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Safadi R. The liver in Greco-Arabic and Islamic medicine. Clin Liver Dis (Hoboken) 2024; 23:e0137. [PMID: 38576470 PMCID: PMC10994509 DOI: 10.1097/cld.0000000000000137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/09/2023] [Indexed: 04/06/2024] Open
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2
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Sanai F, Alkhatry M, Alzanbagi A, Kumar S. Hepatitis B virus infection in Saudi Arabia and the UAE: Public health challenges and their remedial measures. J Infect Public Health 2023; 16:1410-1417. [PMID: 37482014 DOI: 10.1016/j.jiph.2023.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/02/2023] [Accepted: 07/17/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) infection is a major public health concern globally with higher prevalence in Middle Eastern countries. Both Saudi Arabia and the UAE face critical challenges in HBV treatment and management despite the implementation of a mass vaccination program. This review aimed to understand the gaps and unmet needs related to HBV infection, public health challenges associated with its diagnosis, and treatment barriers in Saudi Arabia and the UAE. Additionally, the review aimed to provide the best practices in the HBV care pathway for effective remedial measures and disease reduction. METHODS The literature search was done from Pubmed. RESULTS The lack of disease awareness and knowledge about disease transmission among patients and their family members and healthcare professionals, lack of proper screening, underdiagnosis, social stigma, lack of established referral system, and treatment cost are the primary barriers to HBV diagnosis and management. CONCLUSION Appropriate healthcare initiatives should be undertaken to lower the disease burden in Saudi Arabia and the UAE.
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Affiliation(s)
- Faisal Sanai
- Liver Disease Research Centre, College of Medicine, King Saud University, P.O. Box 22480, Riyadh 11495, Saudi Arabia; Gastroenterology Unit, Department of Medicine, King Abdulaziz Medical City, P.O. Box 9515, Jeddah 21423, Saudi Arabia.
| | - Maryam Alkhatry
- Department of GI Endoscopy, Ibrahim Bin Hamad Obaidullah Hospital, Ras Al Khaimah, United Arab Emirates
| | - Adnan Alzanbagi
- Department of Gastroenterology and Hepatology, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Shiva Kumar
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
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3
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Molecular and Genetic Characterization of Hepatitis B Virus (HBV) among Saudi Chronically HBV-Infected Individuals. Viruses 2023; 15:v15020458. [PMID: 36851671 PMCID: PMC9964524 DOI: 10.3390/v15020458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/10/2023] Open
Abstract
The study aimed to characterize the genotype and subgenotypes of HBV circulating in Saudi Arabia, the presence of clinically relevant mutations possibly associated with resistance to antivirals or immune escape phenomena, and the possible impact of mutations in the structural characteristics of HBV polymerase. Plasma samples from 12 Saudi Arabian HBV-infected patients were analyzed using an in-house PCR method and direct sequencing. Saudi patients were infected with mainly subgenotype D1. A number of mutations in the RT gene (correlated to antiviral resistance) and within and outside the major hydrophilic region of the S gene (claimed to influence immunogenicity and be related to immune escape) were observed in almost all patients. Furthermore, the presence of mutations in the S region caused a change in the tertiary structure of the protein compared with the consensus region. Clinical manifestations of HBV infection may change dramatically as a result of viral and host factors: the study of mutations and protein-associated cofactors might define possible aspects relevant for the natural and therapeutic history of HBV infection.
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4
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Al-Matary AM, Al Gashaa FAS. Comparison of different rapid screening tests and ELISA for HBV, HCV, and HIV among healthy blood donors and recipients at Jibla University Hospital Yemen. J Med Life 2022; 15:1403-1408. [PMID: 36567845 PMCID: PMC9762378 DOI: 10.25122/jml-2022-0051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 09/21/2022] [Indexed: 12/27/2022] Open
Abstract
Blood transfusion is associated with many risks, especially exposure to blood transfusion-transmitted infections considered one of the main causes of death worldwide, including hepatitis B (HBV) and C virus (HCV) and human immunodeficiency virus (HIV). The threat posed by blood-borne pathogens is disproportionately high, especially in developing countries, so there is a need for continuous monitoring of blood transfusions to prevent transmitting diseases. Rapid diagnostic immunochromatographic technique (ICT) methods are the most widely used methods in developing countries, although ELISA and molecular testing are considered more accurate worldwide. Therefore, the study aimed to compare the analytical sensitivity between rapid tests and the ELISA method for detecting HBV, HCV, and HIV infection among blood donors. Four hundred (400) blood donor samples were tested using the Rapid Test Kits (INTEC, SD, ABON, and CLUN), and the ELISA method was used as a confirmatory test. Out of 400 blood samples tested for viral infection, HBV, HCV, and HIV were detected in 8, 10, and 2 samples, respectively, using the ELISA technique. This study observed that the rate of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), in addition to determining the diagnostic accuracy rate and error rate for all rapid diagnostic kits in detecting HBV, HCV and HIV are less accurate and associated with more false negatives compared to the ELISA technique. This study showed a significant difference in sensitivity between ELISA and rapid diagnostic immunochromatographic technique (ICT) groups; therefore, rapid diagnosis is not suitable for testing the quality of infectious markers for blood donors.
