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Yaow CYL, Hong ASY, Chong NZY, Chong RIH, Mai AS, Tan EK. Risk of Parkinson's disease in hepatitis B and C populations: a systematic review and meta-analysis. J Neural Transm (Vienna) 2024; 131:609-616. [PMID: 37899363 DOI: 10.1007/s00702-023-02705-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/27/2023] [Indexed: 10/31/2023]
Abstract
Parkinson's disease (PD) is a common neurodegenerative disorder, and its association with viral hepatitis has been debated. We performed a meta-analysis to examine the association between PD risk and viral hepatitis. Medline, EMBASE, and the Cochrane library were searched from inception till July 2022. Meta-analysis was conducted using a fixed-effect model with the inverse variance method. Three groups were compared to controls: infection with either hepatitis B or C virus (HBV and HCV, respectively), or coinfection with both viruses. We found 551 records, and six studies comprising of 2,566,947 patients were included in the analysis. PD risk was increased in HCV-infected population (OR 1.10, 95% CI 1.03-1.17, p = 0.005) and (HR 1.37, 95% CI 1.26-1.49, p < 0.001). This increase was not observed for the HBV-infected and HBV-HCV-coinfected coinfection populations. For pooled OR, the risk was significantly lower in HBV-infected (OR 0.79, 95% CI 0.76-0.83, p < 0.001) but not significantly different in HBV-HCV-coinfected populations (OR 0.96, 95% CI 0.82-1.12, p = 0.57). For pooled HR, the risk was significantly higher in both HBV-infected (HR 1.22, 95% CI 1.14-1.31, p < 0.001) and HBV-HCV-coinfected populations (HR 1.29, 95% CI 1.05-1.58, p = 0.013). We found that the risk of PD was increased in the HCV-infected population, but results were inconsistent in those with HBV and HBV-HCV infections. Our findings provide impetus for further clinical and functional studies to unravel the role of the adaptive immune system in PD.
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Affiliation(s)
- Clyve Yu Leon Yaow
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | | | - Ryan Ian Houe Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Aaron Shengting Mai
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Eng-King Tan
- Department of Neurology, Singapore General Hospital Campus, National Neuroscience Institute, Duke NUS Medical School, Outram Road, Singapore, 169608, Singapore.
- Neuroscience and Behavioural Disorders, Duke-NUS Medical School, Singapore, Singapore.
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Mokhtari F, Kaboosi H, Mohebbi SR, Asadzadeh Aghdaei H, Zali MR. Circulating Plasma miR-122 and miR-583 Levels Are Involved in Chronic Hepatitis B Virus Pathogenesis and Serve As Novel Diagnostic Biomarkers. Genet Test Mol Biomarkers 2023; 27:232-238. [PMID: 37643324 DOI: 10.1089/gtmb.2023.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
Background: MicroRNAs regulate many biological processes and are involved in the pathogenesis of many diseases including chronic hepatitis B (CHB). Moreover, besides investigation of their roles in hepatitis B virus (HBV) infection, a noninvasive, sensitive, and specific biomarker is essential in the diagnosis of liver diseases. This study was designed to evaluate the role of miR-122, miR-583, and miR-24 in the pathogenesis of CHB both in active chronic hepatitis (ACH) patients and in inactive carriers (IC). Materials and Methods: Plasma samples and all relevant clinical features were collected from 43 patients with CHB (28 ACH and 15 IC) and 43 healthy controls. Quantitative real-time PCR was performed to detect the plasma levels of miR-122, miR-583, and miR-24. Results: Results show miR-122 (p = 0.0001) and miR-583 (p = 0.006) but not miR-24 (p = 0.65) were upregulated in patients with CHB versus the control group. Interestingly, there was a significant increase in the plasma expression of miR-583 in IC versus ACH. Moreover, receiver operating characteristic curve analysis determined plasma levels of miR-122 (area under the ROC curve [AUC] = 0.89, p < 0.0001, sensitivity: 100%, specificity: 62.5%) and miR-583 (AUC = 0.71, p = 0.0007, sensitivity: 90%, specificity: 47.62%) as sensitive biomarkers to discriminate CHB patients from controls. Conclusion: Our data showed an increase in the plasma levels of miR-583 in IC versus ACH patients. Moreover, we demonstrated that miR-122 and miR-583 may serve as potential biomarkers for CHB diagnosis and activity.
