RESUMEN

BACKGROUND: In Togo, few data are available on viral hepatitis in street adolescents, a vulnerable population due to their lifestyle. The aim of this study was to describe the lifestyle of street adolescents (sexual practices and drug use), to estimate the prevalence of hepatitis B and C viruses, and to describe their HBV immunization profile in Togo. METHODS: A cross-sectional study was conducted in Lomé (Togo) in July 2021. Street adolescents aged between 13 and 19 years were included. A questionnaire was used to document lifestyle. ELISA tests were performed for Hepatitis B surface antigen (HBsAg), Hepatitis B core and surface antibodies (anti-HBc, anti-HBs), and antibodies against hepatitis C virus (anti-HCV). RESULTS: A total of 299 adolescents (5.4% female) with a median age of 15 years (IQR: 14-17) were included. Of these, 70.6% (211/299) were sexually active and 70.6% (149/211) had not used a condom during their last sexual intercourse. Drug use was reported by 42.1% of the adolescents. The most used substances were cannabis (39.0%), cocaine (36.6%), glue solvents (19.5%), and tramadol (11.4%). However, cocaine use may have been overestimated due to information bias. Current HBV infection (HBsAg+) was detected in 3.7% (95%CI: 1.9-6.5) of the adolescents. Isolated anti-HBc + was present in 5.3%. All three HBV markers (HBsAg, anti-HBs, and anti-HBc) were negative in 71.6% of adolescents. Anti-HCV was detected in 4.7% of adolescents. CONCLUSION: Nearly one in 10 street adolescents has markers for HBV contact/current infection, and approximately 72% of street adolescents may still be infected with HBV, as they have no HBV markers. HCV is also circulating in this population. Given the reported high-risk sexual practices and high levels of drug use, there is an urgent need to develop integrated strategies to prevent infections, including HBV, and drug dependence in this population.

Asunto(s)

RESUMEN

The management of patients affected by moderate-to-severe psoriasis may be challenging, in particular in patients with serious infectious diseases [tuberculosis (TB), hepatitis B and C, HIV, COVID-19]. Indeed, these infections should be ruled out before starting and during systemic treatment for psoriasis. Currently, four conventional systemic drugs (methotrexate, dimethyl fumarate, acitretin, cyclosporine), four classes of biologics (anti-tumour necrosis factor alpha, anti-interleukin (IL)12/23, anti-IL-17s, and anti-IL-23], and two oral small molecules (apremilast, deucravacitinib) have been licensed for the treatment of moderate-to-severe psoriasis. Each of these drugs is characterized by a unique safety profile which should be considered before starting therapy. Indeed, some comorbidities or risk factors may limit their use. In this context, the aim of this manuscript was to evaluate the management of patients affected by moderate-to-severe psoriasis with serious infectious diseases.

Asunto(s)

RESUMEN

Antecedentes: Las hepatitis B y C son infecciones hepáticas potencialmente mortales y un importante desafío para la salud pública que afecta a 350 millones de personas con aproximadamente 1,4 millones de muertes anuales. Objetivo: Determinar el conocimiento e investigar la prevalencia de HBV y HCV entre conductores de minibuses comerciales en Ado-Ekiti, estado de Ekiti, Nigeria. Metodología: Diseño descriptivo transversal con estrategia cuantitativa. Se utilizó la técnica de muestreo de etapas múltiples para reclutar a 110 encuestados. Se utilizó un cuestionario adaptado de dos estudios previos para las características sociodemográficas de los participantes, el nivel de conocimiento de la hepatitis B y C, los factores de riesgo y la indecisión ante la vacunación, mientras que las investigaciones de laboratorio se utilizaron para la prevalencia del VHB y el VHC. Para el análisis de los datos se utilizó estadística descriptiva e inferencial. Resultados: Los hallazgos revelaron que un tercio (32,7%) de los encuestados tenían entre 39 y 48 años. La mayoría (73,6%) estaba casada y el 39,1% tenía al menos dos parejas sexuales. La mayoría (80%) ha oído hablar del VHB, mientras que el 75% nunca ha oído hablar del VHC, el 43,6 % y el 59,1% tienen un bajo nivel de conocimiento de la hepatitis B y C. La prevalencia del VHB y anti-VHC entre los encuestados fue del 7,3% y el 1%, respectivamente. Los principales factores de riesgo identificados fueron los tatuajes, las múltiples parejas sexuales y las relaciones sexuales sin protección. Hubo una relación significativa entre el conocimiento de los encuestados sobre la hepatitis B y la edad (X2 = 21,39, p = 0,006) y el número de parejas sexuales (X2 = 21,25, p = 0,002), mientras que solo el nivel educativo (X2 = 13,58, p = 0,035) se asoció significativamente con el nivel de conocimiento de la hepatitis C. (AU)