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Affiliation(s)
| | - Fadhl Ahmed Saed Al Gashaa
- Department of Biology, Al Farabi University College, Baghdad, Iraq,Department of Medical Microbiology, College of Science, Ibb University, Ibb, Yemen,Corresponding Author: Fadhl Ahmed Saed Al Gashaa, Department of Biology, Al Farabi University College, Baghdad, Iraq. Department of Medical Microbiology, College of Science, Ibb University, Ibb, Yemen. E-mail:
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5
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Al-Qahtani AA, Pourkarim MR, Trovão NS, Vergote V, Li G, Thijssen M, Abdo AA, Sanai FM, Dela Cruz D, Bohol MFF, Al-Anazi MR, Al-Ahdal MN. Molecular epidemiology, phylogenetic analysis and genotype distribution of hepatitis B virus in Saudi Arabia: Predominance of genotype D1. INFECTION GENETICS AND EVOLUTION 2019; 77:104051. [PMID: 31634640 DOI: 10.1016/j.meegid.2019.104051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 08/28/2019] [Accepted: 09/24/2019] [Indexed: 02/06/2023]
Abstract
Despite the implementation of various vaccination programs, hepatitis B virus (HBV) poses a considerable health problem in Saudi Arabia. Insight on HBV evolutionary history in the region is limited. We performed a comprehensive epidemiological and phylogenetic reconstruction based on a large cohort of HBV infected patients. Three hundred and nineteen HBV-infected patients with different clinical manifestations, including inactive and active chronic carriers and patients with cirrhosis and hepatocellular carcinoma (HCC), were enrolled in this study. The full-length large S gene was amplified and sequenced. Phylogenetic analysis was performed to determine the genotype and subgenotypes of the isolates. Phylogenetic tree analysis revealed that genotype D is the most dominant genotype among patients. Moreover, this analysis identified two strains with genotype E isolated from active carriers. Detailed phylogenetic analyses confirmed the presence of four HBV D subgenotypes, D1 (93%, n = 296), D2 (0.02%, n = 5), D3 (0.003%, n = 1), and D4 (0.003%, n = 1). In addition, six genotype D strains were not assigned to any existing HBV D subgenotype. The large S gene of eight strains showed signatures of genotype recombination between the genotypes D and A and between D and E. Several strains harbored medically important point mutations at the protein level. Along with the dominance of the HBV genotype D, isolation of the E genotype and several recombinant strains from patients with Saudi Arabian origin is an essential result for decisions involving therapeutic measures for patients. Development of vaccines and detection of diagnostic escape mutations at antigenic epitopes on the HBsAg will be valuable to public health authorities. Furthermore, the diversity at the nucleotide and amino acid levels and different proportions of dN/dS at the PreS1, PreS2, and HBsAg reveal the selective pressure trend from inactive status towards advanced liver diseases.
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Affiliation(s)
- Ahmed A Al-Qahtani
- Department of Infection and Immunity, Research Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Department of Microbiology and Immunology, Alfaisal University, School of Medicine, Riyadh, Saudi Arabia.
