, China
| | - Ke Huang
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, Guangdong, China
| | - Jieting Huang
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, Guangdong, China
| | - Xi Tang
- School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, Guangdong, China
| | - Qiao Liao
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, Guangdong, China
| | - Dandan Song
- School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhengang Shan
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, Guangdong, China
| | - Chengyao Li
- School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, Guangdong, China
| | - John Mclauchlan
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Xia Rong
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, Guangdong, China.,School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, Guangdong, China
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Gao Y, Yang J, Sun F, Zhan S, Fang Z, Liu X, Zhuang H. Prevalence of Anti-HCV Antibody Among the General Population in Mainland China Between 1991 and 2015: A Systematic Review and Meta-analysis. Open Forum Infect Dis 2019; 6:ofz040. [PMID: 30863789 PMCID: PMC6408870 DOI: 10.1093/ofid/ofz040] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 01/24/2019] [Indexed: 12/13/2022] Open
Abstract
Our study aims to estimate the burden of hepatitis C virus (HCV) infection among the general population in Mainland China. We searched 4 databases for studies of the prevalence of anti-HCV antibody among the general population. Studies that met the selection criteria were included in the meta-analysis. Ninety-four studies with 10729 929 individuals were finally included. Overall, the prevalence of anti-HCV antibody among the general population in Mainland China is 0.91% (95% confidence interval, 0.81%-1.03%). The prevalence rates of anti-HCV antibody were geographically different, with a range of 0.32%-6.51%, and the East and South of China had a relatively lower prevalence. The prevalence of anti-HCV antibody increased successively from 0.16% to 3.95% with advancing age. It was noteworthy that the prevalence of anti-HCV antibody decreased continuously from 2.09% to 0.45% during 1991-2010, whereas it increased to 0.58% during 2011-2015.
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Affiliation(s)
- Yuhua Gao
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Beijing, China
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jun Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Feng Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Zhongliao Fang
- Guangxi Key Laboratory of the Prevention and Control of Viral Hepatitis, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, Guangxi, China
| | - Xueen Liu
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Beijing, China
| | - Hui Zhuang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Beijing, China
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6
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Hu JH, Chen MY, Yeh CT, Chiu WN, Chiang MS, Chang ML. Effects of gender and age on prevalence of cholelithiasis in patients with chronic HCV infection: A community-based cross-sectional study in an HCV-hyperendemic area. Medicine (Baltimore) 2018; 97:e10846. [PMID: 29851796 PMCID: PMC6392741 DOI: 10.1097/md.0000000000010846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
This study investigated the effects of age and gender on the prevalence of cholelithiasis in patients with chronic HCV infection.Demographic and clinical data of 8489 subjects (3671 males, 4818 females; mean age 47.5 years) receiving township-wide health examinations between September 2012 and August 2013 were analyzed. The main endpoint was prevalence of cholelithiasis. Risk factors (age, gender, body mass index, concomitant diseases, lifestyle, laboratory parameters, and HCV status) were evaluated. Univariate and multivariate logistic regression analyses were performed to identify associations between cholelithiasis and variables.Cholelithiasis was more prevalent among HCV subjects than non-HCV subjects (females: 8.1% vs 4.2%; males: 9.1% vs 3.9%; both P < .001); rates ranged from 5.6% to 8.3% in females and 4.7% to 10.6% in males. HCV status and age were associated with cholelithiasis occurrence (OR = 2.17 for HCV vs non-HCV; OR = 2.44, 3.54 for age 45-55, and >55 vs <45 years; all P < .05). Multivariate analysis showed a significant association between cholelithiasis and age/sex interaction terms (OR = 0.517 for age >55 vs <45 for sex; P = .011). Cholelithiasis prevalence was significantly associated between age and sex interaction terms but not anymore if considering positive HCV status. All noninvasive tests for liver fibrosis were associated with cholelithiasis but only fibrosis-4 index was significantly associated (OR = 1.28, P = .019).Age, gender, and HCV infection are associated with increased risk and prevalence of cholelithiasis. After age of 55 years, cholelithiasis is more prevalent among HCV-positive males than females. Females of age 55 and more may be protected against cholelithiasis as sex hormones decrease.
