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Yang F, Luo J. The association between hepatitis C virus infection status and blood pressure in adults in the United States: NHANES 1999-2012. Front Cell Infect Microbiol 2024; 14:1401323. [PMID: 38895738 PMCID: PMC11183278 DOI: 10.3389/fcimb.2024.1401323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
Background The Hepatitis C virus (HCV) infection is strongly associated with cardiovascular disease risk factors, but the relationship with blood pressure (BP) remains unclear. Objectives To assess the association between HCV infection status and BP in US adults. Methods Data for the study were obtained from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2012. The association of HCV infection status (including HCV infection, current HCV infection, and past HCV infection) with hypertension, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were explored using logistic or linear regression analyses respectively. Results A total of 25,850 participants (age≥18 years) were enrolled in the current study, including 14,162 participants with hypertension. After adjusting for all covariates, HCV infection/current HCV infection was not associated with hypertension and SBP compared to participants with non-HCV infection (OR: 1.34,95% CI 0.96-1.87/1.31 95% CI 0.91,1.91, β: -0.92, 95% CI -2.7-0.86/-0.35 95% CI -2.51,1.81, respectively). HCV infection/current HCV infection was only associated with elevated DBP (β: 4.1,95% CI 2.57-5.63/4.24,95% CI 2.27-6.21). However, there was no correlation with past HCV infection in participants with hypertension, SBP, and DBP compared to those with non-HCV infection (OR: 1.23,95% CI 0.59-2.54; β: -3.79, 95% CI -7.67-0.08 and 2.28 95% CI -0.36-4.92, respectively). Conclusion In a representative sample of US adults, it was found that both HCV infection and current HCV infection were independently linked to higher DBP. However, there was no association between past HCV infection and DBP.
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Affiliation(s)
| | - Jianping Luo
- Department of Cardiology, Ganzhou People’s Hospital, Ganzhou, Jiangxi, China
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2
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Henriot P, Castry M, Luong Nguyen LB, Shimakawa Y, Jean K, Temime L. Meta-analysis: risk of hepatitis C virus infection associated with hospital-based invasive procedures. Aliment Pharmacol Ther 2022; 56:558-569. [PMID: 35758763 PMCID: PMC9543323 DOI: 10.1111/apt.17106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/08/2022] [Accepted: 06/13/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND Healthcare settings, where invasive procedures are frequently performed, may play an important role in the transmission dynamics of blood-borne pathogens when compliance with infection control precautions is suboptimal. AIMS To understand and quantify the role of hospital-based invasive procedures on hepatitis C virus (HCV) transmission. METHODS We conducted a systematic review and meta-analysis to identify recent studies reporting association measures of HCV infection risk that are linked to iatrogenic procedures. Based on expert opinion, invasive procedures were categorised into 10 groups for which pooled measures were calculated. Finally, the relationship between pooled measures and the country-level HCV prevalence or the Healthcare Access and Quality (HAQ) index was assessed by meta-regression. RESULTS We included 71 studies in the analysis. The most frequently evaluated procedures were blood transfusion (66 measures) and surgery (43 measures). The pooled odds ratio (OR) of HCV infection varied widely, ranging from 1.46 (95% confidence interval: 1.14-1.88) for dental procedures to 3.22 (1.7-6.11) for transplantation. The OR for blood transfusion was higher for transfusions performed before 1998 (3.77, 2.42-5.88) than for those without a specified/recent date (2.20, 1.77-2.75). In procedure-specific analyses, the HCV infection risk was significantly negatively associated with the HAQ for endoscopy and positively associated with HCV prevalence for endoscopy and surgery. CONCLUSIONS Various invasive procedures were significantly associated with HCV infection. Our results provide a ranking of procedures in terms of HCV risk that may be used for prioritisation of infection control interventions, especially in high HCV prevalence settings.
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Affiliation(s)
- Paul Henriot
- MESuRS LaboratoryConservatoire National des Arts et MétiersParisFrance,PACRI UnitConservatoire National des Arts et Métiers/Institut PasteurParisFrance
| | | | | | - Yusuke Shimakawa
- PACRI UnitConservatoire National des Arts et Métiers/Institut PasteurParisFrance,Unité d'Epidémiologie des Maladies ÉmergentesInstitut PasteurParisFrance
| | - Kévin Jean
- MESuRS LaboratoryConservatoire National des Arts et MétiersParisFrance,PACRI UnitConservatoire National des Arts et Métiers/Institut PasteurParisFrance
| | - Laura Temime
- MESuRS LaboratoryConservatoire National des Arts et MétiersParisFrance,PACRI UnitConservatoire National des Arts et Métiers/Institut PasteurParisFrance
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Flower B, Du Hong D, Vu Thi Kim H, Pham Minh K, Geskus RB, Day J, Cooke GS. Seroprevalence of Hepatitis B, C and D in Vietnam: A systematic review and meta-analysis. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 24:100468. [PMID: 35573318 PMCID: PMC9096228 DOI: 10.1016/j.lanwpc.2022.100468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/30/2022]
Abstract
Background Vietnam has one of the greatest disease burdens from chronic viral hepatitis. Comprehensive prevalence data are essential to support its elimination as a public health threat. Methods We searched Medline and Embase from 1990 to 2021 for seroprevalence data relating to Hepatitis B (HBV), C (HCV) and D (HDV) in Vietnam. We estimated pooled prevalence with a DerSimonian-Laird random-effects model and stratified study populations into i) low-risk ii) high-risk exposure and iii) liver disease. We further estimated prevalence by decade and region and rates of HIV-coinfection. Findings We analysed 72 studies, including 120 HBV, 114 HCV and 23 HDV study populations. Pooled HBV prevalence was low in blood donors (1.86% [1.82-1.90]) but high in antenatal populations (10.8% [10.1-11.6]) and adults in the general population (10.5% [10.0-11.0]). It was similar or modestly increased in groups at highest risk of exposure, suggesting the epidemic is largely driven by chronic infections acquired in childhood. HCV pooled prevalence in the general population was lower than historical estimates: 0.26% (0.09-0.51) have active infection defined by detectable antigen or HCV RNA. In contrast, there is an extremely high prevalence of active HCV infection in people who inject drugs (PWID) (57.8% [56.5-59.1]), which has persisted through the decades despite harm-reduction interventions. HDV appears mainly confined to high-risk groups. Interpretation Blood safety has improved, but renewed focus on HBV vaccination at birth and targeted HCV screening and treatment of PWID are urgently required to meet elimination targets. Large cross-sectional studies are needed to better characterize HDV prevalence, but mass screening may not be warranted. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Affiliation(s)
- Barnaby Flower
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam,Imperial College London, UK,Corresponding author. Barnaby Flower, Oxford University Clinical Research Unit, 764 Vo Van Kiet, Phuong 1, Quan 5, Ho Chi Minh City, Vietnam.
