RESUMO
Hepatitis B virus and hepatitis C virus remains one of the leading causes of morbidity and mortality worldwide, particularly in countries with limited resources. The two hepatotropic viruses have common mode of transmission. Hepatitis B virus and hepatitis C virus are the main causes of Cirrhosis, liver cancer and death. To determine the Seroprevalence of HBsAg and anti-HCV antibodies among clinically suspected cases of viral hepatitis visiting Guhalla Primary Hospital, Northwest Ethiopia. A hospital-based retrospective study was conducted at Guhalla Primary Hospital, Northwest Ethiopia. The study included serology registration logbook data from all patients who visited the hospital and were tested using a rapid test kit between September 1st, 2017 to August 30, 2021. Data were entered, cleaned, and analyzed using SPSS version 26 software. Bivariate analysis was computed and a multivariable analysis was conducted to provide an adjusted odds ratio (AOR). p-value < 0.05 at a 95% confidence interval was considered statistically significant. In this study, a total of 883(883 for HBV and 366 for HCV) study participants were included. The overall prevalence of HBsAg and anti-HCV were 124/883(14%) and 73/366 (19.9%), respectively. The prevalence of HBV and HCV among males from the total HBV and HCV screened was 70/410 (17.1%) and 53/366(14.4%) respectively. In this study, being female (AOR 1.53, 95% CI 1.03-2.27, p = 0.003) and age group of 31-40 years (AOR 2.85; 95% CI 1.56, 5.17, p = 0.001) were statistically significant factors to HBV infection. Similarly, being female (AOR 1.97, 95% CI 1.10-3.53, p = 0.02), age group of 21-30 years (AOR 2.71; 95% CI 1.15, 6.40, p = 0.02) and age group greater than 40 years (AOR 3.13; 95% CI 1.31, 7.44, p = 0.01) were significantly associated with HCV infection. In our study, high seroprevalence of HBV and HCV infection was detected among clinically suspected patients. Females and the age groups between 31 and 40 were more affected. Community awareness of the prevention and transmission of viral hepatitis infection should be strengthened through herd immunization and health education. The prospective study should be conducted in this area.
Assuntos
Hepacivirus , Hepatite B , Hepatite C , Humanos , Etiópia/epidemiologia , Masculino , Feminino , Adulto , Estudos Soroepidemiológicos , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Estudos Retrospectivos , Hepacivirus/imunologia , Hepacivirus/isolamento & purificação , Criança , Vírus da Hepatite B/imunologia , Vírus da Hepatite B/isolamento & purificação , Anticorpos Anti-Hepatite C/sangue , Pré-Escolar , Antígenos de Superfície da Hepatite B/sangue , Prevalência , IdosoRESUMO
Objective: To examine the effects of peripheral blood eosinophil (EOS) count and its dynamic alterations on the treatment efficacy and prognosis of patients with advanced hepatitis B virus-associated hepatocellular carcinoma (HBV-HCC) receiving camrelizumab combined with lenvatinib (C + L) therapy. Methods: A retrospective analysis was performed on 200 patients with advanced HBV-HCC who were admitted to two centers from January 2018 to August 2023 and treated with C + L. EOS, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were determined before C + L treatment (EOS0, NLR0, and PLR0) and after three cycles of treatment (EOS3, NLR3, and PLR3). The area under the curve was calculated using the receiver operating characteristic (ROC) curve. NLR and PLR served as references to analyze the effect of differences in EOS in predicting the survival efficacy of patients with HBV-HCC treated using C + L. The independent risk factors affecting progression-free survival (PFS) and overall survival (OS) were analyzed using univariate and multivariate Cox proportional risk models. Results: The ROC curve revealed that the predictive value of EOS3 was better than those of NLR3 and PLR3 for the long-term treatment efficacy of patients with intermediate and advanced HBV-HCC receiving C + L. Statistically significant differences were observed between groups with different levels of EOS0 and EOS3 and the evaluation of treatment efficacy after 3 weeks (P < 0.05). The median PFS of the high-EOS0 group was higher than that of the low-EOS0 group (P = 0.027); median PFS of the high EOS3 group was higher than that of the low EOS3 group (P = 0.018); median OS of the high EOS0 group was higher than that of the low EOS0 group (P = 0.032); median OS of the high EOS3 group was higher than that of the low EOS3 group (P < 0.0001). Multifactorial Cox analysis revealed that EOS3 was an independent predictor of PFS and that EOS0 was an independent predictor of OS (P < 0.05). Conclusion: EOS may be an ideal indicator for predicting the treatment efficacy and prognosis of patients with advanced HBV-HCC receiving C + L.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica , Carcinoma Hepatocelular , Eosinófilos , Hepatite B , Neoplasias Hepáticas , Compostos de Fenilureia , Quinolinas , Humanos , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/etiologia , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/virologia , Carcinoma Hepatocelular/sangue , Feminino , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/etiologia , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/virologia , Neoplasias Hepáticas/sangue , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Prognóstico , Compostos de Fenilureia/uso terapêutico , Quinolinas/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Hepatite B/complicações , Hepatite B/tratamento farmacológico , Anticorpos Monoclonais Humanizados/uso terapêutico , Curva ROC , Idoso , Contagem de Leucócitos , Adulto , Vírus da Hepatite B/isolamento & purificação , Resultado do TratamentoRESUMO
INTRODUCTION: In Sub-Saharan Africa alone, about 40-65% of Hepatitis B Virus infections among HCWs were a result of percutaneous occupational exposures to contaminated blood and body fluids of patients. Occupational exposure to blood and body fluids among healthcare workers is on the rise in Ghana. However, the relationship between self-reported exposures to blood and body fluids suspected to be contaminated with the hepatitis B virus and actual serological evidence of exposure remains unknown. The aim of the study however was to assess the self-reported exposure to HBV as against the serological evidence of lifetime exposure to HBV and associated factors among Ghanaian HCWs. METHODS: The study was a cross-sectional analytical survey that involved 340 HCWs who were recruited using a simple random sampling procedure from six cadres of staff from five districts in Greater Accra. The participants were surveyed using a validated instrument and 5mls of venous blood was aseptically withdrawn for qualitative detection of Anti-HBc. SPSS version 23.0 was used to analyze the data to obtain proportions, odds ratios and their corresponding confidence intervals with the level of significance set at 0.05. RESULTS: The response rate was 94% with Nurses and Doctors in the majority with a mean age of 35.6 ± 7.2. Self-reported exposure to HBV was 63% whereas lifetime exposure to HBV (Anti-HBc) prevalence was 8.2% (95% CI = 5.0-11.0%). Females were 60% less likely to be exposed to HBV (aOR = 0.4; 95% CI = 0.1-0.9) than their male counterparts. HCWs without training in the prevention of blood-borne infections had almost three times higher odds of being exposed to HBV in their lifetime (aOR = 2.6; 95% CI = 1.0-6.4). CONCLUSIONS: The findings of this study suggest that self-reported exposure to HBV-contaminated biological materials was high with a corresponding high lifetime exposure to HBV. The female gender was protective of anti-HBc acquisition. Apart from direct interventions for preventing occupational exposures to HBV in the healthcare setting, periodic training of all categories of healthcare workers in infection prevention techniques could significantly reduce exposure to the Hepatitis B virus.