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Affiliation(s)
- Fedra Mokhtari
- Department of Microbiology, Ayatollah Amoli Branch, Islamic Azad University, Amol, Iran
| | - Hami Kaboosi
- Department of Microbiology, Ayatollah Amoli Branch, Islamic Azad University, Amol, Iran
| | - Seyed Reza Mohebbi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Asadzadeh Aghdaei
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Patwa AK, Amardeep, Atam V, Mishra P, Rungta S, Gangwar A, Yadav A, Gupta KK, Agrawal B, Verma SK, Goel A. KGHeBTA (King George's Medical University Hepatitis B Therapeutic Algorithm): A New Diagnostic and Therapeutic Algorithm and Clinico-epidemiological Spectrum of Hepatitis B. J Clin Exp Hepatol 2023; 13:629-637. [PMID: 37440941 PMCID: PMC10333945 DOI: 10.1016/j.jceh.2023.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/28/2023] [Indexed: 07/18/2023] Open
Abstract
Background Diagnostic and therapeutic algorithms given by various societies for hepatitis B are fragmented and complex. The clinico-epidemiologic spectrum of hepatitis B is not studied with large-scale data from our region. We aimed to develop a comprehensive algorithm for the treatment of hepatitis B and study its clinico-epidemiological spectrum. Methods From 2014-2019, the clinico-laboratory data of hepatitis B surface antigen (HbsAg)-positive patients were prospectively recorded. King George's Medical University hepatitis B therapeutic algorithm (KGHeBTA) was developed on the basis of the standard existing guidelines. The prevalence of different clinical stages of HBsAg-positive patients was calculated and their treatment records reviewed. Testing circumstances and risk factors were noted. Results Among 1,508 data record sheets, 421 were complete. According to the KGHeBTA algorithm, 221 had detectable hepatitis B virus DNA. 21% were cirrhotic and 79% non-cirrhotic. 72% were incidentally detected asymptomatic hepatitis B, 7% were hepatitis B with acute symptoms, 0.7% were acute hepatitis B, and 22% were chronic hepatitis B. 20% patients were eligible for antivirals and 80% patients were not eligible. 32% patients were actually treated with antivirals due to the inclusion of some special indications as pregnancy and family history. Screening during various medical illnesses (40%) was the most common and during health camps (0.2%), the least common testing approach. Road-side shaving (52%) was the most common and intravenous drug abuse (0.2%) and the least common risk factor for the detection of hepatitis B in our data pool. Conclusions HBsAg-positive patients can be easily worked up and treated based on the proposed algorithm (KGHeBTA). About one fourth to one fifth of all HBsAg-positive patients were eligible and treated with oral antivirals. Most of the patients were incidentally detected asymptomatic hepatitis B screened during medical illnesses. Roadside shaving and intravenous drug abuse were the most and the least common risk factors.
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Affiliation(s)
- Ajay K. Patwa
- Department of Medicine, King George's Medical University, Lucknow, India
| | - Amardeep
- Department of Medical Gastroenterology, King George's Medical University, Lucknow, India
| | - Virendra Atam
- Department of Medicine, King George's Medical University, Lucknow, India
| | - Pratishtha Mishra
- Department of Medicine, King George's Medical University, Lucknow, India
| | - Sumit Rungta
- Department of Medical Gastroenterology, King George's Medical University, Lucknow, India
| | - Anil Gangwar
- Department of Medical Gastroenterology, King George's Medical University, Lucknow, India
| | - Ankur Yadav
- Department of Medical Gastroenterology, King George's Medical University, Lucknow, India
| | - Kamlesh K. Gupta
- Department of Medicine, King George's Medical University, Lucknow, India
| | - Bhaskar Agrawal
- Department of Prosthodontics, King George's Medical University, Lucknow, India
| | - Sanjeev K. Verma
- Department of Pediatrics, King George's Medical University, Lucknow, India
| | - Amit Goel