Background: Hepatitis B and C are potentially life-threatening liver infections and major public health challenge affecting 350 million people with approximately annual deaths of 1.4 million. Objective: Determine the knowledge and investigate the prevalence of HBV and HCV among commercial mini-bus drivers in Ado- Ekiti, Ekiti State, Nigeria. Methodology: Descriptive, cross-sectional design using quantitative strategy. Multistage sampling technique was used to recruit 110 respondents. An adapted questionnaire from two previous studies was used for participants’ sociodemographic characteristics, knowledge level of Hepatitis B and C, risk factors and vaccination hesitancy while laboratory investigations were used for HBV and HCV prevalence. Descriptive and inferential statistics were used for data analysis. Results: Findings revealed that one-third (32.7%) of the respondents were between 39-48 years. Majority (73.6%) were married with 39.1% having at least two sexual partners. Majority (80%) have heard of HBV while 75% have never heard of HCV, 43.6% and 59.1% have poor knowledge level of hepatitis B and C. The prevalence of HBV and anti-HCV among the respondents were 7.3% and 1% respectively. Major risk factors identified were tattooing, multiple sexual partners, and unprotected sex. There was a significant relationship between respondents’ knowledge of hepatitis B and age (X2 =21.39, p=0.006) and number of sexual partners (X2=21.25, p= 0.002) while only educational background (X2=13.58, p= 0.035) was significantly associated with the knowledge level of hepatitis C. (AU)

Asunto(s)

RESUMEN

Background: Uterine Cervical Carcinoma (UCC) is the most prevalent gynecological malignancy globally, with a rising incidence in recent years. Accumulating evidence indicates that specific viral infections, including human papillomavirus (HPV), Epstein-Barr virus (EBV), Hepatitis B and C viruses (HBV and HCV), and human herpesvirus (HHV), may contribute to UCC development and progression. Understanding the complex interplay between viral infections and UCC risk is crucial for developing novel preventative and therapeutic interventions. Methods: This comprehensive review investigates the association between viral infections and UCC risk by examining the roles of various viral pathogens in UCC etiology and pathogenesis, and possible molecular mechanisms. Additionally, we evaluate current diagnostic methods and potential therapeutic strategies targeting viral infections for UCC prevention or treatment. Results: The prevention of UCC has been significantly advanced by the emergence of self-sampling for HPV testing as a crucial tool, allowing for early detection and intervention. However, an essential challenge in UCC prevention lies in understanding how HPV and other viral coinfections, including EBV, HBV, HCV, HHV, HIV, or their concurrent presence, may potentially contribute to UCC development. The molecular mechanisms implicated in the association between viral infections and cervical cancer development include: (1) interference of viral oncogenes with cellular regulatory proteins, resulting in uncontrolled cell proliferation and malignant transformation; (2) inactivation of tumor suppressor genes by viral proteins; (3) evasion of host immune responses by viruses; (4) induction of a persistent inflammatory response, contributing to a tumor-promoting microenvironment; (5) epigenetic modifications that lead to aberrant gene expression; (6) stimulation of angiogenesis by viruses; and (7) activation of telomerase by viral proteins, leading to cellular immortalization. Additionally, viral coinfections can also enhance oncogenic potential through synergistic interactions between viral oncoproteins, employ immune evasion strategies, contribute to chronic inflammation, modulate host cellular signaling pathways, and induce epigenetic alterations, ultimately leading to cervical carcinogenesis. Conclusion: Recognizing the implications of viral oncogenes in UCC etiology and pathogenesis is vital for addressing the escalating burden of UCC. Developing innovative preventative and therapeutic interventions requires a thorough understanding of the intricate relationship between viral infections and UCC risk.