| | - Duc Du Hong
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Hang Vu Thi Kim
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Ronald B Geskus
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Jeremy Day
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
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El Hasbani G, Jawad A, Uthman I. Septic arthritis of the knee caused by cupping (Hijama). J R Coll Physicians Edinb 2021; 50:58-59. [PMID: 32539042 DOI: 10.4997/jrcpe.2020.117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Georges El Hasbani
- Division of Rheumatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali Jawad
- Consultant Rheumatologist, Department of Rheumatology, The Royal London Hospital, London, UK
| | - Imad Uthman
- Division of Rheumatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon,
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Alajmi T, Aljulaihim A, Alzahrani M, Aljuhayyiam S. Necrotizing Fasciitis Following Wet Cupping: A Case Report. Cureus 2021; 13:e14039. [PMID: 33898125 PMCID: PMC8059418 DOI: 10.7759/cureus.14039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cupping therapy is a widely practiced form of adjunctive medicine and it has been used since ancient times. It involves using cups over the skin to create negative pressure. The exact mechanism by which cupping therapy exerts its effects is unknown, but it is thought to act as an artificial kidney. In this report, we present a case of a 35-year-old male who developed Pseudomonas-positive necrotizing fasciitis following wet cupping therapy. He refused surgical intervention and subsequently died. Necrotizing fasciitis is a severe soft tissue infection that has a high mortality rate. The only proven intervention to improve survival is aggressive surgical debridement. There have been a few reports of infectious complications following wet cupping, including lumbar abscess and septic arthritis; however, to the best of our knowledge, this is the first report of a necrotizing soft tissue infection following cupping therapy.
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Affiliation(s)
- Turki Alajmi
- Orthopedic Surgery, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, SAU
| | | | - Mosa Alzahrani
- Trauma, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, SAU
| | - Saad Aljuhayyiam
- Orthopedic Surgery, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, SAU
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Cognitive and Emotional Aspects of Cupping Therapy. Brain Sci 2020; 10:brainsci10030144. [PMID: 32143284 PMCID: PMC7139758 DOI: 10.3390/brainsci10030144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 03/01/2020] [Accepted: 03/02/2020] [Indexed: 11/17/2022] Open
Abstract
Cupping therapy has recently gained public attention and is widely used in many regions. Some patients are resistant to being treated with cupping therapy, as visually unpleasant marks on the skin may elicit negative reactions. This study aimed to identify the cognitive and emotional components of cupping therapy. Twenty-five healthy volunteers were presented with emotionally evocative visual stimuli representing fear, disgust, happiness, neutral emotion, and cupping, along with control images. Participants evaluated the valence and arousal level of each stimulus. Before the experiment, they completed the Fear of Pain Questionnaire-III. In two-dimensional affective space, emotional arousal increases as hedonic valence ratings become increasingly pleasant or unpleasant. Cupping therapy images were more unpleasant and more arousing than the control images. Cluster analysis showed that the response to cupping therapy images had emotional characteristics similar to those for fear images. Individuals with a greater fear of pain rated cupping therapy images as more unpleasant and more arousing. Psychophysical analysis showed that individuals experienced unpleasant and aroused emotional states in response to the cupping therapy images. Our findings suggest that cupping therapy might be associated with unpleasant-defensive motivation and motivational activation. Determining the emotional components of cupping therapy would help clinicians and researchers to understand the intrinsic effects of cupping therapy.
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Abe CM, Aguwa M, Zhao M, Sullivan J, Porsa E, Nijhawan AE. Hepatitis C Virus Infection in the Dallas County Jail: Implications for Screening, Prevention, and Linkage to Care. Public Health Rep 2019; 134:626-633. [PMID: 31530093 PMCID: PMC6832085 DOI: 10.1177/0033354919874081] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Screening for hepatitis C virus (HCV) infection in jail provides an opportunity to educate and offer care to a high-risk population. We aimed to (1) estimate the prevalence of HCV infection in jail; (2) describe the demographic characteristics, risk factors, and pre-incarceration health insurance status associated with HCV infection; and (3) examine the implementation of HCV screening in jail. METHODS We conducted a retrospective analysis of an opt-out HCV screening program with HCV RNA confirmation and patient education at the Dallas County Jail from April 1 through November 2, 2017. We extracted data on test results, demographic characteristics, and release destination from electronic medical records. A nurse navigator recorded data on patient self-reported risk factors and pre-incarceration health insurance status. RESULTS Of 4089 incarcerated persons screened, 708 (17.3%) had a positive HCV antibody result. Of these, 641 (90.5%) had an HCV RNA test ordered; 576 (89.9%) had RNA tests completed, of whom 413 (71.7%) had a positive HCV RNA result. Of these 413, 352 (85.2%) received patient education. Half of HCV RNA-positive incarcerated persons (n = 207, 50.1%) were born outside the birth cohort (1945-1965). Among those with HCV infection, commonly reported risk factors were injection drug use (168 of 352; 47.8%) and tattoos (82 of 352; 23.4%). Most incarcerated persons with HCV infection (284 of 350; 81.1%) did not have health insurance. HCV antibody prevalence was higher among incarcerated persons released to prison (232 of 961; 24.1%) than to outside agencies (38 of 403; 9.4%) or the community (178 of 1026; 17.4%). CONCLUSIONS Screening for HCV with RNA confirmation in jail provides an opportunity for disease education, transmission prevention, and navigation to HCV treatment. Future efforts should examine post-incarceration linkage to care.
