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Kinetics and mechanism of the oxidative degradation of sofosbuvir by N-bromosuccinimide in aqueous medium. SN APPLIED SCIENCES 2019. [DOI: 10.1007/s42452-019-1021-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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52
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Dawood RM, Salum GM, Abdelhafez TH, El Shenawy R, Ibrahim NE, El Awady MK. Safety and tolerability of mice to repeated subcutaneous injections of a peptide mix as a potential vaccine against HCV infection. Hum Antibodies 2019; 27:105-110. [PMID: 30594921 DOI: 10.3233/hab-180354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS In this study, the safety and tolerability of new candidate HCV vaccine named Cenv6 were screened in mice. Cenv6 peptide is composed of 6 synthetic HCV peptides (3 structural and 3 nonstructural peptides). METHODS Forty eight mice were enrolled in this study, 12 controls and 36 mice (the thirty-six mice were categorized into 3 groups according to administered doses (3 monthly doses of 800 ng, 1600 ng, and 16 μg/25 gm mouse body weight (bw))). Hematological, biochemical and histopathological changes were appraised. RESULTS Our data indicated that the doses of 800 ng and 1600 ng of Cenv6 per 25 gm mouse body weight were safe as compared to the dose 16 μg/25 gm bw (10 times more than the potential therapeutic dose) for all examined tissues while the 16 μg Cenv6 dose provoked histopathological changes in kidneys, liver and lungs. CONCLUSIONS The extravagant histopathological changes in different organs have exiled the 16 μg dose out of acceptable range and validated that Cenv6 is safe and tolerable at the two lower doses (800 and 1600 ng/25 gm bw).
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Damola AB, Adeniji JA, Bakarey AS. Hepatitis C virus seropositivity and the risk factors for transmission among blood donors in some selected centers in Lagos State, Southwest Nigeria. J Immunoassay Immunochem 2019; 40:528-539. [PMID: 31378189 DOI: 10.1080/15321819.2019.1647853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Introduction: Hepatitis C virus (HCV) infects about 0.5% to 2.3% of the world population with most of the cases occurring in developing countries. It is primarily transmitted through transfusion of blood and blood products. There exists dearth of information on burden and circulation of HCV and their attendant health challenges in Nigeria. This study was therefore designed to determine the seroprevalence rate and risk of HCV transmission among blood donors in Lagos State Nigeria. Methodology: Blood samples were collected between January 2002 and December 2006 from 3,002 consenting (Male = 2,922; Female = 80; Age range = 18-63; Median age = 32 years) donors in five selected public hospitals' blood donation centers between 2002 and 2006. Sera was tested for anti-HCV by ELISA technique. Demographic and other relevant information were obtained by a semi-structured questionnaire to assess risk factors for HCV transmission. Results: This study found an overall rate of 3.1% for anti-HCV among the blood donors sampled. Highest rate of 6.0% for HCV was found among participants age ranged ≥50 years and lowest in the age group 40-49 years. Prevalence of HCV was higher in female (6.3%) than in male (3.0%) and was 0.21 times less risky in female compared to their male counterparts (OR = 1.29, 95%CI 0.11-1.31). By location, MSCH had the highest HCV rate (3.9%) and lowest (2.1%) in GHOA. Sharing of sharps for tattoo/tribal markings had a statistical association (p = .0379) with HCV infection. However, no significant difference was found by gender (CI = 0.99-2.01; p = .1002), age (CI = 0.79-1.55; p = .1001) and location (p = .5326). Conclusion: The relatively high prevalence of HCV infection detected and the risk of transmission among blood donors in this study are of public health importance. Hence, the institution of appropriate measures to stem down the trend of HCV circulation among this population in Nigeria is therefore advocated.
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Affiliation(s)
- A B Damola
- Department of Virology, College of Medicine, University of Ibadan , Ibadan , Nigeria
| | - J A Adeniji
- Department of Virology, College of Medicine, University of Ibadan , Ibadan , Nigeria
| | - A S Bakarey
- Institute for Advanced Medical Research & Training, College of Medicine, University College Hospital, University of Ibadan , Ibadan , Nigeria
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El-Ghitany EM, Farghaly AG. Geospatial epidemiology of hepatitis C infection in Egypt 2017 by governorate. Heliyon 2019; 5:e02249. [PMID: 31463388 PMCID: PMC6709406 DOI: 10.1016/j.heliyon.2019.e02249] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 05/17/2019] [Accepted: 08/05/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Geographic Information Systems (GIS) and spatial epidemiological methods may provide a basis for disease investigation through which hotspots and disease determinants can be identified. Applying these methods for hepatitis C virus (HCV) in Egypt would support a more effective strategy to control its transmission. Therefore, this study used GIS software to draw one of the first HCV maps in Egypt elucidating and analyzing geographical and epidemiological differences in HCV distribution within the country. METHODS A cross-sectional survey of 21 governorates (n = 12169, 8080 rural, 3733 urban and 356 slums areas) was completed. All participants were interviewed regarding potential exposures to HCV. Third generation ELISA was used to test serum for HCV antibody. Quantitative real-time RT-PCR was used to test anti-HCV positive subjects for HCV-RNA. RESULTS The participants ranged in age from 14-90 years. Overall, anti-HCV sero-prevalence was 14.8%. The prevalence of HCV-RNA, was 9.5%. Proportionally, 65.8% of anti-HCV positives were positive for HCV-RNA. The map of Egyptian governorates highlighted the darkest spot of HCV infection in Menoufeya (37.8%) followed by Beni Suef (29.2%) and Minya (28.6%). Anti-HCV prevalence was higher among males and logistic regression models revealed a strong independent association with increasing age, rural residence and parenteral anti-schistosomal therapy. CONCLUSIONS Rural residences and HCV hotspots should be prioritized for HCV prevention programs. The unique age distribution first shown in this study shows that the older age groups (≥60 years old) constitutes a considerable reservoir of infection and must not be neglected.
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Mattlinger C, Thumfart JO, Heinen W, Michels H, Berres M, Vogt M, Jansky M. [Hepatitis C virus seroprevalence and dependency on country of origin of refugees in Rhineland-Palatinate, Germany in 2015]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 61:1472-1480. [PMID: 30225596 DOI: 10.1007/s00103-018-2816-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Hepatitis C, a liver disease transmitted by the hepatitis C virus (HCV), can result in liver cirrhosis and hepatocellular carcinoma (HCC). According to WHO estimates for 2015, approximately 71 million people worldwide are chronically infected with HCV, representing 1% of the world population. Worldwide migration movements lead to immigration from HCV high- to low-prevalence countries. There are, however, no published data available on HCV seroprevalence and its correlation with the country of origin in current unselected larger refugee populations (>1000 people) having entered Europe/Germany. OBJECTIVES Documentation and evaluation of hepatitis C seroprevalence and its correlation with the country of origin of refugees in Rhineland-Palatinate/Germany in 2015. METHODS As part of routine diagnostics during the initial medical examination, 12,880 refugees in Rhineland-Palatinate were screened for HCV antibodies in 2015. The data have been analyzed retrospectively and anonymously. RESULTS The collective comprising 12,880 refugees showed a HCV seroprevalence of 1.5%. This is higher than the HCV prevalence of the general German population (0.5%). In particular, a correlation between HCV seroprevalence and the country of origin could be demonstrated. CONCLUSIONS To reach the 2030 HCV-elimination target of the WHO, national and international recommendations to screen refugees/migrants from HCV high-prevalence countries for HCV should be emphasized. The chronically infected should be treated in accordance with HCV-guidelines. National, easily accessible information on HCV high-prevalence countries is required by attending physicians.
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Affiliation(s)
- Christina Mattlinger
- Zentrum für Allgemeinmedizin und Geriatrie, Abteilung Allgemeinmedizin, Universitätsmedizin Mainz, Am Pulverturm 13, 55131, Mainz, Deutschland.
| | | | - Wilma Heinen
- Gesundheitsamt der Kreisverwaltung Trier-Saarburg, Trier, Deutschland
| | - Harald Michels
- Gesundheitsamt der Kreisverwaltung Trier-Saarburg, Trier, Deutschland
| | - Manfred Berres
- RheinAhrCampus Remagen, Hochschule Koblenz, Remagen, Deutschland.,Institut für Medizinische Biometrie, Epidemiologie und Informatik, Universitätsmedizin Mainz, Mainz, Deutschland
| | - Manfred Vogt
- Abteilung Humanmedizin, Landesuntersuchungsamt Rheinland-Pfalz, Koblenz, Deutschland
| | - Michael Jansky
- Zentrum für Allgemeinmedizin und Geriatrie, Abteilung Allgemeinmedizin, Universitätsmedizin Mainz, Am Pulverturm 13, 55131, Mainz, Deutschland
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Abstract
OBJECTIVE Direct-acting antivirals have opened an opportunity for controlling hepatitis C virus (HCV) infection in Pakistan, where 10% of the global infection burden is found. We aimed to evaluate the implications of five treatment programme scenarios for HCV treatment as prevention (HCV-TasP) in Pakistan. DESIGN An age-structured mathematical model was used to evaluate programme impact using epidemiological and programme indicators. SETTING Total Pakistan population. PARTICIPANTS Total Pakistan HCV-infected population. INTERVENTIONS HCV treatment programme scenarios from 2018 up to 2030. RESULTS By 2030 across the five HCV-TasP scenarios, 0.6-7.3 million treatments were administered, treatment coverage reached between 3.7% and 98.7%, prevalence of chronic infection reached 2.4%-0.03%, incidence reduction ranged between 41% and 99%, program-attributed reduction in incidence rate ranged between 7.2% and 98.5% and number of averted infections ranged between 126 221 and 750 547. Annual incidence rate reduction in the first decade of the programme was around 6%-18%. Number of treatments needed to prevent one new infection ranged between 4.7-9.8, at a drug cost of about US$900. Cost of the programme by 2030, in the most ambitious elimination scenario, reached US$708 million. Stipulated WHO target for 2030 cannot be accomplished without scaling up treatment to 490 000 per year, and maintaining it for a decade. CONCLUSION HCV-TasP is a highly impactful and potent approach to control Pakistan's HCV epidemic and achieve elimination by 2030.
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Affiliation(s)
- Houssein H Ayoub
- Department of Mathematics, Statistics, and Physics, Qatar University, Doha, Qatar
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Doha, Qatar
- Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, USA
- College of Health and Life Sciences, Hamad bin Khalifa University, Doha, Qatar
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Elsayed Metawlly D, Noby Amer A, Mostafa Mostafa H, El Din Elsawaf G, Abd El Kader O. Low cost detection of hepatitis C virus RNA in HCV infected patients by SYBR Green I real-time PCR. ALEXANDRIA JOURNAL OF MEDICINE 2019. [DOI: 10.1016/j.ajme.2017.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
| | - Ahmed Noby Amer
- Department of Microbiology, Faculty of Pharmacy, University of Pharos, Egypt
| | - Hanan Mostafa Mostafa
- Department of Internal Medicine, Medical Research Institute, Alexandria University, Egypt
| | - Gamal El Din Elsawaf
- Department of Microbiology, Medical Research Institute, Alexandria University, Egypt
| | - Ola Abd El Kader
- Department of Microbiology, Medical Research Institute, Alexandria University, Egypt
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Elshimi E, Morad W, Mohamad NE. Male Sexual Dysfunction Among Egyptian Patients with Chronic Hepatitis C Virus Infection Before and After Direct-Acting Antiviral Drugs. J Sex Med 2019; 16:402-409. [DOI: 10.1016/j.jsxm.2019.01.309] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/18/2019] [Accepted: 01/21/2019] [Indexed: 02/06/2023]
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Chemaitelly H, Mahmud S, Kouyoumjian SP, Al‐Kanaani Z, Hermez JG, Abu‐Raddad LJ. Who to Test for Hepatitis C Virus in the Middle East and North Africa?: Pooled Analyses of 2,500 Prevalence Measures, Including 49 Million Tests. Hepatol Commun 2019; 3:325-339. [PMID: 30859146 PMCID: PMC6396361 DOI: 10.1002/hep4.1310] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 12/18/2018] [Indexed: 12/11/2022] Open
Abstract
Expanding hepatitis C virus (HCV) treatment coverage is challenged by limited testing and diagnosis. This study assessed the risk of exposure, for the Middle East and North Africa, by population, yields of testing, and program efficiency of testing strategies. A standardized and systematically assembled database of 2,542 HCV antibody prevalence studies on 49 million individuals was analyzed. Random effects meta-analyses were conducted to estimate pooled measures for risk of exposure, risk ratio (RR) of exposure, and yields of testing. Program expansion path curves were calculated to assess program efficiency. Countries clustered into two patterns: generalized versus concentrated epidemics. In generalized epidemics (Egypt and Pakistan) relative to general populations, RR of exposure was 6.8 for people who inject drugs (PWID), 6.7 for populations with liver conditions, and 5.0 for populations with high-risk health care exposures. In concentrated epidemics (remaining countries), corresponding RRs were 97.2, 45.1, and 22.2, respectively. In generalized epidemics, the number of tests needed to identify a chronic infection was 2.5 for PWID, 2.4 for populations with liver conditions, 2.7 for populations with high-risk health care exposures, and 14.2 for general populations. In concentrated epidemics, corresponding numbers were 2.8, 8.6, 5.1, and 222.2, respectively. Program expansion path curves demonstrated major gains in program efficiency by targeting specific populations. Risk of exposure varies immensely by population and shows a distinctive hierarchy, particularly in concentrated epidemics. Testing strategies can be much more efficient through population prioritization by risk of exposure. General population testing is not programmatically efficient in concentrated epidemics.