RESUMEN

Background Needlestick injuries (NSIs) and sharps injuries (SIs) remain significant hazards in most healthcare facilities that expose healthcare workers (HCWs) to blood-borne pathogens (e.g., HIV, hepatitis B, and hepatitis C). This study aims to review the incidence of NSIs and SIs in King Fahad Medical City (KFMC) and correlate this incidence with several parameters related to the event, including age, sex, length of work experience, type of injury, type of instrument causing the injury, type of activity during which the injury happened, nature of the job of the HCWs, and location within the hospital where the injury happened. Methodology This cross-sectional study involves all self-reported documents related to needlestick and sharp injuries among HCWs at King Fahad Medical City (KFMC) in Riyadh, Kingdom of Saudi Arabia, from January 2017 to December 2020. The data of 389 reports of needlestick and sharp injuries detailing incidence and site, shift, type, and instrument related to the incidents were reported to the infection control department for coding and analysis using the Statistical Package for the Social Sciences (SPSS) version 22 (IBM SPSS Statistics, Armonk, NY, USA). Results Our data showed that NSIs/SIs could be caused by a wide range of objects used by healthcare workers, including needles, suture needles, scalpels, and sharp devices. Remarkably, the most common cause of NSIs was handling the sharp object (38.8%), followed by disposing of the sharp object (19.3%). Furthermore, nurses were found to be the highest at-risk category of HCWs experiencing NSIs (49.9%), while medical waste handlers (1.5%) and dentists (1.3%) were least likely to incur injuries. Conclusion This study sheds some light on the incidence rates of NCIs and SIs at KFMC and correlates these rates with several demographical, occupational, and experiential parameters related to these events.

RESUMEN

Background: In Bangladesh, labour migration is a source of employment and workers' remittances are critical to poverty mitigation. The aim of this study was to assess the prevalence of hepatitis B, C, HIV, tuberculosis, syphilis, kidney and liver diseases along with presence of infections among aspirant migrant workers of Bangladesh. Method: This study was carried out from September-December 2019. We analysed data collected on screening tests of specific diseases of aspirant workers. For each test, the prevalence was computed with 95% confidence interval. Association between categorical data was determined by the Chi-square test. Results: A total of 2385 aspirants, 1988 (83.35%) males, aged between 18 and 65 years (29.76±6.578) were studied. Positive results for screening tests of HBsAg were 38 (1.6%,), anti-HCV were 2 (0.08%), TPHA were 25 (1.05%) and VDRL were 5 (0.21%) though no individual was positive for HIV and TB. Elevated level of SGOT (n=99, 4.2%), SGPT (n=322, 13.5%), RBS (n=57, 2.4%), bilirubin (n=46, 1.92%), creatinine (n=7, 0.3%) and ESR (n=19, 0.8%) were found in the workers. Conclusion: Diagnosis of diseases of workers is obligatory before going abroad to safeguard the health of the workers and residents of destination country. Consequently, it will contribute to reducing the global burden of infectious diseases.

Asunto(s)

RESUMEN

BACKGROUND: Globally, more than 350 million people live with viral hepatitis, out of which over 20 million are in Nigeria. The prevalence of anxiety, depression and stress among patients with viral hepatitis in the primary care setting is not well established. OBJECTIVES: The objectives of this study were to determine the prevalence and factors associated with depression, anxiety and stress among hepatitis patients in a primary care clinic in North Central Nigeria using the Patient Health Questionnaire (PHQ2), Generalized Anxiety Disorder (GAD 2) and Kessler 6 scales respectively. METHODS: This cross-sectional study was carried out among Hepatitis B and C patients attending the Hepatitis Clinic of the Family Medicine Department, Federal Medical Centre Keffi. A total of 123 participants were recruited using a simple random sampling technique. Their sociodemographic and clinical data were collected after which they were screened for depression, anxiety and stress. Data collected was analysed using IBM SPSS. RESULTS: The mean age of study participants was 38.9±11.6 years. Most of them had hepatitis B infection (89.7%) and were on antiviral medications or liver supplements (45.2%). The prevalence of anxiety, depression and stress among them were found to be 18.9%, 25% and 77.6% respectively. Illness duration and medication use were found to be significantly associated with both depression and stress among them. CONCLUSION: The prevalence of anxiety, depression and stress is high among adult primary care patients with viral hepatitis in FMC Keffi.

CONTEXTE: À l'échelle mondiale, plus de 350 millions de personnes vivent avec les hépatites virales, dont plus de 20 millions au Nigeria. La prévalence de l'anxiété, de la dépression et du stress chez les patients atteints d'hépatite virale dans le cadre des soins primaires n'est pas bien établie. OBJECTIFS: Cette étude visait à déterminer la prévalence et les facteurs associés à la dépression, à l'anxiété et au stress chez les patients atteints d'hépatite dans une clinique de soins primaires dans le centre-nord du Nigeria en utilisant les échelles du Questionnaire de Santé Patient (PHQ2), du Trouble Anxieux Généralisé (GAD 2) et de Kessler 6 respectivement. MÉTHODES: Cette étude transversale a été réalisée parmi les patients atteints d'hépatite B et C fréquentant la clinique d'hépatite du département de médecine familiale du Centre Médical Fédéral de Keffi. Un total de 123 participants ont été recrutés à l'aide d'une technique d'échantillonnage aléatoire simple. Leurs données sociodémographiques et cliniques ont été recueillies, après quoi ils ont été dépistés pour la dépression, l'anxiété et le stress. Les données collectées ont été analysées à l'aide d'IBM SPSS. RÉSULTATS: L'âge moyen des participants à l'étude était de 38,9±11,6 ans. La plupart d'entre eux étaient atteints d'une infection par l'hépatite B (89,7 %) et prenaient des médicaments antiviraux ou des compléments hépatiques (45,2 %). La prévalence de l'anxiété, de la dépression et du stress parmi eux s'est avérée être respectivement de 18,9 %, 25 % et 77,6 %. La durée de la maladie et l'utilisation de médicaments ont été significativement associées à la dépression et au stress chez ces patients. CONCLUSION: La prévalence de l'anxiété, de la dépression et du stress est élevée parmi les patients adultes en soins primaires atteints d'hépatite virale au FMC Keffi. MOTS-CLÉS: Prévalence et facteurs, stress, anxiété, dépression, patients atteints d'hépatite B et C.