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Souda S, Mwita JC, Cainelli F, Mannathoko NB, Anderson M, Moyo S. Seroprevalence and risk factors of hepatitis B, C and D virus infection amongst patients with features of hepatitis in a referral hospital in Botswana: A cross-sectional study. S Afr J Infect Dis 2021. [DOI: 10.4102/sajid.v36i1.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Undiagnosed Hepatitis B and C Virus Infection at a Teaching Hospital in Rawalpindi. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2020. [DOI: 10.22207/jpam.14.2.23] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Barman B, Bora K, Lynrah KG, Lyngdoh WV, Jamil M. Hepatitis C virus and its genotypes in chronic liver disease patients from Meghalaya, Northeast India. Indian J Med Microbiol 2019; 36:376-380. [PMID: 30429390 DOI: 10.4103/ijmm.ijmm_17_371] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background and Objectives Hepatitis C virus (HCV) is an important cause of chronic liver disease (CLD). Although Northeast India is believed to be a HCV hotspot, the proportion of HCV infection and the distribution of HCV genotypes in CLD cases from the region are not known. The objectives of the study were to determine the proportion of HCV infection in newly diagnosed CLD patients from Meghalaya, Northeast India, and further investigate the HCV genotype distribution in those patients. Materials and Methods The aetiology of CLD was evaluated in 196 newly diagnosed patients, recruited consecutively over a period of 1 year in a medical college hospital from Meghalaya. Those positive for HCV infection were genotyped, and the mode of transmission of the virus was investigated. Results A considerable proportion (43 patients, 21.9%) of CLD patients were positive for HCV (95% confidence interval [CI]: 16.7%-28.2%). Other leading causes of CLD were alcohol (36.32%) and hepatitis B virus infection (39.3%). Genotype 3 was the most prevalent (48.7%, 95% CI: 33.9%-63.8%), followed by genotype 6 (30.8%, 95% CI: 18.6%-46.6%) and genotype 1 (20.5%, 95% CI: 10.8%-35.5%). The frequency of genotype 6 was remarkably higher than in the other regions of India. Injecting drug use appeared to be the most common mode (28 patients) of acquiring HCV. This was true irrespective of the genotype. Conclusions The presence of HCV in newly diagnosed CLD cases from Meghalaya was considerable. The genotype distribution of HCV was distinct from the other regions of India.
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Affiliation(s)
- Bhupen Barman
- Department of General Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Kaustubh Bora
- ICMR-Regional Medical Research Centre, N. E. Region, Dibrugarh, Assam; Department of Biochemistry, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Kryshanlang G Lynrah
- Department of General Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - W Valarie Lyngdoh
- Department of Microbiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Mohammad Jamil
- Department of General Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
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Ray G. Current Scenario of Hepatitis B and Its Treatment in India. J Clin Transl Hepatol 2017; 5:277-296. [PMID: 28936409 PMCID: PMC5606974 DOI: 10.14218/jcth.2017.00024] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 05/18/2017] [Accepted: 06/03/2017] [Indexed: 02/06/2023] Open
Abstract
Hepatitis B is a significant public health problem in India, yet disease awareness is very low among the general population. The disease is mostly acquired horizontally, but the role of vertical transmission should not be underestimated. In spite of the fact that the majority of cases are e negative disease, most patients present in the advanced stage and even with hepatocellular carcinoma, the leading cause of which is hepatitis B. High-risk groups (especially tribals) also harbour significant disease burden and have a high prevalence of occult infection, supporting the potential of unknowingly spreading the disease. Findings on the relation of genotypes with disease severity or drug action have been conflicting. Though recently, oral antivirals with high genetic barrier to resistance have shown good viral suppression in the long term, e and s seroconversion is poor and relapse is universal upon therapy discontinuation. As no cure is possible with the currently available therapy, the target is long-term viral suppression by prolonged administration of oral antivirals; unfortunately, this leads to poor treatment adherence, which along with the high cost of therapy results in disease progression and spread of infection. At present, therefore, emphasis should be put on health education of the general and high-risk populations, along with health care workers to increase knowledge on such preventive measures as avoiding unsafe injection practices, high-risk sex, performing unnecessary injection and blood transfusion and providing proper screening of blood products; these efforts should be combined with intensive screening and aggressive vaccination programs, especially in high-risk groups and areas of high endemicity. Vaccination strategies are still below par and logistics should be developed for wider coverage; in addition, further research should be carried out on the efficacy and mode of usage for different types of vaccine.