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Affiliation(s)
- Jing-Hong Hu
- Department of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Yunlin
| | - Mei-Yen Chen
- College of Nursing, Chang Gung University of Science and Technology, Putz City
| | - Chau-Ting Yeh
- Liver Research Center and Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Nan Chiu
- Department of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Yunlin
| | - Ming-shih Chiang
- Department of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Yunlin
| | - Ming-Ling Chang
- Liver Research Center and Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Zhang H, Zhu X, Li Q, Lou J, Sun J, Shen Z, Chen H, Li X, Wu M, Li C, Liu J, Liu C, Hu Y, Wang J, Chen G, Ding Y, Niu J. Clinical evaluation of efficacy, tolerability and pharmacokinetics of yimitasvir phosphate in patients infected with hepatitis C virus. J Pharm Pharmacol 2018; 70:855-864. [PMID: 29630721 DOI: 10.1111/jphp.12916] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 03/03/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Yimitasvir phosphate, an inhibitor of nonstructural protein 5A (NS5A) replication complex of hepatitis C virus (HCV), was evaluated in a double-blind, placebo-controlled, parallel, multiple-dose study. METHODS Twenty-four patients with chronic HCV genotype 1 infection were randomized to receive a 7-day course of yimitasvir phosphate at daily doses of 30, 100 or 200 mg or placebo. Antiviral efficacy, resistance profile, pharmacokinetics (PK), safety and tolerability were assessed. KEY FINDINGS The maximal reduction in HCV RNA from baseline was 5.17 log10 IU/ml. However, most patients experienced viral rebound on or before day 3 after yimitasvir treatment was initiated. The PK profile revealed median peak plasma concentrations at 4-12 h postdose and a mean terminal half-life of 14.47-17.09 h, the basis for daily dosing. Steady drug state was achieved following 5 days of daily dosing. The accumulation rate was low (1.29-1.73). There were no significant alterations in vital signs and laboratory findings among all participants. CONCLUSIONS This study shows that yimitasvir phosphate was well tolerated, and the PK profile supported daily dosing regimens. A 1-week (7-day) treatment course led to a quick and significant reduction in HCV RNA level in this cohort with HCV GT-1 infection.
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Affiliation(s)
- Hong Zhang
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Xiaoxue Zhu
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Qingmei Li
- The First Hospital of Jilin University, Jilin, China
| | - Jinfeng Lou
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Jixuan Sun
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Zhenwei Shen
- The First Hospital of Jilin University, Jilin, China
| | - Hong Chen
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Xiaojiao Li
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Min Wu
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Cuiyun Li
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Jingrui Liu
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Chengjiao Liu
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Yue Hu
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Jing Wang
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Guiling Chen
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Yanhua Ding
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Junqi Niu
- The First Hospital of Jilin University, Jilin, China
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Abstract
HCV in the East is a complex scenario with prevalence rates of 0.5% to as high as 4.7%, and variable distributions of genotypes, with a dominance of genotype 1b in East Asia, genotype 3 in South Asia and South East Asia, and genotype 6 in Indochina. Approvals for the new oral directing antiviral agents (DAAs), in the East have been very slow, but ultimately will be achieved by 2019, consequently, pegylated interferon and ribavirin are still widely used. Nonetheless the main issues are the problems of screening and linkage to management, and the considerable barriers to access HCV care.
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Affiliation(s)
- Yock Young Dan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E, Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228, Singapore; Division of Gastroenterology and Hepatology, National University Health System, Singapore, Singapore; Cancer Science Institute, National University of Singapore, Singapore, Singapore
| | - Seng Gee Lim
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E, Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228, Singapore; Division of Gastroenterology and Hepatology, National University Health System, Singapore, Singapore; Cancer Science Institute, National University of Singapore, Singapore, Singapore; Institute of Molecular and Cell Biology, Agency for Science and Technology, 61 Biopolis Drive, Singapore 138673, Singapore; Department of Gastroenterology and Hepatology, National University Hospital, 1E Lower Kent Ridge Road, Singapore 119228, Singapore.