Asunto(s)

RESUMEN

Background: Hepatitis B and C lead to chronic disease in hundreds of millions of people and together constitute the most common cause of liver cirrhosis and cancer with attendant mortality. Objective: The objective of this study was to estimate the prevalence of hepatitis B and C virus infection among different categories of health-care workers, looking at the exposure to patients' samples and the prevalence rate among these categories of health workers. This will help to ascertain the risk and the need to pay more attention to preventive measures. Materials and Methods: This was a cross-sectional study conducted over a 2-year period among 217 health-care workers at the department of Haematology of the Federal Teaching Hospital, Ido-Ekiti, Nigeria. Respondents were randomly selected, and blood samples were taken for the hepatitis B and C screening. Data were analyzed using SPSS 20; bivariate analyses were done, and the level of statistical significance was set at P < 0.05. Results: A total of 13 (6.0%) tested positive for HBsAg. Analysis of the marital status of those that tested positive to Hepatitis B, revealed that the highest number (77%) was found among the married, while the singles and the divorced constitute 15.3% and 7.7% respectively. The nurses and nonhealth professionals (admin staff) constitute the highest positive yield of hepatitis B virus (HBV), followed by medical doctors and laboratory staff. The age of the respondent was found to have a statistically significant association with HBV serology (P < 0.05). Conclusion: There is a comparatively lower prevalence of HBsAg among the health-care workers who are directly exposed to patients' samples. The age of the respondent has a significant association with hepatitis B infection.

Résumé Contexte: L'hépatite B et C conduisent à des maladies chroniques chez des centaines de millions de personnes et constituent ensemble la cause la plus courante de cirrhose du foie et de cancer avec la mortalité des participants. Objectif: L'objectif de cette étude était d'estimer la prévalence de l'infection par le virus de l'hépatite B et du C entre différentes catégories de travailleurs de la santé, en examinant l'exposition aux échantillons des patients et le taux de prévalence entre ces catégories d'agents de santé. Cela aidera à déterminer le risque et la nécessité de prêter plus d'attention aux mesures préventives. Matériel et méthodes: Il s'agissait d'une étude transversale menée sur une période de 2 ans parmi 217 travailleurs de la santé au Département d'hématologie de l'hôpital fédéral universitaire, Ido - Ekiti, au Nigéria. Les répondants ont été sélectionnés au hasard et des échantillons de sang ont été prélevés pour le dépistage de l'hépatite B et du C. Les données ont été analysées à l'aide de SPSS 20; Des analyses bivariées ont été effectuées et le niveau de signification statistique a été fixé à p <0,05. Résultats: Un total de 13 (6,0%) ont été testés positifs pour HBSAG. L'analyse de l'état matrimonial de ceux qui se sont testés positifs à l'hépatite B, ont révélé que le nombre le plus élevé (77%) a été trouvé chez les mariés, tandis que les célibataires et les divorcés constituent respectivement 15,3% et 7,7%. Les infirmières et les professionnels de la santé (personnel administratif) constituent le plus élevé Rendement positif du virus de l'hépatite B (HBV), suivi des médecins et du personnel de laboratoire. L'âge du répondant s'est avéré avoir une association statistiquement significative avec la sérologie du VHB (p <0,05). Conclusion: Il existe une prévalence relativement plus faible de HBSAG chez les travailleurs de la santé qui sont directement exposés aux échantillons des patients. L'âge du répondant a une association significative avec l'infection à l'hépatite B. Mots-clés: Exposition, hépatite B et C, prévalence.

