Predominant amino acid substitutions in NS5B gene of hepatitis C virus in blood donors and treatment-naïve hepatitis and HIV patients in Nigeria

Background: Hepatitis C virus (HCV) genome undergoes high rate of mutation, which results in generation of genetically diverse HCV isolates. There is paucity of data on mutations in the nonstructural 5b (NS5b) gene of circulating HCV and their implications in the Nigerian population. Here, we identified clinically-important mutations in HCV isolates, which may influence response to therapy and disease prognosis. Methodology: HCV RNA was extracted from a total of 301 blood samples collected from 99 symptomatic treatment-naïve hepatitis patients, 125 HIV-infected individuals and 77 asymptomatic blood donors in Ibadan, Nigeria. The RNA was reverse­transcribed to complimentary DNA and HCV NS5B gene amplified by nested PCR. The amplified products of 42 HCV were sequenced and sequences were aligned with those from GenBank and HCV databases in MEGA 7.0. Nucleotide sequences were translated to amino acids while substitutions in the amino acids were analyzed with reference to H77 prototype strain of HCV. Results: A total of 10 amino acid polymorphisms were observed from the 42 sequenced NS5B gene, with the major clinically-important amino acid mutations being S15G in 28 (66.7%) participants, T7N (24, 57.1%), G61R (23, 54.8%), S54L (22, 52.4%), G89E (14, 33.3%), T79M (12, 28.6%), and T711 (11, 26.2%). Others were Q67R (7, 16.7%), Q47H (7, 16.7%) and S84F (2, 4.8%). S15G/A/V mutations were more predominant in patients with HIV (76.9%, 10/13) followed by patients with clinical hepatitis (75.0%, 12/16) and blood donors (46.1%, 6/13). Q67R and T71I mutations were not predominant in patients with clinical hepatitis as they were detected in only 31.3% (5/16) and 43.8% (7/16) participants respectively, compared to S15G (75.0%, 12/16), S54L (68.8%, 11/16), G61R/E (68.8%, 11/16) and T7N/S (56.3%, 9/16). There was no statistically significant difference in the distribution of each of the 10 amino acid polymorphisms detected within patients with symptomatic clinical hepatitis (x 2=9.311, p=0.409), HIV-infected patients (x 2=13.431, p=0.1440) and asymptomatic blood donors (x 2=3.775, p=0.9256). Similarly, there was no significant difference in the distribution between the 3 categories of the study participants except for T79M mutation, which was significantly higher in HIV-infected patients (61.5%, 8/13) compared to patients with clinical hepatitis (18.8%, 3/16) and asymptomatic blood donors (7.7%, 1/13) (x 2=10.456, p=0.0054). Conclusion: Mutations in the NS5B gene could be associated with worse prognosis of the disease or antiviral failure due to viral resistance in patients undergoing therapy. The absence of Q47H mutations in majority of the study participants in our study implies that they will not respond well to daprevir and mericitabine. Screening of patients for pre-existing resistant mutations before commencement of therapy and monitoring during and after therapy are recommended.

Perfil bioquímico e sorológico das hepatites b e c num centro recuperação para dependentes químicos / Biochemical and serological profile of hepatitis b and c in a recovery center for chemical dependents / Perfil bioquímico y serológico de hepatitis b y c en un centro de recuperación de dependientes químicos

Objetivo: A pesquisa visa determinar o perfil bioquímico e sorológico das hepatites B e C em internos de um centro de recuperação, Ananindeua, Pará, Brasil. Métodos: Estudo transversal, descritivo e quantitativo, desenvolvido entre 2015 e 2018. Os dados foram coletados com o uso de Ficha de Inquérito e entrevista. Os participantes foram submetidos à coleta de sangue para realização de testes sorológicos para as hepatites virais B e C e bioquímicos. Resultados: Participaram 125 internos, com frequência de 97,6% para o sexo masculino, prevalecendo a faixa etária de 31 a 40 anos (38,4%). Os marcadores bioquímicos que mais sofreram alterações: ácido úrico, alanina aminotransferase e lipoproteína de alta densidade. O HBsAg não foi detectado, porém houve detecção de anti-HBc total reagente isolado em 1,6% dos indivíduos. Em 20,8% pode-se observar resposta vacinal contra o vírus da hepatite B. A pesquisa detectou prevalência de 3,2% de anti-VHC reagente. Conclusão: É baixa prevalência da infecção pelos vírus das hepatites B e C, apesar dessa população ser considerada de elevado risco para a transmissão desses vírus, os examinados na sua maioria referiu utilizar apenas drogas inaláveis. A baixa cobertura vacinal encontrada entre os examinados demonstrou a vulnerabilidade em adquirir a hepatite B e a importância de estudos entre usuários de drogas no Pará. (AU)

Objective: The research aims to determine the biochemical and serological profile of hepatitis B and C in inmates of a recovery center, Ananindeua, Pará, Brazil. Methods: Cross-sectional, descriptive and quantitative study, developed between 2015 and 2018. Data were collected using an Inquiry Form and an interview. Participants underwent blood collection to perform serological tests for viral hepatitis B and C and biochemicals. Results: 125 inmates participated, with a frequency of 97.6% for males, with the age group of 31 to 40 years old prevailing (38.4%). The biochemical markers that suffered the most changes: uric acid, Alanine aminotransferase and High density lipoprotein. HBsAg was not detected, but total anti-HBc reagent isolated was detected in 1.6% of individuals. In 20.8%, a vaccine response against the hepatitis B virus can be observed. The survey found a 3.2% prevalence of anti-HCV reagent. Conclusion: The prevalence of infection by the hepatitis B and C viruses is low, although this population is considered to be at high risk for the transmission of these viruses, the majority of those examined reported using only inhalable drugs. The low vaccination coverage found among those examined demonstrated the vulnerability to acquire hepatitis B and the importance of studies among drug users in Pará. (AU)