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Affiliation(s)
- Hiam Chemaitelly
- Infectious Disease Epidemiology GroupWeill Cornell Medicine‐Qatar, Cornell University, Qatar Foundation‐Education CityDohaQatar
| | - Sarwat Mahmud
- Infectious Disease Epidemiology GroupWeill Cornell Medicine‐Qatar, Cornell University, Qatar Foundation‐Education CityDohaQatar
| | - Silva P. Kouyoumjian
- Infectious Disease Epidemiology GroupWeill Cornell Medicine‐Qatar, Cornell University, Qatar Foundation‐Education CityDohaQatar
| | - Zaina Al‐Kanaani
- Infectious Disease Epidemiology GroupWeill Cornell Medicine‐Qatar, Cornell University, Qatar Foundation‐Education CityDohaQatar
| | - Joumana G. Hermez
- Department of Communicable DiseasesHIV/Hepatitis/STIs Unit, World Health Organization Regional Office for the Eastern MediterraneanCairoEgypt
| | - Laith J. Abu‐Raddad
- Infectious Disease Epidemiology GroupWeill Cornell Medicine‐Qatar, Cornell University, Qatar Foundation‐Education CityDohaQatar
- Department of Healthcare Policy and Research, Weill Cornell MedicineCornell UniversityNew YorkNY
- College of Health and Life SciencesHamad bin Khalifa UniversityDohaQatar
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Botheju WSP, Zghyer F, Mahmud S, Terlikbayeva A, El-Bassel N, Abu-Raddad LJ. The epidemiology of hepatitis C virus in Central Asia: Systematic review, meta-analyses, and meta-regression analyses. Sci Rep 2019; 9:2090. [PMID: 30765844 PMCID: PMC6376025 DOI: 10.1038/s41598-019-38853-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 01/11/2019] [Indexed: 02/08/2023] Open
Abstract
The objective was to delineate hepatitis C virus (HCV) epidemiology in countries of Central Asia (CA), specifically Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. A systematic review was conducted guided by the Cochrane Collaboration Handbook, and reported using PRISMA guidelines. Meta-analyses were performed using DerSimonian-Laird random-effects models with inverse variance weighting. Random-effects meta-regression analyses were performed on general population studies. The systematic review identified a total of 208 HCV prevalence measures. No incidence or Turkmenistan studies were identified. Meta-analyses estimated HCV prevalence among the general population at 0.7% (95%CI: 0.7-0.8%) in Kazakhstan, 2.0% (95%CI: 1.7-2.4%) in Kyrgyzstan, 2.6% (95%CI: 1.7-3.6%) in Tajikistan, and 9.6 (95%CI: 5.8-14.2%) in Uzbekistan. Across CA, the pooled mean prevalence was 13.5% (95%CI: 10.9-16.4%) among non-specific clinical populations, 31.6% (95%CI: 25.8-37.7%) among populations with liver-related conditions, and 51.3% (95%CI: 46.9-55.6%) among people who inject drugs. Genotypes 1 (52.6%) and 3 (38.0%) were most frequent. Evidence was found for statistically-significant differences in prevalence by country, but not for a temporal decline in prevalence. CA is one of the most affected regions by HCV infection with Uzbekistan enduring one of the highest prevalence levels worldwide. Ongoing HCV transmission seems to be driven by injecting drug use and healthcare exposures.
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Affiliation(s)
| | - Fawzi Zghyer
- Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Sarwat Mahmud
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Assel Terlikbayeva
- Global Health Research Center of Central Asia in Kazakhstan, Almaty, Kazakhstan
| | - Nabila El-Bassel
- Social Intervention Group, Columbia University School of Social Work, New York, New York, USA
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
- Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York, USA.
- College of Health and Life Sciences, Hamad bin Khalifa University, Doha, Qatar.
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Abdel Ghaffar TY, El Naghi S, Abdel Gawad M, Helmy S, Abdel Ghaffar A, Yousef M, Moafy M. Safety and efficacy of combined sofosbuvir/daclatasvir treatment of children and adolescents with chronic hepatitis C Genotype 4. J Viral Hepat 2019; 26:263-270. [PMID: 30380158 DOI: 10.1111/jvh.13032] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 10/03/2018] [Indexed: 12/16/2022]
Abstract
Direct-acting antivirals have become available for treating chronic HCV (hepatitis C virus) infection in adults and, recently, in children at least 12 years old. Our aim was to investigate the safety and efficacy of combined sofosbuvir (SOF)/daclatasvir (DCV) for HCV Genotype 4 in children aged 8 to 18 years or weighing 17 kg or more. A total of 40 chronic HCV-infected, treatment-naïve children with well compensated livers were recruited from two sites. Patients received combined therapy of SOF (400 mg/d for patients weighing greater than 45 kg; 200 mg/d for patients weighing 17 to 45 kg) and DCV (60 mg/d for patients weighing greater than 45 kg; 30 mg/d for patients weighing 17 to 45 kg) for 12 weeks. They were followed up regularly by clinical examination and laboratory tests during treatment (weekly in the first month then monthly to the end of treatment), every 3 months for 6 months post-treatment, and at 48 weeks post-treatment. In our cohort, which included 45% of children below the age of 12 years (72.5% genotype 4 and 27.5% mixed genotype 4 and 1), end of treatment response (ETR) was 97.5%. Sustained virologic response for weeks 12 and 24 post-treatment (SVR12 and SVR24) were 97.5% and 95%, respectively, on an intention to treat basis, and 100% and 100% for those who completed the study protocol. Observed side effects were mild and none required drug cessation. Combined SOF/DCV was found to be effective and safe for treating HCV Genotype 4-infected children, 8 years of age and above.
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Affiliation(s)
- Tawhida Y Abdel Ghaffar
- Yassin Abdel Ghaffar Charity Center for Liver Disease and Research, Cairo, Egypt.,Department of Pediatrics, Ain Shams University, Cairo, Egypt
| | - Suzan El Naghi
- Yassin Abdel Ghaffar Charity Center for Liver Disease and Research, Cairo, Egypt.,Department of Pediatrics, National Hepatology & Tropical Medicine Research Institute, Cairo, Egypt
| | | | - Sarah Helmy
- Yassin Abdel Ghaffar Charity Center for Liver Disease and Research, Cairo, Egypt
| | | | | | - Mohamad Moafy
- Department of Pediatrics, Ain Shams University, Cairo, Egypt
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Ali HEA, Emam AA, Zeeneldin AA, Srour R, Tabashy R, El-Desouky ED, Abd Elmageed ZY, Abdel-Wahab AHA. Circulating miR-26a, miR-106b, miR-107 and miR-133b stratify hepatocellular carcinoma patients according to their response to transarterial chemoembolization. Clin Biochem 2019; 65:45-52. [PMID: 30653948 DOI: 10.1016/j.clinbiochem.2019.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 11/09/2018] [Accepted: 01/10/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND A number of hepatocellular carcinoma (HCC) patients have developed resistance against transcatheter arterial chemoembolization (TACE) treatment. In this study, we aimed to develop a panel of microRNAs (miRs) biomarkers to predict clinical outcomes in HCC patients after TACE treatment. METHODS The expression level of twenty miRs was evaluated in FFPE tissues collected from 33 HCC patients. We selected four differentially expressed miRs in TACE-responders versus non-responders and re-assessed their expression in 51 serum samples. The expressions of miRs associated with overall survival (OS), progression-free survival (PFS), and treatment outcomes were investigated. The diagnostic accuracy of these miRs in predicting patients' response to TACE was also evaluated. RESULTS The baseline of miR-106b, miR-107 and miR-133b was significantly elevated (p < .001) in sera of TACE-responders while miR-26a was elevated (p < .001) in non-responders. miR-26a and miR-133b recorded the highest diagnostic performance as individual classifiers in response to TACE (AUC = 1.0 and 100% sensitivity and specificity). Intriguingly, miR-133b distinguished complete responders from partial responders and non-responders (AUC ≥ 0.90). The PFS was improved (p < .05) in the high expression group of miR-31, miR-200b, miR-133b and miR-181a over their low expression group. CONCLUSION Circulating miR-133b, miR-26a, miR-107 and miR-106 in serum are potential candidates to be utilized as prognostic biomarkers for predication of TACE treatment outcomes in HCC patients.
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Affiliation(s)
- Hamdy E A Ali
- Department of Pharmaceutical Sciences, Rangel College of Pharmacy, Texas A&M Health Sciences Center, College Station, TX, USA; Department of Radiobiological Applications, Nuclear Research Center, Atomic Energy Authority, Cairo, Egypt
| | - Ahmed A Emam
- Department of Cancer Biology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Ahmed A Zeeneldin
- Medical Oncology Department, National Cancer Institute, Cairo University, Kasr Al-Eini Street, Fom El Khalig, Cairo, Egypt
| | - Reham Srour
- Department of Cancer Biology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Reda Tabashy
- Department of Radiodiagnosis, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Eman D El-Desouky
- Epidemiology and Biostatistics Department, National Cancer Institute, Cairo, Egypt
| | - Zakaria Y Abd Elmageed
- Department of Pharmaceutical Sciences, Rangel College of Pharmacy, Texas A&M Health Sciences Center, College Station, TX, USA.
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Selim FO, El-Deeb NA, Farrag HA, Ahmed AM. Assessment of calprotectin in ascitic fluid as a marker for spontaneous bacterial peritonitis diagnosis in cirrhotic patients. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2019. [DOI: 10.4103/ejim.ejim_17_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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Shiha G, Soliman R, Mikhail NNH, Easterbrook P. Hepatitis C incidence 3 years after implementation of an educate, test, and treat programme in an Egyptian village. Lancet Gastroenterol Hepatol 2019; 4:13-14. [PMID: 30527578 DOI: 10.1016/s2468-1253(18)30336-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 10/01/2018] [Indexed: 11/26/2022]
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65
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Lawson-Ananissoh LM, Bagny A, Bouglouga O, Kaaga L, Yakoubou REH, Kogoe L, Redah D. Effectiveness of Treatment of Chronic Viral Hepatitis C by Direct-Acting Antivirals in Togo. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/ojgas.2019.97015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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66
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Interferon-α-induced retinopathy in chronic hepatitis C treatment: summary, considerations, and recommendations. Graefes Arch Clin Exp Ophthalmol 2018; 257:447-452. [PMID: 30547319 DOI: 10.1007/s00417-018-04209-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 11/27/2018] [Accepted: 11/29/2018] [Indexed: 12/13/2022] Open
Abstract
Interferons are cytokines that regulate the host's response to viral infection, particularly in the setting of the immunologic response to the hepatitis C virus (HCV). While the virus has the ability to evade the host's innate and specific immunity, exogenous interferon-α with combined ribavirin, treatments have been found to achieve a significant sustained viral response in subgroups of patients with chronic HCV. One of the major side effects of interferon-α is an ocular retinopathy characterized by flame-shaped hemorrhages and cotton wool spots visualized on funduscopic examination. There have been documented cases of more severe side effects including optic nerve and retinal artery damage; however, these instances are the minority. We sought to investigate the literature surrounding interferon-induced retinopathy, clinically correlate our findings with two recent cases, and provide recommendations for practitioners who continue to manage chronic HCV patients using interferon-α with combined ribavirin treatments.
