Risk factors of transfusion transmissible infections among blood donors at Karongi Regional Centre for blood transfusion in Rwanda

Background Blood transfusion saves human lives, but also it can be a route for TransfusionTransmissible Infections (TTIs) including Human Immuno-Deficiency Virus (HIV), Hepatitis B virus (HBV), Hepatitis C virus (HCV), and syphilis. Objective This study aimed to explore the risk factors associated with TTIs among blood donors at Regional Centre for Blood Transfusion (RCBT) of Karongi, Rwanda. Methods This was a retrospective cross-sectional study design conducted among 36,708 blood donors from 2015 to 2019. Data were extracted from the system known as eProgesaused and the outcome variable were TTIs including HBV, HCV and HIV (measured using Enzyme Immuno-Assay/Chemiluminescence Immunoassay) and syphilis (determined by Rapid Reagin Plasma). Descriptive statistics was computed to describe the characteristics of the blood donors. Bivariate and multivariable logistic regression were performed to assess the risk factors associated with TTIs. P value less than 0.05 was considered statistically significant. Results The study found that the overall prevalence of TTIs was 2.1%, while the prevalences of HBV, HCV, HIV, and syphilis were 1.3%, 0.4%, 0.06%, and 0.34%, respectively. Multivariable analysis showed that the factors associated with HBV, HCV, HIV and syphilis were being male, age more than 25 years, being married, living in urban areas, first time blood donors and blood donors living in Rusizi, Rusizi, Nyamasheke and Karongi districts. Conclusion This study revealed that the most frequent TTI was HBV among blood donors and the main risk groups were males, age group of 26-35 years, married and first time donors. Hence, while developing health policies to reduce the effects of HBV infection on safe blood transfusion, these study findings should be taken into account.

Knowledge, attitude, and practice towards hepatitis B and C viruses among the population of Lubumbashi, Democratic Republic of Congo

Background Hepatitis B (HBV) and C (HCV) infection remains significant public health problem worldwide. Unfortunately, the Democratic Republic of Congo is in an area of high endemicity, and its population remains poorly informed about these viral infections. Therefore, this study aims to determine Lubumbashi's knowledge, attitudes, and practices toward HBV and HCV. Methods We conducted a cross-sectional descriptive study from March to August 2022 in Lubumbashi. A total of 704 participants were enrolled. We targeted all people of both sexes and ages. The participants' Knowledge, Attitudes, and Practices (KAP) survey was assessed using online and printed or paper questionnaires. Data were analyzed using SPSS version 22 software. Results Of the 704 participants, 70.9% had poor knowledge of viral hepatitis B and C, whereas 28.6% had terrible attitudes towards these infections and preferred to consult traditional healers instead of going to the hospital. A minority of the participants (12.2%) had good practices, those as being screened regularly to exclude any possible infection and being willing to be vaccinated depending on the availability of the HBV vaccine. Most participants (69.2%) needed to be aware of drugs that could effectively treat these infections. Conclusion Knowledge and practice about HBV and HCV in the Congolese population living in Lubumbashi have proven wrong. Similarly, the attitudes of the people towards these infections were negative. Therefore, an extensive health education program should be given to increase the awareness of this part of the Congolese population about HBV and HCV infection to provide better care.

Sécurité transfusionnelle infectieuse pendant la pandémie à COVID-19: Evaluation de quelques marqueurs sérologiques au centre hospitalier et universitaire de Yaoundé, Cameroun / Infectious transfusion safety during the COVID-19 pandemic: evaluation of some serological markers at the Yaoundé University Teaching Hospital, Cameroon