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Affiliation(s)
- Gautam Ray
- Gastroenterology Unit, Department of Medicine, B.R.Singh Hospital, Kolkata, India
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Shah SR, Rao PN, Sarin SK, Chowdhury A, Bhatia S, Dharamsi R, Goswami BD, Kapoor D, Luaia R, Mehta R, Mukewar S, Prasad VGM, Rai RR, Saigal S, Singh D, Trehanpati N, Chen S, Gaggar A, Knox SJ, Subramanian GM, Singh SP, Sood A, Varghese J, Venugopal RV. Chronic hepatitis C virus infection in India: Regional demographics and distribution of viral genotypes. Indian J Gastroenterol 2016; 35:469-477. [PMID: 27844277 DOI: 10.1007/s12664-016-0709-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 10/11/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Although chronic hepatitis C virus (HCV) infection affects millions of people in India, few studies have assessed host, viral, and disease characteristics of chronically infected patients at national and regional levels. Such information is critical to support large scale screening and treatment initiatives for chronic HCV infection in India. METHODS Patients with known chronic HCV infection making routine or for-cause visits to the participating study centers were enrolled in this observational study. Patients attended a single outpatient visit during which demographics and medical history were collected, a physical examination was performed, and blood and urine samples were collected for laboratory assessments. Samples were analyzed to determine HCV genotypes and subtypes, and genotypes of interferon lambda 3 (IFNL3) single nucleotide polymorphism. No therapeutic interventions were administered. RESULTS We enrolled 500 patients at 19 centers, categorized into four geographic regions (North, South, East, and West). All patients self-identified as Indian, and most (66 %) were male. Genotype 3 was the most common genotype overall (54 %); however, its prevalence varied greatly by region, ranging from 34 % in the South to 69 % in the East. Genotypes 1 (24 %) and 4 (6 %) were the next most common, and HCV genotype could not be determined for 16 % of patients. CONCLUSIONS This prospective survey suggests that demographics, viral, and host factors in patients with chronic HCV infection are highly variable in India and pose significant challenges for the implementation of broad-scale screening and treatment initiatives.
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Affiliation(s)
- Samir R Shah
- Global Hospitals, 35, Dr. E Borges Road, Parel, Mumbai, 400 012, India.
| | - P N Rao
- Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India
| | - Shiv K Sarin
- Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, Delhi, 110 070, India
| | - Abhijit Chowdhury
- Institute of Post Graduate Medical Education and Research, 244 A.J.C Bose Road, Kolkata, 700 020, India
| | - Shobna Bhatia
- Seth GS Medical College and KEM Hospital, Acharya Donde Marg, Parel, Mumbai, 400 012, India
| | - Rajesh Dharamsi
- Dharamsi Hospital, Chandni Chowk, South Shivaji Nagar, Nishant Colony, Sangli, 416 416, India
| | - B D Goswami
- Institute of Digestive and Liver Disease, Guwahati, Assam, India
| | | | - Rosang Luaia
- Civil Hospital, Dawrpui, Aizawl, Mizoram, 796 001, India
| | - Rajiv Mehta
- Liver Clinic, U-9 Jolly Plaza, Athwagate, Surat, 395 001, India
| | - Shrikant Mukewar
- Midas Institute of Gastroenterology, Midas Heights, Central Bazar Road, Ramdas Peth, Ramdaspeth, Nagpur, 440 012, India
| | - V G Mohan Prasad
- VGM Hospital, 2100, Trichy Road, Singanallur, Coimbatore, 641 005, India
| | - Ramesh Roop Rai
- Rai Speciality Care Centre, H-6, Janpath, Shyam Nagar, Ajmer Road, Sodala, Jaipur, 302 019, India
| | - Sanjiv Saigal
- Medanta-The Medicity, Sector 38, Gurgaon, Delhi (NCR), 122 018, India
| | | | - Nirupama Trehanpati
- Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, Delhi, 110 070, India
| | - Sandra Chen
- Gilead Sciences, 333 Lakeside Dr, Foster City, CA, 94404, USA
| | - Anuj Gaggar
- Gilead Sciences, 333 Lakeside Dr, Foster City, CA, 94404, USA
| | - Steven J Knox
- Gilead Sciences, 333 Lakeside Dr, Foster City, CA, 94404, USA
| | | | - Shivaram Prasad Singh
- Department of Gastroenterology, S.C.B. Medical College, Manglabag, Cuttack, 753 007, India
| | - Ajit Sood
- Dayanand Medical College and Hospital, Tagore Nagar, Civil Lines, Ludhiana, 141 001, India
| | - Joy Varghese
- Global Hospitals and Health City, 439, Cheran Nagar, Perumbakkam, Chennai, 600 100, India