| | - Mahmoud Reza Pourkarim
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute, Division of Clinical and Epidemiological Virology, Leuven, Belgium
| | - Nídia Sequeira Trovão
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute, Division of Clinical and Epidemiological Virology, Leuven, Belgium
| | - Valentijn Vergote
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute, Division of Clinical and Epidemiological Virology, Leuven, Belgium
| | - Guangdi Li
- Department of Public Health, Central South University, Changsha 410078, Hunan, China
| | - Marijn Thijssen
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute, Division of Clinical and Epidemiological Virology, Leuven, Belgium
| | - Ayman A Abdo
- Section of Gastroenterology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Faisal M Sanai
- Gastroenterology Unit, Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Damian Dela Cruz
- Department of Infection and Immunity, Research Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Marie Fe F Bohol
- Department of Infection and Immunity, Research Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Mashael R Al-Anazi
- Department of Infection and Immunity, Research Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Mohammed N Al-Ahdal
- Department of Infection and Immunity, Research Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Department of Microbiology and Immunology, Alfaisal University, School of Medicine, Riyadh, Saudi Arabia
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6
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Al Romaihi HE, Ganesan N, Farag EA, Smatti MK, Nasrallah GK, Himatt SM, Derbala MF, Alshamali M, Mahadoon LK, Khogali HS, Sallam M, Al Thani AA, Al Thani M, Al Kaabi S, Yassine HM. Demographics and Epidemiology of Hepatitis B in the State of Qatar: A Five-Year Surveillance-Based Incidence Study. Pathogens 2019; 8:pathogens8020068. [PMID: 31117254 PMCID: PMC6630982 DOI: 10.3390/pathogens8020068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/09/2019] [Accepted: 05/18/2019] [Indexed: 01/29/2023] Open
Abstract
Background: Expatriates represent >80% of Qatar’s population, mostly arriving from countries in Africa and Asia that are endemic with many diseases. This increases the risk for introducing new pathogens into the country and provides a platform for maintenance of endemic pathogen circulation. Here, we report on the incidence and epidemiological characteristics of hepatitis B in Qatar between 2010 and 2014. Methods: We performed a retrospective epidemiological data analysis using the data available at the surveillance system of the Ministry of Public Health (MOPH) in Qatar. Data were collected from distinctive public and private incorporates around the nation. Reported cases of hepatitis B patients represent those who met the stringent case definition as per World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) guidelines and eventually reported to MOPH. Results: The annual incidence rates of hepatitis B cases were 30.0, 34.2, 30.5, 39.4, and 19.8 per 100,000 population in 2010, 2011, 2012, 2013, and 2014, respectively. There was no specific trend or seasonality for the reported cases. The incidence rates were higher in females compared to males between 2010 and 2012, but similar in 2013 and 2014. The highest incidence rates were reported among individuals between 25 and 34 years of age. No cases were reported in children younger than five years in 2013 and 2014. Rates of hepatitis B cases declined dramatically in 2014, in both Qataris and non-Qataris, as compared to the previous years. Conclusion: Our results indicate a dramatic decline of hepatitis B cases in Qatar but mandate improved surveillance and vaccination efforts in expatriates in the nation.
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Affiliation(s)
| | | | | | - Maria K Smatti
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
| | - Gheyath K Nasrallah
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
- College of Health Sciences, Qatar University, QU Health, Doha 2713, Qatar.
| | | | - Moutaz F Derbala
- Gastroenterology and Hepatology Department, Hamad Medical Corporation, Doha 3050, Qatar.
| | | | | | | | | | - Asmaa A Al Thani
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
- College of Health Sciences, Qatar University, QU Health, Doha 2713, Qatar.
| | | | - Saad Al Kaabi
- Gastroenterology and Hepatology Department, Hamad Medical Corporation, Doha 3050, Qatar.
| | - Hadi M Yassine
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
- College of Health Sciences, Qatar University, QU Health, Doha 2713, Qatar.
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7
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Al-Sadeq DW, Taleb SA, Zaied RE, Fahad SM, Smatti MK, Rizeq BR, Al Thani AA, Yassine HM, Nasrallah GK. Hepatitis B Virus Molecular Epidemiology, Host-Virus Interaction, Coinfection, and Laboratory Diagnosis in the MENA Region: An Update. Pathogens 2019; 8:pathogens8020063. [PMID: 31083509 PMCID: PMC6630671 DOI: 10.3390/pathogens8020063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 04/18/2019] [Accepted: 05/08/2019] [Indexed: 02/07/2023] Open
Abstract
Hepatitis B virus (HBV) is an enveloped partial double-stranded DNA virus that can cause acute and chronic hepatitis. According to the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), 257 million people are living with HBV. Moreover, 20,900 acute hepatitis B cases were reported in 2016. Hepatitis B is highly prevalent in the African, Western Pacific, Eastern Mediterranean, South-East Asia, and European regions, respectively. Due to the high mutational rate of HBV and lack of reverse transcriptase proofreading activity, ten different genotypes with different geographical distributions have been identified. HBV pathogenesis and severity of infection depend on several host and viral factors, particularly, the genetic variability of both the host and virus. Although HBV infection is a global health concern, there is a lack of adequate studies and reports in the Middle East and North Africa (MENA) region. Here, we provide a review on HBV epidemiology, pathogenesis, host-pathogen interactions, coinfection with selected viruses, and laboratory diagnosis, focusing on studies conducted in the MENA region to determine the current situation of the HBV infection and outline the future study areas.
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Affiliation(s)
- Duaa W Al-Sadeq
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
- Biomedical Science Department, College of Health Sciences, Qatar University, Doha 2713, Qatar.
| | - Sara A Taleb
- Biomedical Science Department, College of Health Sciences, Qatar University, Doha 2713, Qatar.
| | - Roan E Zaied
- Biomedical Science Department, College of Health Sciences, Qatar University, Doha 2713, Qatar.
| | - Sara M Fahad
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
| | - Maria K Smatti
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
| | - Balsam R Rizeq
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
- Department of Biological and Environmental Sciences, College of Arts & Sciences, Qatar University, Doha 2713, Qatar.
| | - Asmaa A Al Thani
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
- Biomedical Science Department, College of Health Sciences, Qatar University, Doha 2713, Qatar.
| | - Hadi M Yassine
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
| | - Gheyath K Nasrallah
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
- Biomedical Science Department, College of Health Sciences, Qatar University, Doha 2713, Qatar.