Objectif. Mettre à jour les données sur la prévalence des infections transmissibles par transfusion en contexte de pandémie à coronavirus est très important pour la sécurité transfusionnelle dans notre milieu. Méthodes. Une étude transversale prospective a été menée du 05 avril au 02 mai 2021 au Centre Hospitalier et Universitaire de Yaoundé. Les donneurs de sang ont été inclus consécutivement après un entretien médical et dépistés pour les infections du Virus de l'Immunodéficience Humaine, du virus de l'hépatite B, du virus de l'hépatite C et du Treponema pallidum. L'analyse statistique a été faite à l'aide du logiciel SPSS version 23.0 avec pour seuil de significativité p<0,05. Résultats. Au total, 32/232 donneurs (13,8 %) avaient au moins une infection transmissible par transfusion. Les prévalences étaient de 7,8 %, 5,6 %, 0,9 % et 0,9 % respectivement pour l'infection à Virus de l'Immunodéficience Humaine, Virus de l'hépatite B, Virus de l'hépatite C et Treponema pallidum. La régression logistique binaire concernant le Virus de l'Immunodéficience Humaine a montré que le sexe masculin et le groupe sanguin AB étaient significativement associés à cette infection. Aucune association n'a été retrouvée pour les autres infections. Conclusion. Avec le contexte difficile lié à la pandémie à coronavirus, la prévalence cumulée des infections transmissibles par transfusion est restée relativement élevée. Une bonne sélection médicale des donneurs reste la clé pour permettre la sécurité transfusionnelle.

Objective. Updating data on the prevalence of transfusion-transmissible infections in the context of the coronavirus pandemic is very important for blood safety in our environment. Method. A prospective cross-sectional study was conducted from April 05 to May 02, 2021 at the Yaoundé University Teaching Hospital. Blood donors were included consecutively after a medical interview and screened for Human Immunodeficiency Virus, Hepatitis B virus, Hepatitis C virus and Treponema pallidum infections. Statistical analysis was performed using SPSS version 23.0 software with the significance level p<0.05. Results. In total, 32/232 donors (13.8%) had at least one transfusion-transmissible infection. The prevalences were 7.8%, 5.6%, 0.9% and 0.9% respectively for infection with Human Immunodeficiency Virus, Hepatitis B Virus, Hepatitis C Virus and Treponema pallidum. Binary logistic regression for Human Immunodeficiency Virus showed that male sex and AB blood group were significantly associated with this infection. No association was found for the other infections. Conclusion. With the difficult context linked to the coronavirus pandemic, the cumulative prevalence of infections transmissible by transfusion has remained relatively high. A good medical selection of donors remains the key to allow transfusion safety.

Abnormal liver function test in patients with diabetes and hypertension on treatment at the Laquintinie and Douala General Hospitals

Comorbidity of diabetes mellitus and hypertension is common, with both diseases and their treatment being able to cause liver function abnormalities, which can lead to liver failure. This study aims to access the effect of drugs used in the management of these diseases on liver function. A cross sectional study will be conducted, followed by a case-control design. Ethical clearance will be obtained from the Faculty of Health Sciences Institutional Review Board and administrative authorization from the various hospital directorates. The sampling procedure adopted will be consecutive and shall include all consenting patients aged 21 years and above, treated for hypertension, diabetes mellitus, or both. Pregnant women, patients with liver disease, viral hepatitis, as well as those on known hepatotoxic drugs will be excluded. Clinical, lifestyle, anthropometric data as well as venous blood samples will be collected and analyzed for liver enzymes (aspartate transaminase, alanine transaminase, and gamma glutamyl transferase) total or conjugated bilirubin, hepatitis B surface antigen and hepatitis C virus antibodies. Student T-test will be used to compare means and chi-square to test for proportion. Associated factors will also be determined using odds ratios. A p-value of <0.05 will be considered significant. The prevalence of liver function abnormalities shall be determined. Determinants of liver function abnormalities shall also be identified.

The Gamma-glutamyl Transpeptidase to Platelet Ratio (GPR) Predict Significant Liver Fibrosis and Cirrhosis in Chronic Egyptian HCV Patients

Non- invasive parameters of liver fibrosis are being widely incorporated and adopted in clinical practice, of them, 2 ratios APRI and FIB-4 were proposed and applied. The gamma-glutamyl transferase -to platelet ratio (GPR) was developed and investigated as available test that is useful in predicting liver fibrosis stages in chronic HBV patients. We aimed to estimate the diagnostic performance of GPR compared to APRI in assessing different fibrosis stages estimated by ultrasound based Transient Elastography in chronic HCV Egyptian patients

Prevalence and determinants of Hepatitis C Virus Infection and Genotypes in Chronic Hemodialysis Patients in Kinshasa