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Tamayo A, Shah SR, Bhatia S, Chowdhury A, Rao PN, Dinh P, Knox SJ, Gaggar A, Subramanian GM, Mohan VG, Sood A, Mehta R, Sarin SK. Correlates of disease-specific knowledge among patients with chronic hepatitis B or hepatitis C infection in India. Hepatol Int 2016; 10:988-995. [PMID: 27146692 PMCID: PMC5083769 DOI: 10.1007/s12072-016-9728-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 03/21/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Patient knowledge about chronic diseases increases health-promoting behaviors and improves clinical outcomes. We assessed this association for patients with chronic viral hepatitis. METHODS Untreated patients chronically infected with HBV (n = 500) or HCV (n = 500) were enrolled at 19 centers across India. A survey, adapted from the US CDC National Health and Nutrition Examination Survey (NHANES) questionnaire, was administered at a single visit to assess HBV/HCV knowledge, community disease awareness, treatment quality, and healthcare barriers. We developed the India Hepatitis Knowledge Index (IHKI), where a higher IHKI score (range 0-10) indicates increased hepatitis knowledge. Multivariate regression models evaluated demographic and disease factors. RESULTS The overall mean IHKI score was 5.6 out of 10, with higher scores among patients with HBV (5.9) than HCV (5.3); p < 0.001. In HBV patients lower IHKI was associated with shorter disease duration, government clinic attendance (p < 0.0001), fewer personal experiences with HBV (p < 0.0001), and residing in northern India. Among HCV patients, lower IHKI was associated with shorter disease duration, community (p < 0.0001) and government clinic attendance (p < 0.0001), and fewer personal experiences with HCV (p < 0.0001). Among HBV patients, IHKI was independently associated with disease severity as assessed by MELD score, albumin, and APRI. This association was strongest for HBV patients with elevated ALT and HBV DNA >2000 IU/ml. Among HCV patients, IHKI results had no significant associations with disease severity. CONCLUSIONS The association of IHKI with disease underscores the need to understand connections between hepatitis knowledge and progression and may guide efforts to address patient education and awareness of chronic viral hepatitis in India.
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Affiliation(s)
- Aracely Tamayo
- University of California Berkeley School of Public Health, Berkeley, CA, USA.
| | - Samir R Shah
- Jaslok Hospital and Research Centre and Breach Candy Hospital, Mumbai, India
| | - Shobna Bhatia
- Seth GS Medical College and KEM Hospital, Mumbai, India
| | - Abhijit Chowdhury
- Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Padaki N Rao
- Asian Institute of Gastroenterology, Hyderabad, India
| | | | | | | | | | | | - Ajit Sood
- Dayanand Medical College and Hospital, Ludhiana, India
| | | | - Shiv K Sarin
- Institute of Liver and Biliary Sciences, New Delhi, India
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Bastani MN, Bokharaei-Salim F, Keyvani H, Esghaei M, Monavari SH, Ebrahimi M, Garshasebi S, Fakhim S. Prevalence of occult hepatitis C virus infection in Iranian patients with beta thalassemia major. Arch Virol 2016; 161:1899-906. [PMID: 27132015 DOI: 10.1007/s00705-016-2862-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/06/2016] [Indexed: 12/15/2022]
Abstract
Occult hepatitis C virus infection (OCI) is a new pathological form of chronic hepatitis virus (HCV) infection characterized by the presence of HCV RNA in liver biopsy and/or peripheral blood mononuclear cell (PBMC) specimens and the absence of HCV RNA and anti-HCV antibodies (Abs) in plasma samples. β-thalassemia major is a hereditary recessive blood disease with deficiency in the hemoglobin beta chain. Thalassemic patients need blood transfusion therapy; repeated blood transfusion increases the risk of viral blood-borne infection. The aim of this study was to determine the prevalence of OCI in Iranian patients with β-thalassemia major. From February 2015 to November 2015, a total of 147 Iranian patients with β-thalassemia major were enrolled in this cross-sectional study. After extraction of viral RNA from the plasma and PBMC samples, HCV genomic RNA in the specimens was amplified by RT-nested PCR using primers from the 5'-UTR. The HCV genotypes of the positive specimens were tested using the RFLP assay. To confirm the HCV genotypes, the 5'-UTR fragment was amplified and cloned into the pJET1.2/blunt cloning vector and then sequenced. Out of 147 patients, 106 (72.1 %) were negative for anti-HCV Abs and HCV RNA. HCV RNA was found in PBMC specimens of six (5.7 %) patients, from a total of 106 patients with undetectable plasma HCV RNA and anti-HCV Abs. Therefore, six out of 106 patients had OCI. HCV genotyping revealed that three patients were infected with HCV subtype 1b, two patients were infected with HCV subtype 3a, and one patient was infected with HCV subtype 1a. These results revealed that Iranian patients with beta-thalassemia major might have OCI. Therefore, it seems that the design of a study to identify this infection in patients with β-thalassemia major would provide valuable information.
