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Shivangi, Mishra MK, Gupta S, Razdan K, Sudan S, Sehgal S. Clinical diagnosis of viral hepatitis: Current status and future strategies. Diagn Microbiol Infect Dis 2024; 108:116151. [PMID: 38184983 DOI: 10.1016/j.diagmicrobio.2023.116151] [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: 02/01/2023] [Revised: 08/15/2023] [Accepted: 11/24/2023] [Indexed: 01/09/2024]
Abstract
Viral hepatitis (VH) is a significant public health issue with tremendous potential to aggravate into chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. Recent decade has witnessed remarkable uprising in the drug development and effective treatment of VH. An upsurge is seen in identification of antiviral therapies with low rates of viral resistance, the improvement of Hepatitis B Virus (HBV) vaccination and the development of direct-acting antivirals for Hepatitis C Virus (HCV). But unfortunately, the "2030 worldwide eradication" objective of World Health Organization (WHO) is still unmet. It can be largely attributed to the deficit faced by the healthcare system concerning screening and diagnosis. A timely, accurate and comprehensive screening; encompassing maximum population coverage is essential to combat this disease. However, advancements in VH diagnostics remain inadequate and with a marginal use in routine practice. This paper deliberates upon the lacunae in traditional and prevailing diagnostic methodology of viral hepatitis, especially their inadequacy in meeting the unique situations prevailing low- and middle-income countries (LMIC).
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Affiliation(s)
- Shivangi
- Centre for Molecular Biology, Central University of Jammu, Jammu (J&K), India
| | - Manish Kumar Mishra
- Centre for Molecular Biology, Central University of Jammu, Jammu (J&K), India
| | | | - Konika Razdan
- Government Medical College, Bakshi Nagar, Jammu, Jammu and Kashmir 180001, India
| | - Shashi Sudan
- Government Medical College, Bakshi Nagar, Jammu, Jammu and Kashmir 180001, India
| | - Shelly Sehgal
- Centre for Molecular Biology, Central University of Jammu, Jammu (J&K), India.
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Syangbo A, Hickman M, Colledge‐Frisby S, Leung J, Grebely J, Larney S, Degenhardt L, Trickey A. Associations between the prevalence of chronic hepatitis B among people who inject drugs and country-level characteristics: An ecological analysis. Drug Alcohol Rev 2023; 42:569-581. [PMID: 36600489 PMCID: PMC10728688 DOI: 10.1111/dar.13595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/17/2022] [Accepted: 12/07/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Globally, hepatitis B virus (HBV) is a leading cause of liver disease. People who inject drugs (PWID) are at greater risk than the general population of contracting HBV. This risk could depend on societal factors in different countries. We investigated the associations between country-level chronic HBV prevalence in PWID with national indicators of development and prevalence of HIV and hepatitis C virus (HCV). METHODS We used global systematic review data on chronic HBV prevalence (hepatitis B surface antigen-positive) among PWID and country-level sociodemographic characteristics from online databases. National random-effects meta-analysis estimates of HBV prevalence were the outcome in linear regression models testing for associations with country-level characteristics. RESULTS The study included 131,710 PWID from 304 estimates in 55 countries: the pooled HBV prevalence among PWID in the countries analysed was 4.5% (95% CI 3.9-5.1), the highest regional pooled prevalence was in East and Southeast Asia (17.6% [13.3-22.3]), and the lowest was in Western Europe (1.7% [1.4-2.1]). In multivariable models, no indicators of development were associated with HBV prevalence, but there was evidence of positive associations between HBV prevalence in the general population and among PWID, and evidence of HIV and HCV prevalence in PWID being associated with HBV prevalence in PWID: multivariable coefficients 0.03 (95% CI 0.01-0.04); p < 0.001, and 0.01 (95% CI 0.00-0.03); p = 0.01, respectively. DISCUSSION AND CONCLUSIONS HBV prevalence among PWID was associated with HIV and HCV prevalence among PWID and background HBV prevalence in the general population, highlighting the need for improving harm reduction in PWID and implementation of HBV vaccination, especially where HBV is endemic.