Context and objective. The steady increase in the number of chronic hemodialysis patients in sub-Saharan Africa (SSA) calls for improved management of those patients. The present study aimed to determine the frequency of hepatitis C virus (HCV) infection, the prevalent genotypes, and the risk factors associated with HCV in hemodialysis patients in Kinshasa (DR Congo). Methods. A cross-sectional study was conducted from February to June 2018 in all hemodialysis centers in Kinshasa. Blood samples were collected from 127 chronic hemodialysis patients and tested for the presence of antibodies against HCV. The HCV genotype was identified by real-time polymerase chain reaction (RT- PCR). Results. Twenty-two (17.3 %) patients were positive for anti-HCV antibodies, ranging from 0 % to 52.9 % in different centers. Genotype 4 was detected in 18/22 (81.8 %), followed by genotype 2 in 2/22 (9.1%), and both genotypes 2 and 4 in one patient (4.5%). One patient had an undetermined genotype (4.5 %). Having received at least 4 transfusions [7,21 (1,09- 10,61); p=0.040)], not being under EPO treatment [5,81(1,47-12,96); p=0.012)], being on hemodialysis for at least 14 months [3,63(1,60-5,05); p=0.035)]and being dialyzed in an overloaded center [2,06(0,83-5,86); p=0.073)] were associated with a greater risk of HCV infection. Conclusion. This high HCV prevalence (17.3 %) represents a substantial health burden in HD patients from Kinshasa, DR Congo. It is largely driven by the number of blood transfusions, the duration time in hemodialysis. Observations from the present study underscore the need of reducing the number of blood transfusions in people on dialysis through the administration of erythropoietin, given the unaffordable cost of HCV therapy for most individuals in DR Congo.

Contexte et Objectifs. Le nombre des patients hémodialisés en Afrique subsaharienne en constante augmentation ; justifiant de ce fait une meilleure prise en charge de ces patients. La présente étude détermine la prévalence de l'infection par le virus de l'hépatite C en en determinant les génotypes ainsi que les facteurs y associés dans ce groupe de patients. Méthodes. 127 patients hémodialisés chroniques ont subis des tests sérologiques à la recherche des anticorps anti-VHC dans plusieurs centres de Kinshasa de février à juin 2018. Le génotype viral a été déterminé par la RT-PCR. Résultats. La fréquence des anticorps anti-VHC a varié de 0 à 52,9 % dans ce groupe. Les génotypes le plus fréquents ont été le 4 (18/22) et le 2 (2/22) ; étant sumultanément rétrouvé chez un patient, et indéterminé chez un autre sujet. Avoir reçu au moins 4 transfusions [7,21 (1,09-10,61; p=0.040)], ne pas être sous EPO [5,81(1,47-12,96); p=0.012)], être en hémodialyse depuis au moins 14 mois [3,63(1,60- 5,05); p=0.035)] et être dialysé dans un centre surchargé [2,06 (0,83-5,86); p=0.073)] étaient associés à un risque plus élevé d'infection par le VHC. Conclusion. Ses principaux déterminants sont : le nombre des transfusions sanguines et la durée d'HD ; d'où la nécessité de réduire les transfusions sanguines chez les sujets dialysés par l'administration d'EPO, étant donné le coût prohibitif du traitement contre le VHC dans notre contexte

Serum cholinesterase level as a biomarker in detecting liver injury in Patients with chronic hepatitis c

Background: hepatitis C virus can cause both acute and chronic hepatitis. The acute process is self-limited, rarely causes hepatic failure and usually leads to chronic infection. Chronic HCV infection often follows a progressive course over many years and can ultimately result in cirrhosis, HCC and the need for liver transplantation. Objective: the aim of this study is to evaluate serum cholinesterase (CHE) level as a biomarker for detecting liver damage in patients with chronic hepatitis C. Patients and Methods: the current study was carried out on 50 subjects selected from the outpatient's clinic of Internal Medicine Department of Sayed Galal Hospital, Al-Azhar University and admitted to the internal department. The study was performed in the period between July-2014 to July -2019. Results: Sensitivity of cholinesterase is 100%, its specificity is 100% and its accuracy is 100%, in predicting liver injury in patients with chronic hepatitis C. Cholinesterase is positively correlated with Hb, platelets and albumin. Cholinesterase is negatively correlated with ALT, AST and ALP, total & direct bilirubin, PT, INR, urea, creatinine and AFP. There is significant increase of cholinesterase among compensated compared with decompensated cirrhotic patients. There is significant decrease of cholinesterase among compensated cirrhotic patients compared with controls. There is significant decrease of cholinesterase among decompensated cirrhotic patients compared with controls. Conclusion: cholinesterase is an excellent biomarker of cirrhosis with good sensitivity and specificity. Cholinesterase shows good correlation with albumin, PT, INR and Child-Puch score. Cholinesterase distinguishes decompensated cirrhosis from compensated cirrhosis well