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Affiliation(s)
- Caroline M. Abe
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Michelle Zhao
- Parkland Health and Hospital Systems, Dallas, TX, USA
| | - Jacqueline Sullivan
- Office of Strategy and Integration, Parkland Health and Hospital System,
Dallas, TX, USA
| | - Esmaeil Porsa
- Office of Strategy and Integration, Parkland Health and Hospital System,
Dallas, TX, USA
| | - Ank E. Nijhawan
- Division of Infectious Diseases, Department of Internal Medicine, University
of Texas Southwestern Medical Center, Dallas, TX, USA
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8
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Lier AJ, Smith K, Odekon K, Bronson S, Taub E, Tharakan M, Kelly GJ, Patel P, Marcos LA. Risk Factors Associated with Linkage to Care among Suburban Hepatitis C-Positive Baby Boomers and Injection Drug Users. Infect Dis Ther 2019; 8:417-428. [PMID: 31129777 PMCID: PMC6702540 DOI: 10.1007/s40121-019-0249-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Suffolk County, located in Eastern Long Island, has been an epicenter for the opioid epidemic in New York State, yet no studies have examined hepatitis C virus (HCV) prevalence in this population. Additionally, few studies have assessed barriers for linkage to care (LTC) to HCV treatment in people who inject drugs (PWID), a high-risk HCV cohort. We aimed to determine prevalence of HCV infection in a suburban medical center and to assess risk factors associated with LTC in HCV-positive baby boomers and young PWID. METHODS A retrospective chart review was carried out on adult patients with ICD-9/10 diagnostic codes for HCV from January 2016 to December 2018 at Stony Brook Medicine. Data collected included sociodemographics, RNA serostatus, LTC, health insurance, employment, past medical or psychiatric history, and substance or injection drug use. RESULTS Overall, 27,049 individuals were screened for HCV and 1017 were HCV seropositive (3.8%), 437 (42.9%) were HCV RNA-positive and 153 (40.6%) achieved LTC. In multivariate analysis, living with cirrhosis was associated with a positive LTC. Medicaid or Medicare insurance was associated with a negative LTC. Intravenous drug users were more likely to be young and have concomitant polysubstance use and psychiatric disease. A bimodal distribution of HCV-positives is present in our population. CONCLUSION Those with liver cirrhosis are more likely to achieve LTC, as are those with private insurance. Public health efforts to promote awareness of HCV and to facilitate access to treatment among PWID are needed.
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Affiliation(s)
- Audun J Lier
- Department of Internal Medicine, Stony Brook University Hospital, New York, USA.
| | - Kalie Smith
- Division of Infectious Diseases, Department of Internal Medicine, Stony Brook University Hospital, New York, USA
| | - Kerim Odekon
- Department of Internal Medicine, Stony Brook University Hospital, New York, USA
| | - Silvia Bronson
- Division of Infectious Diseases, Department of Internal Medicine, Stony Brook University Hospital, New York, USA
| | - Erin Taub
- Department of Internal Medicine, Stony Brook University Hospital, New York, USA
| | - Mathew Tharakan
- Department of Internal Medicine, Stony Brook University Hospital, New York, USA
| | - Gerald J Kelly
- Division of Family and Community Medicine, Department of Family, Population and Preventive Medicine, Stony Brook University Hospital, New York, USA
| | - Pruthvi Patel
- Division of Gastroenterology, Department of Internal Medicine, Stony Brook University Hospital, New York, USA
| | - Luis A Marcos
- Division of Infectious Diseases, Department of Internal Medicine, Stony Brook University Hospital, New York, USA
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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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Lanini S, Pisapia R, Capobianchi MR, Ippolito G. Global epidemiology of viral hepatitis and national needs for complete control. Expert Rev Anti Infect Ther 2018; 16:625-639. [PMID: 30067107 DOI: 10.1080/14787210.2018.1505503] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The World Health Organization recognizes that viral hepatitis is not only a massive public health issue but also a huge opportunity to improve quality of life and equity at a global level. Viral hepatitis causes about 1.5 million deaths each year and significantly affects the quality of life of hundreds of millions of people. To date, frail individuals in high-income countries and people living in low-income settings are paying the heaviest tool. Areas covered. Here we present a broad discussion on current knowledge and topical issues about the hepatitis pandemic. The report includes a structured overview of global epidemiology, including the definition of specific local epidemic profiles for each hepatitis agents (HAV, HBV, HCV, and HEV), and a perspective about the critical actions needed for achieving a complete control. Expert commentary. The control of viral hepatitis is currently, ethically urgent and even economically convenient. There is a wide consensus that viral hepatitis can be controlled through comprehensive intervention tailored on local needs addressing the issue of viral hepatitis as a unique public health issue. These strategies should include: (1) primary prevention (including vaccination and improved infection control), (2) improving diagnosis rate, and (3) management of existing cases of infections.
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Affiliation(s)
- Simone Lanini
- a Dipartimento Epidemiologia, Ricerca Preclinica e Diagnostica Avanzata , National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS , Rome , Italy
| | - Raffaella Pisapia
- a Dipartimento Epidemiologia, Ricerca Preclinica e Diagnostica Avanzata , National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS , Rome , Italy
| | - Maria Rosaria Capobianchi
- a Dipartimento Epidemiologia, Ricerca Preclinica e Diagnostica Avanzata , National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS , Rome , Italy
| | - Giuseppe Ippolito
- a Dipartimento Epidemiologia, Ricerca Preclinica e Diagnostica Avanzata , National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS , Rome , Italy
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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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Greenaway C, Makarenko I, Tanveer F, Janjua NZ. Addressing hepatitis C in the foreign-born population: A key to hepatitis C virus elimination in Canada. CANADIAN LIVER JOURNAL 2018; 1:34-50. [PMID: 35990716 PMCID: PMC9202799 DOI: 10.3138/canlivj.1.2.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 03/12/2018] [Indexed: 10/26/2023]
Abstract
Hepatitis C virus (HCV) is the leading cause of death from infectious disease in Canada. Immigrants are an important group who are at increased risk for HCV; they account for a disproportionate number of all HCV cases in Canada (~30%) and have approximately a twofold higher prevalence of HCV (~2%) than those born in Canada. HCV-infected immigrants are more likely to develop cirrhosis and hepatocellular carcinoma and are more likely to have a liver-related death during a hospitalization than HCV-infected non-immigrants. Several factors, including lack of routine HCV screening programs in Canada for immigrants before or after arrival, lack of awareness on the part of health practitioners that immigrants are at increased risk of HCV and could benefit from screening, and several patient- and health system-level barriers that affect access to health care and treatment likely contribute to delayed diagnosis and treatment uptake. HCV screening and engagement in care among immigrants can be improved through reminders in electronic medical records that prompt practitioners to screen for HCV during clinical visits and implementation of decentralized community-based screening strategies that address cultural and language barriers. In conclusion, early screening and linkage to care for immigrants from countries with an intermediate or high prevalence of HCV would not only improve the health of this population but will be key to achieving HCV elimination in Canada. This article describes the unique barriers encountered by the foreign-born population in accessing HCV care and approaches to overcoming these barriers.