Assuntos
Pessoal de Saúde , Hepatite B , Exposição Ocupacional , Autorrelato , Humanos , Estudos Transversais , Gana/epidemiologia , Feminino , Masculino , Pessoal de Saúde/estatística & dados numéricos , Adulto , Hepatite B/epidemiologia , Hepatite B/transmissão , Exposição Ocupacional/estatística & dados numéricos , Pessoa de Meia-Idade , Líquidos Corporais/virologia , Vírus da Hepatite B/imunologia , Vírus da Hepatite B/isolamento & purificação , Adulto Jovem , Anticorpos Anti-Hepatite B/sangueRESUMO
PURPOSE: This study aims to analyze whether undergoing amniocentesis during pregnancy in women diagnosed with hepatitis B virus (HBV) infection leads to HBV transmission to newborns. METHODS: Retrospective data collection was conducted from June 2019 to November 2022 on expectant mothers positive for hepatitis B surface antigen (HBsAg) who underwent amniocentesis at The Third Affiliated Hospital of Sun Yat-sen University, along with data on their newborns. The study summarized the HBV infection status of newborns born to mothers with different expressions of hepatitis B e antigen (HBeAg), antiviral treatment versus no treatment, and different HBV DNA viral loads before delivery. RESULTS: In this study, 346 expectant mothers tested positive for HBsAg, along with 351 newborns (including 5 sets of twins, with 8 infants (2.28%) testing HBsAg-positive at birth. All newborns received dual immunotherapy and were followed up. At 7-12 months, retesting for HBsAg positivity and HBV DNA positivity among infants revealed that out of the infants born with HBsAg positivity, 7 cases had seroconverted to negative, while the remaining infant, who was positive for both HBsAg and HBeAg at birth, tested positive for both HBsAg and HBV DNA at 7-12 months. Thus, one case of vertical transmission of hepatitis B from mother to child occurred in this study. The proportion of infants born with HBsAg + among newborns born to HBeAg-positive mothers (4 cases, 6.06%) was significantly higher than that among newborns born to HBeAg-negative mothers (4 cases, 1.41%) (P < 0.05). The proportion of infants born with HBsAg + showed no significant difference between newborns born to mothers receiving antiviral therapy (2 cases, 2.90%) and those born to mothers not receiving antiviral therapy (6 cases, 2.13%) (P > 0.05). Among expectant mothers with viral load ≥ 6 log 10 IU/mL before delivery, 3 newborns (30.00%) were manifesting HBsAg positivity at birth, significantly higher than the group with viral load < 6 log 10 IU/mL before delivery (5 cases, 1.47%) (P < 0.05). CONCLUSION: Among HBsAg-positive expectant mothers, only a small number of infants are infected with the hepatitis B virus at birth, the proportion of which is relatively low. Infants born to mothers who are HBeAg-positive or have a viral load ≥ 6 log10 IU/mL have a higher risk of being born positive.
Assuntos
Amniocentese , DNA Viral , Antígenos de Superfície da Hepatite B , Antígenos E da Hepatite B , Vírus da Hepatite B , Hepatite B , Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez , Carga Viral , Humanos , Feminino , Gravidez , Estudos Retrospectivos , Recém-Nascido , Hepatite B/transmissão , Adulto , Antígenos de Superfície da Hepatite B/sangue , Complicações Infecciosas na Gravidez/virologia , Complicações Infecciosas na Gravidez/tratamento farmacológico , Vírus da Hepatite B/genética , Vírus da Hepatite B/isolamento & purificação , DNA Viral/sangue , Antígenos E da Hepatite B/sangue , Antivirais/uso terapêutico , Masculino , Mães , Adulto JovemRESUMO
Herein, we report a target-triggered CRISPR/Cas12a assay by coupling lanthanide tagging and inductively coupled plasma mass spectrometry (ICP-MS) for highly sensitive elemental detection. Hepatitis B virus (HBV) DNA was chosen as a model analyte, and recombinase polymerase amplification (RPA) was used for target amplification. The double-stranded RPA amplicons containing a 5' TTTG PAM sequence can be recognized by Cas12a through a specific CRISPR RNA, activating the trans-cleavage activity of CRISPR/Cas12a and nonspecific cleavage of terbium (Tb)-ssDNA modified on magnetic beads (MBs). Following magnetic separation and acid digestion, the released Tb3+ ions were quantitated by ICP-MS and correlated to the concentration of HBV DNA. Taking advantage of the accelerated cleavage of Tb-ssDNA attached to the MB particles, RPA for target amplification, and ICP-MS for highly selective signal readout, this method permits the detection of 1 copy/µL of HBV DNA in serum with high specificity and holds great promise in the early diagnosis of viral infections or tumor development.