Prevalence and associated risk factors of transfusion transmissible infections among blood donors at Regional Blood Transfusion Center Nakuru and Tenwek Mission Hospital, Kenya

Introduction: unsafe transfusion practices can put millions of people at risk of Transfusion Transmissible Infections (TTIs). In Kenya the current blood transfusion scheme involves screening of blood for HIV, Hepatitis B virus (HBV), Hepatitis C virus (HCV) and syphilis. Malaria is also a blood-borne disease which is not currently screened for. In Kenya blood donor selection criteria were reviewed in 2009. Regular review of effectiveness of donor selection criteria can help reduce TTIs prevalence amongst donors and thus make the blood supply safer.Methods: a cross sectional study was conducted between November 2011 to January 2012 among 594 blood donors in the Regional Blood Transfusion Center Nakuru and Tenwek Mission Hospital. Socio-demographic characteristics and associated risk factors were collected using a standard blood transfusion service questionnaire. Donors were obtained through systematic sampling. Each donor sample was screened, for HIV-1 and HIV-2, HBV, HCV, syphilis and malaria parasites.Results: the overall prevalence of TTIs was 14.1%, which ranged from 0.7% for malaria to 5.6% for HBsAg. Blood donors who were married (P=0.0057), had non-formal or just primary education (P=0.0262), had multiple sexual partners (P=0.0144) and in informal occupation (P=0.0176) were at higher risk of HIV positivity. History of blood transfusion/blood products (P=0.0055), being married (P=0.0053) were high risk factors associated with positive syphilis. Being male (P=0.0479) was a high risk factor to HBV infection. Conclusion: the prevalence of TTIs indicates a need to review the questionnaire and apply it strictly for donor selection. The 0.7% prevalence of malaria, poses a serious health risk to non-immune recipients of transfusion. Malaria should be included among mandatory TTI tests in Kenya

The relation between interstitial lung disease and chronic HCV infection

Background and study aim: Interstitial lung disease (ILD) includes a variety group of about 200 conditions that insult the lung parenchyma with different patterns of inflammation and fibrosis. Hepatitis C virus (HCV)is Flavivirus with diverse hepatic and extrahepatic diseases. Its direct and indirect pathogenic association with many pulmonary manifestations-including interstitial lung disease-has been suggested yet needs more elucidation.Patients and Methods: A case control study was conducted with a total of 50 chronic hepatic patients. They were equally divided into two groups, HCV positive group (group 1= 25 patients) and HCV negative group (group 2= 25 patients). Group 1 was subdivided into two subgroups, without-idiopathic interstitial pneumonias patients (without IIPs subgroup A= 13 patients) and with idiopathic interstitial pneumonias patients (IIPs subgroup B = 12 patients). Both groups were subjected to thorough history taking, clinical examination, and routine investigations. The diagnosis of HCV was confirmed by viral markers including HCV antibodies and PCR. Other chronic hepatic liver diseases were confirmed by abdominal ultrasound and ultrasound- guided liver biopsy. Arterial blood gases, auto antibodies, Computerized pulmonary function tests and radiological studies including plain X ray chest and heart and HRCT scanning were also done. All patients with idiopathic pulmonary fibrosis (IPF) had fulfilled the ATS/ ERS diagnostic guidelines. Both groups were matched according to age, sex and body mass index.Results: The HCV positive group was found to have a significantly higher frequency of ILD than the HCV negative group with also more restrictive pattern hypoxemia and higher scores of IPF (by computed tomography).Conclusion: ILD is more frequent in patients with chronic HCV infection with higher grades of fibrosis and hypoxemia.HCV infection may be predisposing factor for IPF

Seroprevalence of antibodies to Hepatitis c virus in newly diagnosed HIV-1/2 positive patients in a tertiary hospital in Portharcourt Nigeria