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8
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Aljumah AA, Babatin M, Hashim A, Abaalkhail F, Bassil N, Safwat M, Sanai FM. Hepatitis B care pathway in Saudi Arabia: Current situation, gaps and actions. Saudi J Gastroenterol 2019; 25:73-80. [PMID: 30720000 PMCID: PMC6457186 DOI: 10.4103/sjg.sjg_421_18] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Hepatitis B virus (HBV) infection remains a public health problem worldwide. In this review, we aim to assess the current situation of the HBV care pathway in the Kingdom of Saudi Arabia (KSA), identify gaps/barriers therein, and recommend initiatives to be taken to improve the management of such patients. Towards this end, a literature search was conducted in PubMed and free Internet searches. Interviews with individuals and focus group discussions were held with HBV experts in KSA. Although significant improvements have been made in the past 30 years in KSA in terms of the decline in prevalence (currently estimated to be around 1.3%), the morbidity and mortality related to the disease have not shown a parallel decline. This makes HBV an important public health concern. Furthermore, poor disease awareness, low diagnosis rates, and nonadherence to therapy amplify the disease burden. There are several mandated national screening structures present; however, established protocols for those who test positive and subsequent linkage-to-care are inadequate. In the absence of a virologic cure, a concerted effort should be made to provide safe and effective lifelong treatment. This review provides recommendations to reduce the HBV disease burden in the Saudi population.
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Affiliation(s)
- Abdulrahman A. Aljumah
- Hepatology Division, Department of Hepatobiliary Sciences and Organ transplant Center, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Mohamed Babatin
- Department of Medicine, Gastroenterology Unit, King Fahad Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Almoataz Hashim
- Department of Medicine, Gastroenterology Unit, University of Jeddah, Jeddah, Kingdom of Saudi Arabia
| | - Faisal Abaalkhail
- Division of Organ Transplant Center, Department of Liver Transplantation and Hepatobiliary-Pancreatic Surgery, King Faisal Specialist Hospital and Research Center; Department of Medicine, College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | | | | | - Faisal M. Sanai
- Gastroenterology Unit, Department of Medicine, King Abdulaziz Medical City, Jeddah, Riyadh, Kingdom of Saudi Arabia,Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia,Address for correspondence: Dr. Faisal M. Sanai, Gastroenterology Unit, Department of Gastroenterology, King Abdulaziz Medical City, PO Box 9515, Jeddah - 21423, Kingdom of Saudi Arabia. E-mail:
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9
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Badawi MM, Atif MS, Mustafa YY. Systematic review and meta-analysis of HIV, HBV and HCV infection prevalence in Sudan. Virol J 2018; 15:148. [PMID: 30253805 PMCID: PMC6157049 DOI: 10.1186/s12985-018-1060-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 09/19/2018] [Indexed: 02/07/2023] Open
Abstract
Viral hepatitis constitutes a global health problem; previous studies have affirmed a considerable morbidity and mortality from both acute infections and chronic complications. On the other hand, Human Immunodeficiency Virus (HIV) infection is also of known burden. Determining prevalence measures of these viruses is crucial for establishing appropriate country specific strategies regarding prevention, diagnosis, and containment. This systematic review was aimed to provide pooled seroprevalence estimates of the three viruses in Sudan. Structured review of the literature was conducted to obtain relevant studies published in both national and international databases. After assessment of quality and bias in all proposed studies, 57 prevalence studies were included. Meta-analysis was conducted for all studies and subgroup analysis was also approached. The total sample size of participants in included studies providing HIV antibodies prevalence was 15,479. Based on information retrieved from these studies, HIV prevalence ranged from 0 to 18.3% among different study populations. However, pooled prevalence estimate for HIV antibodies was 1%. Kassala, Eastern Sudan was the most endemic State (4.18%). The HBV reported seroprevalence rates ranged from 5.1 up to 26.81% among different populations and the overall pooled prevalence was 12.07%. For HCV antibodies; 2.74% was determined to be the pooled prevalence. Khartoum State was the most endemic State of both HBV and HCV with seroprevalence of 12.69% and 6.78%, respectively.Based on data reviewed and synthesized; there is no evidence for an HIV endemic in the general population of Sudan. However, both HBV and HCV seroprevalence rates are indicating otherwise. Reducing the overall burden of HIV, HBV and HCV infections will require new measures and national strategies and the recognition of the infections as one of the country's priority issues.