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9
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Zhang T, Tully DC, Zhou S, He N. Characteristics of HCV co-infection among HIV infected individuals from an area with high risk of blood-borne infections in central China. PLoS One 2014; 9:e94219. [PMID: 24709894 PMCID: PMC3978003 DOI: 10.1371/journal.pone.0094219] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 03/14/2014] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) co-infection has been proved to be a growing public health concern. The prevalence and genotypic pattern vary with geographic locations. Limited information is available to date with regard to HCV genotype and its clinical implications among those former commercial blood donor communities. The aims of this study were to genetically define the HCV genotype and associated clinical characteristics of HIV/HCV co-infected patients from a region with commercial blood donation history in central China. METHODS A cross sectional study, including 164 HIV infected subjects, was conducted in Shanxi province central China. Serum samples were collected and HCV antibody testing, AST and ALT testing were performed. Seropositive samples were further subjected to RT-PCR followed by direct sequence coupled with phylogenetic analysis of Core-E1 and NS5B regions performed in comparison with known reference genotypes. FINDINGS A total of 139 subjects were HCV antibody positive. Genotype could be determined for 88 isolates. Phylogenetic analysis revealed that the predominant circulating subtype was HCV 1b (65.9%), followed by HCV 2a (34.1%). The HCV viral load in the subjects infected with HIV1b was significantly higher than those infected with HCV 2a (P = 0.006). No significant difference for HCV RNA level was detected between ART status, CD4+ cell count level and HIV RNA level. Serum AST and ALT level were likely to increase with HCV RNA level, although no significance was observed. Those who had conducted commercial donation later than 1991 (OR 3.43, 95% CI: 1.12-10.48) and had a short duration of donation (OR 0.35, 95% CI: 0.13-0.96) were more likely to be infected with HCV 1b. CONCLUSION These results suggest that HCV subtype 1b predominates in this population, and the impact of HIV status and ART on HCV disease progression is not significantly correlated.
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Affiliation(s)
- Tiejun Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China and Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, China
| | - Damien C Tully
- Ragon Institute of MGH, MIT and Harvard University, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Sujuan Zhou
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China and Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, China
| | - Na He
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China and Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, China
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Piao HX, Yang AT, Sun YM, Kong YY, Wu XN, Zhang YZ, Ding B, Wang BE, Jia JD, You H. Increasing newly diagnosed rate and changing risk factors of HCV in Yanbian Prefecture, a high endemic area in China. PLoS One 2014; 9:e86190. [PMID: 24475084 PMCID: PMC3903515 DOI: 10.1371/journal.pone.0086190] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 12/09/2013] [Indexed: 12/29/2022] Open
Abstract
Background The newly diagnosed rate of HCV infection is increasing in China. However, the risk factors have not been fully identified. Here, a survey was performed in Yanbian Prefecture, a high-endemic area in China. Methods We identified newly diagnosed HCV infection in 2007–2011, using the local National Disease Supervision Information Management System from the Chinese Center for Disease Control and Prevention. We determined the risk factors using a case-control survey by questionnaire. Results Yanbian Prefecture had a rapid increase in the yearly newly diagnosed rate of HCV infection from 32.6 to 72.1/100.000 from the year 2007 to 2011. People aged 50–64 years had a high HCV infection of 43.4%, but only 0.3% of cases were reported in those aged less than 20 years. Cosmetic treatment, family history, blood transfusion, and dental treatment were independent risk factors for HCV infection. Unexpectedly, cosmetic treatments [odd ratio (OR) = 5.15, 95% confidence interval (CI) = 2.31–11.48, P = 0.00] and family history (OR = 4.68, 95% CI = 2.67–8.75, P = 0.00) showed a higher risk than the conventional risk factors of blood transfusion (OR = 4.49, 95% CI = 1.95–10.37, P = 0.001) and dental treatment (OR = 2.98, 95% CI = 1.42–6.25, P = 0.00). To further analyze the intrafamilial transmission, we found that spouses of HCV patients had an increased risk for acquiring HCV (OR = 5.75, 95% CI: 1.94–17.07), without significant association between either HCV RNA viral load (P = 0.29) or genotype (P = 0.43). Conclusions HCV infection was increased in Yanbian Prefecture. Cosmetic treatment was a higher risk factor than medical procedure. HCV infection had a clear family clustering phenomenon, especially between spouses.