Background There is a growing burden of Hepatits C virus (HCV) and Human Immunodeficiency virus (HIV) co-infection, with worsening mortality and limitations in the treatment of HIV infected persons. This study was done to determine the seroprevalence of antibodies to HCV in newly diagnosed HIV patients. Materials and Methods A desk review of laboratory records of serological testing for HIV and HCV performed in the Department of Haematology and Blood Transfusion of the University of Port Harcourt Teaching Hospital over a one year period, between July 2015 and June 2016 was done. Serologic test results and data of newly diagnosed HIV patients sent for confirmatory screening and routine HCV screening were obtained from the serology laboratory records. A total of 752 HIV positive cases were screened within this period. Laboratory tests for HIV-1/2 are performed using Determine kit (Alere, USA) and Uni-Gold kit (Trinity Biotech), while that of HCV was done using HCV rapid test strip (Hangzhou Biotest Biotech Co., Ltd, China and Citrus Diagnostics Inc., Canada).Results Out of the 752 newly diagnosed HIV cases, 2 tested positive to antibodies to HCV. Thus the co-infection rate is 0.3%. HCV and HIV co-infection occurred only in females with 30years being the mean age of prevalence. Conclusion The prevalence of HCV in HIV patients in this study is low. The low frequency of HIV/HCV co-infection may be explained by the fact that the high risk group of PWID and MSM are not so prevalent in our environment

Evaluation of Ledipasvir plus Sofosbuvir for treatment of compensated and decompensated HCV cirrhotic patients

Background:unlike human immunodeficiency virus (HIV) and hepatitis B virus (HBV), hepatitis C virus (HCV) infection is a curable disease. Current direct acting antiviral agent (DAA) targets are focused on HCV NS3/4A protein (protease), NS5B protein (polymerase) and NS5A protein. The first generation of DAAs includes boceprevir and telaprevir, which are protease inhibitors and were approved for clinical use in 2011. The cure rate for genotype 1 patients increased from 45% to 70% when boceprevir or telaprevir was added to standard PEG-IFN/ribavirin. More effective and less toxic second generation DAAs supplanted these drugs by 2013. The second generation of DAAs includes sofosbuvir, simeprevir and fixed combination medicines containing ledipasvir plus sofosbuvir and Viekira Pak. These drugs increase cure rates to over 90% without the need for interferon and effectively treat all HCV genotypes. With these drugs the "cure HCV" goal has become a reality. The aim of this study was to assess of ledipasvir plus sofosbuvir as treatment of HCV infection in patients with advanced liver disease including cirrhotic patients with child B and C. Patients and methods:in this prospective study, seventy five HCV PCR positive patients were classified into three groups according to child score. Each group included twenty five patients. All patients received ledipasvir plus sofosbuvir for six months. For all patients thorough medical history, clinical examination, kidney function tests, liver function tests, complete blood count, pelvi-abdominal ultrasound, HCVantibodies, hepatitis C viral RNA, quantitative, HbsAg, alpha fetoprotein as baseline screening. HCV PCR done for all patients at end of treatment and three months later to detect sustained virological response (SVR12). Patients with combined HCV and HBV infection, hepatic or extrahepatic malignancies and late child C were excluded. Results: showed that no statistical significant difference were detected in patients of group A as regard liver function tests before and after treatment and SVR12 achieved by 96%. Patients of group B showed significant statistical difference as regard liver function tests before and after treatment with SVR12 achieved by 88%. In patients of group C there were significant statistical difference in liver function tests with SVR12 achieved by 80%. Also there were clinical improvement in patients of group B and C after end of treatment. Conclusion:it could be concluded that there will be a dramatic improvement in HCV therapy followed the introduction of oral medicines that directly inhibiting the replication cycle of HCV. The combination pill contains a fixed-dose of ledipasvir 90 mg and sofosbuvir 400 mg, two direct-acting antiviral agents against HCV. Ledipasvir is an inhibitor of the NS5A protein, which is required for HCV replication. Sofosbuvir inhibits the HCV NS5B RNA-dependent RNA polymerase, which is also required for viral replication. Sofosbuvir is a nucleotide prodrug that undergoes intracellular metabolism to form a pharmacologically active triphosphate that can incorporate into the HCV RNA. Ledipasvir plus sofosbuvir can be used safely in treatment of compensated and decompensated post hepatitis C liver cirrhosis. SVR12 can be achieved by 96% in patients with early cirrhosis (child A), 88% in patients with child B cirrhosis and 80% in patients with child C with subsequent improvement in liver functions