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Affiliation(s)
- Mohammad-Navid Bastani
- Department of Virology, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Farah Bokharaei-Salim
- Department of Virology, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran. .,HIV Laboratory of National Center, Deputy of Health, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran.
| | - Hossein Keyvani
- Department of Virology, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Maryam Esghaei
- Department of Virology, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | | | - Mojtaba Ebrahimi
- Iranian Blood Transfusion Organization (IBTO), Thalassemia Center, Tehran, Islamic Republic of Iran
| | - Saba Garshasebi
- HIV Laboratory of National Center, Deputy of Health, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Shahin Fakhim
- Department of Civil Engineering, Faculty of Engineering, Payame Noor University, Karaj, Islamic Republic of Iran
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Barathan M, Mohamed R, Saeidi A, Vadivelu J, Chang LY, Gopal K, Ram MR, Ansari AW, Kamarulzaman A, Velu V, Larsson M, Shankar EM. Increased frequency of late-senescent T cells lacking CD127 in chronic hepatitis C disease. Eur J Clin Invest 2015; 45:466-74. [PMID: 25721991 DOI: 10.1111/eci.12429] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 02/25/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND Hepatitis C virus (HCV) causes persistent disease in ~85% of infected individuals, where the viral replication appears to be tightly controlled by HCV-specific CD8+ T cells. Accumulation of senescent T cells during infection results in considerable loss of functional HCV-specific immune responses. MATERIALS AND METHODS We characterized the distinct T-cell phenotypes based on the expression of costimulatory molecules CD28 and CD27, senescence markers PD-1 and CD57, chronic immune activation markers CD38 and HLA-DR, and survival marker CD127 (IL-7R) by flow cytometry following activation of T cells using HCV peptides and phytohemagglutinin. RESULTS HCV-specific CD4+ and CD8+ T cells from chronic HCV (CHC) patients showed increased expression of PD-1. Furthermore, virus-specific CD4+ T cells of CHC-infected subjects displayed relatively increased expression of HLA-DR and CD38 relative to HCV-specific CD8+ T cells. The CD4+ and CD8+ T cells from HCV-infected individuals showed significant increase of late-differentiated T cells suggestive of immunosenescence. In addition, we found that the plasma viral loads positively correlated with the levels of CD57 and PD-1 expressed on T cells. CONCLUSIONS Chronic HCV infection results in increased turnover of late-senescent T cells that lack survival potentials, possibly contributing to viral persistence. Our findings challenge the prominence of senescent T-cell phenotypes in clinical hepatitis C infection.
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Affiliation(s)
- Muttiah Barathan
- Department of Medical Microbiology, Tropical Infectious Disease Research and Education Center (TIDREC), University of Malaya, Lembah Pantai, Kuala Lumpur, Malaysia
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Gupta E, Bajpai M, Choudhary A. Hepatitis C virus: Screening, diagnosis, and interpretation of laboratory assays. Asian J Transfus Sci 2014; 8:19-25. [PMID: 24678168 PMCID: PMC3943138 DOI: 10.4103/0973-6247.126683] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
An estimated 3% of the world population is infected with Hepatitis C virus (HCV), a hepatotropic RNA virus, transmitted primarily via the blood route. The major modes of transmission of the virus include injection drug use, unsafe injection practices, blood transfusion etc. HCV causes chronic hepatitis in about 80% of those infected by it. The mainstay in diagnosing infection with HCV is to initially screen high risk groups for antibodies to HCV (anti-HCV). The inclusion of serum to cut-off ratio (S/CO) in recent guidelines is helpful in deciding the supplemental assay to be used to confirm initially reactive screening results. Nucleic acid amplification tests (NAT) are used as confirmatory tools, and also to determine viral load prior to initiating treatment. Quantitative NAT has replaced qualitative assays. Genotyping is an important tool in clinical management to predict the likelihood of response and determine the optimal duration of therapy. The impact of this infection has begun to emerge in India. The problem of professional blood donation despite an existing law against it, and flourishing unsafe injection practices, are potential sources for the spread of hepatitis C in our country. All health care practitioners need to understand how to establish or exclude a diagnosis of HCV infection and to interpret the tests correctly. In the absence of a preventive or therapeutic vaccine, and also of post-exposure prophylaxis against the virus, it is imperative to diagnose infection by HCV so as to prevent hepatic insult and the ensuing complications that follow, including primary hepatocellular carcinoma (HCC). This review aims to help blood bank staff regarding options for diagnosis and management of donors positive for HCV.