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Affiliation(s)
- Hong-Xin Piao
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Affiliated Hospital of Yanbian University, Yanji, Jilin, China
| | - Ai-Ting Yang
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ya-Meng Sun
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yuan-Yuan Kong
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiao-Ning Wu
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ying-Zhe Zhang
- Affiliated Hospital of Yanbian University, Yanji, Jilin, China
| | - Bo Ding
- Affiliated Hospital of Yanbian University, Yanji, Jilin, China
| | - Bao-En Wang
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ji-Dong Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hong You
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- * E-mail:
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11
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Wang J, Liu J, Huang Y, Wright DJ, Li J, Zhou Z, He W, Yang T, Yao F, Zhu X, Wen G, Bi X, Tiemuer MHL, Wen X, Huang M, Cao R, Yun Z, Lü Y, Ma H, Guo N, Yu Q, Ness P, Shan H. The persistence of hepatitis C virus transmission risk in China despite serologic screening of blood donations. Transfusion 2013; 53:2489-97. [DOI: 10.1111/trf.12297] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 05/03/2013] [Accepted: 05/05/2013] [Indexed: 12/22/2022]
Affiliation(s)
- Jingxing Wang
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Jing Liu
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Yi Huang
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - David J. Wright
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Julin Li
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Zhongmin Zhou
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Weilan He
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Tonghan Yang
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Fuzhu Yao
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Xiangming Zhu
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Guoxin Wen
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Xinhong Bi
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Mei-hei-li Tiemuer
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Xiuqiong Wen
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Mei Huang
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Ru'an Cao
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Zhongqiao Yun
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Yunlai Lü
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Hongli Ma
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Nan Guo
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Qilu Yu
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Paul Ness
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
| | - Hua Shan
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences; Chengdu P.R. China
- Johns Hopkins School of Medicine; Baltimore Maryland
- Westat, Inc.; Rockville Maryland
- Guangxi Blood Center; Liuzhou Guangxi P.R. China
- Kunming Blood Center; Kunming Yunnan P.R. China. Urumqi Blood Center; Urumqi Xinjiang P.R. China. Mianyang Blood Center; Mianyang Sichuan P.R. China. Luoyang Blood Center; Luoyang Henan P.R. China. Johns Hopkins School of Public Health; Baltimore Maryland
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12
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Nguyen LH, Nguyen MH. Systematic review: Asian patients with chronic hepatitis C infection. Aliment Pharmacol Ther 2013; 37:921-36. [PMID: 23557103 DOI: 10.1111/apt.12300] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Revised: 10/16/2012] [Accepted: 03/12/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND Chronic hepatitis C (CHC) infection is a risk factor for both the development of end-stage liver disease and hepatocellular carcinoma (HCC). Globally, approximately 170 million people are chronically infected with the hepatitis C virus (HCV), and the majority of these individuals come from the western Pacific and Southeast Asia regions (94.6 million persons combined). CHC is an understudied and underappreciated health problem in many Asian countries and in the US, where Asians represent one of the fastest growing groups of new Americans. AIM To perform a systematic review of the current literature on the epidemiology, diagnosis and screening, clinical characteristics and response to anti-viral therapy of Asians with CHC. METHODS Using a PubMed search of 'hepatitis C' and 'Asia,' 341 original manuscripts published in peer-reviewed journals were identified, and 99 were selected based on their relevance. RESULTS Many Asian CHC patients do not have easily identifiable risk factors and may be underdiagnosed. Rates of HCV infection in Asians on community screening in the US are unexpectedly high, and there is a high prevalence of HCV genotype 6 in Southeast Asia and Southern China. HCV-infected Asians tend to present at older age and may have higher risk of HCC; however, they respond better to anti-viral therapy than non-Asians across all HCV genotypes. CONCLUSIONS Given the high HCV endemicity in Asia, lack of identifiable risk factors and favourable treatment response rates in Asians, we advocate the screening for HCV infection of all Asians who come from areas where HCV prevalence is ≥2%.
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Affiliation(s)
- L H Nguyen
- Stanford University School of Medicine, Stanford, CA, USA
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13
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Prevalence and risk factors of hepatitis C among former blood donors in rural China. Int J Infect Dis 2012; 16:e731-4. [PMID: 22796320 DOI: 10.1016/j.ijid.2012.05.1035] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 05/23/2012] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND Illegal commercial plasma and blood donation activities in the late 1980s and early 1990s caused a large number of hepatitis C virus (HCV) infections in rural areas of China. METHODS A cross-sectional survey was carried out in 2008, in which all residents in a former blood donation village in rural Hebei Province were invited for a questionnaire interview and testing for HCV antibodies. Questionnaires were administered to collect information about their personal status and commercial blood donation history, and HCV antibodies were tested by enzyme immunoassay. RESULTS Of 520 villagers who participated in the interviews, 236 (45.4%) reported a history of selling whole blood or plasma. HCV seropositivity was confirmed in 148/520 (28.5%) interviewees and 101/236 (42.8%) former commercial plasma and blood donors. Selling plasma was the strongest independent predictor of HCV seropositivity (p=0.0037). Past history of an operation was also independently associated with HCV infection (p=0.0270). CONCLUSIONS Unsafe practices during illegal plasma donation led to a high risk of HCV seropositivity for donors during the late 1980s and early 1990s. Many infected people suffered chronic hepatitis from that time onwards and urgently needed treatment and care.