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Affiliation(s)
- Christina Greenaway
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montréal, Québec, Canada
- Division of Infectious Diseases, Jewish General Hospital, McGill University, Montréal, Québec, Canada
| | - Iuliia Makarenko
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montréal, Québec, Canada
| | - Fozia Tanveer
- CATIE (Canada’s source for HIV and hepatitis C information), Toronto, Ontario, Canada
| | - Naveed Z Janjua
- Clinical Preventative Services, British Columbia Centers for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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13
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Ma SY, Wang Y, Xu JQ, Zheng L. Cupping therapy for treating ankylosing spondylitis: The evidence from systematic review and meta-analysis. Complement Ther Clin Pract 2018; 32:187-194. [PMID: 30057049 DOI: 10.1016/j.ctcp.2018.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 06/16/2018] [Accepted: 07/05/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Cupping therapy has been widely used in Eastern Asia, the Middle East, or Central and North Europe to manage the symptom of ankylosing spondylitis (AS). The aim of this systematic review was to review data from randomized controlled trials (RCTs) of cupping therapy for treating patients with AS. METHODS Databases that were searched from their inception until December 2017 included: MEDLINE, CINAHL, EMBASE, AMED, Cochrane Central Register of Controlled Trials, four Chinese databases [Chinese BioMedical Database, China National Knowledge Infrastructure, Wan-Fang Data, and the Chinese WeiPu Database], KoreaMed, The Korean National Assembly Library, Japana Centra Revuo Medicina (http://www.jamas.gr.jp/) and CiNii. In this systematic review, only RCTs that were related to the effects of cupping therapy on managing AS were included. A quantitative synthesis of RCTs will be conducted using RevMan 5.3 software. Study selection, data extraction, and validation were performed independently by two reviewers. Quantitative analysis of RCTs were performed using RevMan 5.3 software, and cochrane criteria for risk-of-bias were used to assess the methodological quality of the trials. RESULTS A total of 5 RCTs met the inclusion criteria, and most were of low methodological quality. Participants in cupping therapy plus Western medicine group showed significantly greater improvements in the response rate [RR = 1.13, 95%CI (1.06, 1.22), p < 0.01] with low heterogeneity (Chi2 = 2.88, p = 0.41, I2 = 0%). Moreover, when compared with western medicine alone, meta-analysis indicated favorable statistically significant effects of cupping therapy plus western medicine on the Bath Ankylosing Spondylitis Functional Index (BASFI) [MD = -16.63, 95%CI (-17.75, -15.51), p < 0.01] and Bath Ankylosing Disease Activity Index (BASDAI) [MD = -9.93, 95%CI (-10.34, -9.52), p < 0.01], with low heterogeneity (Chi2 = 0.32, p = 0.85, I2 = 0% in BASFI; (Chi2 = 2.46, p = 0.29, I2 = 19% in BASDAI). Furthermore, when compared with western medicine alone, meta-analysis demonstrated statistically significant effects of cupping therapy plus western medicine on the serum level of ESR [MD = -1.28, 95% CI (-1.44, -1.13), p < 0.01] and the serum level of CRP [MD = -3.97, 95%CI (-4.71, -3.22), p < 0.01], with low heterogeneity (Chi2 = 0.50, p = 0.78, I2 = 0% in the serum level of ESR; Chi2 = 0.19, p = 0.91, I2 = 0% in the serum level of CRP). CONCLUSION Taken together, only weak evidence supported the hypothesis that cupping therapy had potential benefits for patients with AS.
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Affiliation(s)
- Shi-Yu Ma
- Department of Pharmacy, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ying Wang
- Department of Traditional Chinese Medicine, Ruijin Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Jia-Qi Xu
- Department of Pharmacy, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lin Zheng
- Department of Bone and Jount Surgery, Shanghai GuangHua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China.
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14
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Olmedo DB, Precioso PM, Lugdero-Correia A, Silva GD, Santos AMGD, Pôrto LC. Exposure source prevalence is associated with gender in hepatitis C virus patients from Rio de Janeiro, Brazil. Mem Inst Oswaldo Cruz 2017; 112:632-639. [PMID: 28902289 PMCID: PMC5572449 DOI: 10.1590/0074-02760160553] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 04/17/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) infection is a worldwide public health problem. A characterisation of the differences in exposure sources among genders will enable improvements in surveillance actions. METHODS Exposure data were obtained for 1180 confirmed HCV cases Brazil's mandatory reporting to epidemiological surveillance, which was directed by a reference laboratory in Rio de Janeiro, Brazil. The Chi-square test (χ2) was used to assess the associations between exposure sources and gender. The prevalence ratio (PR) was calculated for exposures that showed an association. RESULTS The results showed 57.7% cases were female, and associations with snorting drugs, sexual activity, surgery, aesthetic procedures, blood transfusions, and educational level were observed (p < 0.001). Men showed 2.53 (1.33-3.57), 4.83 (3.54-6.59), and 2.18 (1.33-3.57) times more exposure to sniffing drugs, risky sex and higher levels of education, respectively, than women. Women demonstrated 4.46 (3.21-6.21), 1.94 (1.43-2.63), and 3.10 (2.09-4.61) times more exposure to surgery, aesthetic procedures, and blood transfusions, respectively, than men. CONCLUSION Our results showed differences in risk behaviours associated with gender among HCV carriers. These data are likely to significantly influence clinical practice regarding the adoption of specific approaches for counselling and control policies to prevent the emergence of new cases and break the chain of transmission of the virus.
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Affiliation(s)
- Daniele Blasquez Olmedo
- Universidade do Estado do Rio de Janeiro, Laboratório de Histocompatibilidade e Criopreservação, Rio de Janeiro, RJ, Brasil
| | - Patrícia Marraccini Precioso
- Universidade do Estado do Rio de Janeiro, Laboratório de Histocompatibilidade e Criopreservação, Rio de Janeiro, RJ, Brasil
| | - António Lugdero-Correia
- Universidade do Estado do Rio de Janeiro, Laboratório de Histocompatibilidade e Criopreservação, Rio de Janeiro, RJ, Brasil
| | - Guida da Silva
- Secretaria Municipal de Saúde do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | | | - Luís Cristóvão Pôrto
- Universidade do Estado do Rio de Janeiro, Laboratório de Histocompatibilidade e Criopreservação, Rio de Janeiro, RJ, Brasil
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15
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Trickey A, May MT, Davies C, Qureshi H, Hamid S, Mahmood H, Saeed Q, Hickman M, Glass N, Averhoff F, Vickerman P. Importance and Contribution of Community, Social, and Healthcare Risk Factors for Hepatitis C Infection in Pakistan. Am J Trop Med Hyg 2017; 97:1920-1928. [PMID: 29141707 DOI: 10.4269/ajtmh.17-0019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Pakistan has a high prevalence of hepatitis C virus (HCV) infection, estimated at 4.9% (2,290/46,843) in the 2007 national HCV seroprevalence survey. We used data from this survey to assess the importance of risk factor associations with HCV prevalence in Pakistan. Exposures were grouped as community (going to the barbers, sharing smoking equipment, having an ear/nose piercing, tattoo, or acupuncture), healthcare (ever having hemodialysis, blood transfusion, or ≥ 5 injections in the last year), demographic (marital status and age), and socio-economic (illiterate or laborer). We used mutually adjusted multivariable regression analysis, stratified by sex, to determine associations with HCV infection, their population attributable fraction, and how risk of infection accumulates with multiple exposures. Strength of associations was assessed using adjusted odds ratios (aOR). Community [aOR females 1.5 (95% confidence interval [CI]: 1.2, 1.8); males 1.2 (1.1, 1.4)] and healthcare [females 1.4 (1.2, 1.6); males 1.2 (1.1, 1.4)] exposures, low socio-economic status [females 1.6 (1.3, 1.80); males 1.3 (1.2, 1.5)], and marriage [females 1.5 (1.2, 1.9); males 1.4 (1.1, 1.8)] were associated with increased HCV infection. Among married women, the number of children was associated with an increase in HCV infection; linear trend aOR per child 1.06 (1.01, 1.11). Fewer infections could be attributed to healthcare exposures (females 13%; males 6%) than to community exposures (females 25%; males 9%). Prevalence increased from 3% to 10% when cumulative exposures increased from 1 to ≥ 4 [aOR per additional exposure for females 1.5 (1.4, 1.6); males 1.2 (1.2, 1.3)]. A combination of community, healthcare, and other factors appear to drive the Pakistan HCV epidemic, highlighting the need for a comprehensive array of prevention strategies.