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Emara DM, Reda MM, Elwazzan DA. Utility of diffusion weighted imaging (DWI) in assessment of liver fibrosis. ALEXANDRIA JOURNAL OF MEDICINE 2018. [DOI: 10.1016/j.ajme.2017.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Doaa M. Emara
- Department of Radiology, Faculty of Medicine, Alexandria University, Egypt
| | - Marwa M. Reda
- Hepatobiliary Unit, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Egypt
| | - Doaa A. Elwazzan
- Department of Tropical Medicine, Faculty of Medicine, Alexandria University, Egypt
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68
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Holah NS, El-Azab DS, Aiad HAES, Sweed DMM. The Diagnostic Role of SPINK1 in Differentiating Hepatocellular Carcinoma From Nonmalignant Lesions. Appl Immunohistochem Mol Morphol 2018; 25:703-711. [PMID: 27028242 DOI: 10.1097/pai.0000000000000363] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIM Distinction of small-sized hepatocellular carcinoma (HCC) from dysplastic nodules may be difficult. In addition, distinction of well-differentiated HCC (WD-HCC) from high-grade dysplastic nodule (HGDN) is also difficult in small needle biopsy. We aimed to study serine peptidase inhibitor, Kazal type 1 (SPINK1) immunohistochemical expression in HCC to differentiate it from nonmalignant lesions. METHODS This study included 179 specimens from the archival material of Pathology Department, National Liver Institute, Menoufia University, between 2007 and 2014, divided as 93 HCC and 86 nonmalignant lesions. All cases were stained for SPINK1 antibody. RESULTS SPINK1 was expressed in 76.3% of HCC cases with a diagnostic accuracy of 79.3%.There was a significant difference between focal nodular hyperplasia and WD-HCC cases regarding mean value of SPINK1 expression (P=0.015). In addition, there was low SPINK1 score in cirrhosis cases compared with WD-HCC. Moreover, there was a high significant difference between WD-HCC and HGDN regarding SPINK1 expression (P=0.001), with 83.3% sensitivity and 84.6% specificity. CONCLUSIONS SPINK1 can be used to differentiate between a WD-HCC and a HGDN with high diagnostic validity.
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Affiliation(s)
- Nanis S Holah
- Departments of *Pathology, Faculty of Medicine †Pathology, National Liver Institute, Menoufia University, Shebin El-Kom, Menoufia, Egypt
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Abo-Amer YEE, Abd-Elsalam S, Eldosoky H, ELShenawy AK, Awny S, Elagawy W, Abgeegy ME, Elsergany HF, Elashry H, Negm MS. Declining prevalence of hepatitis C virus among university students in one of the main governorates in Egypt. Infect Drug Resist 2018; 11:2435-2441. [PMID: 30538509 PMCID: PMC6254504 DOI: 10.2147/idr.s183462] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background and aims Egypt is considered to have the highest rate of hepatitis C virus (HCV) prevalence worldwide. However, HCV prevalence is currently declining due to the improvement of health education programs, improved environmental sanitation, and the introduction of novel treatment regimens. The aim of this work was to determine the HCV seroprevalence among Menoufia University students. Methods The current study included 48,972 students from Menoufia University, Egypt. Blood sample was obtained from every patient for HCV seromarker testing. In anti-HCV-positive subjects, quantitative PCR for HCV RNA was done. Results Overall, HCV antibody prevalence rate was 1%. This prevalence was higher in females (304/27,421; 1.1%) than in males (194/21,371; 0.9%). HCV-RNA PCR was positive in 355/48,972 (0.7%); the percentage of HCV PCR positive among the anti-HCV-positive was 71.3% (355/498 patients), with a higher prevalence among females than in males but without statistical significance. In addition, rural areas showed more prevalent HCV seroprevalence than urban areas. Conclusion These prevalence rates for HCV infection are lower than that previously reported in the same age group denoting a new evidence for the reduction of prevalence and a hope for successful eradication of HCV in the forthcoming years.
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Affiliation(s)
- Yousry Esam-Eldin Abo-Amer
- Hepatology, Gastroenterology and Infectious Diseases Department, Mahala Hepatology Teaching Hospital, Gharbia, Egypt
| | | | - Hazim Eldosoky
- Clinical Pathology Department, Student Hospital, Menoufia University, Menoufia, Egypt
| | - Amira K ELShenawy
- Public Health and Community Medicine Department, Tanta University, Tanta, Egypt
| | - Shereen Awny
- Internal Medicine Department, Tanta University, Tanta, Egypt
| | - Waleed Elagawy
- Tropical Medicine Department, National Hepatology and Tropical Medicine Research Institute in Cairo, Cairo, Egypt
| | - Mohamed El Abgeegy
- Tropical Medicine Department, National Hepatology and Tropical Medicine Research Institute in Cairo, Cairo, Egypt
| | - Heba Fadl Elsergany
- Tropical Medicine Department, National Hepatology and Tropical Medicine Research Institute in Cairo, Cairo, Egypt
| | - Heba Elashry
- Tropical Medicine Department, Tanta University, Tanta, Egypt,
| | - Manal Saad Negm
- Internal Medicine Department, Tanta University, Tanta, Egypt
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Jakupi X, Mlakar J, Lunar MM, Seme K, Rudhani I, Raka L, Vince A, Poljak M. A very high prevalence of hepatitis C virus infection among patients undergoing hemodialysis in Kosovo: a nationwide study. BMC Nephrol 2018; 19:304. [PMID: 30390638 PMCID: PMC6215601 DOI: 10.1186/s12882-018-1100-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 10/12/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Patients on hemodialysis are at high risk for hepatitis C virus (HCV) infection if measures for effective control of HCV infection in the hemodialysis environment are not implemented. Whereas in developed countries isolated small-scale outbreaks of HCV in hemodialysis units are occasionally reported, HCV transmission in the hemodialysis environment still represents a substantial problem in low-resource countries. This study systematically assessed the prevalence of HCV infection among all patients at all hemodialysis centers in Kosovo, determined the HCV genotype distribution, and reviewed the main risk factors associated with HCV infection in this group of patients. METHODS From January to March 2013, blood samples from all patients undergoing hemodialysis at all seven hemodialysis centers in Kosovo were collected. The samples were screened for the presence of anti-HCV antibodies, and seropositive samples were also tested for HCV RNA. Genotyping was performed by sequencing the core region of the HCV genome. Subsequently, face-to-face interviews were conducted with consented patients attending hemodialysis in December 2015 and with the management of all hemodialysis centers in Kosovo. RESULTS The overall seroprevalence of HCV infection among hemodialysis patients in Kosovo was 53.0% (354/668), ranging from 22.3 to 91.1% at different centers. HCV RNA was detected in 323/354 (91.2%) seropositive patients. The most frequent HCV genotype was genotype 1a (62.2%), followed by genotypes 4d (33.1%), 1b (4.0%), and 2c (0.7%). The duration of hemodialysis and receiving dialysis at more than one center were identified as independent significant predictors of anti-HCV positivity. Shortage of staff, lack of resources, and inconsistent use of hygienic precautions and/or isolation strategies were observed. CONCLUSIONS The prevalence of HCV infection among hemodialysis patients in Kosovo is extremely high. The relatively low prevalence of HCV infection in the general population, predominance of two otherwise rare HCV genotypes among hemodialysis patients, and longer history of hemodialysis as a predictor of HCV infection all indicate nosocomial transmission due to inappropriate infection control practices as the main transmission route.
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Affiliation(s)
- Xhevat Jakupi
- Department of Microbiology, Kosovo National Institute of Public Health, Rrethi i Spitalit, p.n, 10000 Prishtina, Kosovo
| | - Jana Mlakar
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Maja M. Lunar
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Katja Seme
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Ibrahim Rudhani
- Clinic for Nephrology, University Medical Center of Kosovo, Bulevardi i Dëshmorëve, p.n, 10000 Prishtina, Kosovo
| | - Lul Raka
- Faculty of Medicine, Hasan Prishtina University of Prishtina, Bulevardi i Dëshmorëve, p.n, 10000 Prishtina, Kosovo
| | - Adriana Vince
- Dr Fran Mihaljević University Hospital for Infectious Diseases, Mirogojska 8, 10000 Zagreb, Croatia
| | - Mario Poljak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
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Development of a Robust UPLC Method for Simultaneous Determination of a Novel Combination of Sofosbuvir and Daclatasvir in Human Plasma: Clinical Application to Therapeutic Drug Monitoring. Int J Anal Chem 2018; 2018:6535816. [PMID: 30420886 PMCID: PMC6215565 DOI: 10.1155/2018/6535816] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 10/02/2018] [Indexed: 12/29/2022] Open
Abstract
A rapid and selective UPLC-DAD method was developed and validated for simultaneous analysis of the novel two-drug combination Darvoni® for the treatment of HCV: Sofosbuvir (SF)/Daclatasvir (DC) in human plasma using Ledipasvir as internal standard (IS) where the extraction process was conducted using automated SPE. Although the analysis of the combination after concomitant oral intake of two tablets of SF and DC individually was reported in literature, yet simultaneous analysis of this new combination in human plasma after a single oral dose was not previously reported. The adopted chromatographic separation was achieved on Waters® Acquity UPLC BEH C18 column (2.1 × 50 mm, 1.7 µm) as a stationary phase using isocratic elution using a mobile phase system of ammonium formate (pH 3.5; 5 mM) and acetonitrile (60:40 v/v) pumped at a flow rate of 0.2 mL.min−1. The UV detection was carried out at 261 nm for SF and 318 nm for DC and IS. SF was eluted at 1.123 min while DC was eluted at 3.179 min. The proposed chromatographic method was validated in accordance with guidelines of FDA for bioanalytical method validation. A linear range was achieved in the range of 25-6400 and 50-12800 ng.mL−1 for SF and DC, respectively. The proposed UPLC-DAD method was found to be accurate with % bias ranging between -10.0-7.2 for SF and -6.9-8.0 for DC. Also it was proved to be precise with % CV for intraday precision ranging between 3.8-9.6 for SF and 2.8-9.2 for DC whereas interday precision ranged between 5.1-9.3 for SF and 3.7-9.1 for DC. Moreover, % extraction recovery ranged between 90.0-107.2 for SF and 93.1-108.0 for DC using the suggested method. The adopted chromatographic method was successfully applied to the therapeutic drug monitoring of SF and DC in healthy volunteers after the oral intake of one Darvoni® tablet.
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Omran D, Alboraie M, Zayed RA, Wifi MN, Naguib M, Eltabbakh M, Abdellah M, Sherief AF, Maklad S, Eldemellawy HH, Saad OK, Khamiss DM, El Kassas M. Towards hepatitis C virus elimination: Egyptian experience, achievements and limitations. World J Gastroenterol 2018; 24:4330-4340. [PMID: 30344418 PMCID: PMC6189850 DOI: 10.3748/wjg.v24.i38.4330] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 09/13/2018] [Accepted: 10/05/2018] [Indexed: 02/06/2023] Open
Abstract
Worldwide, more than one million people die each year from hepatitis C virus (HCV) related diseases, and over 300 million people are chronically infected with hepatitis B or C. Egypt used to be on the top of the countries with heavy HCV burden. Some countries are making advances in elimination of HCV, yet multiple factors preventing progress; remain for the majority. These factors include lack of global funding sources for treatment, late diagnosis, poor data, and inadequate screening. Treatment of HCV in Egypt has become one of the top national priorities since 2007. Egypt started a national treatment program intending to provide cure for Egyptian HCV-infected patients. Mass HCV treatment program had started using Pegylated interferon and ribavirin between 2007 and 2014. Yet, with the development of highly-effective direct acting antivirals (DAAs) for HCV, elimination of viral hepatitis has become a real possibility. The Egyptian National Committee for the Control of Viral Hepatitis did its best to provide Egyptian HCV patients with DAAs. Egypt adopted a strategy that represents a model of care that could help other countries with high HCV prevalence rate in their battle against HCV. This review covers the effects of HCV management in Egyptian real life settings and the outcome of different treatment protocols. Also, it deals with the current and future strategies for HCV prevention and screening as well as the challenges facing HCV elimination and the prospect of future eradication of HCV.