Assuntos
Sistemas CRISPR-Cas , DNA Viral , Vírus da Hepatite B , Elementos da Série dos Lantanídeos , Espectrometria de Massas , Vírus da Hepatite B/genética , Vírus da Hepatite B/isolamento & purificação , DNA Viral/genética , DNA Viral/análise , Elementos da Série dos Lantanídeos/química , Espectrometria de Massas/métodos , Sistemas CRISPR-Cas/genética , Humanos , Técnicas de Amplificação de Ácido Nucleico/métodos , Recombinases/metabolismoRESUMO
BACKGROUND: Most Chinese blood centers have implemented mini pool (MP) HBV nucleic acid testing (NAT) together with HBsAg ELISA in routine blood donor screening for HBV infection since 2015, and a few centers upgraded MP to individual donation (ID) NAT screening recently, raising urgent need for cost-benefit analysis of different screening strategies. In an effort to prevent transfusion-transmitted infections (TTIs) for HBV, cost-benefit analyses of three different screening strategies: HBsAg alone, HBsAg plus MP NAT and HBsAg plus ID NAT were performed in blood donors from southern China where HBV infection was endemic. METHODS: MP-6 HBV NAT and ID NAT were adopted in parallel to screen blood donors for further comparative analysis. On the basis of screening data and the documented parameters, the number of window period (WP) infection, HBV acute infection, chronic hepatitis B infection (CHB) and occult hepatitis B infection (OBI) was evaluated, and the potential prevented HBV TTIs and benefits of these three strategies were predicted based on cost-benefit analysis by an estimation model. RESULTS: Of 132,323 donations, the yield rate for HBsAg-/DNA + screened by ID NAT (0.12%) was significantly higher than that by MP NAT (0.058%, P < 0.05). Furthermore, the predicted transfusion-transmitted HBV cases prevented was 1.25 times more by ID NAT compared to MP-6 NAT. The cost-benefit ratio of the universal HBsAg screening, HBsAg plus ID NAT and HBsAg plus MP NAT were 1:58, 1:27 and 1:22, respectively. CONCLUSIONS: Universal HBsAg ELISA screening in combination with HBV ID NAT or MP-6 NAT strategies was highly cost effective in China. To further improve blood safety, HBsAg plus HBV DNA ID NAT screening should be considered in HBV endemic regions/countries.
Assuntos
Doadores de Sangue , Análise Custo-Benefício , DNA Viral , Antígenos de Superfície da Hepatite B , Vírus da Hepatite B , Hepatite B , Humanos , China/epidemiologia , Vírus da Hepatite B/genética , Vírus da Hepatite B/isolamento & purificação , Vírus da Hepatite B/imunologia , Hepatite B/diagnóstico , Hepatite B/prevenção & controle , Antígenos de Superfície da Hepatite B/sangue , DNA Viral/sangue , Feminino , Masculino , Adulto , Programas de Rastreamento/economia , Programas de Rastreamento/métodos , Técnicas de Amplificação de Ácido Nucleico/métodos , Técnicas de Amplificação de Ácido Nucleico/economia , Pessoa de Meia-Idade , Testes Sorológicos/economia , Testes Sorológicos/métodos , Ensaio de Imunoadsorção Enzimática/economia , Ensaio de Imunoadsorção Enzimática/métodos , Adulto JovemRESUMO
BACKGROUND: Gut microbiota (GM) affects the progression and response to treatment in liver diseases. The GM composition is diverse and associated with different etiologies of liver diseases. Notably, alterations in GM alterations are observed in patients with portal hypertension (PH) secondary to cirrhosis, with hepatitis B virus (HBV) infection being a major cause of cirrhosis in China. Thus, understanding the role of GM alterations in patients with HBV infection-related PH is essential. AIM: To evaluate GM alterations in patients with HBV-related PH after transjugular intrahepatic portosystemic shunt (TIPS) placement. METHODS: This was a prospective, observational clinical study. There were 30 patients (with a 100% technical success rate) recruited in the present study. Patients with esophagogastric variceal bleeding due to HBV infection-associated PH who underwent TIPS were enrolled. Stool samples were obtained before and one month after TIPS treatment, and GM was analyzed using 16S ribosomal RNA amplicon sequencing. RESULTS: One month after TIPS placement, 8 patients developed hepatic encephalopathy (HE) and were assigned to the HE group; the other 22 patients were assigned to the non-HE group. There was no substantial disparity in the abundance of GM at the phylum level between the two groups, regardless of TIPS treatment (all, P > 0.05). However, following TIPS placement, the following results were observed: (1) The abundance of Haemophilus and Eggerthella increased, whereas that of Anaerostipes, Dialister, Butyricicoccus, and Oscillospira declined in the HE group; (2) The richness of Eggerthella, Streptococcus, and Bilophila increased, whereas that of Roseburia and Ruminococcus decreased in the non-HE group; and (3) Members from the pathogenic genus Morganella appeared in the HE group but not in the non-HE group. CONCLUSION: Intestinal microbiota-related synergism may predict the risk of HE following TIPS placement in patients with HBV-related PH. Prophylactic microbiome therapies may be useful for preventing and treating HE after TIPS placement.