Asunto(s)

RESUMEN

Background & Objectives: Hepatitis-B and C is currently a major health problem all over the world including Pakistan. All beauty treatments including manicures are used by many people and can be a risk factor because of sharing of contaminated instruments. Proper sterilization needs to be achieved by an autoclave. Our study was conducted to know the awareness and safe practices of Hepatitis-B and C prevention and transmission by beauty salon workers in Karachi. Methods: This was a cross-sectional descriptive study performed from February 2021- July 2021 among workers of women's beauty salons across Karachi. Validated questioners were distributed and were filled in the presence of research worker. Data was compiled and analyzed using SPSS version 22. Workers who scored ≥ 70% were considered to have adequate knowledge. Results: Our results showed that out of 261 participants, 240 (92.3%) were females. 49(18.8%) had adequate knowledge about hepatitis-B, 63(24.1%) had adequate knowledge about hepatitis-C. 111(42.5%) had adequate practices. According to the independent T test, there was statistically significant relationship between family history of hepatitis-B and knowledge of Hepatitis-B (p=0.022), hepatitis-B vaccination and knowledge of Hepatitis-B (p=0.006). We also found significant relationship between family history of hepatitis-C and knowledge of hepatitis-C (p=0.019), also between previous blood test performed for hepatitis antibodies and knowledge about hepatitis-B and C. On Uni-Variate logistic regression we found that males participants are less likely to have adequate Hepatitis-C knowledge in comparison of female participants (OR=0.152). We also found that participants who have Hepatitis-B family history, have more likely to have adequate Hepatitis-C knowledge (OR=1.874) and males participants are less likely to have adequate Hepatitis-B knowledge in comparison of female participants (OR=0.212). Only 45(17.2%) workers were fully vaccinated with Hepatitis-B and 126(48.3%) had knowledge of adequate sterilization technique of equipment's. Conclusion: This study showed that overall awareness among workers of women beauty salon in Karachi about Hepatitis-B and C is inadequate with low vaccination rates. There is dire need to organize awareness programs with mass vaccination campaigns for safe practices and to curb viral transmission.

RESUMEN

INTRODUCTION: Although the idea that carcinogenesis might be caused by viruses was first voiced about 100 years ago, today's data disappointingly show that we have not made much progress in preventing and/or treating viral cancers in a century. According to recent studies, infections are responsible for approximately 13% of cancer development in the world. Today, it is accepted and proven by many authorities that Epstein-Barr virus (EBV), Hepatitis B virus (HBV), Hepatitis C virus (HCV), Human Herpesvirus 8 (HHV8), Human T-cell Lymphotropic virus 1 (HTLV1) and highly oncogenic Human Papillomaviruses (HPVs) cause or/and contribute to cancer development in humans. AREAS COVERED: Considering the insufficient prevention and/or treatment strategies for viral cancers, in this review we present the current knowledge on protein biomarkers of oncogenic viruses. In addition, we aimed to decipher their potential for clinical use by evaluating whether the proposed biomarkers are expressed in body fluids, are druggable, and act as tumor suppressors or oncoproteins. EXPERT OPINION: Consequently, we believe that this review will shed light on researchers and provide a guide to find remarkable solutions for the prevention and/or treatment of viral cancers.

Asunto(s)

RESUMEN

Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver resulting in approximately 800,000 deaths annually. A growing body of research investigating statin use and HCC risk has shown conflicting results. We aim to evaluate the current evidence of statin impact on HCC risk. We performed a comprehensive literature search in PubMed, PubMed Central, Embase, and ScienceDirect databases from inception through May 2019 to identify all studies that evaluated the association between statin use and HCC. We included studies that presented an odds ratio (OR) with a 95% confidence interval (CI) or presented data sufficient to calculate the OR with a 95% CI. Statistical analysis was performed using the Comprehensive Meta-Analysis (CMA), Version 3 software, and a Forrest plot was generated. We assessed for publication bias using conventional techniques. Twenty studies (three randomized controlled trials, six cohorts, and 11 case-controls) with 2,668,497 patients including 24,341 cases of HCC were included in the meta-analysis. Our findings indicate a significant risk reduction of HCC among all statin users with a pooled odds ratio of 0.573 (95% CI: 0.491-0.668, I2= 86.57%) compared to non-users. No publication bias was found using Egger's regression test or on visual inspection of the generated Funnel plot. The results indicate that statin use was associated with a 43% lower risk of HCC compared to statin non-users. Further prospective randomized research is needed to confirm the association.