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Affiliation(s)
- M. M. Badawi
- Medical Microbiology department, Faculty of Medical Laboratory Sciences, Elrazi University, Khartoum, Sudan
| | - M. S. Atif
- Medical Microbiology department, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
| | - Y. Y. Mustafa
- Medical Microbiology department, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
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10
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Elkheir SM, Babiker ZO, Elamin SK, Yassin MI, Awadalla KE, Bealy MA, Agab Eldour AA, Alloba FE, Atabani SF, Osman HK, Babiker AG, Herieka EA. Seroprevalence of maternal HIV, hepatitis B, and syphilis in a major maternity hospital in North Kordofan, Sudan. Int J STD AIDS 2018; 29:1330-1336. [PMID: 30049254 DOI: 10.1177/0956462418784687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Routine infectious diseases screening of Sudanese pregnant women has been patchy due to scarcity of healthcare resources and social stigma. We sought to determine the seroprevalence of HIV, hepatitis B, and syphilis among pregnant women attending antenatal care (ANC) at El Obeid Maternity Hospital in western Sudan. We also explored the association between these infections and a set of socio-demographic and maternal variables. Unlinked anonymous testing for HIV-1/2 antibodies, hepatitis B surface antigen, and Treponema pallidum antibodies was performed on residual blood samples collected during routine ANC (August 2016-March 2017). Seroprevalence of HIV was 1.13% (5/444; 95% CI 0.37-2.61%), hepatitis B 2.93% (13/444; 95% CI 1.57-4.95%), and syphilis 7.43% (33/444; 95% CI 5.17-10.28%). On bivariate analysis, there were no statistically significant associations between hepatitis B, syphilis, or a composite outcome including any of the three infections and age, stage of pregnancy, gravidity, parity, previous mode of delivery, history of blood transfusion, or husband polygamy. Urgent action is needed to scale up routine maternal screening for HIV, hepatitis B, and syphilis on an opt-out basis. Further research into the socio-demographic and behavioural determinants of these infections as well as their clinical outcomes is needed.
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Affiliation(s)
- Sirelkhatim M Elkheir
- 1 Department of Obstetrics and Gynaecology, El Obeid Maternity Hospital, El Obeid, Sudan
| | - Zahir Oe Babiker
- 2 Sudan HIV/AIDS Working Group (SHAWG), Glasgow, UK.,3 Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Sabah K Elamin
- 1 Department of Obstetrics and Gynaecology, El Obeid Maternity Hospital, El Obeid, Sudan
| | - Mohammed Ia Yassin
- 1 Department of Obstetrics and Gynaecology, El Obeid Maternity Hospital, El Obeid, Sudan.,4 Department of Obstetrics and Gynaecology, Faculty of Medicine & Health Sciences, University of Kordofan, El Obeid, Sudan
| | - Khidir E Awadalla
- 1 Department of Obstetrics and Gynaecology, El Obeid Maternity Hospital, El Obeid, Sudan.,4 Department of Obstetrics and Gynaecology, Faculty of Medicine & Health Sciences, University of Kordofan, El Obeid, Sudan
| | - Mohamed A Bealy
- 5 Diagnostic Centre, Faculty of Medicine & Health Sciences, University of Kordofan, El Obeid, Sudan
| | - Ahmed A Agab Eldour
- 6 Department of Pathology, Faculty of Medicine & Health Sciences, University of Kordofan, El Obeid, Sudan
| | - Fath E Alloba
- 2 Sudan HIV/AIDS Working Group (SHAWG), Glasgow, UK.,7 The Liverpool Centre for Sexual Health, Royal Liverpool University Hospital, Liverpool, UK
| | - Sowsan F Atabani
- 2 Sudan HIV/AIDS Working Group (SHAWG), Glasgow, UK.,8 Public Health Laboratory Birmingham, National Infection Service, Heart of England Foundation NHS Trust, Birmingham, UK
| | - Husam Ke Osman
- 2 Sudan HIV/AIDS Working Group (SHAWG), Glasgow, UK.,8 Public Health Laboratory Birmingham, National Infection Service, Heart of England Foundation NHS Trust, Birmingham, UK
| | - Abdel G Babiker
- 2 Sudan HIV/AIDS Working Group (SHAWG), Glasgow, UK.,9 MRC Clinical Trials Unit at University College London, London, UK
| | - Elbushra Am Herieka
- 2 Sudan HIV/AIDS Working Group (SHAWG), Glasgow, UK.,10 Department of Genitourinary Medicine, Royal Bournemouth Hospital, Bournemouth, UK
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11
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Mohamed AA, Elshimy AA, El Sadik AO, Ezzat E, Nasar M, Elshaer SSM, Sayed MM. Association between Severity of Liver Disease, Frequency of Helicobacter pylori Infection, and Degree of Gastric Lesion in Egyptian Patients with Hepatitis B Virus Infection. Am J Trop Med Hyg 2018; 98:221-226. [PMID: 29342404 PMCID: PMC5928701 DOI: 10.4269/ajtmh.17-0291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 09/18/2017] [Indexed: 12/14/2022] Open