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14
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Tanaka M, Katayama F, Kato H, Tanaka H, Wang J, Qiao YL, Inoue M. Hepatitis B and C virus infection and hepatocellular carcinoma in China: a review of epidemiology and control measures. J Epidemiol 2011. [PMID: 22041528 DOI: 10.2188/jea.je20100190.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2022] Open
Abstract
China has one of the highest carrier prevalences of hepatitis B virus (HBV) in the world: nearly 10% of the general population. The disease burden of HBV infection and hepatocellular carcinoma (HCC) is also believed to be among the world's largest, and that of hepatitis C virus (HCV) infection is likely to be substantial as well. However, the epidemiology and measures to control HBV and HCV infection in China remain relatively unknown outside the country. We review the epidemiology of HBV and HCV infection, the disease burden of and risk factors for HCC, and current control measures against HBV and HCV infection in China. We also discuss the relevant literature and implications for future studies of hepatitis and HCC in China.
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Affiliation(s)
- Masahiro Tanaka
- Department of Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
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15
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Tanaka M, Katayama F, Kato H, Tanaka H, Wang J, Qiao YL, Inoue M. Hepatitis B and C virus infection and hepatocellular carcinoma in China: a review of epidemiology and control measures. J Epidemiol 2011; 21:401-416. [PMID: 22041528 PMCID: PMC3899457 DOI: 10.2188/jea.je20100190] [Citation(s) in RCA: 239] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2011] [Accepted: 06/20/2011] [Indexed: 12/14/2022] Open
Abstract
China has one of the highest carrier prevalences of hepatitis B virus (HBV) in the world: nearly 10% of the general population. The disease burden of HBV infection and hepatocellular carcinoma (HCC) is also believed to be among the world's largest, and that of hepatitis C virus (HCV) infection is likely to be substantial as well. However, the epidemiology and measures to control HBV and HCV infection in China remain relatively unknown outside the country. We review the epidemiology of HBV and HCV infection, the disease burden of and risk factors for HCC, and current control measures against HBV and HCV infection in China. We also discuss the relevant literature and implications for future studies of hepatitis and HCC in China.
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Affiliation(s)
- Masahiro Tanaka
- Department of Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
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16
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Sievert W, Altraif I, Razavi HA, Abdo A, Ahmed EA, Alomair A, Amarapurkar D, Chen CH, Dou X, El Khayat H, Elshazly M, Esmat G, Guan R, Han KH, Koike K, Largen A, McCaughan G, Mogawer S, Monis A, Nawaz A, Piratvisuth T, Sanai FM, Sharara AI, Sibbel S, Sood A, Suh DJ, Wallace C, Young K, Negro F. A systematic review of hepatitis C virus epidemiology in Asia, Australia and Egypt. Liver Int 2011; 31 Suppl 2:61-80. [PMID: 21651703 DOI: 10.1111/j.1478-3231.2011.02540.x] [Citation(s) in RCA: 417] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The hepatitis C pandemic has been systematically studied and characterized in North America and Europe, but this important public health problem has not received equivalent attention in other regions. AIM The objective of this systematic review was to characterize hepatitis C virus (HCV) epidemiology in selected countries of Asia, Australia and Egypt, i.e. in a geographical area inhabited by over 40% of the global population. METHODOLOGY Data references were identified through indexed journals and non-indexed sources. In this work, 7770 articles were reviewed and 690 were selected based on their relevance. RESULTS We estimated that 49.3-64.0 million adults in Asia, Australia and Egypt are anti-HCV positive. China alone has more HCV infections than all of Europe or the Americas. While most countries had prevalence rates from 1 to 2% we documented several with relatively high prevalence rates, including Egypt (15%), Pakistan (4.7%) and Taiwan (4.4%). Nosocomial infection, blood transfusion (before screening) and injection drug use were identified as common risk factors in the region. Genotype 1 was common in Australia, China, Taiwan and other countries in North Asia, while genotype 6 was found in Vietnam and other Southeast Asian countries. In India and Pakistan genotype 3 was predominant, while genotype 4 was found in Middle Eastern countries such as Egypt, Saudi Arabia and Syria. CONCLUSION We recommend implementation of surveillance systems to guide effective public health policy that may lead to the eventual curtailment of the spread of this pandemic infection.