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Affiliation(s)
- Dalia Omran
- Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo 11651, Egypt
| | - Mohamed Alboraie
- Department of Internal Medicine, Al-Azhar University, Cairo 11651, Egypt
| | - Rania A Zayed
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo 11651, Egypt
| | - Mohamed-Naguib Wifi
- Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo 11599, Egypt
| | - Mervat Naguib
- Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo 11599, Egypt
| | - Mohamed Eltabbakh
- Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
| | - Mohamed Abdellah
- Department of Internal Medicine, Al-Azhar University, Cairo 11651, Egypt
| | - Ahmed Fouad Sherief
- Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
| | - Sahar Maklad
- National Hepatology and Tropical Medicine Research Institute, Cairo 11599, Egypt
| | - Heba Hamdy Eldemellawy
- Department of Internal Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef 62511, Egypt
| | | | - Doaa Mohamed Khamiss
- Department of Clinical and Chemical Pathology, El-monera hospital, Ministry of Health, Cairo 11562, Egypt
| | - Mohamed El Kassas
- Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo 11599, Egypt
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Raad II, Chaftari AM, Torres HA, Ayoub EM, Narouz LI, Bartek J, Hachem R. Challenge of hepatitis C in Egypt and hepatitis B in Mauritania. World J Hepatol 2018; 10:549-557. [PMID: 30310533 PMCID: PMC6177572 DOI: 10.4254/wjh.v10.i9.549] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/14/2018] [Accepted: 05/30/2018] [Indexed: 02/06/2023] Open
Abstract
Egypt has one of the highest prevalence rates of hepatitis C virus (HCV) in the world, mostly with genotype 4 that is highly associated with severe fibrosis. As a consequence, hepatocellular carcinoma has become the leading cause of cancer in this country. Mauritania is a highly endemic area for hepatitis B virus (HBV). HBV and HCV could both be iatrogenically transmitted through infected blood products, infected needles, and medical equipment improperly sterilized. Adequate and efficient healthcare and public health measures with good surveillance programs, access for screening, prevention strategies, and successful treatment are needed to halt the spread of these diseases. Herein, we have reviewed the epidemiology, modes of transmission, predisposing factors, and novel treatment modalities of these viruses. We have proposed practices and interventions to decrease the risk of transmission of HCV and HBV in the affected countries, including strict adherence to standard precautions in the healthcare setting, rigorous education and training of patients and healthcare providers, universal screening of blood donors, use of safety-engineered devices, proper sterilization of medical equipment, hepatitis B vaccination, as well as effective direct-acting antiviral agents for the treatment of HCV.
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Affiliation(s)
- Issam I Raad
- Department of Infectious Diseases, Infection Control and Employee Health, the University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Anne-Marie Chaftari
- Department of Infectious Diseases, Infection Control and Employee Health, the University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, United States.
| | - Harrys A Torres
- Department of Infectious Diseases, Infection Control and Employee Health, the University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Ehab Mouris Ayoub
- Department of Internal Medicine, Harpur Memorial Hospital, Menouf 32951, Egypt
| | | | - Jalen Bartek
- Division of Internal Medicine, the University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Ray Hachem
- Department of Infectious Diseases, Infection Control and Employee Health, the University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, United States
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Azab NA, Abd El Salam L, Ahmed E, El Sharkawy M, ElSharkawy A, El Asheiry SG. Interferon gamma and interleukin 8 gene polymorphisms in patients with hepatitis C virus related oral lichen planus. Arch Oral Biol 2018; 96:189-194. [PMID: 30290294 DOI: 10.1016/j.archoralbio.2018.09.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 09/21/2018] [Accepted: 09/22/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to determine the association of rs2430561 and rs4073 polymorphisms in the Interferon gamma (IFN-ɤ) and Interleukin 8 (IL-8) genes, respectively, with hepatitis C virus-related oral lichen planus and disease severity. DESIGN This is a case-control study. 60 subjects were equally divided into patients with and without oral lichen planus. They were further subdivided into hepatitis C virus seropositive and seronegative patients. All patients were genotyped for IFN-γ rs2430561 thymine to adenine (T > A) and IL-8 rs4073 adenine to thymine (A > T) polymorphisms. All patients with oral lichen planus had their lesions measured and documented using the Escudier scoring system. RESULTS Disease activity was significantly higher in the "oral lichen planus/hepatitis C virus-positive" patients than in the "oral lichen planus/hepatitis C virus-negative" patients (P = 0.003). IFN-γ rs2430561 T > A and IL-8 rs4073 A > T genotypes and allele frequencies were not associated with the oral lichen planus group or the normal group. Stratification of the two groups into HCV and non-HCV-infected patients or into erosive and non-erosive types revealed no significant associations. The "A-allele-containing" genotypes of IL-8 rs4073 A > T were significantly more prevalent in the patients with oral lichen planus than in those without. CONCLUSION Hepatitis C virus infection is associated with the development of erosive oral lichen planus. The A-allele of IL-8 rs4073 A > T may have a role in the development and progression of oral lichen planus.
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Affiliation(s)
- Noha A Azab
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Egypt.
| | | | - Enji Ahmed
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Egypt
| | - Marwa El Sharkawy
- Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Egypt
| | - Aisha ElSharkawy
- Endemic Medicine and Hepatogastroenterology Department, Faculty of Medicine, Cairo University, Egypt
| | - Shahira G El Asheiry
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Egypt
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Hassan-Kadle MA, Osman MS, Ogurtsov PP. Epidemiology of viral hepatitis in Somalia: Systematic review and meta-analysis study. World J Gastroenterol 2018; 24:3927-3957. [PMID: 30228786 PMCID: PMC6141335 DOI: 10.3748/wjg.v24.i34.3927] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/25/2018] [Accepted: 06/21/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To provide a clear understanding of viral hepatitis epidemiology and their clinical burdens in Somalia.
METHODS A systematic review and meta-analysis was conducted as Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search of published studies on viral hepatitis was performed from 1977-2016 in PubMed, Google Scholar, Science Direct, World Health Organization African Index Medicus and the Africa Journals Online databases, as well as on the Ministry of Health website. We also captured unpublished articles that were not available on online systems.
RESULTS Twenty-nine studies from Somalia and Somali immigrants (United Kingdom, United States, Italy, Libya) with a combined sample size for each type of viral hepatitis [hepatitis A virus (HAV): 1564, hepatitis B virus (HBV): 8756, hepatitis C virus (HCV): 6257, hepatitis D virus (HDV): 375 and hepatitis E virus (HEV): 278] were analyzed. The overall pooled prevalence rate of HAV was 90.2% (95%CI: 77.8% to 96%). The HAV prevalence among different age groups was as follows: < 1 year old, 61.54% (95%CI: 40.14% to 79.24%); 1-10 years old, 91.91% (95%CI: 87.76% to 94.73%); 11-19 years old, 96.31% (95%CI: 92.84% to 98.14%); 20-39 years old, 91.3% (95%CI: 83.07% to 95.73%); and > 40 years old, 86.96% (95%CI: 75.68% to 93.47%). The overall pooled prevalence of HBV was 18.9% (95%CI: 14% to 29%). The overall pooled prevalence among subgroups of HBV was 20.5% (95%CI: 5.1% to 55.4%) in pregnant women; 5.7% (95%CI: 2.7% to 11.5%) in children; 39.2% (95%CI: 33.4% to 45.4%) in patients with chronic liver disease, including hepatocellular carcinoma (HCC); 7.7% (95%CI: 4.2% to 13.6%), 12.4% (95%CI: 6.3% to 23.0%) and 11.8% (95%CI: 5.3% to 24.5%) in age groups < 20 years old, 20-39 years old and > 40 years old, respectively. The HBV prevalence among risk groups was 20% (95%CI: 7.19% to 44.64%) in female prostitutes, 21.28% (95%CI: 7.15% to 48.69%) in hospitalized adults, 5.56% (95%CI: 0.99% to 25.62%) in hospitalized children, 60% (95%CI: 31.66% to 82.92%) in patients with acute hepatitis, 33.55% (95%CI: 14.44% to 60.16%) in patients with ancylostomiasis, 12.34% (95%CI: 7.24% to 20.26%) in patients with leprosy and 20.19% (95%CI: 11.28% to 33.49%) in schistosomiasis patients. The overall pooled prevalence of HCV was estimated as 4.84% (95%CI: 3.02% to 7.67%). The prevalence rates among blood donors, risk groups, children and patients chronic liver disease (including HCC) was 0.87% (95%CI: 0.33% to 2.30%), 2.43% (95%CI: 1.21% to 4.8%), 1.37% (95%CI: 0.76% to 2.46%) and 29.82% (95%CI: 15.84% to 48.98%), respectively. The prevalence among genotypes of HCV was 21.9% (95%CI: 15.36% to 30.23%) in genotype 1, 0.87% (95%CI: 0.12% to 5.9%) in genotype 2, 25.21% (95%CI: 18.23% to 33.77%) in genotype 3, 46.24% (95%CI: 37.48% to 55.25%) in genotype 4, 2.52% (95%CI: 0.82% to 7.53%) in genotype 5, and 1.19% (95%CI: 0.07% to 16.38%) in genotype 6. The overall pooled prevalence of HDV was 28.99% (95%CI: 16.38% to 45.96%). The HDV prevalence rate among patients with chronic liver disease, including HCC, was 43.77% (95%CI: 35.09% to 52.84%). The overall pooled prevalence of HEV was 46.86% (95%CI: 5.31% to 93.28%).
CONCLUSION Our study demonstrates a high prevalence of all forms of viral hepatitis in Somalia and it also indicates that chronic HBV was the commonest cause of chronic liver disease. This highlights needs for urgent public health interventions and strategic policy directions to controlling the burden of the disease.
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Affiliation(s)
- Mohamed Abdulkadir Hassan-Kadle
- Center For the study of the Liver, Department of Hospital Medicine, Peoples’ Friendship University of Russia (RUDN University), Moscow 117198, Russia
- Abrar Research and Training Center, Abrar University, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Dufle Specialist Hospital, Mogadishu 25, Somalia
| | - Mugtaba Sulaiman Osman
- Department of Psychiatry, School of Medicine, Royal College of Surgeons in Ireland RCSI, Beaumont Hospital, Dublin 9, Ireland
| | - Pavel Petrovich Ogurtsov
- Center For the study of the Liver, Department of Hospital Medicine, Peoples’ Friendship University of Russia (RUDN University), Moscow 117198, Russia
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Naveira MCM, Badal K, Dhakal J, Mayer NA, Pokharel B, Del Prado RF. Seroprevalence of hepatitis B and C in Nepal: a systematic review (1973-2017). HEPATOLOGY, MEDICINE AND POLICY 2018; 3:10. [PMID: 30288333 PMCID: PMC6126038 DOI: 10.1186/s41124-018-0039-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 08/28/2018] [Indexed: 02/08/2023]
Abstract
Introduction Hepatitis B and C represent an important co-infection for people living with HIV worldwide. Nepal wants to be part of the international mobilization for viral hepatitis elimination, and has pursued better understanding of the epidemic in its territory through scientific research. Methods We performed a systematic review of seroprevalence studies hepatitis B and C in Nepal following the PRISMA 2009 Flow Diagram. Results Fifty-four scientific publications and reports were selected for this review. Nearly a quarter of these documents have been issued in recent years and many are authored by non-governmental organizations in Nepal. The collective of information displays a wide range of alarming prevalence rates, particularly for girls and women survivors of human trafficking and a progressive participation of civil society in viral hepatitis epidemiology research in the country. Conclusion This paper presents a most complete review of hepatitis B and C and HIV co-infection prevalence studies in different population groups from 1973 to 2016. A comprehensive analysis of the epidemiology and apparent trends in public health research and policy making in Nepal are also addressed in this document. We expect this to be a most important tool for improvements in future interventions for both epidemics in the country.