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Affiliation(s)
- Adam Trickey
- Bristol Medical School, University of Bristol, Bristol, United Kingdom.,National Institute of Health Research (NIHR) Health Protection Research Unit (HPRU) in Evaluation of Interventions, Bristol, United Kingdom
| | - Margaret T May
- National Institute of Health Research (NIHR) Health Protection Research Unit (HPRU) in Evaluation of Interventions, Bristol, United Kingdom.,Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Charlotte Davies
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Huma Qureshi
- Pakistan Medical Research Council (PMRC), Islamabad, Pakistan
| | - Saeed Hamid
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Hassan Mahmood
- Pakistan Medical Research Council (PMRC), Islamabad, Pakistan
| | - Quaid Saeed
- National AIDS Control Programme, Islamabad, Pakistan
| | - Matthew Hickman
- National Institute of Health Research (NIHR) Health Protection Research Unit (HPRU) in Evaluation of Interventions, Bristol, United Kingdom.,Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Nancy Glass
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Peter Vickerman
- National Institute of Health Research (NIHR) Health Protection Research Unit (HPRU) in Evaluation of Interventions, Bristol, United Kingdom.,Bristol Medical School, University of Bristol, Bristol, United Kingdom
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16
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Nagaty A, Abd El-Wahab EW. Real-life results of sofosbuvir based therapy in chronic hepatitis C -naïve and -experienced patients in Egypt. PLoS One 2017; 12:e0184654. [PMID: 28981513 PMCID: PMC5628811 DOI: 10.1371/journal.pone.0184654] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 08/28/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND More than ten million Egyptians are infected with HCV. Every one of them is going to infect about three to four persons every year. Treating those patients is a matter of national security. A dramatic improvement in hepatitis C virus (HCV) infection treatment was achieved in the last five years. A new era of direct-acting antivirals is now dawning in Egypt. OBJECTIVE(S) We share in this report our clinical experience in treating chronic HCV Egyptian patients with Sofosbuvir based regimens to evaluate its safety and efficacy on real life practical ground. METHODS A total of 205 chronic HCV patients (195 naive and 15 experienced) were enrolled in the study. Patient were treated with Sofosbuvir+Ribavirin 24 weeks as standard of care. Two interferon eligible patients were treated with PEG-INF+ Sofosbuvir+Ribavirin for 12 weeks. The primary efficacy endpoint was the proportion of patients with sustained virologic response at 24 weeks after cessation of therapy. RESULTS The overall response rate was 97.1%. Sustained virological response rate did not differ among treatment-naive patients and patients with previous history of IFN-based therapy. Portal hypertension, prediabetes, and lack of early virologic response were predictors of non response. No clinically significant treatment-emergent adverse effects were noted. No treatment discontinuation was encountered. CONCLUSION In the real-life setting, Sofosbuvir based regimens for 24 weeks has established an efficacious and well tolerated treatment in naïve and experienced patients with chronic HCV genotype 4 infection; although shorter treatment durations may be possible. However, patient follow up should extent to at least 6 months post-treatment and verifying viral load on yearly basis is warranted to track any late relapse.
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Affiliation(s)
- Ahmed Nagaty
- Consultant of Hepatology and Infectious Diseases, Ministry of Health, Alexandria, Egypt
| | - Ekram W. Abd El-Wahab
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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17
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Li JQ, Guo W, Sun ZG, Huang QS, Lee EY, Wang Y, Yao XD. Cupping therapy for treating knee osteoarthritis: The evidence from systematic review and meta-analysis. Complement Ther Clin Pract 2017; 28:152-160. [PMID: 28779923 DOI: 10.1016/j.ctcp.2017.06.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 06/06/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Cupping therapy is widely used in East Asia, the Middle East, or Central and North Europe to manage the symptom of knee osteoarthritis (KOA). The purpose of this systematic review was to evaluate the available evidence from randomized controlled trials (RCTs) of cupping therapy for treating patients with KOA. METHODS The following databases were searched from their inception until January 2017: PubMed, Embase, the Cochrane Central Register of Controlled Trials and four Chinese databases [WanFang Med Database, Chinese BioMedical Database, Chinese WeiPu Database, and China National Knowledge Infrastructure (CNKI)]. Only the RCTs related to the effects of cupping therapy on KOA were included in this systematic review. A quantitative synthesis of RCTs will be conducted using RevMan 5.3 software. Study selection, data extraction, and validation was performed independently by two reviewers. Cochrane criteria for risk-of-bias were used to assess the methodological quality of the trials. RESULTS Seven RCTs met the inclusion criteria, and most were of low methodological quality. Study participants in the dry cupping therapy plus the Western medicine therapy group showed significantly greater improvements in the pain [MD = -1.01, 95%CI (-1.61, -0.41), p < 0.01], stiffness [MD = -0.81, 95%CI (-1.14, -0.48), p < 0.01] and physical function [MD = -5.53, 95%CI (-8.58, -2.47), p < 0.01] domains of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) compared to participants in the Western medicine therapy group, with low heterogeneity (Chi2 = 0.00 p = 1.00, I2 = 0% in pain; Chi2 = 0.45 p = 0.50, I2 = 0% in stiffness; Chi2 = 1.09 p = 0.30, I2 = 9% in physical function). However, it failed to do so on a Visual Analog Scale (VAS) [MD = -0.32, 95%CI (-0.70, 0.05), p = 0.09]. In addition, when compared with Western medicine therapy alone, meta-analysis of four RCTs suggested favorable statistically significant effects of wet cupping therapy plus western medicine on response rate [MD = 1.06, 95%CI (1.01, 1.12), p = 0.03; heterogeneity: Chi2 = 1.13, p = 0.77, I2 = 0%] and Lequesne Algofunctional Index (LAI) [MD = -2.74, 95%CI (-3.41, -2.07), p < 0.01; heterogeneity: Chi2 = 2.03, p = 0.57, I2 = 0% ]. CONCLUSION Only weak evidence can support the hypothesis that cupping therapy can effectively improve the treatment efficacy and physical function in patients with KOA.