Assuntos
Microbioma Gastrointestinal , Encefalopatia Hepática , Vírus da Hepatite B , Hipertensão Portal , Derivação Portossistêmica Transjugular Intra-Hepática , Humanos , Derivação Portossistêmica Transjugular Intra-Hepática/efeitos adversos , Masculino , Feminino , Pessoa de Meia-Idade , Hipertensão Portal/etiologia , Hipertensão Portal/diagnóstico , Hipertensão Portal/microbiologia , Estudos Prospectivos , Encefalopatia Hepática/etiologia , Adulto , Vírus da Hepatite B/isolamento & purificação , Fezes/microbiologia , Cirrose Hepática/virologia , Cirrose Hepática/microbiologia , Cirrose Hepática/cirurgia , China/epidemiologia , Resultado do Tratamento , Hepatite B/complicações , Hepatite B/diagnóstico , Hepatite B/virologia , Varizes Esofágicas e Gástricas/etiologia , Varizes Esofágicas e Gástricas/diagnóstico , Varizes Esofágicas e Gástricas/microbiologia , Varizes Esofágicas e Gástricas/virologia , Hemorragia Gastrointestinal/etiologia , RNA Ribossômico 16S/genética , Disbiose/etiologia , Idoso , Bactérias/isolamento & purificação , Bactérias/genéticaRESUMO
This study aims to characterize the molecular profile of the hepatitis B virus (HBV) among socially vulnerable immigrants residing in Brazil to investigate the introduction of uncommon HBV strains into the country. Serum samples from 102 immigrants with positive serology for the HBV core antibody (anti-HBc) were tested for the presence of HBV DNA by PCR assays. Among these, 24 were also positive for the HBV surface antigen (HBsAg). The full or partial genome was sequenced to determine genotype by phylogenetic analysis. Participants were from Haiti (79.4%), Guinea-Bissau (11.8%), Venezuela (7.8%), and Colombia (1%). Of the 21 HBV DNA-positive samples, subgenotypes A1 (52.4%), A5 (28.6%), E (9.5%), F2 (4.8%), and F3 (4.8%) were identified. Among the 78 HBsAg-negative participants, four were positive for HBV DNA, resulting in an occult HBV infection rate of 5.1%. Phylogenetic analysis suggested that most strains were likely introduced to Brazil by migration. Importantly, 80% of A5 sequences had the A1762T/G1764A double mutation, linked to an increased risk of hepatocellular carcinoma development. In conclusion, this study is the first report of HBV subgenotype A5 in Brazil, shedding new light on the diversity of HBV strains circulating in the country. Understanding the genetic diversity of HBV in immigrant communities can lead to better prevention and control strategies, benefiting both immigrants and wider society.
Assuntos
Carcinoma Hepatocelular , Emigrantes e Imigrantes , Genótipo , Vírus da Hepatite B , Hepatite B , Neoplasias Hepáticas , Mutação , Filogenia , Humanos , Vírus da Hepatite B/genética , Vírus da Hepatite B/isolamento & purificação , Brasil/epidemiologia , Neoplasias Hepáticas/virologia , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/epidemiologia , Carcinoma Hepatocelular/virologia , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/epidemiologia , Feminino , Masculino , Adulto , Hepatite B/virologia , Hepatite B/epidemiologia , Hepatite B/genética , Pessoa de Meia-Idade , DNA Viral/genética , Antígenos de Superfície da Hepatite B/genética , Antígenos de Superfície da Hepatite B/sangue , África/etnologia , África/epidemiologia , América Latina/etnologia , América Latina/epidemiologiaRESUMO
BACKGROUND: Hepatitis B virus (HBV) infection is a major concern regarding blood safety in countries with a high HBV prevalence, such as China. We aimed to understand the prevalence of HBV infection among blood donors in Chongqing and provide an important basis for developing appropriate blood screening strategies. METHODS: Dual enzyme-linked immunosorbent assays (ELISAs) for hepatitis B surface antigen (HBsAg) were conducted in parallel with nucleic acid testing (NAT) of donors. All HBsAg-reactive and/or HBV DNA-positive blood samples were tested for HBsAg and hepatitis B DNA levels. RESULTS: A total of 117,927 blood donor samples were collected from the Chongqing Blood Center between April 2020 and November 2020. In total, 473 HBV-ineligible samples were retained for HBsAg and DNA confirmation. A total of 272 samples were confirmed to be HBsAg+, including 2 HBV DNA - and 270 HBV DNA + samples. A total of 201 donations were HBsAg-, including 72 HBV DNA - samples. The rate of HBV infection was 65.33% (309/473) in men, which was significantly higher than that in women (p < 0.001). The HBV failure rate was higher among the first-time donors (p < 0.05). Of the 182 NAT R/HBsAg N/N samples (Nucleic acid test reactivity/2 anti-HBsAg tests negative), 37.91% (69/182) were false positives. The proportion of hepatitis B infections in the 18 NAT R/HBsAg N/R (Nucleic acid test reactivity/1 anti-HBsAg tests negative) samples was 94.44% (17/18), of which 50% (9/18) were occult HBV infection. A total of 95.83% (69/72) of the false positives were from the NAT R/HBsAg N/N group, and 58.33% (42/72) were first-time donors. CONCLUSION: Our data showed a strikingly high HBV infection rate among blood donors in Chongqing. Double ELISA and single NAT can effectively prevent HBV leakage and improve blood safety. First-time donors have a high rate of HBV transplant failure; therefore, donors should be retained and recruited from low-risk groups.