Objetivo: La investigación tiene como objetivo determinar el perfil bioquímico y serológico de la hepatitis B y C en los reclusos de un centro de recuperación, Ananindeua, Pará, Brasil. Métodos: Estudio transversal, descriptivo y cuantitativo, desarrollado entre 2015 y 2018. Los datos se recopilaron mediante el Formulario de encuesta y la entrevista. Los participantes se sometieron a extracción de sangre para pruebas serológicas de hepatitis viral B y C y bioquímicos. Resultados: Participaron 125 reclusos, con una frecuencia del 97,6% para los hombres, prevaleciendo el grupo de edad de 31 a 40 años (38,4%). Los marcadores bioquímicos que sufrieron más cambios: ácido úrico, Alanina aminotransferasa y Lipoproteínas de alta densidad. No se detectó HBsAg, pero se detectó el reactivo anti-HBc total aislado en el 1,6% de los individuos. En 20.8%, se puede observar una respuesta de vacuna contra el virus de la hepatitis B. La encuesta encontró una prevalencia del 3.2% Del reactivo anti-VHC. Conclusiones: La prevalencia de infección por los virus de la hepatitis B y C es baja, aunque se considera que esta población tiene un alto riesgo de transmisión de estos virus, la mayoría de los examinados informaron que usaban solo medicamentos inhalables. La baja cobertura de vacunación encontrada entre los examinados demostró la vulnerabilidad a contraer hepatitis B y la importancia de los estudios entre usuarios de drogas en Pará. (AU)

Prevalence of HCV Antibody and its Associated Factors: A Study from Sentinel Hospitals in China / 生物医学与环境科学（英文）

OBJECTIVE@#The prevalence and related factors of serum anti-HCV in different regions and hospitals have not been studied extensively in China. We used routine screening data to determine the prevalence of HCV antibody in hospital patients, evaluate the epidemic trend of hepatitis C and formulate screening strategies.@*METHODS@#Patient information and HCV antibody testing results were collected from January 2017 to December 2019 in 77 HCV sentinel hospitals in China. Univariate and multivariate logistic regression was used to determine the characteristics and associations.@*RESULTS@#HCV antibody prevalence rates were distinct among patients in different departments, with a range of 0.33%-6.93%. Patients who were admitted to the liver disease-related departments (a OR = 10.76; 95% CI, 10.27-11.28), Internal Medicine (a OR = 2.87; 95% CI, 2.75-3.00), and Department of Surgery (a OR = 1.95; 95% CI, 1.87-2.04), were more likely to be tested for HCV antibody positive. HCV antibody prevalence was associated with patients aged 45 years and older (a OR = 2.74; 95% CI, 2.69-2.80), testing in infetious disease hospitals (a OR = 2.33; 95% CI, 2.26-2.40) and secondary hospitals (a OR = 1.72; 95% CI, 1.69-1.75). Patients in sentinel hospitals of the Northeast (a OR = 12.75; 95% CI, 12.40-13.11), the Central (a OR = 1.65; 95% CI, 1.61-1.70), and the West (a OR = 1.78; 95% CI, 1.73-1.83) China had higher HCV prevalence than those who were in the Eastern coastal area.@*CONCLUSION@#Those who were over 45 years old and saw doctors for liver diseases, and invasive diagnosis and treatment should be referred to HCV antibody testing.

Global trajectories of liver cancer burden from 1990 to 2019 and projection to 2035 / 中华医学杂志(英文版)

BACKGROUND@#Large disparities exist in liver cancer burden trends across countries but are poorly understood. We aimed to investigate the global trajectories of liver cancer burden, explore the driving forces, and predict future trends.@*METHODS@#Data on the liver cancer burden in 204 countries and territories from 1990 to 2019 were extracted from the Global Burden of Disease Study. The age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) trajectories were defined using growth mixture models. Five major risk factors contributing to changes in the ASIR or ASMR and socioeconomic determinants were explored using the identified trajectories. A Bayesian age-period-cohort model was used to predict future trends through 2035.@*RESULTS@#Three trajectories of liver cancer burden were identified: increasing, stable, and decreasing groups. Almost half of the American countries were classified in the decreasing group (48.6% for ASIR and ASMR), and the increasing group was the most common in the European region (ASIR, 49.1%; ASMR, 37.7%). In the decreasing group, the decrease of liver cancer due to hepatitis B contributed 63.4% and 60.4% of the total decreases in ASIR and ASMR, respectively. The increase of liver cancer due to alcohol use, hepatitis C, and hepatitis B contributed the most to the increase in the increasing group (30.8%, 31.1%, and 24.2% for ASIR; 33.7%, 30.2%, and 22.2% for ASMR, respectively). The increasing group was associated with a higher sociodemographic index, gross domestic product per capita, health expenditure per capita, and universal health coverage (all P <0.05). Significant variations in disease burden are predicted to continue through 2035, with a disproportionate burden in the decreasing group.@*CONCLUSION@#Global disparities were observed in liver cancer burden trajectories. Hepatitis B, alcohol use, and hepatitis C were identified as driving forces in different regions.