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Affiliation(s)
- Jin-Quan Li
- Department of Orthopedics, Fuzhou General Hospital of Nanjing Command, PLA, FuZhou 350025, China
| | - Wen Guo
- Department of Endocrinology, Fuzhou General Hospital of Nanjing Command, PLA, FuZhou 350025, China
| | - Ze-Gan Sun
- Department of Orthopedics, Fuzhou General Hospital of Nanjing Command, PLA, FuZhou 350025, China
| | - Qing-Song Huang
- Department of Orthopedics, Fuzhou General Hospital of Nanjing Command, PLA, FuZhou 350025, China
| | - En Yeong Lee
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, Bundoora, Victoria, Australia
| | - Ying Wang
- Department of First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province 210023, China
| | - Xiao-Dong Yao
- Department of Orthopedics, Fuzhou General Hospital of Nanjing Command, PLA, FuZhou 350025, China.
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18
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Mazhar Uddin SM, Haq A, Sheikh H. The Use of Hijama (Wet Cupping) in Alternative and Complementary Medicine: Efficacious or Perilous? J Acupunct Meridian Stud 2016; 9:285-286. [PMID: 28010828 DOI: 10.1016/j.jams.2016.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 08/31/2016] [Accepted: 09/05/2016] [Indexed: 12/13/2022] Open
Affiliation(s)
| | - Aatera Haq
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Haris Sheikh
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
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19
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Sohn HS, Kim JR, Ryu SY, Lee YJ, Lee MJ, Min HJ, Lee J, Choi HY, Song YJ, Ki M. Risk Factors for Hepatitis C Virus (HCV) Infection in Areas with a High Prevalence of HCV in the Republic of Korea in 2013. Gut Liver 2016; 10:126-32. [PMID: 26260752 PMCID: PMC4694744 DOI: 10.5009/gnl14403] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background/Aims The prevalence of hepatitis C virus (HCV) infection in Busan, Gyeongnam, and Jeonnam Provinces in Korea is more than twice the national average. This study aimed to examine whether demographic and lifestyle characteristics are associated with HCV infection in these areas. Methods A case control study was performed at three study hospitals. HCV cases were matched with two controls for sex and age. Patient controls were selected from non-HCV patients at the same hospital. Healthy controls were subjects participating in medical checkups. Conditional logistic regression models were used. Results A total of 234 matched-case and patient- and healthy-control pairs were analyzed. The significant risk factors for both controls were sharing razors (adjusted odds ratio [aOR], 2.39 and 3.29, respectively) and having more than four lifetime sexual partners (aOR, 2.15 and 6.89, respectively). Contact dockworkers (aOR, 1.91) and tattoos (aOR, 2.20) were significant risk factors for the patient controls. Transfusion (aOR, 5.38), a bloody operation (aOR, 5.02), acupuncture (aOR, 2.08), and piercing (aOR, 5.95) were significant risk factors for the healthy controls. Needle stick injuries and intravenous drug abuse were significant in the univariate analysis. Conclusions More education concerning the dangers of sharing razors, tattoos and piercings is required to prevent HCV infection. More attention should be paid to needle stick injuries in hospitals and the community.
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Affiliation(s)
- Hae-Sook Sohn
- Department of Preventive Medicine, Inje University College of Medicine, Busan, Korea
| | - Jang Rak Kim
- Department of Preventive Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
| | - So Yeon Ryu
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Youn-Jae Lee
- Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
| | - Myeong Jin Lee
- Department of Health and Medical Administration, Suncheon Jeil College, Suncheon, Korea
| | - Hyun Ju Min
- Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jun Lee
- Department of Internal Medicine, Chosun University Medical School, Gwangju, Korea
| | - Hwa Young Choi
- Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Yeong Jun Song
- Department of Preventive Medicine, College of Medicine, Eulji University, Daejeon, Korea
| | - Moran Ki
- Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
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20
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Lanini S, Easterbrook PJ, Zumla A, Ippolito G. Hepatitis C: global epidemiology and strategies for control. Clin Microbiol Infect 2016; 22:833-838. [PMID: 27521803 DOI: 10.1016/j.cmi.2016.07.035] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/18/2016] [Accepted: 07/28/2016] [Indexed: 12/16/2022]
Abstract
It is estimated that globally there are approximately 100 million persons with serological evidence of current or past HCV infection, and that HCV causes about 700 000 deaths each year. The prevalence of infection is the highest in lower and middle income countries, in which a significant number of past infections were caused by iatrogenic transmission and sub-optimal injection safety. In contrast, in developed countries, infections are caused mainly by high-risk exposures and behaviours among specific populations, such as persons who inject drugs. Recently, new direct antiviral activity (DAA) oral drugs with high rates of cure over short duration, which are well tolerated, have made chronic hepatitis C a curable condition. The extraordinary clinical performance of DAAs and recent substantial price reductions and expansion in access in resource-limited settings has provided new impetus for potential control and elimination of hepatitis C as a public health threat. We review the global epidemiology of HCV and the opportunities for preventative and treatment interventions to achieve global control of HCV infection. We also summarize the key elements of the World Health Organization's first-ever global health sector strategy for addressing the viral hepatitis pandemic.
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Affiliation(s)
- S Lanini
- 'Lazzaro Spallanzani' National Institute for Infectious Diseases-IRCCS, Rome, Italy
| | - P J Easterbrook
- Global Hepatitis Programme, HIV Department, World Health Organization, Geneva, Switzerland
| | - A Zumla
- Division of Infection and Immunity, University College London, London, UK; UK National Institute for Health Research Biomedical Research Centre, UCL Hospitals National Health Service Foundation Trust, London, UK
| | - G Ippolito
- 'Lazzaro Spallanzani' National Institute for Infectious Diseases-IRCCS, Rome, Italy.