Assuntos
Doadores de Sangue , DNA Viral , Ensaio de Imunoadsorção Enzimática , Antígenos de Superfície da Hepatite B , Vírus da Hepatite B , Hepatite B , Humanos , Doadores de Sangue/estatística & dados numéricos , China/epidemiologia , Feminino , Masculino , Hepatite B/epidemiologia , Hepatite B/diagnóstico , Hepatite B/sangue , Vírus da Hepatite B/genética , Vírus da Hepatite B/isolamento & purificação , Vírus da Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/sangue , Adulto , DNA Viral/sangue , Pessoa de Meia-Idade , Prevalência , Adulto Jovem , AdolescenteRESUMO
Hepatitis B virus (HBV) infection poses a considerable public health challenge in limited-resource settings especially in the sub-Saharan African region. Even though HBV infection is incurable, timely treatment is effective in preventing disease progression to liver cirrhosis or hepatocellular carcinoma. However, not all infected patients require treatment. The aim of the study was to determine the clinical, immunological, and virological profiles of treatment naïve patients with HBV infection, seen at the outpatient clinic of the Cape Coast Teaching Hospital. Additionally, the study sought to determine the antiviral treatment eligibility rate based on the 2015 guidelines of the World Health Organization (WHO) compared with the new 2024 guidelines. A hospital-based cross-sectional study involving total sampling of 220 treatment naïve HBV surface antigen positive clients was carried out. A structured questionnaire was used to collect data that were analyzed with STATA version 16. The median age at diagnosis was 34 years (IQR 26.0-41.5) with a male to female ratio of 1:1.5. A total of 138 participants (62.7%) were diagnosed with HBV infection following voluntary testing. There was a median delay of 8.5 months (IQR 3.0-22.5) between initial diagnosis and patients' presentation for medical care. In all, 24 patients (10.9%) had abnormal clinical examination findings, 172 patients (78.2%) had HBV DNA levels ≤ 2000 IU/ml whereas 8 (3.6%) were seropositive for the HBV envelope antigen. A few patients had concomitant human immunodeficiency virus (2.7%) and hepatitis C virus (1.4%) infections. Treatment eligibility rate based on the WHO 2015 guidelines was 6.4% (n = 14), however, with the updated 2024 guidelines, treatment eligibility was 42.3% (n = 93). Increasing the screening rate among the general population, early linkage to clinical care of screen positives and vaccination of screen negatives will help reduce HBV-related clinical conditions in resource-limited settings.
Assuntos
Antivirais , Hepatite B , Hospitais de Ensino , Humanos , Masculino , Feminino , Adulto , Antivirais/uso terapêutico , Hepatite B/tratamento farmacológico , Hepatite B/prevenção & controle , Hepatite B/diagnóstico , Hepatite B/epidemiologia , Gana/epidemiologia , Estudos Transversais , Vírus da Hepatite B/isolamento & purificação , Vírus da Hepatite B/efeitos dos fármacos , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Globally, around 7 to 20 million people are believed to be suffering from coinfection with both hepatitis B virus (HBV) and hepatitis C virus (HCV). The loop-mediated isothermal amplification (LAMP) approach, introduced by Notomi and colleagues, has undergone substantial advancements as an effective molecular tool that enables the simultaneous analysis of multiple samples in a single tube. METHODS: The present study examined the simultaneous detection of HBV and HCV in a single tube using melt curve analysis multiplex LAMP (mLAMP), which is based on the identification of unique melting peak temperatures. Selected regions for primer design including the S gene of HBV and the UTR gene of HCV. Primer optimization is initially performed through individual HBV and HCV LAMP analysis. Following the optimization process, the mLAMP assay was evaluated by optimizing the multiplex reaction mixture, determining the reaction time, and analyzing the limit of detection (LOD). The results are also analyzed using lateral flow dipsticks (LFD), which enable the visual detection of HBV and HCV by adding 20 pmol FITC-labeled LF primers into the reaction mixture prior the mLAMP. RESULTS: The LOD for the mLAMP assay was determined as 10 copies/µl, and no cross-reactivity with other microorganisms was detected. The detection results obtained from patient plasma were also visually demonstrated using LFD, and displayed significant concordance with those obtained from Real-Time Polymerase Chain Assay. The mLAMP assay revealed a diagnostic sensitivity of 95% for detecting the HBV, and LOD is 90% for HCV. The overall diagnostic sensitivity of the mLAMP assay for both viruses was 85%. The assay confirmed a specificity of 100%. CONCLUSION: The mLAMP assay displays significant promise for analyzing coinfected samples by simultaneously detecting the dual targets HBV and HCV within a set temperature of 62 °C, all within a time frame of 1 h. Additionally, when paired with disposable LFD, the mLAMP assay enables rapid visual detection of assay results in a matter of minutes. The result contributes to the mLAMP assay being highly suitable for coinfection screening, particularly in field conditions.
Assuntos
Coinfecção , Hepacivirus , Vírus da Hepatite B , Hepatite B , Hepatite C , Técnicas de Diagnóstico Molecular , Técnicas de Amplificação de Ácido Nucleico , Sensibilidade e Especificidade , Humanos , Técnicas de Amplificação de Ácido Nucleico/métodos , Hepatite C/diagnóstico , Hepatite C/virologia , Hepatite C/complicações , Hepatite B/diagnóstico , Hepatite B/virologia , Vírus da Hepatite B/genética , Vírus da Hepatite B/isolamento & purificação , Hepacivirus/genética , Hepacivirus/isolamento & purificação , Coinfecção/diagnóstico , Coinfecção/virologia , Técnicas de Diagnóstico Molecular/métodos , Limite de Detecção , Primers do DNA/genéticaRESUMO
BACKGROUND: Cancer patients are prone to infections such as hepatitis B virus (HBV) and hepatitis C virus (HCV), which pose a major public health challenge, especially in developing countries. However, little is known about the magnitude of these infections among cancer patients in Ethiopia. Thus, this study determined the prevalence of HBV and HCV in cancer patients at the Oncology Treatment Center, Gondar, Northwest Ethiopia. MATERIALS AND METHODS: An institutional-based cross-sectional study was conducted on 115 cancer patients from 15 April to 22 July 2023 at the Oncology Treatment Center, Gondar, Northwest Ethiopia. Sociodemographic, clinical, and other relevant data were collected using a pretested structured questionnaire. Five milliliters of venous blood were collected using a vacutainer tube, serum was harvested and tested for HBV and HCV using a one-step HBsAg and anti-HCV test strip with further confirmation through an ELISA test kit. Data were analyzed using SPSS version 20 and Fisher exact test was used to determine the association between HBV/HCV infection and associated factors. RESULTS: Out of 115 cancer patients, the majority (62.6%) were females. The median age was 50 (IQR; 40-56) years. The overall prevalence of HBV and HCV infections was 4.3% (95% CI; 0.6-8%) and 6.1% (95% CI; 1.7-10.5%), respectively. Sex was significantly associated with the prevalence of HCV (p = 0.011) with higher anti-HCV positivity in males (14%) than in females (1.4%). CONCLUSIONS: In this study, the prevalence of HCV was higher and the HBV prevalence was intermediate in cancer patients. To reduce the burden of HBV and HCV infections, it is crucial to provide access to HBV and HCV screening services, strengthen vaccination, and improve prompt treatment in cancer patients.