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Affiliation(s)
- William Sievert
- Monash Medical Centre and Monash University, Melbourne, Vic., Australia
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17
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Abstract
More than 20 years after the discovery of the hepatitis C virus (HCV), it is now well established that HCV is of global importance affecting all countries, leading to a major global health problem that requires widespread active interventions for its prevention and control. Chronic hepatitis C was linked to the development of cirrhosis and hepatocellular carcinoma in many areas of the world. Current epidemiological assessments have identified complex patterns with highly variable local prevalence rates between countries and within countries. HCV infection patterns have not significantly changed in most parts of the world since 1997, when first analyzed, partly due to the lack of new and more accurate data. The assessment of the national HCV prevalence and transmission modes should be completed to enable national authorities to prioritize preventive measures and to make the most appropriate use of available resources. The 'patchy' epidemiological situation in some areas will continue to complicate the task of the establishment of global, regional and national base line data. The present assessment finds a global prevalence of 2.35%, affecting 160 million chronically infected individuals. There is an urgent need for more accurate Information on the costs and burden of HCV to society. Twenty-one year after the discovery of HCV, the assessment is far from being complete and little progress has been made in the past 10 years in many countries. In some countries significant increases have been reported and this may also apply to countries were insufficient data exist. A safe and efficient vaccine against HCV is urgently needed.
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Affiliation(s)
- D Lavanchy
- Interlifescience, Massagno Ticino, Switzerland.
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18
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Liu F, Chen K, He Z, Ning T, Pan Y, Cai H, Ke Y. Hepatitis C seroprevalence and associated risk factors, Anyang, China. Emerg Infect Dis 2010. [PMID: 19891874 PMCID: PMC2857224 DOI: 10.3201/eid1511.0900263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Hepatitis C virus screening was conducted among 8,226 residents 25–65 years of age in 4 counties of China; virus prevalence was 0.9%. A subsequent case–control study indicated blood transfusion (odds ratio [OR] 4.55), esophageal balloon examination (OR 3.78), and intravenous injection (OR 5.83) were associated with infection.
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Affiliation(s)
- Fangfang Liu
- Ministry of Education Key Laboratory, Beijing, People's Republic of China
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19
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Liu F, Chen K, He Z, Ning T, Pan Y, Cai H, Ke Y. Hepatitis C seroprevalence and associated risk factors, Anyang, China. Emerg Infect Dis 2010; 15:1819-22. [PMID: 19891874 DOI: 10.3201/eid1511.090263] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Hepatitis C virus screening was conducted among 8,226 residents 25-65 years of age in 4 counties of China; virus prevalence was 0.9%. A subsequent case-control study indicated blood transfusion (odds ratio [OR] 4.55), esophageal balloon examination (OR 3.78), and intravenous injection (OR 5.83) were associated with infection.
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Affiliation(s)
- Fangfang Liu
- Ministry of Education Key Laboratory, Beijing, People's Republic of China
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20
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Abstract
SUMMARYA case-control study was conducted in Linxian, Henan Province in China to explore potential risk factors for hepatitis C virus (HCV) infection unassociated with injection drug use. One hundred and ninety-two persons (41·7% male, 95·8% aged >60 years) were recruited from an earlier cohort. Of these, 48 were HCV positive and 144 HCV negative. Residence in a plain region and 3–10 injections in a health setting per year were significantly associated with HCV in both univariate and multivariate analysis (P<0·01). In rural China, the geographic distribution of HCV infection was heterogeneous and associated with injections in a health setting, a pattern which differed from the epidemics in injection drug users in urban cities.