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Affiliation(s)
- Ekta Gupta
- Department of Virology and Transfusion Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Meenu Bajpai
- Department of Virology and Transfusion Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Aashish Choudhary
- Department of Virology and Transfusion Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
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Nguyen LH, Nguyen MH. Systematic review: Asian patients with chronic hepatitis C infection. Aliment Pharmacol Ther 2013; 37:921-36. [PMID: 23557103 DOI: 10.1111/apt.12300] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Revised: 10/16/2012] [Accepted: 03/12/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND Chronic hepatitis C (CHC) infection is a risk factor for both the development of end-stage liver disease and hepatocellular carcinoma (HCC). Globally, approximately 170 million people are chronically infected with the hepatitis C virus (HCV), and the majority of these individuals come from the western Pacific and Southeast Asia regions (94.6 million persons combined). CHC is an understudied and underappreciated health problem in many Asian countries and in the US, where Asians represent one of the fastest growing groups of new Americans. AIM To perform a systematic review of the current literature on the epidemiology, diagnosis and screening, clinical characteristics and response to anti-viral therapy of Asians with CHC. METHODS Using a PubMed search of 'hepatitis C' and 'Asia,' 341 original manuscripts published in peer-reviewed journals were identified, and 99 were selected based on their relevance. RESULTS Many Asian CHC patients do not have easily identifiable risk factors and may be underdiagnosed. Rates of HCV infection in Asians on community screening in the US are unexpectedly high, and there is a high prevalence of HCV genotype 6 in Southeast Asia and Southern China. HCV-infected Asians tend to present at older age and may have higher risk of HCC; however, they respond better to anti-viral therapy than non-Asians across all HCV genotypes. CONCLUSIONS Given the high HCV endemicity in Asia, lack of identifiable risk factors and favourable treatment response rates in Asians, we advocate the screening for HCV infection of all Asians who come from areas where HCV prevalence is ≥2%.
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Affiliation(s)
- L H Nguyen
- Stanford University School of Medicine, Stanford, CA, USA
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Ahmed B, Ali T, Qureshi H, Hamid S. Population-attributable estimates for risk factors associated with hepatitis B and C: policy implications for Pakistan and other South Asian countries. Hepatol Int 2013. [PMID: 26201782 DOI: 10.1007/s12072-012-9417-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Reuse of contaminated syringes, high frequency of injections, tattooing and skin piercing have repeatedly been shown to be important and independent risk factors for the transmission of hepatitis B (HBV) and C (HCV) infections in South Asian countries. Estimation of population-attributable risks indicates the potential for hepatitis prevention if the exposure to certain modifiable factors can be eliminated. METHODS We estimated the population-attributable risks of various risk factors for transmission of HBV and HCV using data from a large, nationally representative survey conducted in 2007 across Pakistan, a country known to have a high prevalence of chronic viral hepatitis. Odds ratio estimates and observed prevalence of the risk factors were used for calculating PAR estimates. We also performed a systematic review of published studies that identify the prevalence of similar modifiable risk factors for HBV and HCV from other South Asian countries in order to define an overall prevention strategy for the region. RESULTS For HBV, a high frequency (>10) of therapeutic injections in the past 1 year had an attributable risk of 3.5 % (95 % CI 2.9-3.9), reuse of syringes had a 2.7 % risk (95 % CI 2.2-3.1), the practice of being shaved by a barber 2.1 % (95 % CI 1.7-2.6), sharing of smoking utensils 4.4 % (95 % CI 3.8-4.9) and ear/nose piercing 1.4 % (95 % CI 1.2-1.7). Population-attributable risks for HCV were as follows: high frequency of therapeutic injections in the past 1 year 11.3 % (95 % CI 10.5-11.7), reuse of syringes 6.2 % (95 % CI 6.1-6.9), practice of being shaved by a barber shop 7.9 % (95 % CI 7.1-8.2), sharing of smoking utensils 8.1 % (95 % CI 6.9-8.5), practice of ear/nose piercing among females 5.9 % (95 % CI 5.2-6.1) and tattooing 5 % (95 % CI 4.3-5.6). A systematic review showed that other South Asian countries share a number of common risk factors for the transmission of viral hepatitis. CONCLUSION A substantial number of HBV and HCV infections in Pakistan and other South Asian countries can be prevented by key interventions targeted toward a few selected and modifiable risk factors. Hence, policies specifically targeted at key risk factors for HBV and HCV such as safe and rational use of injections prescribed by trained health-care providers are urgently needed for countries like Pakistan.
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Affiliation(s)
- Bilal Ahmed
- Department of Medicine, Aga Khan University and Hospital, Stadium Road, Karachi, 74800, Pakistan
| | - Tooba Ali
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Huma Qureshi
- Pakistan Medical and Research Council, Islamabad, Pakistan
| | - Saeed Hamid
- Department of Medicine, Aga Khan University and Hospital, Stadium Road, Karachi, 74800, Pakistan.