Assuntos
Hepacivirus , Vírus da Hepatite B , Hepatite B , Hepatite C , Neoplasias , Humanos , Etiópia/epidemiologia , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Hepatite B/epidemiologia , Hepatite B/sangue , Hepatite C/epidemiologia , Hepatite C/sangue , Estudos Soroepidemiológicos , Neoplasias/epidemiologia , Neoplasias/sangue , Vírus da Hepatite B/imunologia , Vírus da Hepatite B/isolamento & purificação , Hepacivirus/imunologia , Prevalência , Fatores de RiscoRESUMO
Background: Hepatitis B Virus (HBV) remains a major global health challenge, with significant morbidity and mortality associated with chronic infections. Methods: This study examines the epidemiology, screening, and risk factors associated with HBV in Romania, focusing on a comprehensive national screening program, LIVE(RO)2, involving 320,000 individuals (majority of them considered vulnerable population). A questionnaire was used to collect information on the potential risk factors for HBV transmission. Results: The overall prevalence rate of HBV chronic infection among all the participants tested was 1.67% (confidence interval: 1.63-1.72%), with significant differences (p = 0.0001) between participants from the main geographical regions of residence (North-East 1.89%, South 1.38%, South-East 2.06%, and South-West 1.54%). Male persons aged 30-49 or 60-69 years old, from the rural and Eastern parts of Romania and non-Romanian ethnia, with a low level of education, unvaccinated, not married, unemployed, with family members with hepatitis, with personal histories of blood or blood product transfusion, surgical interventions, tattooing, hospitalizations, imprisonment, haemodialysis, unsafe sexual contacts, or with sexual transmitted infectious diseases were risk factors associated with HBsAg seropositivity. Conclusions: Our findings highlight significant demographic and epidemiological patterns of reduced HBV prevalence even in vulnerable persons, as well as modified risk factors and the impact of socio-economic factors.
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Hepatite B , Programas de Rastreamento , Populações Vulneráveis , Humanos , Pessoa de Meia-Idade , Masculino , Feminino , Adulto , Prevalência , Fatores de Risco , Romênia/epidemiologia , Idoso , Hepatite B/epidemiologia , Hepatite B Crônica/epidemiologia , Adulto Jovem , Encaminhamento e Consulta , Vírus da Hepatite B/imunologia , Vírus da Hepatite B/isolamento & purificação , Inquéritos e Questionários , AdolescenteRESUMO
The clinical diagnosis of pathogen infectious diseases increasingly requires sensitive and rapid RNA detection technologies. The RNA-guided clustered regularly interspaced short palindromic repeats (CRISPR)/Cas13a system has shown immense potential in molecular diagnostics due to its trans-cleavage activity. However, most Cas13a-based detection methods require an amplicon transcription step, and the multi-step open-tube operations are prone to contamination, limiting their widespread application. Here, we propose an ultrasensitive (single-copy range, â¼aM) and rapid (within 40 min) isothermal one-pot RNA detection platform, termed SATCAS (Simultaneous Amplification and Testing platform based on Cas13a). This method effectively distinguishes viable bacteria (0%-100%) under constant total bacterial conditions, demonstrating its robustness and universality. SATCAS excels in identifying single nucleotide polymorphisms (SNPs), particularly detecting 0.5% drug-resistant mutations. We validated SATCAS by detecting infections in biological samples from 68 HBV, 23 EBV, and 48 SARS-CoV-2 patients, achieving 100% sensitivity, 92.86% specificity, and 97.06% accuracy in HBV infection testing. We anticipate that SATCAS has broad application potential in the early diagnosis, subtyping, drug resistance detection, and point-of-care monitoring of pathogen infectious diseases.
Assuntos
Técnicas Biossensoriais , Sistemas CRISPR-Cas , Técnicas de Amplificação de Ácido Nucleico , Polimorfismo de Nucleotídeo Único , SARS-CoV-2 , Humanos , Técnicas Biossensoriais/métodos , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação , Técnicas de Amplificação de Ácido Nucleico/métodos , COVID-19/diagnóstico , COVID-19/virologia , RNA Viral/genética , Técnicas de Diagnóstico Molecular/métodos , Vírus da Hepatite B/genética , Vírus da Hepatite B/isolamento & purificaçãoRESUMO
BACKGROUND: Accurate laboratory confirmation for Hepatitis B diagnosis and monitoring are crucial. Recently an ultrasensitive immunoassay test, the HBsAg Next (HBsAgNx), has been reported approximately eight times more sensitive than current HBsAg assays. The aim of our study was to assess the analytical performances of this new test. METHODOLOGY: 253 clinical samples from Saint Louis University Hospital were analyzed, splitted into four panels: (1) routine prospectively screening serums (n = 196), (2) retrospective serum samples before HBV reactivation (HBV-R) (n = 18), (3) occult HBV infection (OBI) (n = 10) and (4) a selection of wild type HBV genotypes (n = 29) RESULTS: Panel 1, showed robust agreement with the HBsAg Qualitative II (HBsAgQII) assay (Cohen's kappa = 0.83). Despite this agreement, 7 false positive with the HBsAgQII assay were found negative with HBsAgNx. One OBI was detected only with HBsAgNx. Panel 2 showed potential time savings in diagnosing HBV-R using HBsAgNx among 4/18 HBsAg positives samples. Panel 3 highlighted the ability of HBsAgNx to detect HBsAg in OBI patients defined by negative for HBsAg with HBsAgQII assay and positive for HBV DNA. Furthermore, the HBsAgNx assay detected all different genotypes. CONCLUSION: The study highlights the effectiveness of the HBsAgNx assay, showing its performance. It excels in detecting weakly positive samples and addressing challenging cases. HBsAgNx assay demonstrates promising analytical performances, with improved sensitivity and specificity compared to standard HBsAgQII assay, able to detect all genotypes. Its potential impact on early detecting and monitoring reactivations, and occult infections could be very useful in clinical practice.