Interpretation of the important update of the Guideline for the prevention and treatment of hepatitis C (2022 edition) / 中华肝脏病杂志

In the past 20 years, Chinese Medical Association had issued several versions of hepatitis C prevention and treatment guidelines. In the latest guidelines published in 2022, the Chinese Society of Hepatology and the Society of Infectious Diseases for the Chinese Medical Association organized experts to update their recommendations for hepatitis C screening and treatment. The updated key points on prevention, diagnosis, and treatment proposed in the guidelines are now interpreted, aiming to provide reference for more effective clinical application of the guidelines.

Survey of prevalence of hepatitis C in people aged 1-69 years in Henan Province, 2020 / 中华流行病学杂志

Objective: To understand the infection status and epidemiological characteristics of hepatitis C in people aged 1-69 years in Henan Province in 2020. Methods: The estimated sample size was 5 827. From August to December 2020, multistage sampling was used to select 8 counties (districts) in Henan, and two survey sites were selected in each county (district), and a questionnaire survey was conducted in local people aged 1-69 years, blood samples were collected from them for anti-HCV, HCV RNA and genotype detections. Results: A total of 5 165 people aged 1-69 years completed the questionnaire survey. Men accounted for 44.76% (2 312/5 165), women accounted for 55.24% (2 853/5 165). In the people aged 1-69 years, the overall prevalence rates of anti-HCV and HCV RNA were 0.69% (95%CI: 0.68%-0.70%) and 0.20% (95%CI: 0.19%-0.21%) respectively. The prevalence rates of anti-HCV and HCV RNA were 0.48% (95%CI: 0.46%-0.50%), 0.09% (95%CI: 0.08%-0.10%) in men and 0.86% (95%CI: 0.85%-0.87%), 0.30% (95%CI: 0.28%-0.32%) in women. The prevalence rates of anti-HCV and HCV RNA increased with age. The prevalence rates of anti-HCV and HCV RNA were 0.87% (95%CI: 0.86%-0.88%), 0.28% (95%CI: 0.26%-0.30%) in urban residents and 0.53% (95%CI: 0.51%-0.55%), 0.14% (95%CI: 0.13%-0.15%) in rural residents. The genotyping results of 10 HCV RNA positive samples ware genotype 1b (4/10), genotype 2 (3/10), genotype 1b/3 (1/10), genotype 1b/3/6 (1/10) and genotype 2/6 (1/10). Conclusions: The prevalence of hepatitis C was low in Henan in 2020. It is necessary to strengthen hepatitis C surveillance in people aged 40 years and above. The major HCV genotypes were 1b and 2, and mixed genotype infection existed.

Study on the related factors of antiviral treatment in previously reported hepatitis C patients based on the Andersen model / 中华肝脏病杂志

Objective: To understand the basic characteristics of previously reported patients with hepatitis C and analyze the related factors affecting their antiviral treatment. Methods: A convenient sampling method was adopted. Patients who had been previously diagnosed with hepatitis C in the Wenshan Prefecture of Yunnan Province and Xuzhou City of Jiangsu Province were contacted by telephone for an interview study. The Andersen health service utilization behavior model and related literature were used to design the research framework for antiviral treatment in previously reported hepatitis C patients. A step-by-step multivariate regression analysis was used in previously reported hepatitis C patients treated with antiviral therapy. Results: A total of 483 hepatitis C patients, aged 51.73 ± 12.06 years, were investigated. The proportion of male, agricultural occupants who were registered permanent residents, farmers and migrant workers was 65.24%, 67.49%, and 58.18%, respectively. Han ethnicity (70.81%), married (77.02%), and junior high school and below educational level (82.61%) were the main ones. Multivariate logistic regression analysis results showed that married patients with hepatitis C (OR = 3.19, 95% CI: 1.93-5.25, compared with unmarried, divorced, and widowed patients) with high school education or above (OR = 2.54, 95% CI: 1.54-4.20, compared with patients with junior high school education or below) were more likely to receive antiviral treatment in the predisposition module. Patients with severe self-perceived hepatitis C in the need factor module (compared with patients with mild self-perceived disease, OR = 3.36, 95% CI: 2.09-5.40) were more likely to receive treatment. In the competency module, the family's per capita monthly income was more than 1,000 yuan (compared with patients with per capita monthly income below 1,000 yuan, OR = 1.59, 95% CI: 1.02-2.47), and the patients had a high level of awareness of hepatitis C knowledge (compared with patients with a low level of knowledge, OR = 1.54, 95% CI: 1.01-2.35), and the family members who knew the patient's infection status (compared with patients with an unknown infection status, OR = 4.59, 95% CI: 2.24-9.39) were more likely to receive antiviral treatment. Conclusion: Different income, educational, and marital statuses are related to antiviral treatment behavior in hepatitis C patients. Family support of hepatitis C patients receiving hepatitis C-related knowledge and their families knowing the infection status is more important in promoting the antiviral treatment of patients, suggesting that in the future, we should further strengthen the hepatitis C knowledge of hepatitis C patients, especially the family support of hepatitis C patients' families in treatment.