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21
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El-Ghitany EM, Farghaly AG, Abdel Wahab MM, Farag S, Abd El-Wahab EW. Toward a simple risk assessment screening tool for HCV infection in Egypt. J Med Virol 2016; 88:1767-75. [PMID: 26970264 DOI: 10.1002/jmv.24520] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2016] [Indexed: 12/31/2022]
Abstract
Asymptomatic patients with HCV infection identified through screening program could benefit not only from treatment but also from other interventions such as counseling to maintain health and avoid risk behaviors. This might prevent the spread of infection and result in significant public health benefits. However, mass screening would quickly deplete resources. This work aims to develop a brief HCV risk assessment questionnaire that inquires initially about a wide range of risk factors found to be potentially associated with HCV infection in order to identify the few most significant questions that could be quickly used to facilitate cost-effective HCV case-finding in the general population in Egypt. An exhaustive literature search was done to include all reported HCV risk factors that were pooled in a 65 item questionnaire. After an initial pilot study, a case-control study was performed that included 1,024 cases and 1,046 controls. In a multivariable model, a list of independent risk factors were found to be significant predictors for being HCV seropositive among two age strata (<45 and >45 years) for each gender. A simplified model that assigned values of the odds ratio as a weight for each factor present predicted HCV infection with high diagnostic accuracy. Attaining the defined cut-off value of the total risk score enhances the effectiveness of screening. HCV risk factors in the Egyptian population vary by age and gender. An accurate prediction screening tool can be used to identify those at high risk who may benefit most from HCV serologic testing. These results are to be further validated in a large scale cross-sectional study to assess the wider use of this tool. J. Med. Virol. 88:1767-1775, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Engy M El-Ghitany
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Egypt
| | - Azza G Farghaly
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Egypt
| | - Moataza M Abdel Wahab
- Department of Biostatistics, High Institute of Public Health, Alexandria University, Egypt
| | - Shehata Farag
- Department of Biostatistics, High Institute of Public Health, Alexandria University, Egypt
| | - Ekram W Abd El-Wahab
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Egypt
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22
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Bensalem A, Selmani K, Hihi N, Bencherifa N, Mostefaoui F, Kerioui C, Pineau P, Debzi N, Berkane S. Eastern region represents a worrying cluster of active hepatitis C in Algeria in 2012. J Med Virol 2016; 88:1394-403. [PMID: 26856380 DOI: 10.1002/jmv.24491] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2016] [Indexed: 12/19/2022]
Abstract
Algeria is the largest country of Africa, peopled with populations living a range of traditional/rural and modern/urban lifestyles. The variations of prevalence of chronic active hepatitis care poorly known on the Algerian territory. We conducted a retrospective survey on all patients (n = 998) referred to our institution in 2012 and confirmed by us for an active hepatitis C. Half of the hepatitis C virus (HCV) isolates were genotyped. Forty Algerian regions out of the 48 were represented in our study. Three geographical clusters (Aïn-Temouchent/SidiBelAbbes, Algiers, and a large Eastern region) with an excess of active hepatitis C were observed. Patients coming from the Eastern cluster (Batna, Khenchela, Oum el Bouaghi, and Tebessa) were strongly over-represented (49% of cases, OR = 14.5, P < 0.0001). The hallmarks of Eastern region were an excess of women (65% vs. 46% in the remaining population, P < 0.0001) and the almost exclusive presence of HCV genotype 1 (93% vs. 63%, P = 0.0001). The core of the epidemics was apparently located in Khenchela (odds ratio = 24.6, P < 0.0001). This situation is plausibly connected with nosocomial transmission or traditional practices as scarification (Hijama), piercing or tattooing, very lively in this region. Distinct hepatitis C epidemics are currently affecting Algerian population. The most worrying situation is observed in rural regions located east of Algeria. J. Med. Virol. 88:1394-1403, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Aïcha Bensalem
- Laboratoire des Hépatites Virales, Institut Pasteur d'Algérie, Sidi Fredj, Algiers, Algeria
| | - Karima Selmani
- Laboratoire des Hépatites Virales, Institut Pasteur d'Algérie, Sidi Fredj, Algiers, Algeria
| | - Narjes Hihi
- Laboratoire des Hépatites Virales, Institut Pasteur d'Algérie, Sidi Fredj, Algiers, Algeria
| | - Nesrine Bencherifa
- Laboratoire des Hépatites Virales, Institut Pasteur d'Algérie, Sidi Fredj, Algiers, Algeria
| | - Fatma Mostefaoui
- Laboratoire des Hépatites Virales, Institut Pasteur d'Algérie, Sidi Fredj, Algiers, Algeria
| | - Cherif Kerioui
- Laboratoire des Hépatites Virales, Institut Pasteur d'Algérie, Sidi Fredj, Algiers, Algeria
| | - Pascal Pineau
- Unité « Organisation nucléaire et oncogenèse », INSERM U993, Institut Pasteur, Paris, France
| | - Nabil Debzi
- Service d'Hépatologie, CHU Mustapha Bacha, Algiers, Algeria
| | - Saadi Berkane
- Service de Gastro-entérologie, CHU Mustapha Bacha, Algiers, Algeria
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23
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Shire NJ, Sherman KE. Epidemiology of Hepatitis C Virus: A Battle on New Frontiers. Gastroenterol Clin North Am 2015; 44:699-716. [PMID: 26600215 DOI: 10.1016/j.gtc.2015.07.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The hepatitis C virus (HCV) is a leading cause of liver-related morbidity and mortality in the United States and other parts of the world. The epidemiology of the disease is highly variable between and within countries, and strategies to deal with HCV identification and treatment must be tailored to the geographic location and the political and economic environment of the region. Although great strides have been made in improving HCV transmission risk in blood supply products, new challenges related to changing patterns of disease incidence continue to require fresh evaluation and new approaches to disease prevention.
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Affiliation(s)
- Norah J Shire
- Epidemiology, AstraZeneca Pharmaceuticals LLC, 1 MedImmune Way, Gaithersburg, MD 20878, USA.
| | - Kenneth E Sherman
- Division of Digestive Diseases, University of Cincinnati College of Medicine, University of Cincinnati, 231 Albert B Sabin Way, Cincinnati, OH 45267-0595, USA
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Gondeau C, Pageaux GP, Larrey D. Hepatitis C virus infection: Are there still specific problems with genotype 3? World J Gastroenterol 2015; 21:12101-13. [PMID: 26576095 PMCID: PMC4641128 DOI: 10.3748/wjg.v21.i42.12101] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 08/07/2015] [Accepted: 09/30/2015] [Indexed: 02/06/2023] Open
Abstract
Hepatitis C virus (HCV) infection is one of the most common causes of chronic liver disease and the main indication for liver transplantation worldwide. As promising specific treatments have been introduced for genotype 1, clinicians and researchers are now focusing on patients infected by non-genotype 1 HCV, particularly genotype 3. Indeed, in the golden era of direct-acting antiviral drugs, genotype 3 infections are no longer considered as easy to treat and are associated with higher risk of developing severe liver injuries, such as cirrhosis and hepatocellular carcinoma. Moreover, HCV genotype 3 accounts for 40% of all HCV infections in Asia and is the most frequent genotype among HCV-positive injecting drug users in several countries. Here, we review recent data on HCV genotype 3 infection/treatment, including clinical aspects and the underlying genotype-specific molecular mechanisms.