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Optimization and application of subtype specific polymerase chain reaction for detection and identification of mixed subtypes of hepatitis C virus in patients with renal disease. J Virol Methods 2012; 186:113-8. [DOI: 10.1016/j.jviromet.2012.06.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Revised: 06/26/2012] [Accepted: 06/27/2012] [Indexed: 02/04/2023]
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Jayavelu P, Sambandan T. Prevalence of hepatitis C and hepatitis B virus infection(s) in patients with oral lichen planus. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2012; 4:S397-405. [PMID: 23066298 PMCID: PMC3467868 DOI: 10.4103/0975-7406.100302] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 01/02/2012] [Accepted: 01/26/2012] [Indexed: 12/23/2022] Open
Abstract
AIM The aim of this study was to determine the prevalence of hepatitis B virus and hepatitis C virus (HCV) infections in patients with oral lichen planus (OLP) and to compare it with that of general population. MATERIALS AND METHODS A total of 60 patients were included in the study. Patients were selected from the outpatient department of Rama Dental College Research Centre, Kanpur, Uttar Pradesh. Thirty patients with OLP were included in Group 1. Thirty age- and sex-matched healthy patients with no history of oral or skin lesions were included in Group 2. Detailed case history, biopsy (the most representative site of the lesion is chosen for specimen), detection of hepatitis B surface antigen (HBsAg), and detection of anti-HCV antibody were carried out. RESULTS The serum of the entire study sample (Group 1 and Group 2) was tested for both hepatitis C antibodies and HBsAgs with the enzyme-linked immunosorbent assay (ELISA) test (using the third generation kit). It was found negative for both HBsAgs and hepatitis C antibodies. CONCLUSION In the present study, all the samples including OLP patients and healthy patients were seronegative for both hepatitis B (HBsAg) and hepatitis C (HCV antibody).
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Affiliation(s)
- Perumal Jayavelu
- Department of Oral and Maxillo Facial Surgery, Rama Dental College and Research Centre, Kanpur, UP, India
| | - Thirumal Sambandan
- Department of Oral Medicine and Radiology, Tamilnadu Government Dental College and Hospital, Chennai, India
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Sievert W, Altraif I, Razavi HA, Abdo A, Ahmed EA, Alomair A, Amarapurkar D, Chen CH, Dou X, El Khayat H, Elshazly M, Esmat G, Guan R, Han KH, Koike K, Largen A, McCaughan G, Mogawer S, Monis A, Nawaz A, Piratvisuth T, Sanai FM, Sharara AI, Sibbel S, Sood A, Suh DJ, Wallace C, Young K, Negro F. A systematic review of hepatitis C virus epidemiology in Asia, Australia and Egypt. Liver Int 2011; 31 Suppl 2:61-80. [PMID: 21651703 DOI: 10.1111/j.1478-3231.2011.02540.x] [Citation(s) in RCA: 417] [Impact Index Per Article: 32.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The hepatitis C pandemic has been systematically studied and characterized in North America and Europe, but this important public health problem has not received equivalent attention in other regions. AIM The objective of this systematic review was to characterize hepatitis C virus (HCV) epidemiology in selected countries of Asia, Australia and Egypt, i.e. in a geographical area inhabited by over 40% of the global population. METHODOLOGY Data references were identified through indexed journals and non-indexed sources. In this work, 7770 articles were reviewed and 690 were selected based on their relevance. RESULTS We estimated that 49.3-64.0 million adults in Asia, Australia and Egypt are anti-HCV positive. China alone has more HCV infections than all of Europe or the Americas. While most countries had prevalence rates from 1 to 2% we documented several with relatively high prevalence rates, including Egypt (15%), Pakistan (4.7%) and Taiwan (4.4%). Nosocomial infection, blood transfusion (before screening) and injection drug use were identified as common risk factors in the region. Genotype 1 was common in Australia, China, Taiwan and other countries in North Asia, while genotype 6 was found in Vietnam and other Southeast Asian countries. In India and Pakistan genotype 3 was predominant, while genotype 4 was found in Middle Eastern countries such as Egypt, Saudi Arabia and Syria. CONCLUSION We recommend implementation of surveillance systems to guide effective public health policy that may lead to the eventual curtailment of the spread of this pandemic infection.
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Affiliation(s)
- William Sievert
- Monash Medical Centre and Monash University, Melbourne, Vic., Australia
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