Perfil da hepatite C em Goiás: epidemiologia, distribuição genotípica e carga viral / Profile of hepatitis C in Goiás: epidemiology, genotypic distribution and viral load

O Virus da Hepatite C (HCV) possui vasta diversidade. Com base nas variações genômicas, existem oito genótipos, designados de G1 a G8, com prevalências distintas de acordo com a região geográfica observada. Objetivo: O objetivo do estudo foi avaliar o perfil epidemiológico, genotípico e carga viral (CV) do HCV. Métodos: Estudo observacional analítico do tipo transversal, com dados de janeiro de 2018 a dezembro de 2021. O estudo analisou dados referentes a genotipagem, CV e do Formulário de Solicitação de CV do HCV, obtidos no Laboratório Estadual de Saúde Pública do estado de Goiás. Resultados: A maioria dos casos de HCV, concentram-se nas macrorregiões de saúde Centro Sudeste (42,90%) e Centro Oeste (34,15%) do Estado, com maior frequência do G1, seguido do G3 e presença dos G2, G4 e G5. O G1 vem diminuindo a frequência no decorrer dos anos, enquanto o G3 aumenta. Em geral, 49,33% dos casos apresentam alta CV (> 1.000.000 UI/mL). Em relação ao sexo, 31,75% dos indivíduos do sexo masculino apresentaram CV nessa mesma faixa, e o sexo feminino com 17,58%. A CV foi consideravelmente alta entre os casos analisados, com o sexo feminino, apresentando CV significativamente menor que o sexo masculino. Foram identificados o subtipo 1d e o G5 incomuns na região Central do Brasil. Conclusão: Os dados apresentados demonstram que o HCV pode estar em expansão, com o aparecimento de novos genótipos, subtipos e demonstra uma mudança na distribuição genotípica, no estado de Goiás nos últimos anos

The Hepatitis C Virus (HCV) has vast diversity. Based on genomic variations, there are eight genotypes, designated from G1 to G8, with different prevalences according to the geographical region observed. Objective: The objective of the study was to evaluate the epidemiological, genotypic and viral load (CV) profile of HCV. Methods: Cross-sectional analytical observational study, with data from January 2018 to December 2021. The study analyzed data relating to genotyping, CV and the HCV CV Request Form, obtained from the State Public Health Laboratory of the state of Goiás. Results: The majority of HCV cases are concentrated in the Central Southeast (42.90%) and Central West (34.15%) health macro-regions of the State, with a higher frequency in G1, followed by G3 and the presence of G2Genotype, G4 and G5. G1 has been decreasing in frequency over the years, while G3 is increasing. In general, 49.33% of cases have high CV (> 1,000,000 IU/mL). In relation to sex, 31.75% of males had CV in the same range, and females had 17.58%. The CV was considerably high among the cases analyzed, with females presenting a significantly lower CV than males. Subtype 1d and G5, uncommon in the Central region of Brazil, were identified. Conclusion: The data presented demonstrate that HCV may be expanding, with the emergence of new genotypes, subtypes and demonstrates a change in genotypic distribution in the state of Goiás in recent years

Prevalence of active HCV infection and genotypic distribution among the general population of district Mardan, Pakistan / Prevalência de infecção HCV ativa a distribuição genotípica entre a população geral do distrito de Mardan, Paquistão

Abstract Hepatitis C virus (HCV) is the serious global public health burden of liver disease. Approximately 170 million people in the world are infected with (HCV). In Pakistan, where the disease has high occurrence rate. The present study envisages an up-to-date prevalence of HCV and genotypic distribution in the general population of Mardan District, Khyber Pakhtunkhwa (KP), Pakistan. The blood samples from 6,538 individuals including 3,263 males and 3,275 females were analyzed for hepatitis C surface antigen by Immuno-chromatographic test (ICT), Enzyme-linked immunosorbent assay (ELISA), and reverse transcription-polymerase chain reaction (PCR). It was found that 396 (12.13%) out of 3263 individuals contained antibodies in their blood against HCV, while among the different age groups, the highest incidences of HCV antibodies were found in the 31-40 age group (11.01%). The ICT positive samples were further screened by nested PCR to determine the existence of active HCV-RNA. It was identified that 7.11% (3263) of the total population (6538) tested was positive, among which the 461 (14.07%) females possessed antibodies in their blood against HCV. Our data showed total HCV infection in the investigated population was 5.78%. Higher percentage of HCV prevalence was detected in males than females in the age group 31-40 and 41-50. To compare the prevalence of HCV genotypes age-wise in male and female genotype 3a was found most prevalent genotype followed by 1a, 2a and 3b, respectively.

Resumo O vírus da hepatite C (HCV) é o grave problema de saúde pública das doenças hepáticas. Aproximadamente 170 milhões de pessoas no mundo estão infectadas com HCV; no Paquistão, a doença tem alto índice de ocorrência. O presente estudo prevê uma prevalência atualizada do HCV e distribuição genotípica na população geral do distrito de Mardan, Khyber Pakhtunkhwa (KP), Paquistão. As amostras de sangue de 6.538 indivíduos, incluindo 3.263 homens e 3.275 mulheres, foram analisadas para o antígeno de superfície da hepatite C por teste imunocromatográfico (ICT), ensaio imunoenzimático (ELISA) e reação em cadeia da polimerase de transcrição reversa (PCR). Verificou-se que 396 (12,13%) de 3.263 indivíduos continham anticorpos no sangue contra o HCV, enquanto entre as diferentes faixas etárias as maiores incidências de anticorpos anti-HCV foram encontradas na faixa etária de 31 a 40 anos (11,01%). As amostras positivas para ICT foram posteriormente rastreadas por nested PCR para determinar a existência de HCV-RNA ativo. Identificou-se que 7,11% (3.263) do total da população (6.538) testada foram positivos, dentre os quais 461 (14,07%) mulheres possuíam anticorpos no sangue contra o HCV. Nossos dados mostraram que a infecção total pelo HCV na população investigada foi de 5,78%. Maior porcentagem de prevalência de HCV foi detectada em homens do que em mulheres nas faixas etárias de 31-40 e 41-50. Para comparar a prevalência de genótipos de HCV com relação à idade no genótipo masculino e feminino 3a foi encontrado o genótipo mais prevalente seguido por 1a, 2a e 3b, respectivamente.