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Affiliation(s)
| | - Komal Badal
- UNAIDS Nepal, UN House, Pulchowk, Lalitpur, GPO 107 Nepal
| | | | | | - Bina Pokharel
- UNAIDS Nepal, UN House, Pulchowk, Lalitpur, GPO 107 Nepal
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Meda N, Tuaillon E, Kania D, Tiendrebeogo A, Pisoni A, Zida S, Bollore K, Medah I, Laureillard D, Moles JP, Nagot N, Nebie KY, Van de Perre P, Dujols P. Hepatitis B and C virus seroprevalence, Burkina Faso: a cross-sectional study. Bull World Health Organ 2018; 96:750-759. [PMID: 30455530 PMCID: PMC6239015 DOI: 10.2471/blt.18.208603] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 06/30/2018] [Accepted: 07/01/2018] [Indexed: 12/24/2022] Open
Abstract
Objective To estimate population-wide hepatitis B and C seroprevalence using dried blood spot samples acquired for human immunodeficiency virus (HIV) surveillance as part of the 2010–2011 Demographic and Health Survey in Burkina Faso. Methods We used the database acquired during the multistage, clustered, population-based survey, in which 15 377 participants completed questionnaires and provided dried blood spot samples for HIV testing. We extracted sociodemographic and geographic data including age, sex, ethnicity, education, wealth, marital status and region for each participant. We performed hepatitis B and C assays on 14 886 HIV-negative samples between March to October 2015, and calculated weighted percentages of hepatitis seroprevalence for each variable. Findings We estimated seroprevalence as 9.1% (95% confidence interval, CI: 8.5–9.7) for the hepatitis B surface antigen and 3.6% (95% CI: 3.3–3.8) for hepatitis C virus antibodies, classifying Burkina Faso as highly endemic for hepatitis B and low-intermediate for hepatitis C. The seroprevalence of hepatitis was higher in men than in women, and varied significantly for both with age, education, ethnicity and region. Extremely high HCV-Ab seroprevalence (13.2%; 95% CI: 10.6–15.7) was identified in the Sud-Ouest region, in particular within the youngest age group (15–20 years), indicating an ongoing epidemic. Conclusion Our population-representative hepatitis seroprevalence estimates in Burkina Faso advocate for the inclusion of hepatitis serological tests and risk factor questionnaire items in future surveys, the results of which are crucial for the development of appropriate health policies and infection control programmes.
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Affiliation(s)
- Nicolas Meda
- Ministère de la Santé, Ouagadougou, Burkina Faso
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic Infections, Université de Montpellier, U 1058, 60 rue de Navacelles Montpellier, 34394 cedex 5, France
| | | | - Adama Tiendrebeogo
- Institut National de la Statistique et de la Demographie, Ministère de l'Economie, des Finances et du Développement, Ouagadougou, Burkina Faso
| | - Amandine Pisoni
- Pathogenesis and Control of Chronic Infections, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | | | - Karine Bollore
- Pathogenesis and Control of Chronic Infections, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Isaïe Medah
- Ministère de la Santé, Ouagadougou, Burkina Faso
| | - Didier Laureillard
- Pathogenesis and Control of Chronic Infections, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | - Jean Pierre Moles
- Pathogenesis and Control of Chronic Infections, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | - Nicolas Nagot
- Pathogenesis and Control of Chronic Infections, Université de Montpellier, U 1058, 60 rue de Navacelles Montpellier, 34394 cedex 5, France
| | | | - Philippe Van de Perre
- Pathogenesis and Control of Chronic Infections, Université de Montpellier, U 1058, 60 rue de Navacelles Montpellier, 34394 cedex 5, France
| | - Pierre Dujols
- Pathogenesis and Control of Chronic Infections, Université de Montpellier, U 1058, 60 rue de Navacelles Montpellier, 34394 cedex 5, France
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78
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Abdelrazik AM, Abozaid HE, Montasser KA. Role of Hepatitis C Virus (HCV) core antigen in improving blood transfusion safety in high prevalence, resource limited countries, a step forward. Transfus Apher Sci 2018; 57:566-568. [DOI: 10.1016/j.transci.2018.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 06/14/2018] [Accepted: 06/19/2018] [Indexed: 02/06/2023]
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79
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Abdallah OM, Abdel-Megied AM, Gouda AS. Pharmacokinetic evaluation of daclatasvir and ledipasvir in healthy volunteers using a validated highly sensitive spectrofluorimetric method. LUMINESCENCE 2018; 33:1094-1100. [DOI: 10.1002/bio.3514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 05/03/2018] [Accepted: 05/13/2018] [Indexed: 01/26/2023]
Affiliation(s)
- Ola M. Abdallah
- Analytical Chemistry Department, Faculty of Pharmacy; Al-Azhar University (Girls); Cairo Egypt
- Pharmaceutical Chemistry Department, Faculty of Pharmacy; Badr University in Cairo (BUC); Badr City Cairo Egypt
| | - Ahmed M. Abdel-Megied
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy and Pharmaceutical Manufacturing; Kafrelsheikh University; Kafrelsheikh City Egypt
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80
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El Batae H, Amer I, Kobtan A, Saied SM, Ghazy A, Elkalla F, El Sharawy S. Seroprevalence of hepatitis C virus among the newcomer students, Kafrelsheikh University, Egypt. J Med Virol 2018; 90:1745-1749. [PMID: 29981144 DOI: 10.1002/jmv.25249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 06/18/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND Hepatitis C virus (HCV) constitutes a global public health problem in Egypt, as it has the highest worldwide prevalence. This study aimed at determining the seroprevalence of HCV among the newcomer students of Kafrelsheikh University, Egypt. METHODS A cross-sectional serosurvey was conducted including 9049 students. Medical examination, ultrasonography, and laboratory investigations were done. Liver function tests and HCV antibody testing were carried out for all students who gave an informed consent; HCV-RNA polymerase chain reaction was performed for students with positive HCV antibody testing. RESULTS The mean age of screened students were 18.6 ± 0.39 years. In total, 4233 (46.8%) were males and 4816 (53.2%) were females. Using HCV antibody testing, only 25 students (0.0028%) had positive antibodies; among them, 24 students (0.0026%) had HCV RNA positive; the study showed none statistically significant higher percentage of HCV infection among males (13 out of 24, 54.2%) than females (11 out of 24, 48.5%), P > 0.05. The results of liver function tests were not significantly different between the HCV-positive and HCV-negative students. However, the liver transaminase enzymes were significantly higher ( P < 0.0001) in HCV positive students compared to the negative ones, despite its mean values did not exceed the upper normal level. HCV infection among young Egyptian generations showed a marked decline. CONCLUSION Prevalence of HCV infection among young Egyptian generations had markedly decline, indicating the start of successful control of HCV infection.
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Affiliation(s)
- Hassan El Batae
- Department of Hepatology, Gastroenterology & Infectious Diseases, Faculty of Medicine, Kafrelsheikh University, Kafr El Sheikh, Egypt
| | - Ibrahim Amer
- Department of Hepatology, Gastroenterology & Infectious Diseases, Faculty of Medicine, Kafrelsheikh University, Kafr El Sheikh, Egypt
| | - Abdelrahman Kobtan
- Department of Tropical Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Shimaa M Saied
- Department of Public Health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Amany Ghazy
- Department of Microbiology & Medical Immunology, Faculty of Medicine, Kafrelsheikh University, Kafr El Sheikh, Egypt
| | - Ferial Elkalla
- Department of Tropical Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Shimaa El Sharawy
- Department of Tropical Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
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81
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Chaabna K, Cheema S, Abraham A, Alrouh H, Lowenfels AB, Maisonneuve P, Mamtani R. Systematic overview of hepatitis C infection in the Middle East and North Africa. World J Gastroenterol 2018; 24:3038-3054. [PMID: 30038471 PMCID: PMC6054949 DOI: 10.3748/wjg.v24.i27.3038] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 06/10/2018] [Accepted: 06/25/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the quality of and to critically synthesize the available data on hepatitis C infections in the Middle East and North Africa (MENA) region to map evidence gaps. METHODS We conducted an overview of systematic reviews (SRs) following an a priori developed protocol (CRD42017076736). Our overview followed the preferred reporting items for systematic reviews and meta-analyses guidelines for reporting SRs and abstracts and did not receive any funding. Two independent reviewers systematically searched MEDLINE and conducted a multistage screening of the identified articles. Out of 5758 identified articles, 37 SRs of hepatitis C virus (HCV) infection in populations living in 20 countries in the MENA region published between 2008 and 2016 were included in our overview. The nine primary outcomes of interest were HCV antibody (anti-) prevalences and incidences in different at-risk populations; the HCV viremic (RNA positive) rate in HCV-positive individuals; HCV viremic prevalence in the general population (GP); the prevalence of HCV co-infection with the hepatitis B virus, human immunodeficiency virus, or schistosomiasis; the HCV genotype/subtype distribution; and the risk factors for HCV transmission. The conflicts of interest declared by the authors of the SRs were also extracted. Good quality outcomes reported by the SRs were defined as having the population, outcome, study time and setting defined as recommended by the PICOTS framework and a sample size > 100. RESULTS We included SRs reporting HCV outcomes with different levels of quality and precision. A substantial proportion of them synthesized data from mixed populations at differing levels of risk for acquiring HCV or at different HCV infection stages (recent and prior HCV transmissions). They also synthesized the data over long periods of time (e.g., two decades). Anti-HCV prevalence in the GP varied widely in the MENA region from 0.1% (study dates not reported) in the United Arab Emirates to 2.1%-13.5% (2003-2006) in Pakistan and 14.7% (2008) in Egypt. Data were not identified for Bahrain, Jordan, or Palestine. Good quality estimates of anti-HCV prevalence in the GP were reported for Algeria, Djibouti, Egypt, Iraq, Morocco, Pakistan, Syria, Sudan, Tunisia, and Yemen. Anti-HCV incidence estimates in the GP were reported only for Egypt (0.8-6.8 per 1000 person-year, 1997-2003). In Egypt, Morocco, and the United Arab Emirates, viremic rates in anti-HCV-positive individuals from the GP were approximately 70%. In the GP, the viremic prevalence varied from 0.7% (2011) in Saudi Arabia to 5.8% (2007-2008) in Pakistan and 10.0% (2008) in Egypt. Anti-HCV prevalence was lower in blood donors than in the GP, ranging from 0.2% (1992-1993) in Algeria to 1.7% (2005) in Yemen. The reporting quality of the outcomes in blood donors was good in the MENA countries, except in Qatar where no time framework was reported for the outcome. Some countries had anti-HCV prevalence estimates for children, transfused patients, contacts of HCV-infected patients, prisoners, sex workers, and men who have sex with men. CONCLUSION A substantial proportion of the reported outcomes may not help policymakers to develop micro-elimination strategies with precise HCV infection prevention and treatment programs in the region, as nowcasting HCV epidemiology using these data is potentially difficult. In addition to providing accurate information on HCV epidemiology, outcomes should also demonstrate practical and clinical significance and relevance. Based on the available data, most countries in the region have low to moderate anti-HCV prevalence. To achieve HCV elimination by 2030, up-to-date, good quality data on HCV epidemiology are required for the GP and key populations such as people who inject drugs and men who have sex with men.