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Lonardo A, Adinolfi LE, Petta S, Craxì A, Loria P. Hepatitis C and diabetes: the inevitable coincidence? Expert Rev Anti Infect Ther 2009; 7:293-308. [PMID: 19344243 DOI: 10.1586/eri.09.3] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Type 2 diabetes (T2D) and HCV infection are common conditions involving, respectively, at least 170 and 130 million people worldwide. However, the distribution of such cases does not overlap in the same age groups in different geographic areas. Following pioneering reports of increased prevalence of T2D in HCV-positive cirrhosis, interest concerning the relationship between HCV and T2D has escalated. HCV is able to induce insulin resistance (IR) directly and the role of specific viral genotypes responsible for such effect is disputed. IR has consistently been found to be closely linked to fibrosis in HCV infection, although also typically associated with T2D in prefibrotic stages. HCV infection could be associated with a reduced prevalence of metabolic syndrome owing to virus-associated reduction in BMI (reported in population but not clinical studies) and hypobetaliproteinemia. A three- to ten-fold increased risk of HCV infection was reported among diabetic patients in comparison with different control groups and a meta-analysis showed a 1.8-fold excess risk of T2D among HCV-positive compared with HBV-positive patients. Moreover, HCV positivity is associated with an increased risk of T2D in patients receiving liver or kidney transplantations. T2D and IR are independent predictors of a more rapid progression of liver fibrosis and impaired response to antiviral treatment in chronic hepatitis C. Patients with cirrhosis and T2D have an increased susceptibility to hepatic encephalopathy and hepatocellular carcinoma (HCC). However, the beneficial effects of antiviral treatment on IR and T2D are controversial. Theoretically, glycemic control in chronic hepatitis C, and particularly in cirrhotic patients, could improve the prognosis and the response to antivirals, although the evidence for this is limited. Future studies should elucidate the relationship between insulin signaling, HCV and interferon signaling, entity of cardiovascular risk in patients with HCV infection, the potential role of 'metabolic' strategies added to antiviral treatment schedules, the impact of IR on liver failure, portal hypertension and HCC, particularly in patients managed in a transplant setting.
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Affiliation(s)
- Amedeo Lonardo
- Department of Internal Medicine, University of Modena and Reggio Emilia, Modena, Italy.
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Xia X, Lu L, Tee KK, Zhao W, Wu J, Yu J, Li X, Lin Y, Mukhtar MM, Hagedorn CH, Takebe Y. The unique HCV genotype distribution and the discovery of a novel subtype 6u among IDUs co-infected with HIV-1 in Yunnan, China. J Med Virol 2008; 80:1142-52. [PMID: 18461611 DOI: 10.1002/jmv.21204] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The Yunnan province is the epicenter of HIV-1 epidemics in China and a center for drug trafficking to the other parts of the world. In six prefectures of this province, a total of 132 IDUs were recruited to determine the sero-prevalence of HCV and HIV-1 and the positive rates were 93.94% and 68.18%, respectively (P<0.001). Co-infection with HCV and HIV-1 was found among 89 IDUs, of whom several HCV fragments were amplified and sequenced. Sequences of the HCV 5'NCR-C and NS5B region were determined from 82 IDUs. Phylogenetic analyses showed consistent genotyping among 80 IDUs. Among them HCV genotypes 1a, 1b, 3a, 3b, 6a, 6n, and a tentatively assigned novel 6u subtype were found in 1 (1.25%), 16 (20%), 19 (23.75%), 24 (30%), 4 (5%), 9 (11.25%) and 7 (8.75%) individuals, respectively. In two IDUs, genotyping results were discordant, suggesting mixed HCV infections or recombination. The proportion of patients with HCV 1b tended to decrease from the north to south and from the east to west in this province. Genotype 3 and 6 strains were more frequent in the southern prefectures. The novel subtype 6u strains were only detected in Dehong which borders Myanmar. Our findings showed a unique pattern of HCV genotype distribution, which is similar to that in the southeastern Asian countries but distinct from that among the general population in China. Routes of drug trafficking and the resulting high prevalence of HIV-1 infection may have contributed to this pattern of HCV genotype distribution.
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Affiliation(s)
- Xueshan Xia
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, China.
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Abstract
Globally, hepatitis C virus (HCV) has infected an estimated 130 million people, most of whom are chronically infected. HCV-infected people serve as a reservoir for transmission to others and are at risk for developing chronic liver disease, cirrhosis, and primary hepatocellular carcinoma (HCC). It has been estimated that HCV accounts for 27% of cirrhosis and 25% of HCC worldwide. HCV infection has likely been endemic in many populations for centuries. However, the wave of increased HCV-related morbidity and mortality that we are now facing is the result of an unprecedented increase in the spread of HCV during the 20th century. Two 20th century events appear to be responsible for this increase; the widespread availability of injectable therapies and the illicit use of injectable drugs.
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Affiliation(s)
- Miriam J Alter
- University of Texas Medical Branch, Galveston, Texas 77555, USA.