Abstract
The relationship between hepatitis B virus (HBV) infection, severity of liver disease, frequency of Helicobacter pylori infection, and degree of gastric lesions was not yet fully investigated in Egyptian patients. The present work was performed on 100 Egyptian patients with HBV from the National Hepatology and Tropical Medicine Institute and 70 healthy volunteers as control group. The participants were subjected to full medical history taking, clinical examination, and laboratory investigations. All patients were positive for HBV surface antigen (HBV sAg), HBV DNA, and negative for hepatitis C virus antibodies. The severity of the liver disease was assessed using Child-Pugh scoring system. Screening of all participants for H. pylori Ag in stool was performed. Biopsy specimens were taken from the gastric lesions of H. pylori-infected patients for histopathological examination. The mean age of the patients and control group were 34.9 and 33.4 years, respectively. The levels of the liver enzymes were statistically higher in HBV patients than the control group. Helicobacter pylori Ag in stool was detected in 45.7% of the control group, and a higher percentage (60%) was detected in the patients group. Chronic gastritis with glandular atrophy and metaplasia was found in 15.6% of patients of Child-Pugh A, 70% of Child-Pugh B, and 100% of Child-Pugh C. It could be concluded that the prognosis of the liver disease significantly influences the severity of the gastric pathology in H. pylori infection.
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Affiliation(s)
- Amal A. Mohamed
- Department of Biochemistry and Molecular Biology, National Hepatology and Tropical Medicine Research institute, Cairo, Egypt
| | - Amal A. Elshimy
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, New Giza University, Cairo, Egypt
| | - Abir O. El Sadik
- Department of Anatomy and Embryology, Faculty of Medicine, Cairo University, New Giza University, Cairo, Egypt
| | - Elham Ezzat
- Department of Microbiology, El Glaa Teaching Hospital, Cairo, Egypt
| | - Mona Nasar
- Department of Clinical Pathology, El Sahel Teaching Hospital, Cairo, Egypt
| | - Shereen S. M. Elshaer
- Department of Biochemistry, Faculty of Pharmacy (Girls), Al Azhar University,Cairo, Egypt
| | - Moataz M. Sayed
- Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Al-Humayed SM. Hepatitis B and C Viral Infections in Tihamet Aseer, South-Western Saudi Arabia: Are There Gender Differences? SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2017; 5:110-115. [PMID: 30787767 PMCID: PMC6298365 DOI: 10.4103/1658-631x.204853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background Hepatitis B virus (HBV) infection is endemic in Saudi Arabia. Many studies have shown varying results in gender differences in HBV and hepatitis C virus (HCV) infection. The objective of this study was to determine if gender differences exist in HBV and HCV infection and to elucidate any related risk factors in Tihamet Aseer, south-western Saudi Arabia. Materials and Methods The study was a cross-sectional study of a representative sample of males and females in Tihamet Aseer, south-western Saudi Arabia. A comprehensive questionnaire was completed by all participants. Blood samples were taken and sera were tested for hepatitis B surface antigen and HCV antibodies by fourth-generation enzyme immunoassays. Results The study included 1532 participants from the Tihamet Aseer area. An overall seroprevalence of 7.9% and 1.7% was found for HBV and HCV infections, respectively. In logistic regression analysis, no gender differences were found for HBV seroprevalence. Identified risk factors for HBV infection included a history of blood transfusion and lack of hepatitis B vaccination. On the other hand, females were more prone to become seropositive for HCV (adjusted odds ratio = 5.034, 95% confidence interval: 1.042-9.321). Other identified risk factors for HCV infection were illiteracy and a history of blood transfusion. Conclusion The prevalence and HBV and HCV infection is high compared to the national figures. Gender differences were only observed in HCV infection. It is recommended to have an active educational and media campaign. A "catch-up" vaccination program against HBV should be introduced for adults as a strategy to achieve the herd immunity effect in the affected area.