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Affiliation(s)
- Karima Chaabna
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Amit Abraham
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Hekmat Alrouh
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Albert B Lowenfels
- Department of Surgery and the Department of Family Medicine, New York Medical College, Valhalla, NY 10595, United States
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan 20141, Italy
| | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
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82
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Shiha G, Metwally AM, Soliman R, Elbasiony M, Mikhail NNH, Easterbrook P. An educate, test, and treat programme towards elimination of hepatitis C infection in Egypt: a community-based demonstration project. Lancet Gastroenterol Hepatol 2018; 3:778-789. [PMID: 30030068 DOI: 10.1016/s2468-1253(18)30139-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/13/2018] [Accepted: 04/16/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Egypt has one of the highest prevalences and burdens of hepatitis C virus (HCV) worldwide, and a large government treatment programme. However, identifying and treating people who are infected in rural communities can be a substantial challenge. We designed and evaluated a comprehensive community-led outreach programme for prevention, testing, and treatment of HCV infection in one village in northern Egypt, with the goal to eliminate HCV infection from all adult villagers, and as a model for potential adoption in rural settings. METHODS A community-based education and test-and-treat project was established in Al-Othmanya village. The programme consisted of community mobilisation facilitated by a network of village promoters and establishment of partnerships; an educational campaign to raise awareness and promote behavioural changes; fundraising for public donations in the local community; and comprehensive testing, diagnosis, and treatment. For the educational campaign, we used public awareness events, house-to-house visits, and promotional materials (eg, booklets, cartoons, songs) to raise awareness of HCV and its transmission, and changes in knowledge, attitudes, and practices were measured through the use of a survey done before and after the educational campaign. Comprehensive testing, linkage to care, and treatment was offered to all eligible villagers (ie, those aged 12-80 years who had not previously been treated for HCV). Testing was done by use of HCV antibody and hepatitis B surface antigen (HBsAg) rapid diagnostic tests, with HCV-RNA PCR confirmation of positive cases, and staging of liver disease by use of transient elastography. HCV-RNA-positive participants were offered a 24-week course of sofosbuvir (400 mg orally, daily) and ribavirin (1000-1200 mg orally, daily) with an assessment of cure (sustained virological response) at 12 weeks after completion of treatment (SVR12). FINDINGS Between June 6, 2015, and June 9, 2016, 4215 (89%) of 4721 eligible villagers were screened for HCV antibodies and HBsAg. Of these participants, 530 (13%) were HCV antibody positive and eight (<1%) were HBsAg positive. All HCV-antibody-positive individuals had an HCV-RNA assay, and 312 (59%) were HCV-RNA positive. All 312 completed a full baseline assessment with staging of liver disease, and 300 (96%) were given 24 weeks of sofosbuvir and ribavirin treatment within a median of 2·3 weeks (IQR 0·0-3·7) from serological diagnosis. 293 (98%) of the treated participants achieved SVR12. 42 (13%) HCV-RNA-positive participants had cirrhosis as determined by transient elastography, of whom 12 (29%) were diagnosed with hepatocellular carcinoma on the basis of α-fetoprotein measurement and ultrasound. 3575 (85%) of 4215 eligible villagers completed the baseline and after educational campaign survey, and awareness, knowledge, and adoption of safer practices to prevent HCV transmission all significantly increased (p<0·0001). INTERPRETATION This community-led educate, test-and-treat demonstration project achieved high uptake of HCV testing, linkage to care and treatment, and attainment of cure in one village, as well as awareness and adoption of practices to prevent transmission in the community. This approach could be an important strategy for adoption in rural settings to complement the national government programme towards the elimination of HCV in Egypt. FUNDING Egyptian Liver Research Institute and Hospital.
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Affiliation(s)
- Gamal Shiha
- Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt; Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt.
| | - Ammal M Metwally
- Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt; Department of Community Medicine Research, Medical Division, National Research Center, Giza, Egypt
| | - Reham Soliman
- Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt; Tropical Medicine Department, Faculty of Medicine, Port Said University, Port Said, Egypt
| | - Mohamed Elbasiony
- Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt; Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt
| | - Nabiel N H Mikhail
- Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt; Department of Biostatistics and Cancer Epidemiology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Philippa Easterbrook
- Global Hepatitis Programme, HIV Department, World Health Organization, Geneva, Switzerland
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83
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Tawfik AK, Amin AM, Yousef M, El-Sayd NM, Elashry H, Elkadeem M, Abd-Elsalam S. IL-1α correlates with severity of hepatitis C virus-related liver diseases. J Inflamm Res 2018; 11:289-295. [PMID: 30022847 PMCID: PMC6044361 DOI: 10.2147/jir.s166564] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND AIMS Immunoregulatory cytokines influence the persistence of hepatitis C virus (HCV) chronic infection and the extent of liver damage. Interleukin-1 (IL-1) plays an important role in the inflammatory process. Some studies have demonstrated that IL-1α production was impaired in patients with chronic infections of HCV, implying that IL-1α may play a role in viral clearance. The aim of this study was to evaluate the serum level of proinflammatory cytokine IL-1α in patients with chronic hepatitis C (CHC). METHODS This study was performed on 20 CHC patients with cirrhosis in (Group I), 20 CHC patients without cirrhosis in (Group II), 20 hepatocellular carcinoma (HCC) patients with positive anti-HCV in (Group III), and 10 healthy subjects as a control group. Serum levels of IL-1α were measured by enzyme-linked immunoassay technique. RESULTS IL-1α had the highest mean concentration in the HCC group and then in the group of CHC with cirrhosis compared to the group of CHC without cirrhosis. Also, it was higher in all studied groups than in the control group (P<0.001). Statistical analysis showed that IL-1α was positively correlated with bilirubin (P≤0.001), alanine aminotransferase (P=0.006), aspartate aminotransferase (P=0.001), and viral load (P=0.001) but it was negatively correlated with albumin (P≤0.001) and Hb (P≤0.001), and was not significantly correlated with other parameters (age, international normalized ratio, urea, creatinine, white blood cells, and platelet count). CONCLUSION Serum level of IL-1α was elevated in patients with CHC and its related liver diseases (liver cirrhosis and HCC) and can be used as an important parameter of inflammatory activity and for fibrosis evaluation in patients with chronic liver disease.
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Affiliation(s)
- Ahmed Khaled Tawfik
- Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt,
| | - Ahmed Mustafa Amin
- Department of Microbiology and Immunology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mohamed Yousef
- Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt,
| | - Noha Mohamed El-Sayd
- Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt,
| | - Heba Elashry
- Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt,
| | - Mahmoud Elkadeem
- Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt,
| | - Sherief Abd-Elsalam
- Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt,
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84
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Abdel Gawad SS, Abu-Sarea EY, Saleh L. Epidemiological determinants correlating hepatitis C and Schistosomiasis mansoni in one of Upper Egypt governorates. BENI-SUEF UNIVERSITY JOURNAL OF BASIC AND APPLIED SCIENCES 2018. [DOI: 10.1016/j.bjbas.2017.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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85
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Ayoub HH, Al Kanaani Z, Abu-Raddad LJ. Characterizing the temporal evolution of the hepatitis C virus epidemic in Pakistan. J Viral Hepat 2018; 25:670-679. [PMID: 29345847 DOI: 10.1111/jvh.12864] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 12/14/2017] [Indexed: 02/06/2023]
Abstract
Pakistan has the second largest number of HCV infections in the world. We assessed past, present and future levels and trends of the HCV epidemic in Pakistan. An age-structured mathematical model was developed and analysed to describe transmission dynamics over 1980-2050. The model was fitted to a nationally representative survey and a comprehensive database of systematically gathered HCV Ab prevalence data. HCV Ab and chronic infection prevalences peaked at 5.3% and 3.9% in 2000 but were projected to decline to 4.3% and 3.2% by 2017, 3.4% and 2.6% by 2030 and 2.6% and 1.9% by 2050, respectively. The number of chronically infected individuals was estimated at 6 663 906 in 2017 and was projected to peak at 6 665 900 in 2018 and decline to 6 372 100 in 2030 and 5 131 500 in 2050. Annual number of new infections peaked at 346 740 in 1992 but was projected to decline to 198 320 in 2017, 151 090 in 2030 and 98 120 in 2050. Incidence rate per 100 000 person-year peaked at 343 in 1988 but was projected to decline to 99 in 2017, 62 in 2030 and 36 in 2050. Prevalence and incidence varied by age, and the majority of new infections occurred in the 20-39 age group. Prevalence and incidence of HCV in Pakistan have been slowly declining for two decades-Pakistan is enduring a large epidemic that will persist for decades if not controlled. Nearly, 10% of global infections are in Pakistan, with about 200 000 additional infections every year. Rapid and mass scale-up of prevention and treatment programmes are critically needed.
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Affiliation(s)
- H H Ayoub
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar, Foundation - Education City, Doha, Qatar.,Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Z Al Kanaani
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar, Foundation - Education City, Doha, Qatar
| | - L J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar, Foundation - Education City, Doha, Qatar.,Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, NY, USA
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86
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Gaballah AM, Esawy MM. Comparison of 2 different antibody assay methods, Elecsys Anti-HCVII (Roche) and Vidas Anti-HCV (Biomerieux), for the detection of antibody to hepatitis C virus in Egypt. Diagn Microbiol Infect Dis 2018; 92:107-111. [PMID: 29925467 DOI: 10.1016/j.diagmicrobio.2018.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 05/16/2018] [Accepted: 05/16/2018] [Indexed: 02/02/2023]
Abstract
The measurement of antibodies against hepatitis C virus (HCV) is important to screen HCV infection. The aim of this study is to investigate the reliability of 2 commercially available anti-HCV antibody kits used in routine laboratory testing in Egypt. One thousand nine hundred and thirty-one serum samples were analyzed using 2 anti-HCV test systems: Cobas e 411® Elecsys Anti-HCVII and Vidas® Anti-HCV Biomerieux. Discrepant samples were tested using the recombinant immunoblot assay Innogenetics® INNO-LIA HCV Score. Overall agreement of the 2 tests was 94%. Following discrepant sample testing by LIA, sensitivity and specificity using Vidas were 94% and 99%, respectively, while those for Cobas were 97% and 96%, respectively. This study demonstrates superior specificity by Vidas and higher sensitivity by Cobas. Both methods are suitable for laboratory and/or blood screening programs. The concomitant use of a supplementary or confirmatory assay is necessary to compare the accuracy of HCV serological assays.
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Affiliation(s)
| | - Marwa Mohammed Esawy
- Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Egypt.
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87
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Ma Y, Luo T, Dong D, Wu X, Wang Y. Characterization of long non-coding RNAs to reveal potential prognostic biomarkers in hepatocellular carcinoma. Gene 2018; 663:148-156. [PMID: 29684484 DOI: 10.1016/j.gene.2018.04.053] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/12/2018] [Accepted: 04/18/2018] [Indexed: 01/10/2023]
Abstract
Dysregulation of long non-coding RNAs (lncRNAs) plays critical roles in a variety of biological processes. Recent studies have documented that lncRNAs can function as potential biomarkers in cancer prognosis, however, little is known in hepatocellular carcinoma (HCC). To identify lncRNA signatures that have prognostic values in HCC, we analyzed lncRNA expression profiles of 364 HCC patients from The Cancer Genome Atlas (TCGA) dataset. A set of four lncRNAs was identified to be significantly associated with the overall survival. Based on the four-lncRNA signature, HCC patients can be classified into high- and low-risk subgroups with significantly different survival. This result can be further validated in the testing set and another independent HCC data. Further analyses showed that the prognostic value of four-lncRNA signature was independent of other clinicopathological factors. The potential functions of candidate lncRNAs were further examined using HCC cell lines, suggesting these lncRNAs might contribute to tumor development of HCC. This work indicated that lncRNA signature could be a useful marker to determine the diagnosis and predict the prognosis of HCC.
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Affiliation(s)
- Yijie Ma
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences, School of Life Sciences, East China Normal University, 200241 Shanghai, China; Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Tong Luo
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences, School of Life Sciences, East China Normal University, 200241 Shanghai, China
| | - Dong Dong
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences, School of Life Sciences, East China Normal University, 200241 Shanghai, China.
| | - Xubo Wu
- General Surgery, Minhang Branch, Zhongshan Hospital, Fudan University, 201199 Shanghai, China.
| | - Yilin Wang
- Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
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88
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Al Kanaani Z, Mahmud S, Kouyoumjian SP, Abu-Raddad LJ. The epidemiology of hepatitis C virus in Pakistan: systematic review and meta-analyses. ROYAL SOCIETY OPEN SCIENCE 2018; 5:180257. [PMID: 29765698 PMCID: PMC5936963 DOI: 10.1098/rsos.180257] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 03/13/2018] [Indexed: 05/06/2023]
Abstract
To characterize hepatitis C virus (HCV) epidemiology in Pakistan and estimate the pooled mean HCV antibody prevalence in different risk populations, we systematically reviewed all available records of HCV incidence and/or prevalence from 1989 to 2016, as informed by the Cochrane Collaboration Handbook. This systematic review was reported following the PRISMA guidelines. Populations were classified into six categories based on the risk of exposure to HCV infection. Meta-analyses were performed using DerSimonian and Laird random-effects models with inverse variance weighting. The search identified one HCV incidence study and 341 prevalence measures/strata. Meta-analyses estimated the pooled mean HCV prevalence at 6.2% among the general population, 34.5% among high-risk clinical populations, 12.8% among populations at intermediate risk, 16.9% among special clinical populations, 55.9% among populations with liver-related conditions and 53.6% among people who inject drugs. Most reported risk factors in analytical epidemiologic studies related to healthcare procedures. Pakistan is enduring an HCV epidemic of historical proportions-one in every 20 Pakistanis is infected. HCV plays a major role in liver disease burden in this country, and HCV prevalence is high in all-risk populations. Most transmission appears to be driven by healthcare procedures. HCV treatment and prevention must become a national priority.