Homens que fazem sexo com homens e a hepatite C: prevalência e fatores de risco em 12 capitais brasileiras / Men who have sex with men and hepatitis C: prevalence and risk factors in 12 Brazilian capitals

Apesar das políticas preventivas adotadas, a redução da transmissão das infecções sexualmente transmissíveis (ISTs) entre homens que fazem sexo com homens (HSH) tem sido limitada. O risco de infecção pelo vírus da hepatite C (HCV) aumentou entre os grupos populacionais mais vulneráveis incluindo HSH O objetivo do estudo foi estimar a prevalência da infecção pelo HCV e avaliar fatores de risco entre HSH em 12 capitais brasileiras Este estudo foi realizado de junho a dezembro de 2016 por meio do método respondent driven sampling (RDS). Os participantes preencheram um questionário autoaplicável para coletar dados socioeconômicos, demográfico s e comportamentais . Além disso, foi ofertado o teste rápido (TR) para Resultados positivos foram enviados ao Instituto Adolfo Lutz para testes confirmatórios. Foram recrutados 4. 176 participantes e 23 amostras foram enviadas para confirmação. Destas, 16 foram confirmadas, demonstrando prevalência de 0, 7% IC 95%: 0,3% 1,7%). A região Sudeste apresentou prevalência de 0,9% ( IC 95%: 0,3 2,6), seguida pela região Sul, com 0,6 % (IC 95%: 0,2 2,1)2,1). A região Nordeste apresentou prevalência de 0,3% (IC 95%: 0,1 1,0) e a C entro O este 0,1 % (IC%: 0,0 0,7)0,7). Nenhum caso positivo foi encontrado na região Norte . Homens solteiros com mais de 40 anos foram a maioria dos participantes expostos ao HCV. O uso irregular de preservativo s e o número elevado de parceiros sexuais, além da infecção por outras ISTs, foram associados ao aumento da exposição ao HCV. De acordo com os dados apresentados, é necessário implantar políticas de prevenção que se concentrem no segmento de HSH e que tenham estratégias de comunicação mais efetivas. Mostra se necessário o desenvolvimento de conhecimentos que fortaleçam a habilidade e estimulem a motivação para um comportamento mais seguro nessa população Os investimentos nas populações mais vulneráveis são fundamentais para atingir a meta da Organização Mundial da Saúde (OMS ) de eliminar as hepatites virais até 2030. (AU)

Despite the preventive policies adopted, the reduction of the transmission of sexually transmitted infections (STIs) among men who have sex with men (MSM) has been limited. The risk of infection with the Hepatitis C (HCV) has increased among the most vulnerable population groups including MSM The aim of the study was to estimate the prevalence of the infection by HCV and assess risk factors among MSM in 12 Brazilian capitals This study was carried out from June to December 2016 using the method respondent driven sampling (RDS). Participants filled out a self-administered questionnaire to collect socioeconomic data, demographic and behavioral . In addition, the rapid test was offered (TR) for Positive results were sent to Instituto Adolfo Lutz for confirmatory tests. 4, 176 participants were recruited and 23 Samples were sent for confirmation. Of these, 16 were confirmed, demonstrating a prevalence of 0.7% CI 95%: 0.3% 1.7%). The Southeast region presented a prevalence of 0.9% (CI 95%: 0.3 2.6), followed by the South region, with 0.6% (95% CI: 0.2 2.1)2.1). The Northeast region showed a prevalence of 0.3% (CI 95%: 0.1 1.0) and Center West 0.1% (CI%: 0.0 0.7)0.7). None positive case was found in the North region. Single men over 40 years were the majority of participants exposed to HCV. The irregular use of condoms and the high number of sexual partners, in addition to the infection by other I STs, were associated with increased exposure to HCV. In according to the data presented, it is necessary to implement policies of prevention programs that focus on the MSM segment and that have more effective communication strategies. Show if necessary development of knowledge that strengthens the ability and encourages the motivation for safer behavior in this population investments in the most vulnerable populations are fundamental to achieve the World Health Organization (WHO) goal of eliminating viral hepatitis by 2030. (AU)

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.

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.