RESUMEN

Introduction Hepatitis B and C viruses can result in both acute and chronic hepatitis, ranging in severity from a mild acute disease to a serious, lifelong manifestation including liver cirrhosis and hepatocellular carcinoma. This study aims to determine the knowledge and attitudes of medical doctors in Rivers State, Nigeria, to hepatitis B and C as well as their practice for prevention and treatment of the same. We also assessed their practice of universal precaution, provision, and use of personal protective tools. Methods One hundred and fifty doctors in both the private and public sectors were interviewed using self-administered questionnaires on viral hepatitis B and C. The questionnaire explored their knowledge and status of vaccination, viral hepatitis treatment, and their practice of universal safety precautions. Their responses were analyzed using SPSS version 21. Data was expressed in means and percentages. Results Out of all participants, 96% were aware that viral hepatitis B is preventable, while 46% erroneously believed that there is vaccination against the hepatitis C virus. Only 50% of the respondents were aware of the availability of a cure for hepatitis C infection, and 16% of the participants knew about drugs used for its treatment. While 76% of the doctors had been vaccinated against hepatitis B virus, only 4% had received treatment after testing positive for hepatitis B. Furthermore, nearly all respondents admit practicing universal precaution, especially during venipuncture; however, protective measures such as disposable gloves were not readily available to 20% of our respondents. There was a statistically significant association between sex and duration of practice with knowledge of hepatitis B and C, as well as between practice type and vaccination status. Conclusion This study shows that knowledge of the treatment of viral hepatitis amongst healthcare practitioners such as doctors is poor, and although universal safety precautions are practiced, personal protective equipment is not readily available for use in our healthcare setting, placing healthcare workers at risk of infections. There is also a need to encourage vaccination amongst healthcare practitioners to protect them against contagious diseases like hepatitis B and C infections.

RESUMEN

Background: HCC is a common cancer worldwide and one of the leading causes of cancer death. This aim of this study is to determine the age and gender characteristics of the HCC patients in our center and to determine the contribution of viral hepatitis (B and C) and alcohol to the etiology of HCC among our patients. Methodology: This is a retrospective study of HCC patients seen at the gastroenterology unit of ABUTH between April 2015 and September 2018. Data on age, gender, HBsAg, and HCV antibody status and alcohol consumption were recorded from the case files of all eligible patients. Results: A total of 87 patients were included in the study. They consisted of 68 males (78.2%) and 19 females (21.8%) with male to female ratio of 4:1. The mean age of the study subjects was 46.7 years (SD ± 12.5), with a range of 22 and maximum age of 80 years. Majority of the patients were within the age group 40-49 (32.2%). HBsAg was present in 48 patients (55.2%), HCV antibody was positive in 14 patients (16.1%) and 3 patients (3.4%) were positive for both HBsAg and HCV antibody. Four (4.6%) had significant alcohol ingestion and in 18 patients (20.7%), the etiology was undetermined. Conclusion: In our study, HCC was found predominantly among male patients in the age group 40-49 years. Viral hepatitis particularly HBV is the most important etiological factor for HCC among our patients.

RESUMEN

Hepatitis B (HBV) and C (HCV) are two among the numerous forms of infections whose clinical degeneration, morbidity-mortality and low immune responsiveness in people living with human immunodeficiency virus (HIV) are highly evident. Co-infection of HIV with HBV and HCV has been associated with reduced survival, increased risk of progression to liver diseases and increased risk of hepatotoxicity associated with antiretroviral therapy (ARV). We carried out biochemical, immunological, virological and clinical analysis of hepatitis B and C positive HIV patients as well as some HIV positive individuals receiving antiretroviral therapy in Kumba Health District to evaluate the immune response to the ARV therapy and identified risk factors associated with the treatment outcomes. A total of 52 HIV patients, 36 HIV/HBV and 12 HIV/HCV patients were involved in this study. We performed CD4 counts, viral load test, analyzed ALAT/ASAT, albumin, bilirubin, and creatinine and measured the weights of HIV patients, HIV/HBV and HIV/HCV enrolled for not more than one year in Kumba Health District. The results were analyzed to evaluate the immune response and possible risk factors associated with the treatment outcomes. The mean increase in weight in participants of all groups over 12 months (17.12 kg) was greater than the mean increase in CD4 (8.92 cell/mm3). However, the mean decrease in viral loads over a 12 months was also very high (1035.17 copies/mL). There was a significant change in the mean values from baseline for all the three variables (p < 0.0001). HIV disease outcomes following HAART (high active antiretroviral therapy) do not appear to be adversely affected by HBV or HCV co-infection, except for slightly poorer CD4 count responses in HIV/HCV co-infected patients. Concerning the renal and liver functions, all the biomarkers witnessed a decrease in patients of all groups in response to HAART over time, with a more rapid decrease in mono-infected patients as compared with those co-infected with HBV but the case was contrary for those co-infected with HCV. Co-infection with HBV or HCV was relatively common among HIV infected participants in Kumba Health District. There were differences in response to HAART between the mono-infected compared with the co-infected, taking into consideration the weight, CD4 count, and viral load. In addition, there was also a variation in the different biomarkers of liver and renal function between mono-infected and co-infected patients.