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Affiliation(s)
- Zaina Al Kanaani
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Qatar Foundation - Education City, PO Box 24144, Doha, Qatar
| | - Sarwat Mahmud
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Qatar Foundation - Education City, PO Box 24144, Doha, Qatar
| | - Silva P. Kouyoumjian
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Qatar Foundation - Education City, PO Box 24144, Doha, Qatar
| | - Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Qatar Foundation - Education City, PO Box 24144, Doha, Qatar
- Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, NY, USA
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89
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Mahmud S, Kouyoumjian SP, Al Kanaani Z, Chemaitelly H, Abu-Raddad LJ. Individual-level key associations and modes of exposure for hepatitis C virus infection in the Middle East and North Africa: a systematic synthesis. Ann Epidemiol 2018; 28:452-461. [PMID: 29661680 DOI: 10.1016/j.annepidem.2018.03.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/01/2018] [Accepted: 03/16/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE To identify, map, and synthesize the individual-level key associations and modes of exposure for hepatitis C virus (HCV) infection in the Middle East and North Africa (MENA), the most affected region by HCV. METHODS Source of data was the MENA HCV Epidemiology Synthesis Project database, populated through systematic literature searches. Risk factors determined to be statistically significant after adjustment for confounders were extracted and categorized into key associations or modes of exposure. RESULTS In total, 329 risk factors were identified from 109 articles in 14 of 24 MENA countries. Among key associations, age was most frequently reported (n = 39; 34.2%), followed by other infections/diseases (n = 20; 17.5%), and incarceration (n = 17; 14.9%). Among modes of exposure, health care-related exposures were most frequently reported (n = 127; 59.5%), followed by injecting drug use exposures (n = 45; 20.9%), community-related exposures (n = 34; 15.8%), and sexual-related exposures (n = 8; 3.7%). Blood transfusion, hemodialysis, surgical and other medical procedures, dental work, and medical injections were identified as key health care-related exposures. CONCLUSIONS Health care appears to be the primary driver of prevalent (and possibly incident) infections in MENA, followed by injecting drug use. HCV screening should target the identified modes of exposure. Commitment to prevention should be an integral component of HCV response to achieve HCV elimination by 2030, with focus on strengthening infection control in health care facilities, improving injection safety and blood screening, and expanding harm reduction services for people who inject drugs.
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Affiliation(s)
- Sarwat Mahmud
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation -Education City, Doha, Qatar
| | - Silva P Kouyoumjian
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation -Education City, Doha, Qatar
| | - Zaina Al Kanaani
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation -Education City, Doha, Qatar
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation -Education City, Doha, Qatar
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation -Education City, Doha, Qatar; Department of Healthcare Policy & Research, Weill Cornell Medicine, Cornell University, New York.
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90
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Elkholy S, Mogawer S, Hosny A, El-Shazli M, Al-Jarhi UM, Abdel-Hamed S, Salah A, El-Garem N, Sholkamy A, El-Amir M, Abdel-Aziz MS, Mukhtar A, El-Sharawy A, Nabil A. Predictors of Mortality in Living Donor Liver Transplantation. Transplant Proc 2018; 49:1376-1382. [PMID: 28736010 DOI: 10.1016/j.transproceed.2017.02.055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 02/18/2017] [Accepted: 02/23/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Egypt has the highest prevalence of the world hepatitis C virus (HCV) load. Hence, the problem of end-stage liver disease (ESLD) is considered a huge burden on the community. Living donor liver transplantation (LDLT) is the only source of donation in Egypt till now. Survival rates had shown significant improvement in the past decades. This study provides analysis of the mortality rates and possible predictors of mortality following LDLT. It also aids in developing a practical and easy-to-apply risk index for prediction of early mortality. PATIENTS AND METHODS This study is a retrospective study that was designed to analyze data from 128 adult patients with ESLD who underwent LDLT in the Liver Transplantation Unit at Faculty of Medicine, Cairo University. Early and late mortality were identified. All potential risk factors were tested using univariate regression for association with early and late mortality. Significant variables were then entered into a multivariable logistic regression model for identifying the predictors for mortality. RESULTS Sepsis was the most common cause of early mortality. Early mortality and 1-year mortality were 29 (23%) and 23 (18%), respectively. Model for End-Stage Liver Disease (MELD) score, intraoperative packed red blood corpuscles (RBCs), and duration of intensive care unit (ICU) stay were found to be independently associated with early mortality. CONCLUSION A MELD score >20, intraoperative transfusion >8 units of packed RBCs, and ICU stay >9 days are three independent predictors of early mortality. Their incorporation into a combined Risk Index can be used to improve outcomes of LDLT.
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Affiliation(s)
- S Elkholy
- Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt.
| | - S Mogawer
- Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt
| | - A Hosny
- General Surgery Department, Faculty of Medicine, Cairo University, Egypt
| | - M El-Shazli
- General Surgery Department, Faculty of Medicine, Cairo University, Egypt
| | - U M Al-Jarhi
- Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt
| | - S Abdel-Hamed
- Clinical Pathology Department, Faculty of Medicine, Cairo University, Egypt
| | - A Salah
- General Surgery Department, Faculty of Medicine, Cairo University, Egypt
| | - N El-Garem
- Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt
| | - A Sholkamy
- Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt
| | - M El-Amir
- Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt
| | - M S Abdel-Aziz
- Tropical Medicine Department, Faculty of Medicine, Cairo University, Egypt
| | - A Mukhtar
- Anesthesia and Intensive Care Department, Faculty of Medicine, Cairo University, Egypt
| | - A El-Sharawy
- Anesthesia and Intensive Care Department, Benisuef University, Benisuef, Egypt
| | - A Nabil
- General Surgery Department, Faculty of Medicine, Cairo University, Egypt
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91
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Morozov VA, Lagaye S. Hepatitis C virus: Morphogenesis, infection and therapy. World J Hepatol 2018; 10:186-212. [PMID: 29527256 PMCID: PMC5838439 DOI: 10.4254/wjh.v10.i2.186] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/11/2018] [Accepted: 02/07/2018] [Indexed: 02/06/2023] Open
Abstract
Hepatitis C virus (HCV) is a major cause of liver diseases including liver cirrhosis and hepatocellular carcinoma. Approximately 3% of the world population is infected with HCV. Thus, HCV infection is considered a public healthy challenge. It is worth mentioning, that the HCV prevalence is dependent on the countries with infection rates around 20% in high endemic countries. The review summarizes recent data on HCV molecular biology, the physiopathology of infection (immune-mediated liver damage, liver fibrosis and lipid metabolism), virus diagnostic and treatment. In addition, currently available in vitro, ex vivo and animal models to study the virus life cycle, virus pathogenesis and therapy are described. Understanding of both host and viral factors may in the future lead to creation of new approaches in generation of an efficient therapeutic vaccine.
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Affiliation(s)
- Vladimir Alexei Morozov
- Center for HIV and Retrovirology, Department of Infectious Diseases, Robert Koch Institute, Berlin 13353, Germany
| | - Sylvie Lagaye
- Department of Immunology, Institut Pasteur, INSERM U1223, Paris 75015, France
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92
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Characterizing hepatitis C virus epidemiology in Egypt: systematic reviews, meta-analyses, and meta-regressions. Sci Rep 2018; 8:1661. [PMID: 29374178 PMCID: PMC5785953 DOI: 10.1038/s41598-017-17936-4] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 12/04/2017] [Indexed: 02/07/2023] Open
Abstract
Egypt is the most affected nation by hepatitis C virus (HCV) and needs a comprehensive characterization of HCV epidemiology to inform the scale-up of treatment and prevention programs. Systematic reviews, meta-analyses, and meta-regressions were conducted. A total of 25 incidence, 259 prevalence, and 47 genotype studies were identified. Incidence and prevalence levels were high across all populations. Genotype 4 accounted for 94.1% of infections with a relative Shannon Diversity Index of only 14.4%. Pooled mean HCV prevalence was estimated at 11.9% (95% CI = 11.1–12.6%) among the general population, 55.6% (95% CI = 49.4–61.7%) among populations at high risk, 14.3% (95% CI = 10.3–18.8%) among populations at intermediate risk, 56.0% (95% CI = 50.4–61.6%) among populations with liver-related conditions, and 35.0% (95% CI = 27.3–43.1%) among special clinical populations. Mean HCV viremic rate was estimated at 66.7% (95% CI = 61.7–71.5%). Meta-regression indicated 6% lower odds for HCV prevalence for each one-year increment in publication year (AOR = 0.94; 95% CI = 0.92–0.96). HCV prevalence is high with evidence for ongoing transmission mainly through healthcare. Genotype diversity is low with genotype 4 dominance. Two-thirds of antibody-positive Egyptians are chronically infected and need treatment. Clinical populations should be prioritized for screening. Despite the large-scale epidemic, prevalence appears to be declining rapidly consistent with a contracting epidemic.
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93
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Mahmud S, Akbarzadeh V, Abu-Raddad LJ. The epidemiology of hepatitis C virus in Iran: Systematic review and meta-analyses. Sci Rep 2018; 8:150. [PMID: 29317673 PMCID: PMC5760657 DOI: 10.1038/s41598-017-18296-9] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/07/2017] [Indexed: 12/12/2022] Open
Abstract
The aim of this study was to characterize hepatitis C virus (HCV) epidemiology in Iran and estimate the pooled mean HCV antibody prevalence in different risk populations. We systematically reviewed and synthesized reports of HCV incidence and/or prevalence, as informed by the Cochrane Collaboration Handbook, and reported our findings following the PRISMA guidelines. DerSimonian-Laird random effects meta-analyses were implemented to estimate HCV prevalence in various risk populations. We identified five HCV incidence and 472 HCV prevalence measures. Our meta-analyses estimated HCV prevalence at 0.3% among the general population, 6.2% among intermediate risk populations, 32.1% among high risk populations, and 4.6% among special clinical populations. Our meta-analyses for subpopulations estimated HCV prevalence at 52.2% among people who inject drugs (PWID), 20.0% among populations at high risk of healthcare-related exposures, and 7.5% among populations with liver-related conditions. Genotype 1 was the most frequent circulating strain at 58.2%, followed by genotype 3 at 39.0%. HCV prevalence in the general population was lower than that found in other Middle East and North Africa countries and globally. However, HCV prevalence was high in PWID and populations at high risk of healthcare-related exposures. Ongoing transmission appears to be driven by drug injection and specific healthcare procedures.
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Affiliation(s)
- Sarwat Mahmud
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Vajiheh Akbarzadeh
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- Department of Healthcare Policy and Research, Weill Cornell Medical College, Cornell University, New York, New York, USA
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
- Department of Healthcare Policy and Research, Weill Cornell Medical College, Cornell University, New York, New York, USA.
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94
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Mahmud S, Al‐Kanaani Z, Chemaitelly H, Chaabna K, Kouyoumjian SP, Abu‐Raddad LJ. Hepatitis C virus genotypes in the Middle East and North Africa: Distribution, diversity, and patterns. J Med Virol 2018; 90:131-141. [PMID: 28842995 PMCID: PMC5724492 DOI: 10.1002/jmv.24921] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Accepted: 08/17/2017] [Indexed: 02/06/2023]
Abstract
Our objective was to characterize the distribution, diversity and patterns of hepatitis C virus (HCV) genotypes in the Middle East and North Africa (MENA). Source of data was a database of HCV genotype studies in MENA populated using a series of systematic literature searches. Pooled mean proportions were estimated for each genotype and by country using DerSimonian-Laird random-effects meta-analyses. Genotype diversity within countries was assessed using Shannon Diversity Index. Number of chronic infections by genotype and country was calculated using the pooled proportions and country-specific numbers of chronic infection. Analyses were conducted on 338 genotype studies including 82 257 genotyped individuals. Genotype 1 was dominant (≥50%) in Algeria, Iran, Morocco, Oman, Tunisia, and UAE, and was overall ubiquitous across the region. Genotype 2 was common (10-50%) in Algeria, Bahrain, Libya, and Morocco. Genotype 3 was dominant in Afghanistan and Pakistan. Genotype 4 was dominant in Egypt, Iraq, Jordan, Palestine, Qatar, Saudi Arabia, and Syria. Genotypes 5, 6, and 7 had limited or no presence across countries. Genotype diversity varied immensely throughout MENA. Weighted by population size, MENA's chronic infections were highest among genotype 3, followed by genotype 4, genotype 1, genotype 2, genotype 5, and genotype 6. Despite ubiquitous presence of genotype 1, the vast majority of chronic infections were of genotypes 3 or 4, because of the sizable epidemics in Pakistan and Egypt. Three sub-regional patterns were identified: genotype 3 pattern centered in Pakistan, genotype 4 pattern centered in Egypt, and genotype 1 pattern ubiquitous in most MENA countries.