Dendritic Cells in Hepatitis C Virus Infection

Background: The global prevalence of chronic hepatitis C is estimated at 2.8%. There is markedly higher prevalence in the Middle East about 14.7% in Egypt. Dendritic cells (DCs) are one of the major Antigen presenting cells in the body. They bridge innate and adaptive immunity and impact priming of HCVspecific immune responses. The current study was aimed to investigate the DC activation status, and their role in interaction with natural killer (NK) cells utilizing different setups with healthy NK and HCV+ DC, HCV+ NK and healthy DC, healthy DC and healthy NK and finally HCV+ NK and HCV+ DC in the presence of HCV peptides and a ratio of 5 NK: 1DC. Results: DC-NK interaction in chronic HCV infection is mainly affected by the affection of DCs by HCV leading to a maturation defect (decreased expression of HLA DR, CD 86 and CD 83). Healthy NK cells were able to stimulate the maturation of DCs particularly with core peptide whereas NS3-4 had no effect. When DCs were healthy, all peptides were able to produce significant maturation of DCs even when cocultured with HCV+ NK cells. Co-cultured HCV+ NK cells and HCV+ DCs showed significantly higher apoptosis of both cells. This could be attributed to the immature moDCs more with chronic HCV infection due to the fact that immature DCs typically under express HLA-class I molecules that would protect from NK-mediated lysis. Conclusion: Cross-talk between DCs and NK cells plays an important role in the induction of both the innate and adaptive immune systems. HCV infection was found to impair the maturation of DCs. Thus consequently affecting its antigen presentation and T cell allostimulatory capacity and rendering them more liable to NK mediated lysis which could explain the persistence of infection and chronicity

Frequency of cholelithiasis in patients with chronic liver disease: a hospital-based study

Background and study aim: Liver Cirrhosis is a strong and a common known risk factor for Cholelithiasis. Cholelithiasis is a multifactorial disease, based on a complex interaction of environmental and genetic factors. The primary aim of this study is to determine the frequency of cholelithiasis in chronic liver disease (CLD) patients admitted to Zagazig university hospitals. The secondary aim is to determine the risk factors and their association with the underlying etiology and severity of liver disease.Patients and Methods: We conducted a hospital based study including 131 patients with chronic liver disease based on clinical, laboratory and Ultrasonographic findings. Demographic, clinical and etiological data were recorded, using a pre-coded questionnaire. A number of laboratory tests as fasting plasma glucose, total cholesterol, triglyceride, aspartate aminotransferase (AST), alanine amino-transferase (ALT), alkaline phosphatase (ALP), hepatitis B surface antigen (HBsAg), and antibody to hepatitis C virus (HCV-Ab) were analyzed.Results: The number of registered cases was 131 with age (52.9±11.7).There were 55 (42%) males and 76 (58%) females. Hepatitis C (HCV) was present in 101 (77%) cases. The prevalence of cholelithiasis was 50.4%% (66 of 131 patients). Most of cholelithiasis patients presented with child C stage (68.2%), followed by child B (21.2%) and the least one was Child A. Hepatitis C (10.6%) was found to be associated with cholelithiasis (75.8%), followed by hepatitis B (13.6%). Auto-immune disease, diabetes mellitus, contraceptive pills and obesity are considered risk factors for cholelithiasis. Conclusion: Cholelithiasis tends to occur more frequently in patients with decompensated CLD. The higher incidence of cholelithiasis in CLD appears to be associated with HCV infection. This is an important parameter to be considered in a country with high prevalence of HCV as Egypt

Study of Interleukin-18 in chronic Hepatitis C Virus related liver diseases

Background and study aim: ELISA can determine serum Interleukin (IL)-18 level. It is a sensitive; simple and rapid test; thus help to study changes of serum IL-18 levels in chronic HCV related liver diseases during different stages. The objective of this study was to study serum IL-18 levels in chronic HCV related liver diseases. Patients and methods: Sera from 60 patients with HCV related chronic liver diseases at various stages of HCV infection (chronic hepatitis; cirrhosis and complications) and sera of 10 normal controls were subjected to measurements of serum IL-18 level by ELISA assay.Results: There were highly significant increase in the mean values of serum IL-18 in chronic HCV related liver cirrhosis; non complicated and complicated patients in comparison to chronic active hepatitis C patients and healthy subjects and highly significant increase in the mean values of serum IL-18 in complicated patients in comparison to non complicated patients. There was highly significant increase in the mean values of serum IL-18 in decompensated liver cirrhosis patients when compared to compensated patients. Conclusion: Serum IL-18 level shows highly positive significant correlation with severity of liver dysfunction in HCV related liver cirrhosis