Assuntos
Antígenos de Superfície da Hepatite B , Hepatite B , Sensibilidade e Especificidade , Humanos , Antígenos de Superfície da Hepatite B/sangue , Hepatite B/diagnóstico , Hepatite B/virologia , Imunoensaio/métodos , Feminino , Masculino , Vírus da Hepatite B/genética , Vírus da Hepatite B/imunologia , Vírus da Hepatite B/isolamento & purificação , Adulto , Estudos Retrospectivos , Pessoa de Meia-Idade , Genótipo , IdosoRESUMO
INTRODUCTION: Hepatitis B virus (HBV) reactivation (HBVr) induced by chemotherapy in patients with resolved or chronic infection can lead to severe consequences. Despite recommendations, rates of HBV screening before chemotherapy are low due to poor recognition of risk factors by clinicians. The aim of the study is to assess whether routine HBV screening using universal HBV screening on chemotherapy orders (CO) could reduce HBVr incidence. METHODS: This is a 1-year retrospective single-center observational study of patients who received intravenous chemotherapy post implementation of CO. We compared the incidence of HBVr in three groups of patients: those screened through CO (group 1), those screened by the medical team (group 2), and those not screened (group 3). RESULTS: On a total of 1374 patients, 179 of 206 patients were screened as requested on CO (group 1) and 421 by the medical team (group 2), whereas 747 patients were not screened (group 3). Only one HBVr occurred, and no difference was seen on the incidence of HBVr between group 1 and group 3 (0% vs 0.1%; p = 1.00), probably because of a lack of follow-up after chemotherapy. Follow-up for HBVr was imperfect in group 1 and group 2 (16.7% vs 5.6%; p = 0.32). Screening was done for 92% of patients on anti-CD20 therapy. In group 3, 89 patients had ALT elevation during chemotherapy but only 17 (19%) were tested for HBVr. CONCLUSION: Systematic HBV detection requested on CO is an effective way to obtain a high percentage of patients with adequate screening, particularly when chemotherapy is at high risk of HBVr. Nevertheless, this screening method do not guarantee optimal follow-up and requires improvements.
Assuntos
Antineoplásicos , Vírus da Hepatite B , Hepatite B , Neoplasias , Ativação Viral , Humanos , Estudos Retrospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Ativação Viral/efeitos dos fármacos , Hepatite B/epidemiologia , Hepatite B/diagnóstico , Vírus da Hepatite B/isolamento & purificação , Vírus da Hepatite B/efeitos dos fármacos , Idoso , Neoplasias/tratamento farmacológico , Antineoplásicos/administração & dosagem , Antineoplásicos/uso terapêutico , Incidência , Programas de Rastreamento/métodos , Adulto , Fatores de RiscoRESUMO
The rampant hepatitis B virus (HBV) seriously endangers human health, and hepatitis B surface antigen (HBsAg) is its early diagnostic marker. Therefore, it is crucial to construct a fast and highly sensitive HBsAg detection method. Based on high-efficiency magnetic separation technology and fluorescent composite material labelling technology, an accurate, fast and sensitive fluorescent immunosensing system for HBsAg detection was developed. Immunomagnetic beads constructed from carboxyl-functionalized Fe3O4 nanoparticles (Fe3O4-COOH) with excellent magnetic response performance were used as efficient capture carriers for HBsAg. Immunofluorescence composite microspheres constructed based on ultra-stable polystyrene-coated CsPbBr3 perovskite nanocrystals (CPB@PSAA) with high hydrophilic properties, were excellent fluorescent markers for HBsAg. Using this sensitive sandwich fluorescence sensing system a good linear relationship within the range of 0.2-15 ng/mL was established between HBsAg concentration and fluorescence intensity with a limit of detection (LOD) of 0.05 ng/mL. The system obtained satisfactory results when tested on real human serum samples. The magnetic-assisted fluorescence immune-sandwich sensor system has broad application prospects in biomedicine such as rapid and early diagnosis and effective prevention of infectious diseases.
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Compostos de Cálcio , Antígenos de Superfície da Hepatite B , Interações Hidrofóbicas e Hidrofílicas , Limite de Detecção , Óxidos , Titânio , Antígenos de Superfície da Hepatite B/sangue , Antígenos de Superfície da Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/análise , Humanos , Óxidos/química , Titânio/química , Compostos de Cálcio/química , Corantes Fluorescentes/química , Nanopartículas de Magnetita/química , Microesferas , Anticorpos Imobilizados/imunologia , Vírus da Hepatite B/imunologia , Vírus da Hepatite B/isolamento & purificação , Imunoensaio/métodosRESUMO
BACKGROUND: To delineate the levels of serum Hepatitis B virus (HBV) RNA in patients with HBV-related hepatocellular carcinoma (HCC) and study comparisons with those of individuals afflicted with cirrhosis. METHODS: Adult patients diagnosed with HBV-related cirrhosis or HCC (initial diagnosis) were enrolled in the cross-sectional study. Serum HBV DNA level was quantified through a real-time polymerase chain reaction assay with a lower limit of quantification (LLQ) of 20 IU/ml. Additionally, serum HBV RNA was quantified employing RNA real-time fluorescence thermostatic amplification detection technology with LLQ of 100 copies/ml. Propensity score matching (PSM) was conducted to ensure balance in between-group confounders. RESULTS: A total of 187 patients (47 with HCC and 140 with cirrhosis) were recruited, among whom 140 (74.9%) had undergone antiviral therapy prior to their inclusion, with varying durations. Serum HBV RNA was detectable in 89.4% of HCC patients at the time of carcinoma diagnosis. After PSM, individuals with HCC exhibited significantly elevated levels of serum HBV DNA and HBV RNA compared to those with cirrhosis (median lgHBV RNA 3.1 vs 2.0 copies/ml, P = 0.001). Subgroup analysis, including 38 patients who exhibited ultrasensitive HBV DNA negativity, revealed similar results (median lgHBV RNA 3.0 vs 0.0 copies/ml, P < 0.001). CONCLUSIONS: Serum HBV RNA levels were significantly higher in HBV-related HCC patients compared to cirrhotic patients. The presence of serum HBV RNA positivity or elevated levels was associated with the onset of HCC.