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Affiliation(s)
- Sarwat Mahmud
- Infectious Disease Epidemiology Group, Weill Cornell Medicine—QatarCornell UniversityQatar Foundation—Education CityDohaQatar
| | - Zaina Al‐Kanaani
- Infectious Disease Epidemiology Group, Weill Cornell Medicine—QatarCornell UniversityQatar Foundation—Education CityDohaQatar
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine—QatarCornell UniversityQatar Foundation—Education CityDohaQatar
| | - Karima Chaabna
- Infectious Disease Epidemiology Group, Weill Cornell Medicine—QatarCornell UniversityQatar Foundation—Education CityDohaQatar
- Department of Healthcare Policy & Research, Weill Cornell MedicineCornell UniversityNew York
| | - Silva P. Kouyoumjian
- Infectious Disease Epidemiology Group, Weill Cornell Medicine—QatarCornell UniversityQatar Foundation—Education CityDohaQatar
| | - Laith J. Abu‐Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine—QatarCornell UniversityQatar Foundation—Education CityDohaQatar
- Department of Healthcare Policy & Research, Weill Cornell MedicineCornell UniversityNew York
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95
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Benova L, Awad SF, Abu-Raddad LJ. Estimate of vertical transmission of Hepatitis C virus in Pakistan in 2007 and 2012 birth cohorts. J Viral Hepat 2017; 24:1177-1183. [PMID: 28662284 DOI: 10.1111/jvh.12748] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 06/06/2017] [Indexed: 12/12/2022]
Abstract
UNLABELLED Despite a combination of high Hepatitis C virus (HCV) prevalence, a large adult population and high fertility, no published estimates of the scale and contribution of vertical transmission to HCV incidence in Pakistan exist. The objective of this study was to estimate the number of new HCV infections occurring in Pakistan as a result of vertical transmission. We adapted a published mathematical model based on HCV antibody and viraemia prevalence, fertility rates, risk of HCV vertical transmission and children mortality rates to estimate the number of infections in the 2007 and 2012 birth cohorts nationally and in four subnational regions. We estimated that 19 708 (95% uncertainty interval [UI]: 15 941-23 819) children were vertically infected by HCV in 2007 and 21 676 (95% UI: 17 498-26 126) in 2012. The majority of these cases (72.9% and 72.5% in 2007 and 2012, respectively) occurred in Punjab. We estimated that vertical transmission as a mode of exposure accounted for a quarter of HCV infections among children under 5 years of age (25.2% in 2007 and 24.0% in 2012). CONCLUSION Our results showed that one in 260 children born in Pakistan in 2007 and 2012 acquired HCV vertically. While currently no interventions during pregnancy and childbirth are recommended to reduce this risk, prevention, testing and treatment strategies should be considered to reduce the burden of vertical HCV infections among young children. Other routes of transmission appear to contribute the majority of HCV infections among children and must also be clarified and urgently addressed.
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Affiliation(s)
- Lenka Benova
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Susanne Faissal Awad
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Laith Jamal Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.,Department of Healthcare Policy and Research, Weill Cornell Medical College, Cornell University, New York, NY, USA.,College of Public Health, Hamad bin Khalifa University, Doha, Qatar
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96
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Ismail SA, Cuadros DF, Benova L. Hepatitis B in Egypt: A cross-sectional analysis of prevalence and risk factors for active infection from a nationwide survey. Liver Int 2017; 37:1814-1822. [PMID: 28481452 DOI: 10.1111/liv.13469] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Accepted: 04/26/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Viral hepatitis is a major public health challenge in Egypt but little is known about the epidemiology of the hepatitis B virus (HBV) infection, its geographical distribution, or risk factors for infection in the Egyptian context. This study addresses this deficit using data from a nationally representative survey. METHODS Cross-sectional analysis of data gathered from men and women aged 15-59 in the Egypt Health Issues Survey (EHIS) 2015, including logistic regression to evaluate the contribution of different factors to risk of HBV infection. This was supplemented by spatial analysis of the distribution of acute or chronic HBV infection at governorate level, and the ecological relationship between HBV and HCV infections. RESULTS Population HBV prevalence was 1.4% (95% confidence interval [CI] 1.2-1.6), with a HBV-HCV co-infection rate of 0.06%. Spatial analysis showed localisation of HBV infected individuals primarily to urban areas of Upper Egypt (in contrast to HCV for which prevalence is highest in rural Lower Egypt), and those in early middle age (Adjusted Odds Ratio [AOR] 3.32, 95% CI: 1.66-6.63). HBV positive status among other household members emerged as a powerful driver of infection risk in this analysis (AOR=10.75, 95% CI: 4.98-23.24). CONCLUSION Spatial distribution of HBV infection in Egypt differs markedly from HCV and co-infection rates are low. Within-household transmissions appear to be particularly important in explaining the persistence of HBV infection in the general population. Prevention strategies should focus on urban Upper Egypt, and particularly those households with documented cases of infection.
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Affiliation(s)
- Sharif A Ismail
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Diego F Cuadros
- Department of Geography and Geographic Information Science, University of Cincinnati, Cincinnati, OH, USA
| | - Lenka Benova
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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97
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Harfouche M, Chemaitelly H, Kouyoumjian SP, Mahmud S, Chaabna K, Al-Kanaani Z, Abu-Raddad LJ. Hepatitis C virus viremic rate in the Middle East and North Africa: Systematic synthesis, meta-analyses, and meta-regressions. PLoS One 2017; 12:e0187177. [PMID: 29088252 PMCID: PMC5663443 DOI: 10.1371/journal.pone.0187177] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 10/13/2017] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To estimate hepatitis C virus (HCV) viremic rate, defined as the proportion of HCV chronically infected individuals out of all ever infected individuals, in the Middle East and North Africa (MENA). METHODS Sources of data were systematically-gathered and standardized databases of the MENA HCV Epidemiology Synthesis Project. Meta-analyses were conducted using DerSimonian-Laird random-effects models to determine pooled HCV viremic rate by risk population or subpopulation, country/subregion, sex, and study sampling method. Random-effects meta-regressions were conducted to identify predictors of higher viremic rate. RESULTS Analyses were conducted on 178 measures for HCV viremic rate among 19,593 HCV antibody positive individuals. In the MENA region, the overall pooled mean viremic rate was 67.6% (95% CI: 64.9-70.3%). Across risk populations, the pooled mean rate ranged between 57.4% (95% CI: 49.4-65.2%) in people who inject drugs, and 75.5% (95% CI: 61.0-87.6%) in populations with liver-related conditions. Across countries/subregions, the pooled mean rate ranged between 62.1% (95% CI: 50.0-72.7%) and 70.4% (95% CI: 65.5-75.1%). Similar pooled estimates were further observed by risk subpopulation, sex, and sampling method. None of the hypothesized population-level predictors of higher viremic rate were statistically significant. CONCLUSIONS Two-thirds of HCV antibody positive individuals in MENA are chronically infected. Though there is extensive variation in study-specific measures of HCV viremic rate, pooled mean estimates are similar regardless of risk population or subpopulation, country/subregion, HCV antibody prevalence in the background population, or sex. HCV viremic rate is a useful indicator to track the progress in (and coverage of) HCV treatment programs towards the set target of HCV elimination by 2030.
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Affiliation(s)
- Manale Harfouche
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Silva P. Kouyoumjian
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Sarwat Mahmud
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Karima Chaabna
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- Department of Healthcare Policy & Research, Weill Cornell Medicine, Cornell University, New York, United States of America
| | - Zaina Al-Kanaani
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- Department of Healthcare Policy & Research, Weill Cornell Medicine, Cornell University, New York, United States of America
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98
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Epidemiology of hepatitis C virus among hemodialysis patients in the Middle East and North Africa: systematic syntheses, meta-analyses, and meta-regressions. Epidemiol Infect 2017; 145:3243-3263. [PMID: 28988562 PMCID: PMC9148758 DOI: 10.1017/s0950268817002242] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
We aimed to investigate hepatitis C virus (HCV) epidemiology among hemodialysis (HD) patients in the Middle East and North Africa (MENA). Our data source was an HCV biological measures database populated through systematic literature searches. Descriptive epidemiologic syntheses, effects meta-analyses and meta-regressions, and genotype analyses were conducted. We analyzed 289 studies, including 106 463 HD patients. HCV incidence ranged between 0 and 100% as seroconversion risk, and between 0 and 14·7 per 1000 person-years as incidence rate. The regional pooled mean estimate was 29·2% (95% CI: 25·6–32·8%) for HCV antibody positive prevalence and 63·0% (95% CI: 55·4–70·3%) for the viremic rate. Region within MENA, country income group, and year of data collection were associated with HCV prevalence; year of data collection adjusted odds ratio was 0·92 (95% CI: 0·90–0·95). Genotype diversity varied across countries with four genotypes documented regionally: genotype 1 (39·3%), genotype 2 (5·7%), genotype 3 (29·6%), and genotype 4 (25·4%). Our findings showed that one-third of HD patients are HCV antibody positive and one-fifth are chronic carriers and can transmit the infection. However, HCV prevalence is declining. In context of growing HD patient population and increasing HCV treatment availability, it is critical to improve standards of infection control in dialysis and expand treatment coverage.
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99
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Boushab BM, Mohamed Limame OCM, Fatim Zahra FM, Mamoudou S, Roseline Darnycka BM, Saliou SM. Estimation of seroprevalence of HIV, hepatitis B and C virus and syphilis among blood donors in the hospital of Aïoun, Mauritania. Pan Afr Med J 2017. [PMID: 29515736 PMCID: PMC5837177 DOI: 10.11604/pamj.2017.28.118.12465] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Introduction To estimating the seroprevalence of HIV, hepatitis B, hepatitis C and syphilis among blood donors in the Aïoun hospital. Methods This is a retrospective study from 1 January 2010 to 31 December 2015. Results On the five-year study period, 1,123 donors were collected. Of these, 182 were HIV-positive, an overall prevalence of 16.2% with predominance in male with a sex ratio Man/Woman of 5.2. The average age of donors was 32.7 ± 10 years (range 17-73 years). The most represented that age group 21-30 years (40.5%). The seroprevalence found were 1.2% for HIV, 11.8% for HBV, HCV 0.2% and 3% for syphilis. Co-infection was found in 0.7% of which 0.5% of dual HIV HBV/Syphilis and 0.2% in HBV/HIV. Conclusion The transmission of infectious agents related to transfusion represents the greatest threat to transfusion safety of the recipient. Therefore, a rigorous selection and screening of blood donors are highly recommended to ensure blood safety for the recipient.
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Affiliation(s)
| | | | - Fall-Malick Fatim Zahra
- National Institute of Hepatology-Virology in Nouakchott, School of Medicine, Nouakchott, Mauritania
| | - Savadogo Mamoudou
- Department of Infectious Diseases, University Teaching Hospital Yalgado Ouédrago, Ouagadougou, Burkina Faso
| | | | - Sow Mamadou Saliou
- Department of Infectious Diseases, University Teaching Hospital Donka, Conakry, Guinée
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100
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Tınazlı M, Güvenir M, Aykaç A, Süer K. Hepatitis C virus infection among patients admitted to a rheumatology ward in northern Cyprus. EGYPTIAN RHEUMATOLOGIST 2017. [DOI: 10.1016/j.ejr.2017.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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