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Affiliation(s)
- Suliman M Al-Humayed
- Department of Internal Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
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Hussein WM, Anwar WA, Attaleb M, Mazini L, Försti A, Trimbitas RD, Khyatti M. A review of the infection-associated cancers in North African countries. Infect Agent Cancer 2016; 11:35. [PMID: 27512409 PMCID: PMC4979152 DOI: 10.1186/s13027-016-0083-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/09/2016] [Indexed: 02/08/2023] Open
Abstract
Cancer is typically classified as a leading non-communicable disease; however, infectious agents, such as Helicobacter pylori (H. pylori), hepatitis B virus (HBV), hepatitis C virus (HCV) and human papilloma virus (HPV), contribute significantly to the pathogenesis of various cancers. Less developed countries, including countries of the North African (NA) region, endure the highest burden of infection-related cancers. The five most common infection-associated cancers in NA in order of incidence are bladder cancer, cervical cancer, liver cancer, stomach cancer, and nasopharyngeal carcinoma. This review aims to outline the epidemiologic pattern of infection-associated cancers in five NA countries (namely: Morocco, Algeria, Tunisia, Libya and Egypt) highlighting the similarities and differences across the region. The present study employed an initial literature review of peer-reviewed articles selected from PubMed, ScienceDirect and World Health Organization (WHO) databases based on key word searches without restriction on publication dates. Original research articles and reports written in French, as well as data from institutional reports and regional meeting abstracts were also included in this extensive review. Egypt, Libya, Tunisia, Algeria and Morocco were selected to be the focus of this review.
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Affiliation(s)
- Wafaa Mohamed Hussein
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain ShamsUniversity, Cairo, Egypt
| | - Wagida A Anwar
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain ShamsUniversity, Cairo, Egypt
| | - Mohammed Attaleb
- Biology and Medical Research Unit, National Center of Energy, Sciences and Nuclear Technics, Rabat, Morocco
| | - Loubna Mazini
- Laboratory of Onco-virology, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Asta Försti
- Department of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany ; Center for Primary Health Care Research, Clinical Research Center, Lund University, Malmö, Sweden
| | | | - Meriem Khyatti
- Laboratory of Onco-virology, Institut Pasteur du Maroc, Casablanca, Morocco
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Epidemiology of hepatitis B and hepatitis C in Lebanon. Arab J Gastroenterol 2016; 17:29-33. [PMID: 27032492 DOI: 10.1016/j.ajg.2016.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 01/10/2016] [Accepted: 01/13/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND STUDY AIMS Hepatitis B and C are two potentially life threatening liver infections. Lebanon is ranked as a zone of moderate endemicity. This study aimed to determine the prevalence of hepatitis B and C in Lebanon and their distribution according to age, region and sex. PATIENTS AND METHODS This national prospective cross-sectional study was conducted from January 2011 till December 2012 in the six Lebanese Governorates in collaboration with municipalities, the Ministry of Public Health, Health Centres and dispensaries. An upcoming screening for hepatitis B and C was announced? in different districts of each Governorate. All individuals presenting to local laboratory, not known to have chronic hepatitis, were asked for a blood sample and answered a questionnaire addressing sex, age, place of birth and residence. Screening tests were "Abbots" for hepatitis B and "Human Hexagon" for hepatitis C. PCR testing was used to confirm the positivity of the previous tests. RESULTS Of 31147 individuals screened, 542 had a rapid test positive for HBV (prevalence 1.74%, 95% CI 1.6-1.89) with a male to female ratio of 1.08. This prevalence was higher in the South and Nabatieh (1.9%) compared to Beirut (0.73%). Of 31,147 individuals screened, 64 had a rapid test positive for HCV (prevalence 0.21%, 95% CI 0.16-0.27) with a male to female ratio of 0.85. This prevalence was higher in Nabatieh (0.61%) compared to Mount Lebanon (0.08%). CONCLUSIONS The prevalence of HBV and HCV in Lebanon is 1.74% and 0.21%, respectively with a higher prevalence in South and Nabatieh districts. These data rank Lebanon amongst countries with low endemicity for both viruses. Decrease in the prevalence of HBV is due to awareness campaign as well as success of the MOPH National Hepatitis Program in vaccinating all new born since 1998 and in screening and vaccinating high risk groups.
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El Sherbiny NA, Younis A, Masoud M. Assessment of hepatitis knowledge and attitudes among Fayoum University students: a cross-sectional study, Fayoum, Egypt. J Public Health (Oxf) 2015. [DOI: 10.1007/s10389-015-0700-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Khan G, Hashim MJ. Burden of virus-associated liver cancer in the Arab world, 1990-2010. Asian Pac J Cancer Prev 2015; 16:265-70. [PMID: 25640363 DOI: 10.7314/apjcp.2015.16.1.265] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is amongst the top three cancer causes of death worldwide with hepatitis B and C viruses (HBV/HCV) as the main etiological agents. An up-to-date descriptive epidemiology of the burden of HBV/HCV-associated HCC in the Arab world is lacking. We therefore determined the burden of HBV/HCV- associated HCC deaths in the Arab world using the Global Burden of Disease (GBD) 2010 dataset. GBD 2010 provides, for the first time, deaths specifically attributable to viral-associated HCC. We analyzed the data for the 22 Arab countries by age, sex and economic status from 1990 to 2010 and compared the findings to global trends. Our analysis revealed that in 2010, an estimated 752,101 deaths occurred from HCC worldwide. Of these 537,093 (71%) were from HBV/HCV-associated HCC. In the Arab world, 17,638 deaths occurred from HCC of which 13,558 (77%) were HBV/HCV-linked. From 1990 to 2010, the burden of HBV and HCV-associated HCC deaths in the Arab world increased by 137% and 216% respectively, compared to global increases of 62% and 73%. Age-standardized death rates also increased in most of the Arab countries, with the highest rates noted in Mauritania and Egypt. Male gender and low economic status correlated with higher rates. These findings indicate that the burden of HBV/HCV-associated HCC in the Arab world is rising at a much faster rate than rest of the world and urgent public health measures are necessary to abate this trend and diminish the impact on already stretched regional healthcare systems.