Osteoporosis in Chronic Hepatitis C

Background and study aim: Hepatitis C virus infection is a multisystemic disease with many extrahepatic manifestations. Affection of bone matrix density is a common complication of chronic hepatitis and cirrhosis. The pathogenesis of osteoporosis in chronic liver disease is still unknown and is expected to be multifactorial. The aim of this work is to assess the frequency of osteoporosis/osteopenia in patients with chronic hepatitis C virus infection with or without cirrhosis.Patients and methods:This study was carried out on 30 patients with chronic HCV infection without cirrhosis (Group II); 30 patients with chronic HCV infection with compensated cirrhosis (Group III) and 20 age and gender matched healthy controls (Group I). All subjects of the study performed liver function tests; viral markers; liver biopsy; hormonal assay and Bone Mineral density measurement (BMD) by Dual energy X-ray absorptiometry (DEXA).Results : In patients with chronic hepatitis C (group II) the frequency of osteopenia was 11 (36.7); osteoporosis 2 (6.7); total patients with low BMD was 13 (43.3). In cirrhotic patients (group III); the frequency of osteopenia was 13 (43.3); osteoporosis was 3 (10.0); and total patients with low BMD was 16(53.3) vs 1(5.0) in the control group (group I). there was also no significant difference between patients with low BMD and patients with normal BMD as regards age; gender; common risk factors; liver function tests or hormonal levels.Conclusion : Reduced BMD is common chronic HCV-infected patients with and without cirrhosis. HCV infection is a risk factor of osteoporosis

Monitoring Hepcidin Level in Chronic Hepatitis C Virus Patients during Therapy

Introduction and study aim : Egypt has the highest prevalence of hepatitis C in the world estimated about 15. There are several host and viral factors that aid in predicting response to treatment; Hepcidine hormone is being investigated as one of these host factors. The aim of the work is to assess the serum concentration of hepcidin in chronic hepatitis C patients and evaluate any possible association with the viral load during therapy.Patients and methods: This study was carried on 35 chronic HCV patients on peg IFN/ Ribavirin therapy and 15 chronic HCV patients not on therapy as a control group.Hepcidin hormone levels were measured in sera of patients before starting therapy (base line) then at 12 and 24 weeks during therapy. RT PCR was used to asses response to ongoing therapy.Results: The level of hepcidin in all cases was low before starting therapy and it showed a significant increase during the course of therapy. This rise was detected earlier in responding cases. A negative correlation was found between baseline hepcidin level and baseline viral load of the responding cases. Conclusion: Chronic HCV infection is associated with reduced level of serum hepcidin hormone. The reduced serum hepcidin in chronic HCV patients is fully reversible after IFN/RBV therapy. Initial rise in serum hepcidin concentration might have a potential for being used as one of the indicators of patient response to therapy

Mean Platelet Volume as a Fibrosis Marker in Patients with Chronic Hepatitis C

Background and study aim: Liver biopsy limitations push us to search for new non invasive methods to detect liver fibrosis such as serum markers. The aim of this study is to evaluate mean platelet volume (MPV) as a fibrosis marker in patient with chronic hepatitis C. Patients and methods: 150 patients diagnosed with chronic hepatitis C infection refereed to Tanta Fever Hospital in period from May 2013 to January 2014 and 20 healthy volunteers as a control were included. All of them were tested for Mean Platelet Volume (MPV) in comparison with who done liver biopsy as standard. Results: Statistically significant differences in MPV and Platelet Count were seen in patients with chronic hepatitis C (CHC) compared to healthy controls (MPV: 8.95 ± 1.39fL vs. 7.57 ± 0.68 fl, P-value = 0.043; PC 226.03 ±68.36 vs. 188.9±46.49, P-value = 0.02) Multi-variate Logistic regression analysis shows only 5 variables remained as independent risk factors for fibrosis progression: (MPV, Schistosomiasis, ALT, AST and Prothrombin time). AST (OR 1.11, 95% CI 1.02 to 1.21), ALT (OR 0.92, 95% CI 0.86 to 0.99), PT (OR 2.11, 95% CI 1.15 to 3.88), and MPV (OR 2.28, 95% CI 1.22 to 4.25). Cut-off values were calculated for diagnostic performance, and the cut-off value for MPV was 9.22 fl., sensitivity 75.5%, specificity 62%, PPV 40.3%, NPPV 93.4% and Accuracy rate 61.8%. Conclusion: We suggest that high MPV levels (especially those over 9.22 fl) may help to predict advanced fibrosis in patients with CHC. However, it should not be forgotten that MPV is not a specific marker for fibrosis, and the negative predictive rate seems more valuable to exclude a high fibrosis ratio in patients with CHC