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Abstract
Globally, hepatitis C virus (HCV) has infected an estimated 130 million people, most of whom are chronically infected. HCV-infected people serve as a reservoir for transmission to others and are at risk for developing chronic liver disease, cirrhosis, and primary hepatocellular carcinoma (HCC). It has been estimated that HCV accounts for 27% of cirrhosis and 25% of HCC worldwide. HCV infection has likely been endemic in many populations for centuries. However, the wave of increased HCV-related morbidity and mortality that we are now facing is the result of an unprecedented increase in the spread of HCV during the 20th century. Two 20th century events appear to be responsible for this increase; the widespread availability of injectable therapies and the illicit use of injectable drugs.
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Affiliation(s)
- Miriam J Alter
- University of Texas Medical Branch, Galveston, Texas 77555, USA.
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Qian HZ, Vermund SH, Kaslow RA, Coffey CS, Chamot E, Yang Z, Qiao X, Zhang Y, Shi X, Jiang Y, Shao Y, Wang N. Co-infection with HIV and hepatitis C virus in former plasma/blood donors: challenge for patient care in rural China. AIDS 2006; 20:1429-35. [PMID: 16791018 PMCID: PMC2749723 DOI: 10.1097/01.aids.0000233577.33973.fa] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Illegal commercial plasma donation in the late 1980s and early 1990s caused blood-borne infections in China. OBJECTIVES To estimate the prevalence of HIV and hepatitis C virus (HCV) infections and to identify associated risk factors in central China with a history of illegal plasma collection activities. DESIGN AND METHODS A cross-sectional study was carried out in 2004, in which all adult residents in four villages in rural Shanxi Province were invited for a questionnaire interview and testing of HIV and HCV antibodies. RESULTS Of 3062 participating villagers, 29.5% reported a history of selling whole blood or plasma. HIV seropositivity was confirmed in 1.3% of subjects and 12.7% were HCV positive. Their co-infection rates were 1.1% among all study subjects, 85% among HIV-positive subjects, and 8.7% among HCV-positive subjects. Selling plasma [odds ratio (OR), 22.5; 95% confidence interval (CI), 16.1-31.7; P < 0.001] or blood (OR, 3.1; 95% CI, 2.3-4.2; P < 0.001) were independently associated with HIV and/or HCV infections. Although a spouse's history of selling plasma/blood was not associated with either infection, the HIV or HCV seropositivity of a spouse was significantly associated with HIV and/or HCV infections (both OR, 3.2; 95% CI, 2.0-5.2 in men, 2.0-4.9 in women; P < 0.001). For men, residence in the village with a prior illegal plasma collection center (OR, 2.5; 95% CI, 1.7-3.7; P < 0.001) and for women, older age (OR, 3.4; 95% CI, 1.2-14.0; P = 0.04) were associated with HIV and/or HCV infections. CONCLUSIONS HIV and HCV infections are now prevalent in these Chinese communities. HIV projects should consider screening and care for HCV co-infection.
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Affiliation(s)
- Han-Zhu Qian
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Schools of Public Health and Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sten H. Vermund
- Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee
- Schools of Public Health and Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Richard A. Kaslow
- Schools of Public Health and Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Christopher S. Coffey
- Schools of Public Health and Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Eric Chamot
- Schools of Public Health and Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Zhongmin Yang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaochun Qiao
- Shanxi Province Center for Disease Control and Prevention, Taiyuan
| | - Yuliang Zhang
- Wenxi County Bureau of Health, Shanxi Province, China
| | - Xiaoming Shi
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yan Jiang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yiming Shao
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ning Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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26
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Abstract
Several reviews have focused on the nature of HIV infection and its spread in various geographical regions of China. In contrast, this review provides a comprehensive update on the prevalence of multiple HIV-1 subtypes, consequent emergence of recombinant and novel forms of HIV-1 in China, and the implications this may have on HIV diversity and the development of effective vaccines. In addition it also examines the dissemination of primary drug resistance in therapy naïve patients, as well as co-infections with two other important viruses-hepatitis B and C. The main purpose of this review is to provide a current snapshot of HIV-1 pathogenesis in China and possibly shed some light on the future of HIV evolution, and potential challenges for future vaccine and anti-retroviral therapeutics against HIV strains in this area.
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Affiliation(s)
- Nitin K Saksena
- Centre for Virus Research, Westmead Millennium Institute, The University of Sydney, Westmead NSW 2145 Sydney, Australia.
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