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Affiliation(s)
- Gulfaraz Khan
- Departments of Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates E-mail :
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Gasim GI, Bella A, Adam I. Immune response to hepatitis B vaccine among patients on hemodialysis. World J Hepatol 2015; 7:270-5. [PMID: 25729482 PMCID: PMC4342609 DOI: 10.4254/wjh.v7.i2.270] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 11/08/2014] [Accepted: 11/17/2014] [Indexed: 02/06/2023] Open
Abstract
Infection with hepatitis B virus (HBV) poses a major health threat worldwide, where the magnitude and overburden of chronic carrier state approaches 150 million chronic carriers. The prevalence of HBV is greater among dialyzed patients compared to the general population owing to their increased vulnerability to blood and its products, along with hazards posed by contaminated hemodialysis tools and devices. An electronic systematic search of the published literature was carried and data on the immunological riposte to hepatitis B vaccination among hemodialysis patients was extracted from relevant studies. End stage renal disease patients on hemodialysis have a lower or an absolutely negative riposte to HBV vaccine. Several means have been tried to improve this response with some success, nevertheless none have been universally adopted. Genetic investigations are foreseen to make a break through concerning HBV vaccination.
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Affiliation(s)
- Gasim I Gasim
- Gasim I Gasim, Ishag Adam, Qassim College of Medicine, Qassim University, PO Box 15085 Buraydah, Saudi Arabia
| | - Abdelhaleem Bella
- Gasim I Gasim, Ishag Adam, Qassim College of Medicine, Qassim University, PO Box 15085 Buraydah, Saudi Arabia
| | - Ishag Adam
- Gasim I Gasim, Ishag Adam, Qassim College of Medicine, Qassim University, PO Box 15085 Buraydah, Saudi Arabia
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Pourkarim MR, Vergote V, Amini-Bavil-Olyaee S, Sharifi Z, Sijmons S, Lemey P, Maes P, Alavian SM, Van Ranst M. Molecular characterization of hepatitis B virus (HBV) strains circulating in the northern coast of the Persian Gulf and its comparison with worldwide distribution of HBV subgenotype D1. J Med Virol 2014; 86:745-57. [PMID: 24532489 DOI: 10.1002/jmv.23864] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2013] [Indexed: 12/17/2022]
Abstract
Iran is a large country that covers the northern coast of the Persian Gulf. Iranian residents of this coastal region interact closely with people from neighboring countries because of historical and cultural relationships, as well as economic activities. In addition, the inhabitants of this border region have experienced several wars, which have affected public health infrastructures. This study characterized for the first time, the evolution of the full-length genome of HBV strains in asymptomatic carrier patients living in this particular region. In addition, this study was compared and complemented by a comprehensive evolutionary analysis of the worldwide geographical distribution of HBV subgenotype D1. Evolutionary analysis demonstrates that patients living in the northern coast of the Persian Gulf are mainly infected with HBV subgenotype D1, subtype ayw2. Specific mutations related to advanced liver disease were found more frequently in these strains compared to other strains isolated from asymptomatic carriers from other regions of Iran. This global comprehensive analysis showed that HBV subgenotype D1 strains have a worldwide distribution and that human mobility and immigration had a large impact on dispersal of HBV subgenotype D1, subtype ayw2 in Middle Eastern countries such as Iran, Syria, and Turkey. In addition to association of subtype ayw2 with subgenotype D1, it was demonstrated that other HBV subtypes like adw2, ayw1, and ayw3 are associated with HBV subgenotype D1 in different regions of the world. This study also revealed a remarkable distribution of subgenotype D1, subtype ayw4 although this particular subtype is associated with subgenotype D4 of HBV in European countries.
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Affiliation(s)
- Mahmoud Reza Pourkarim
- Department of Microbiology and Immunology, Laboratory of Clinical and Epidemiological Virology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium; Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
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