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Chemaitelly H, Chaabna K, Abu-Raddad LJ. The Epidemiology of Hepatitis C Virus in the Fertile Crescent: Systematic Review and Meta-Analysis. PLoS One 2015; 10:e0135281. [PMID: 26296200 PMCID: PMC4546629 DOI: 10.1371/journal.pone.0135281] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 07/20/2015] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To characterize hepatitis C virus (HCV) epidemiology in countries of the Fertile Crescent region of the Middle East and North Africa (MENA), namely Iraq, Jordan, Lebanon, Palestine, and Syria. METHODS We systematically reviewed and synthesized available records of HCV incidence and prevalence following PRISMA guidelines. Meta-analyses were implemented using a DerSimonian-Laird random effects model with inverse weighting to estimate the country-specific HCV prevalence among the various at risk population groups. RESULTS We identified eight HCV incidence and 240 HCV prevalence measures in the Fertile Crescent. HCV sero-conversion risk among hemodialysis patients was 9.2% in Jordan and 40.3% in Iraq, and ranged between 0% and 3.5% among other populations in Iraq over different follow-up times. Our meta-analyses estimated HCV prevalence among the general population at 0.2% in Iraq (range: 0-7.2%; 95% CI: 0.1-0.3%), 0.3% in Jordan (range: 0-2.0%; 95% CI: 0.1-0.5%), 0.2% in Lebanon (range: 0-3.4%; 95% CI: 0.1-0.3%), 0.2% in Palestine (range: 0-9.0%; 95% CI: 0.2-0.3%), and 0.4% in Syria (range: 0.3-0.9%; 95% CI: 0.4-0.5%). Among populations at high risk, HCV prevalence was estimated at 19.5% in Iraq (range: 0-67.3%; 95% CI: 14.9-24.5%), 37.0% in Jordan (range: 21-59.5%; 95% CI: 29.3-45.0%), 14.5% in Lebanon (range: 0-52.8%; 95% CI: 5.6-26.5%), and 47.4% in Syria (range: 21.0-75.0%; 95% CI: 32.5-62.5%). Genotypes 4 and 1 appear to be the dominant circulating strains. CONCLUSIONS HCV prevalence in the population at large appears to be below 1%, lower than that in other MENA sub-regions, and tending towards the lower end of the global range. However, there is evidence for ongoing HCV transmission within medical facilities and among people who inject drugs (PWID). Migration dynamics appear to have played a role in determining the circulating genotypes. HCV prevention efforts should be targeted, and focus on infection control in clinical settings and harm reduction among PWID.
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Affiliation(s)
- Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medical College in Qatar, Cornell University, Qatar Foundation, Education City, Doha, Qatar
| | - Karima Chaabna
- Infectious Disease Epidemiology Group, Weill Cornell Medical College in Qatar, Cornell University, Qatar Foundation, Education City, Doha, Qatar
- Department of Healthcare Policy & Research, Weill Cornell Medical College, Cornell University, New York, New York, United States of America
| | - Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medical College in Qatar, Cornell University, Qatar Foundation, Education City, Doha, Qatar
- Department of Healthcare Policy & Research, Weill Cornell Medical College, Cornell University, New York, New York, United States of America
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Omata M, Kanda T, Yokosuka O, Crawford D, Al-Mahtab M, Wei L, Ibrahim A, Lau GKK, Sharma BC, Hamid SS, Chuang WL, Dokmeci AK. Features of hepatitis C virus infection, current therapies and ongoing clinical trials in ten Asian Pacific countries. Hepatol Int 2015; 9:486-507. [PMID: 25941137 DOI: 10.1007/s12072-015-9630-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 04/06/2015] [Indexed: 02/07/2023]
Abstract
Estimated hepatitis C virus (HCV) infection rates in the general populations were 1.3, 0.9, 0.4-1.0, 14.7, 0.1-0.3, 0.9-1.9, 1.0-2.0, 5, 4.4-8.6 and 0.5-1.3 % in Australia, Bangladesh, Mainland China, Egypt, Hong Kong, India, Japan, Pakistan, Taiwan and Turkey, respectively. The main HCV genotypes (Gs) are G1, G3, G1b, G4, G1b, G3, G1b, G3, G1b and G2, and G1 in Australia, Bangladesh, Mainland China, Egypt, Hong Kong, India, Japan, Pakistan, Taiwan and Turkey, respectively. Of IL28B genotypes, favorable alleles are ~50 % in Australia and Turkey, but 60-70 % in most of the other Asian countries. Peginterferon plus ribavirin is available in all ten Asian Pasific countries. In addition, HCV NS3/4A protease inhibitors with peginterferon plus ribavirin are currently available in several countries. Clinical trials of interferon-free regimens for HCV are ongoing in most of the ten Asian Pacific countries.
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Affiliation(s)
- Masao Omata
- Yamanashi Hospitals (Central and Kita) Organization, 1-1-1 Fujimi, Kofu-shi, Yamanashi, 400-8506, Japan. .,University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Tatsuo Kanda
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan.
| | - Osamu Yokosuka
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan.
| | - Darrell Crawford
- University of Queensland, School of Medicine, Woolloongabba, QLD, 4102, Australia.
| | - Mamun Al-Mahtab
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, 1000, Bangladesh.
| | - Lai Wei
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing, China.
| | - Alaaeldin Ibrahim
- GI/Liver Division, Department of Internal Medicine, University of Benha, Benha, Egypt.
| | - George K K Lau
- Humanity and Health Medical Centre, Hong Kong SAR China Institute of Translational Hepatology and Centre of Liver Fibrosis Diagnosis and Treatment Center, 302 Hospital, Beijing, China.
| | - Barjesh C Sharma
- Department of Gastroenterology, G.B. Pant Hospital, New Delhi, India.
| | - Saeed S Hamid
- Department of Medicine, Aga Khan University and Hospital, Stadium Road, Karachi, 74800, Pakistan.
| | - Wan-Long Chuang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - A Kadir Dokmeci
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey.
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Rehman A, Ul-Ain Baloch N, Awais M. Practice of cupping (Hijama) and the risk of bloodborne infections. Am J Infect Control 2014; 42:1139. [PMID: 25278416 DOI: 10.1016/j.ajic.2014.06.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 06/30/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Abdul Rehman
- Department of Biological & Biomedical Sciences, Aga Khan University, Karachi, Sindh, Pakistan.
| | - Noor Ul-Ain Baloch
- Department of Biological & Biomedical Sciences, Aga Khan University, Karachi, Sindh, Pakistan
| | - Muhammad Awais
- Department of Radiology, Aga Khan University Hospital, Karachi, Sindh, Pakistan
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