Seroepidemiology of HBV infection in South-East of Iran; a population based study

Hepatitis B virus [HBV] infection is a major risk factor of cirrhosis and hepatocellular carcinoma affecting billions of people globally. Since information on its prevalence in general population is mandatory for formulating effective policies, this population based serological survey was conducted in Sistan and Baluchistan, where no previous epidemiological data were available. Using random cluster sampling 3989 healthy subjects were selected from 9 districts of Sistan and Baluchistan Province in southeastern Iran. The subjects' age ranged from 6 to 65 years old. Serum samples were tested for HBcAb, HBsAg. Screening tests were carried out by the third generation of ELISA. Various risk factors were recorded and multivariate analysis was performed. The prevalence of HBsAg and HBcAb in Sistan and Baluchistan was 3.38% [95% CI 2.85; 3.98] and 23.58% [95% CI 22.29; 24.93] respectively. We found 8 cases of positive anti-HDV antibody. Predictors of HBsAg or HBcAb in multivariate analysis were age, marital status and addiction. The rate of HBV infection in Sistan and Baluchistan was higher than other parts of Iran. Approxi-mately 25% of general population in this province had previous exposure to HBV and 3% were HBsAg carriers. Intrafamilial and addiction were major routes of HBV transmission in this province

Epidemiology of HCV infection among thalassemia patients in Eastern Mediterranean countries: a quantitative review of literature

Hepatitis C infection [HCV] is the major co-morbidity in thalassemia patients; however, literature lacks data from many EMRO counties. There is also enormous heterogeneity in the available study results in this region, and distribution of HCV infection among these patients living in this region is still unknown. This study provides a comprehensive and reliable tabulation of available data on the epidemiological characteristics and risk factors for hepatitis C virus [HCV] infection in thalassemia patients in eastern mediterranean countries. A systematic review was carried out based on the computerized literature database. 95% confidence intervals of infection rates were calculated using the approximate normal distribution model. Pooled Odds ratios and 95% CI were calculated by fixed or random effects models. The heterogeneity was assessed by either Q or X[2] statistics. Publication bias was evaluated by either Harbor's modified or Egger's test. We identified 40 studies that fulfilled our inclusion criteria involving 8554 thalassemia subjects. Pooled HCV seroprevalence was 18% [95% CI 14-21], 45% [95% CI 43-48], 63% [95% CI 56-69] and 69% [95% CI 58-80] in Iran, Pakistan, Saudi Arabia and Egypt, respectively. Among Iranian thalassemia patients, splenectomy OR=4.1 [95% CI 1.5-11.2], high transfusion OR=3.5 [95% CI 1.8-7], high age OR=6.1[95% CI 1.2-31.2] and first transfusion before 1996 OR=7.6 [95% CI 4.7-12.3] were major risk factors of HCV infection. There are no data from many EMRO countries. Among major EMRO countries, Iran has the least seroprevalence of HCV infection among thalassemia patients. This underscores more advanced blood safety in this country compared with other countries with comparable population in this region

Distribution of hepatitis C virus genotypes in iranian patients with congenital bleeding disorders

Chronic hepatitis C virus [HCV] infection is the major cause of liver disease related morbidity and mortality in hemophilic patients who needs regular blood product administration. Although genotype of infecting HCV is one of the prime predictors of response to antiviral therapy however, its distribution in hemophilic patients is still unclear and just few studies with low sample sizes have investigated this issue. Therefore, in this study, we aimed to identify this distribution in 367 Iranian hemophilic patients. Blood samples were received from 367 hemophilic patients with chronic hepatitis C detected during a nationwide screening program who referred to our center for therapeutic measures. HCV RNA viral load was detected using Amplicor test [Version 2]. Genotyping was performed by genotype specific primers. HCV genotype distribution was 1a in 58%, 3a in 18.5%, 1b in 14.7%, 4 in 1.1%, 2 in 0.8% and mixed in 6.2% and finally 0.5% of isolates were non-typable. Serum liver enzymes were not associated with HCV viral load and genotypes. Patients with severe bleeding tendency had significantly lower serum liver enzymes than those with a mild bleeding tendency. Genotype 1a followed by 3a and 1b were the most frequently detected HCV genotypes in Iranian hemophilic patients and there was no association between splenomegaly and viral markers and liver enzymes in these patients