Características clinicoepidemiológicas y endoscópicas en portadores del virus C de la hepatitis con tratamiento de hemodiálisis / Clinical epidemiological and endoscopic characteristics in carriers of the viral hepatitis C with hemodialysis treatment i: en

Introducción: Los pacientes con insuficiencia renal crónica en tratamiento de hemodiálisis constituyen un importante grupo de riesgo para adquirir la infección por el virus C de la hepatitis. Objetivo: Caracterizar a portadores del virus C de la hepatitis en tratamiento de hemodiálisis según variables clinicoepidemiológicas y endoscópicas. Métodos: Se realizó una investigación observacional, descriptiva, retrospectiva y longitudinal de 63 pacientes con insuficiencia renal crónica, en tratamiento de hemodiálisis, portadores del virus C de la hepatitis, quienes fueron atendidos en la consulta de Gastroenterología del Hospital General Docente Dr. Juan Bruno Zayas de Santiago de Cuba, desde enero de 2015 hasta septiembre de 2019. Resultados: En la investigación primaron el sexo masculino, el grupo etario de 31-60 años, además de la hipertensión arterial y la diabetes mellitus como antecedentes personales. Los factores de riesgo de mayor incidencia fueron las inyecciones y las transfusiones frecuentes. Conclusiones: Existió una correlación significativa entre el tiempo en hemodiálisis y el tiempo de diagnóstico del virus C de la hepatitis; sin embargo, la replicación viral se mantuvo baja.

Introduction: The patients with chronic renal failure in hemodialysis treatment constitute an important risk group to acquire the infection for the viral hepatitis C. Objective: To characterize carriers of the viral hepatitis C in hemodialysis treatment according to clinical epidemiological and endoscopic variables. Methods: An observational, descriptive, retrospective and longitudinal investigation of 63 patients with chronic renal failure, in hemodialysis treatment, carriers of the viral hepatitis C was carried out, who were assisted in the Gastroenterology Service of Dr. Juan Bruno Zayas Teaching General Hospital in Santiago de Cuba from January, 2015 to September, 2019. Results: In the investigation there was a prevalence of the male sex, the 31-60 age group, besides hypertension and the diabetes mellitus as personal history. The risk factors of more incidence were injections and frequent transfusions. Conclusions: There was a significant correlation between the time in hemodialysis and the time of diagnosis of the viral hepatitis C; however, the viral replication stayed low.

Frequência de esteato-hepatite alcoólica em pacientes portadores do vírus de hepatite C / Frequency of alcoholic steatohepatitis in patients with hepatitis C virus

Introdução: o consumo de álcool é um fator de risco bem conhecido para induzir doença crônica do fígado. O álcool também é um cofator na patogênese induzida pelo vírus da hepatite C (VHC). A infecção crônica pelo VHC pode exacerbar a lesão hepática alcoólica por mecanismos que incluem aumento do estresse oxidativo. Portanto o VHC, concomitantemente com o consumo excessivo de álcool, induz diversos mecanismos fisiopatogênicos que contribuem para a diminuição da depuração viral e para a lesão hepática. Objetivos: 1 ­ avaliar a frequência de esteato-hepatite alcoólica em biópsias de pacientes portadores do vírus da hepatite C; 2 ­ estudar os estágios da fibrose hepática nesses pacientes versus pacientes com e sem ingestão de álcool; 3 ­ analisar os escores bioquímicos e antropométricos desses pacientes. Metodologia: estudo de corte transversal, com pacientes acompanhados no núcleo de hepatologia do Hospital Prof. Edgard Santos da Universidade Federal da Bahia, portadores de hepatite C, com laudos de biópsias disponíveis para avaliar presença de esteato-hepatite alcoólica comprovada pelo registro de consumo de gramas de álcool. Foram considerados etilistas homens que consumiam mais de 30 g por dia e mulheres com consumo maior do que 20 g por dia. As variáveis utilizadas basearam-se em critérios histológicos, epidemiológicos e clínicos aplicados a esses pacientes. Resultados: a amostra total de pacientes portadores de hepatite C analisados foi de 335, sendo 100 indivíduos considerados com ingestão elevada de álcool, e 28,9% dos casos da amostra. A presença de esteatose hepática sem esteato-hepatite foi em 34 indivíduos (10,15%), e os casos de esteato-hepatite aparecem em um total de 30 indivíduos (8,96%). A carga viral elevada dos pacientes, tendo como referência >800.000, esteve em n=102, com 30,4% dos casos de VHC. Conclusão: observou-se, na população de estudo, 43 % os portadores de VHC com uso excessivo de alcool, 8,9 6% tinham esteato-hepatiits e 10,15 % esteatose. Além disso, verificou-se que mais da metade desses pacientes (56,6%) apresentaram grau de fibrose moderada e 53,3%, atividade necroinflamatória leve. A comorbidade mais comum observada foi hipertensão arterial sistêmica (HAS), em 40% dos pacientes.