Assuntos
Carcinoma Hepatocelular , Vírus da Hepatite B , Cirrose Hepática , Neoplasias Hepáticas , Pontuação de Propensão , RNA Viral , Humanos , Carcinoma Hepatocelular/virologia , Carcinoma Hepatocelular/sangue , Neoplasias Hepáticas/virologia , Neoplasias Hepáticas/sangue , Masculino , Feminino , Pessoa de Meia-Idade , Cirrose Hepática/virologia , Cirrose Hepática/sangue , Cirrose Hepática/complicações , Estudos Transversais , RNA Viral/sangue , Vírus da Hepatite B/genética , Vírus da Hepatite B/isolamento & purificação , DNA Viral/sangue , Adulto , Idoso , Hepatite B Crônica/complicações , Hepatite B Crônica/virologia , Hepatite B Crônica/sangueRESUMO
This editorial commented on an article in the World Journal of Gastroenterology titled "Risks of Reactivation of Hepatitis B Virus in Oncological Patients Using Tyrosine Kinase-Inhibitors: Case Report and Literature Analysis" by Colapietro et al. In this editorial, we focused on providing a more comprehensive exploration of hepatitis B virus reactivation (HBVr) associated with the usage of tyrosine kinase inhibitors (TKIs). It includes insights into the mechanisms underlying HBV reactivation, the temporal relationship between TKIs and HBV reactivation, and preventive measures. The aim is to understand the need for nucleos(t)ide analogs (NAT) and serial blood tests for early recognition of reactivation and acute liver injury, along with management strategies. TKIs are considered to be an intermediate (1%-10%) of HBVr. Current guidelines stipulate that patients receiving therapy with high or moderate risks of reactivation or recent cancer diagnosis must have at least tested hepatitis B surface antigen, anti-hepatitis B core antigen (HBc), and anti-hepatitis B surface antibody. Anti-HBc screening in highly endemic areas means people with negative tests should be vaccinated against HBV. Nucleoside or nucleotide analogs (NAs) like entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide (TAF) form the basis of HBV reactivation prophylaxis and treatment during immunosuppression. Conversely, lamivudine, telbivudine, and adefovir are generally discouraged due to their reduced antiviral efficacy and higher risk of fostering drug-resistant viral strains. However, these less effective NAs may still be utilized in cases where ETV, TDF, and TAF are not feasible treatment options.
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Antivirais , Vírus da Hepatite B , Neoplasias , Inibidores de Proteínas Quinases , Ativação Viral , Humanos , Ativação Viral/efeitos dos fármacos , Vírus da Hepatite B/efeitos dos fármacos , Vírus da Hepatite B/imunologia , Vírus da Hepatite B/isolamento & purificação , Antivirais/uso terapêutico , Antivirais/efeitos adversos , Inibidores de Proteínas Quinases/efeitos adversos , Inibidores de Proteínas Quinases/uso terapêutico , Neoplasias/tratamento farmacológico , Hepatite B/diagnóstico , Hepatite B/virologia , Hepatite B/tratamento farmacológico , Fatores de Risco , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Proteínas Tirosina Quinases/antagonistas & inibidores , Antígenos de Superfície da Hepatite B/sangueRESUMO
Hepatitis B virus (HBV) belongs to the genus Orthohepadnavirus, of Hepadnaviridae family, smallest human deoxyribonucleic acid (DNA) virus with 3200 bp in a partially double-stranded circular DNA. Globally, about 2 billion people are infected with over 65 million of the chronically infected residing in Africa. Ten HBV genotypes (A-J) have been reported across the globe. Based on the World Health Organization (WHO) African Regions including Kenya have high HBV prevalence rates yet the data on prevalence rates of the various HBV genotypes and their associated biomarkers is very scanty. A cross-sectional descriptive study with purposive sampling was conducted in which a census of patients with chronic Hepatitis B (CHB) with history >6-month were reviewed for eligibility. Demographics data was abstracted from patient files and blood samples drawn for genotyping, viral load using Rotor gene Q Polymerase Chain Reaction (PCR) equipment, Hepatitis B surface Antigen (HBsAg), Hepatitis B envelope antigen (HbeAg) and Hepatitis B core antibody (Anti-HBc) using Cobas e411 machine. Out of a total of 83 patients, 43 (52%) were eligible; males 29 (67.4%), females 14 (32.6%) with mean ages of 35.1±10.8 and 34.3±9.3 respectively. Genotypes A were 34(79.1%), B were 5(11.6%), C-D were 0 while E-J were 9(20.9%). All cases of genotype B were associated with co-infection of genotype A. Majority were HBeAg negative with HBV DNA >10 IU/ml (81.4% and 86.0% respectively) with distribution among all the genotypes. Across genotypes, viral load mean percentage comparisons were: A vs. A/B = 2600 (p = 0.09), A vs. E-J = 5260 (p = 0.09) and A/B vs. E-J = 200 (p = 0.28). The most prevalent genotype was A followed by mixed co-infection of genotype A/B. Genotype A was associated with HBV DNA viral loads > 10IU/ml and high rates of HBeAg negativity. Genotypes E-J were also detected though not characterized.