RESUMEN

INTRODUCTION: The presence of etiologically unencrypted diagnoses in the structure of viral hepatitis determines the relevance of searching for other pathogens involved in liver pathology formation. The role of Epstein-Barr virus in the development of hepatitis was described in the scientific literature, but official statistics do not allow to assess its contribution to liver damage along with hepatitis B and C viruses. The purpose - to identify common and distinctive epidemiological features of viral hepatitis B (HB), C (HC) and infectious mononucleosis (IM). MATERIAL AND METHODS: A retrospective epidemiological analysis of these nosologies incidence was carried out according to official statistics in 2009-2018 in the Russian Federation. RESULTS AND DISCUSSION: The multidirectional trends in the long-term dynamics of the incidence of IM, acute and chronic HB and HC and the presence of strong direct correlation between the acute and chronic HB and HC incidence were established. Distinctive features include disparity in epidemic process intensity in different age groups (prevalence of morbidity in children aged 1-2 and 3-6 years with IM and persons older than 18 years - with viral hepatitis). It is common for IM and HB and HC to involve the majority of urban population in the epidemic process, as well as children under the age of 1 year. The described differences are due to the action of transmission mechanisms specific to each infection. CONCLUSION: The results obtained in this study may serve as a basis for further study of the interaction of EpsteinBarr virus with hepatitis B and C viruses.

Asunto(s)

RESUMEN

BACKGROUND: Polychlorinated biphenyls (PCBs) were used in electrical equipment and a range of construction materials. Although banned in the United States and most of Europe in the 1970s, they are highly persistent in the environment and bioaccumulate. Whether PCBs are associated with liver cancer risk at general population levels is unknown. METHODS: This study consisted of 136 incident liver cancer cases and 408 matched controls from the Kaiser Permanente Northern California Multiphasic Health Checkup (MHC) cohort and 84 cases and 252 matched controls from the Norwegian Janus cohort. Sera collected in the 1960s-1980s were measured for 37 PCB congeners and markers of hepatitis B (HBV) and C (HCV) infection. Odds ratios (OR) and 95% confidence intervals (CI) for tertiles of each lipid-adjusted PCB were estimated from conditional logistic regression. We also examined the molar sum of congeners in groups: total PCBs; low, medium, and high chlorination; and Wolff functional groups. RESULTS: Concentrations of individual congeners from the 1960s/1970s sera ranged from 1.3-123.0 and 1.4-116.0 ng/g lipid among MHC cases and controls, respectively, and from 1.9-258.0 and 1.9-271.0 ng/g lipid among Janus cases and controls, respectively. Among MHC participants with sera from the 1960s, collected an average of 27 years before diagnosis among cases, the top tertile of PCBs 151, 170, 172, 177, 178, 180, and 195 was significantly associated with elevated odds of liver cancer (OR range = 2.01-2.38); most of these congeners demonstrated exposure-response trends. For example, ORtertile 3vs1 = 2.38 (95% CI: 1.22-4.64, p-trend = 0.01) for PCB 180. As a group, Wolff group 1b congeners, which are biologically persistent and weak phenobarbital inducers, were associated with increased odds. In MHC participants, ever vs. never HBV or HCV infection modified the PCB-liver cancer associations. There was little evidence of an association between PCBs and odds of liver cancer among the Janus cohort. DISCUSSION: We observed associations between a number of PCB congeners and increased odds of liver cancer among MHC, but not Janus, participants with sera from the 1960s/1970s.

Asunto(s)

RESUMEN

The mortality and severity in COVID-19 is increased in patients with comorbidities. The aim of this study was to evaluate the severity and mortality in COVID-19 patients with underlying kidney and liver diseases. We retrieved data on the clinical features and primary composite end point of COVID-19 patients from Medline and Embase which had been released from inception by the April 16, 2020. The data on two comorbidities, liver diseases and chronic kidney disease, were pooled and statistically analysed to explain the associated severity and mortality rate. One hundred and forty-two abstracts were screened, and 41 full articles were then read. In total, 22 studies including 5595 COVID-19 patients were included in this study with case fatality rate of 16%. The prevalence of liver diseases and chronic kidney disease (CKD) were 3% (95% CI; 2-3%) and 1% (95% CI; 1-2%), respectively. In patients with COVID-19 and underlying liver diseases, 57.33% (43/75) of cases were severe, with 17.65% mortality, while in CKD patients, 83.93% (47/56) of cases were severe and 53.33% (8/15) mortality was reported. This study found an increased risk of severity and mortality in COVID-19 patients with liver diseases or CKD. This will lead to better clinical management and inform the process of implementing more stringent preventative measures for this group of patients.