Introduction: alcohol consumption is a well-known risk factor for inducing chronic liver disease, alcohol is also a cofactor in the pathogenesis induced by Hepatitis C Virus (HCV). Chronic HCV infection can exacerbate alcoholic liver damage by mechanisms including increased oxidative stress. Therefore, HCV, concomitantly with excessive alcohol consumption, induces several pathophysiological mechanisms, which contribute to the decrease in viral clearance and liver damage. Objectives: 1 ­ to assess the frequency of alcoholic steatohepatitis in biopsies of patients with the hepatitis C virus, 2 ­ to study the stages of liver fibrosis in these patients versus in patients with or without alcohol intake, 3 ­ analyze biochemical and anthropometric scores of these patients. Methodology: cross-sectional study, with patients monitored at the hepatology center of Hospital Prof. Edgard Santos from the Federal University of Bahia, carriers of hepatitis C with biopsy reports available to assess the presence of alcoholic steatohepatitis proven by recording the consumption of grams of alcohol, considered an alcoholic being a man, who consumed more than 30 g per day and being woman more than 20g a day. The variables used were based on histological, epidemiological and clinical criteria applied to these patients. Results: the total sample of patients with hepatitis C analyzed was (n=335), with n=100 individuals considered to have high alcohol intake, and 28.9% of the cases in the sample. The presence of hepatic steatosis without steatohepatitis was in 34 individuals (10.15%), and cases of steatohepatitis appear in a total of n=30 individuals (8.96%).The high viral load of patients, with >800,000 as reference, was n=102, with 30.4% of cases of HCV. Conclusion: it was observed, in the study population, 43% of HCV carriers with excessive alcohol use, 8.96% had steatohepatitis and 10.15% steatosis. Furthermore, it was found that more than half of these patients (56.6%) had a moderate degree of fibrosis and 53.3% had mild necroinflammatory activity. The most common comorbidity observed was systemic arterial hypertension (SAH), in 40% of patients.

Point-of-care hepatitis C screening with direct access referral to improve linkage to care among halfway house residents: a pilot randomised study

INTRODUCTION@#Linkage to care among individuals with substance misuse remains a barrier to the elimination of the hepatitis C virus (HCV). We aimed to determine whether point-of-care (PoC) education, screening and staging for liver disease with direct access to hospitals would improve linkage to care among this group. @*METHODS@#All participants were offered PoC education and HCV screening. HCV-positive participants were randomised to standard care (controls) or direct access, which provided a direct pathway to hospitals. Linkage to care was determined by reviewing electronic medical records. Linkage of care cascade was defined as attendance at the specialist clinic, confirmation of viraemia by HCV RNA testing, discussion about HCV treatment and initiation of treatment. @*RESULTS@#351 halfway house residents were screened. The overall HCV prevalence was 30.5% (n = 107), with 69 residents in the control group and 38 in the direct access group. The direct access group had a significantly higher percentage of cases linked to specialist review for confirmatory RNA testing (63.2% vs. 40.6%, p = 0.025), HCV treatment discussion (p = 0.009) and treatment initiation (p = 0.01) compared to the controls. Overall, only 12.6% (n = 13) had treatment initiation during follow-up. PoC HCV screening with direct access referral had significantly higher linkage to HCV treatment initiation (adjusted odds ratio 9.13, p = 0.005) in multivariate analysis. @*CONCLUSION@#PoC HCV screening with direct access improves linkage to care and simplifies the HCV care cascade, leading to improved treatment uptake. PoC education, screening, diagnosis and treatment may be an effective strategy to achieving HCV micro-elimination in this population.

A real-world study of the efficacy and safety of sofosbuvir and velpatasvir in the treatment of HCV-infected patients in a county in northern China / 中华肝脏病杂志

Objective: To evaluate the real-world efficacy and safety of sofosbuvir and velpatasvir (SOF/VEL) tablets in the treatment of Chinese patients with chronic HCV infection. Methods: An open-label, single-center, prospective clinical study was conducted in a county in northern China. A total of 299 cases were enrolled. Of these, 161 cases with chronic hepatitis C and 73 cases with compensated cirrhosis received SOF/VEL for 12 weeks. 65 cases with decompensated cirrhosis received SOF/VEL combined with ribavirin for 12 weeks (22 cases) or SOF/VEL for 24 weeks (43 cases). Virological indicators, liver and renal function indexes, and liver stiffness measurement were detected at baseline, the fourth week of treatment, the end of treatment, and the 12-weeks of follow-up. Adverse reactions and laboratory abnormalities were observed during the course of treatment . The primary endpoint was undetectable rate of HCV RNA (SVR12) at 12 weeks of follow-up with the use of modified intention-to-treat (mITT) approach. Measurement data between two groups were compared using t-test. One Way ANOVA was used for comparison between multiple groups. Enumeration data were analyzed by chi-square test or Fisher's exact test. Results: 291 cases had completed treatment. HCV RNA was undetectable after 12 weeks of follow-up, and the SVR12 rate was 97.3% (95% confidence interval: 95.4%-99.3%). Among them, 97.4% of genotype 1b, 96.4% of genotype 2a, and 100% of those with undetected genotype achieved SVR12. The SVR12 rates in patients with chronic hepatitis C, compensated and decompensated liver cirrhosis were 98.1%, 98.6% and 93.8%, respectively. An improvement in alanine aminotransferase, aspartate aminotransferase and other liver biochemical indicators accompanied with virological clearance and reduced liver stiffness measurement was observed in patients with compensated cirrhosis, with statistically significant difference. There was no significant abnormality in renal function before and after treatment. The most common adverse reactions were fatigue, headache, epigastric discomfort and mild diarrhea. The overall adverse reactions were mild. One patient died of decompensated liver cirrhosis combined with massive upper gastrointestinal bleeding, which was unrelated to antiviral treatment. Four patients discontinued treatment prematurely due to adverse events. Relapse was occurred in four cases, and drug-resistance related mutations were detected in three cases. Conclusion: Sofosbuvir and velpatasvir tablets in Chinese HCV-infected patients with different genotypes, different clinical stages or previously treated with pegylated interferon combined with ribavirin resulted in higher SVR12, indicating that the treatment safety profile is good.