Hepatitis C infection markers among blood donors in Kisangani, Democratic Republic of Congo

Objectives: The role of blood transfusion in the spread of hepatitis C virus (HCV) is of concern in the DRC. Screened since the end of 2004 in blood donors, few data are however available on HCV in Kisangani. A study is needed to determine the seroprevalence of HCV in blood donors. Patients and method: 1247 blood samples collected from all volunteer blood donors who donated blood from August 1, 2005 to April 30, 2006 at the Provincial Blood Transfusion Centre were tested for anti-HCV antibodies. At the same time as HCV serology, markers for HIV and HBV were tested. Results: A total of 51(4.1%) volunteer blood donors (Table I) were HCV antibody positive. Fifty-two (4.2%) of the subjects were HIV positive and 60 (4.8%) were HBV positive. The mean age of HCV-positive donors was 31.4 years (±13.1) (Table II). HCV-positive seropositivity is lower among donors aged 17 to 24 years compared with those aged 25 years and older (p < 0.05). Positive HCV seropositivity is not related to gender. Conclusion: The seroprevalence of hepatitis C virus is relatively high like that of HIV among volunteer blood donors in Kisangani. It justifies that every blood donor be tested for HCV in order to prevent its transmission in Kisangani

Molecular epidemiology of hepatitis C virus (HCV) in Kadun State

Objective: To determine the distribution of hepatitis C virus (HCV) genotypes and subtypes among blood donors and outpatients attendees positive for antibody to HCV (anti-HCV). Justification: Hepatitis C virus (HCV) continues to be a major disease burden on the world and Man is the only known natural host of Hepatitis C virus (Chivaliez and Pawlotsky; 2007). There is no published data on the prevalence of the genotypes and subtypes of HCV in Kaduna State. Setting: Three hospitals one in each of the 3 senatorial zones in Kaduna State. Patients: Blood donors who reported for blood donation and outpatient department attendees. Method: Antibody detection by a third generation HCV ELISA (Biotech Laboratories; UK); HCV RNA and genotyping by Reverse Transcriptase polymerase chain reaction with genotype-specific primers. (Sacace Biotechnologies; UK). Results: of the 259 plasma specimens screened for Hepatitis C virus in this study; 20(7.7) were positive for anti-HCV antibodies by ELISA and 16(6.2) of the antibodies positive specimen were positive for HCV RNA. Of the 139 blood donors tested; 8 (5.8) were HCV RNA positive. Similarly; 120 were tested from the outpatient Department attendees and 8 (6.7) were HCV RNA positive. Hepatitis C virus genotype 1b was found in the entire HCV RNA positive sample. Conclusions: The findings of 6.2prevalence of HCV infection based on HCV RNA test confirmed that there is Hepatitis C virus in Kaduna State with genotype 1b as the predominant genotype found in all the three senatorial zones

A Review of Hepatitis C Virus (HCV) and the Current Management of Genotype 1 Chronic HCV Infection

Chronic Hepatitis C virus (HCV) is the primary cause of cirrhosis; hepatocellular carcinoma (HCC); and end- stage liver disease. The addition of protease inhibitor with peginterferon alfa and ribavirin (triple therapy) for genotype 1 infected patients; are the current standard of care.Method: Data was sourced from available journals and internet based search using pubmed; medline and google search.Results: successful Treatment of Genotype 1 HCV infected patients with protease inhibitor based triple therapy has improved sustained virologic response (SVR) rates and treatment induced clearance of HCV infection.Conclusion: significant progress in the management of chronic hepatitis C genotype 1 with the introduction of protease inhibitor (PI) in 2011 with peginterferon and ribavirin has optimized sustained virologic response (SVR)