RESUMEN

Introduction Chronic hepatitis B and C are the leading causes of chronic liver disease and a significant cause of mortality and morbidity worldwide. Hepatitis B is a preventable disease with vaccination, which is available worldwide. About 257 million people are affected worldwide with hepatitis B and around 71 million people with hepatitis C, and Pakistan is the second most prevalent country with hepatitis C. The possible mode of spread of hepatitis B and C in chronic liver disease patients presenting at CMH medical wards and dental clinics was evaluated. Among various types of hepatitis, A, B, and C are the most common. The course of disease followed by hepatitis A is short term, but when we talk about the common types, which are B and C, the disease is chronic and, moreover, the complications associated with these types are more severe too. Materials and methods The study was carried out at the medical wards and dental clinics of CMH Lahore Medical College. A total of 240 patients were evaluated for the possible mode of spread of hepatitis B and C. A detailed history regarding the use of needles, surgical procedures, including dental treatment, unsterilized razors for shaving (barbers'), blood transfusions, tattooing, and mode of delivery in females, was evaluated and data were interpreted. Aims and objectives To observe the mode of spread of hepatitis B and C among patients of CMH Lahore Medical College and Institute of Dentistry. Results The results of our study revealed that the most common mode of spread of disease in males was exposure to infected blades and instruments at barbers' shops. In females, blood transfusion and caesarian section, especially in rural areas, remained the most common possible cause of spread. A small number of patients was not aware of the possible mode of transmission, whereas a few others did not seek treatment for the disease. Conclusion From our study, we can conclude that a substantial number of patients with chronic liver disease have exposure to various risk factors. Exposure to the unsterilized equipment of barbers and improperly screened blood remains the main cause of the spread of hepatitis B and C in males whereas surgical procedures related to gynecological procedures and blood transfusions remain the second most common cause. Dental procedures in the hands of trained dental professionals/dentists carry less danger of transmitting the disease but carry an equally high incidence if quacks do the dental procedures.

RESUMEN

About 20% of total cancer cases are associated to infections. To date, seven human viruses have been directly linked to cancer development: high-risk human papillomaviruses (hrHPVs), Merkel cell polyomavirus (MCPyV), hepatitis B virus (HBV), hepatitis C virus (HCV), Epstein-Barr virus (EBV), Kaposi's sarcoma-associated herpesvirus (KSHV), and human T-lymphotropic virus 1 (HTLV-1). These viruses impact on several molecular mechanisms in the host cells, often resulting in chronic inflammation, uncontrolled proliferation, and cell death inhibition, and mechanisms, which favor viral life cycle but may indirectly promote tumorigenesis. Recently, the ability of oncogenic viruses to alter autophagy, a catabolic process activated during the innate immune response to infections, is emerging as a key event for the onset of human cancers. Here, we summarize the current understanding of the molecular mechanisms by which human oncogenic viruses regulate autophagy and how this negative regulation impacts on cancer development. Finally, we highlight novel autophagy-related candidates for the treatment of virus-related cancers.

RESUMEN

Hepatocellular carcinoma (HCC) accounts for about 80-90% of all liver cancers and is found to be the third most common cause of cancer mortality in the Asia-Pacific region. Risk factors include hepatitis B and C virus, cirrhosis, aflatoxin-contaminated food, alcohol, and diabetes. Surgically removing the tumor tissue seems effective but a high chance of recurrence has led to an urgent need to develop novel molecules for the treatment of HCC. Clinical management with sorafenib is found to be effective but it is only able to prolong survival for a few months. Various side effects like gastrointestinal and abdominal pain, hypertension, and hemorrhage are also associated with sorafenib, which calls for the unmet need of effective therapies against HCC. Similarly, the genetic mechanisms behind the occurrence of HCC are still unknown and need to be expounded further for developing newer candidates. Since unearthing the concept of these variants, transcriptomics has revealed the role of noncoding RNAs (ncRNAs) in many cellular, physiological and pathobiological processes. They are also found to be widely associated and abundantly expressed in a variety of cancer. Aberrant expression and mutations are closely related to tumorigenesis and metastasis and hence are classified as novel biomarkers and therapeutic targets for the treatment of cancer, including HCC. Herein, this review summarises the relationship between ncRNAs and hepatocellular carcinoma.

Asunto(s)