Drug selection for simultaneous treatment of tuberculosis combined with hepatitis C virus infection / 中华肝脏病杂志

Clinically, patients with tuberculosis (TB) combined with hepatitis C virus (HCV) infection often require simultaneous treatment. Consequently, when anti-HCV and TB drugs are used in combination drug-drug interactions (DDIs), anti-TB drug-induced hepatotoxicity, and liver disease states need to be considered. This paper focuses on discussing the metabolic mechanisms of commonly used anti-TB and HCV drugs and the selection options of combined drugs, so as to provide rational drug use for TB patients combined with HCV infection.

Trend and prediction of hepatitis C cases in children aged 14 years old and younger in Henan province, 2005-2020 / 中华流行病学杂志

Objective: To explore the time series characteristics of hepatitis C cases in children aged ≤14 years old in Henan and predict their epidemic situation with effective model. Methods: Hepatitis C reported data among children aged ≤14 years old in Henan from 2005 to 2020 were collected from China information system for diseases control and prevention. Descriptive and time series analyses were used to demonstrate characteristics of time trend, decomposition methods were used to show the seasonality by using seasonal indices and the long-term trend by using a linear regression model. An auto-regressive integrated moving average (ARIMA) model was established. Results: From 2005 to 2020, a total of 5 355 hepatitis C cases in children were reported in Henan, the seasonal index range of the hepatitis C was lower than 1, and no obvious seasonality characteristics was observed. The average of monthly incidence of 2005-2011 showed increase trend (0.351 case/month), and the incidence of 2012-2020 decreased (-0.474 case/month). The predicted reported case number of hepatitis C in children in Henan from January 2005 to December 2020 fitted by ARIMA model was consistent with the actual number, the RMSE of the number of reported cases in the current year and the existing number of children cases was 10.240, 10.558, the MAPE was 35.566, 0.659, and the MAE was 6.688, 7.156, respectively. Conclusion: Time series analysis on surveillance data is useful for the better understanding of the epidemic situation of hepatitis C in children aged ≤14 years. ARIMA model can be used in the short-term prediction and dynamic analysis of the incidence of hepatitis C in children in Henan.

Episode of Hepatitis C viral infection in the people of Swat, Pakistan / Episódio de infecção viral por Hepatite C no povo de Swat, Paquistão

Infectious agents cause serious diseases in humans worldwide and are responsible for the high rate of morbidity and mortality. The prevalence and epidemiology of infectious disease (HCV) in the hospital visited patients referred by the physicians through the initial findings and their associated risk factors were studied in Swat. The data of 174 infected patients were collected during the period of 2015 to 2017 from two clinical laboratories of Tehsil Matta Swat. Inform consent form was taken before blood collection. After taking informed consent blood samples were collected and ICT test was performed and then ICT positive cases were conform through PCR. A total of 174 ICT positive samples [106 male and 68 females] were included in this study. Age was considered from 10 to 72 years. Of the 174 ICT strip positive, 99 [63 males, 36 females] were confirmed through PCR. The prevalence rate was recorded 56.89%. I.V/I.M injection was recorded in 100% of the individuals. Visits to the barber shop was reported in (58%) of the individuals, married individuals were (81.0), surgical operation was reported in (44.8%), sharing toothbrush was observed in (29.9%), piercing was reported in (39.7%), family history was reported in (26.4%), dental treatment was observed in (21.8%), jaundice were (13.2%) and tattooing was (1.7%). Blood transfusion, surgical operations, Jaundice, family history and dental treatment were found significant risk factors for acquiring HCV infection. It was concluded that proper implementation of precautionary measures should be needed to control the spread of HCV in far near future.

Agentes infecciosos causam doenças graves em humanos em todo o mundo, e são responsáveis pelo alto índice de morbimortalidade. A prevalência e a epidemiologia das doenças infecciosas no hospital que atendeu pacientes encaminhados pelos médicos por meio dos achados iniciais e seus fatores de risco associados foram estudadas em Peshawar. Os dados de 174 pacientes infectados foram coletados durante o período de 2015 a 2017 oriundos de dois laboratórios clínicos de Tehsil Matta Swat. O formulário de consentimento informado foi obtido antes da coleta de sangue. Após a obtenção do consentimento informado, foram coletadas amostras de sangue e foi realizado o teste ICT e, em seguida, os casos ICT positivos foram confirmados por PCR. Um total de 174 amostras ICT positivas [106 homens e 68 mulheres] foi incluído neste estudo. A idade considerada foi de 10 a 72 anos. Das 174 tiras de ICT positivas, 99 casos [63 homens, 36 mulheres] foram confirmados por PCR. A taxa de prevalência foi de 56,89%. A injeção IV / IM foi registrada em 100% dos indivíduos. A visita à barbearia foi relatada em (58%) dos indivíduos, os números de casados foram (81,0%), e a operação cirúrgica foi relatada em (44,8%), o compartilhamento de escova de dente foi observado em (29,9%), o piercing foi relatado em (39,7%), antecedentes familiares foram relatados em (26,4%), tratamento odontológico em (21,8%), icterícia (13,2%) e tatuagem em (1,7%). Transfusão de sangue, operações cirúrgicas, icterícia, histórico familiar e tratamento odontológico foram fatores de risco significativos para adquirir infecção por Vírus da Hepatite C (VHC). Concluiu-se que a implementação adequada de medidas de precaução deve ser necessária para controlar a propagação do VHC em um futuro próximo.