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Affiliation(s)
| | | | - Samantha Colledge‐Frisby
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- National Drug Research InstituteMelbourneAustralia
| | - Janni Leung
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- National Centre for Youth Substance Use ResearchThe University of QueenslandBrisbaneAustralia
| | | | - Sarah Larney
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- Department of Family Medicine and Emergency MedicineUniversity of MontrealMontrealCanada
- Research Centre of the Hospital Centre of the University of MontrealMontrealCanada
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
| | - Adam Trickey
- Population Health SciencesUniversity of BristolBristolUK
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Suarez-Palacio D, Muñoz-Garzón A, Parra-Pérez M, Rodríguez-Villa N, Prieto-Suarez E, Maestre-Serrano R. [Epidemiological behavior of hepatitis A in Barranquilla, Colombia, in the period 2013-2017]. Rev Salud Publica (Bogota) 2023; 21:287-291. [PMID: 36753172 DOI: 10.15446/rsap.v21n3.74932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 04/07/2019] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To analyze the epidemiological behavior of hepatitis A in the district of Barranquilla (Colombia), in the period 2013-2017. MATERIALS AND METHODS Descriptive study, in which the database of all hepatitis A cases reported in the district of Barranquilla during the observation period were retrospectively reviewed. RESULTS There were 293 new cases of hepatitis A reported in the district of Barranquilla, of which 62.4% occurred in men and 37.6% in women. The age groups most affected by the disease were adults (39.6%), followed by young people and schoolchildren (15%, respectively). The incidence of hepatitis A in the district of Barranquilla decreased between 2013 and 2016 from 10.9 to 1.5 cases per 100 000 inhabitants; however, in 2017 there was a slight increase to 2.5 cases per 100 000 inhabitants. CONCLUSIONS Hepatitis A is an event of interest for public health in the district of Barranquilla, and the behavior of its incidence has had a downward trend in recent years.
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Affiliation(s)
- Damaris Suarez-Palacio
- DS: Fisioterapeuta y Abogada. M. Sc. Salud Pública Universidad Simón Bolívar. Facultad de Ciencias de la Salud. Barranquilla, Colombia.
| | - Andrés Muñoz-Garzón
- AM: MD. Universidad Simón Bolívar. Facultad de Ciencias de la Salud. Barranquilla, Colombia.
| | - Marco Parra-Pérez
- MP: MD. Universidad Simón Bolívar. Facultad de Ciencias de la Salud. Barranquilla, Colombia.
| | - Nefer Rodríguez-Villa
- NR: MD. Universidad Simón Bolívar. Facultad de Ciencias de la Salud. Barranquilla, Colombia.
| | - Edgar Prieto-Suarez
- EP: MD. Ing. Electrónico. M. Sc. Infecciones y Salud en el Trópico. Facultad de Medicina, Departamento de Salud Pública. Universidad Nacional de Colombia. Bogotá, Colombia.
| | - Ronald Maestre-Serrano
- RM: Biólogo. Ph. D. Medicina Tropical. Universidad Simón Bolívar. Facultad de Ciencias de la Salud. Barranquilla, Colombia.
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Lai JCT, Wong VWS, Yip TCF, Hui VWK, Tse YK, Lee HW, Liang LY, Lui GCY, Chan HLY, Wong GLH. Secular trend of treatment uptake in patients with chronic hepatitis B: A territory-wide study of 135 395 patients from 2000 to 2017. J Gastroenterol Hepatol 2021; 36:3487-3499. [PMID: 34404113 DOI: 10.1111/jgh.15664] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 07/22/2021] [Accepted: 08/10/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS The uptake of antiviral treatment for patients with chronic hepatitis B (CHB) has been suboptimal. We aimed to determine the secular trend of treatment uptake in the territory-wide CHB cohort in Hong Kong from 2000 to 2017 and the factors for no treatment despite fulfilling treatment criteria. METHODS Chronic hepatitis B patients under public clinics and hospitals were identified through electronic medical records. The treatment indications were defined according to the Asian-Pacific guidelines published at the time of patients' first appearance in four periods: 2000-2004, 2005-2009, 2010-2013, and 2014-2017. RESULTS There were 135 395 CHB patients were included; 1493/12472 (12.0%), 7416/43426 (17.1%), 10 129/46559 (21.8%), 8051/32 938 (24.4%) patients fulfilled treatment criteria in the four periods, respectively. The treatment uptake rate increased with time: 35.1%, 43.4%, 60.2%, and 68.6% respectively. High fibrosis indices (APRI, FIB-4, and Forns indices) appeared to be the main factors for treatment indication in non-cirrhotic patients, with over 90% fulfilling treatment criteria due to high fibrosis indices alone. Of those fulfilling treatment criteria by high fibrosis indices, less than 60% of patients (25.2%, 36.1%, 46.0%, and 58.9%, respectively) had antiviral treatment initiated. Normal platelet count (odds ratio 0.42, P < 0.001) was the independent factor associated with not initiating antiviral treatment in patients fulfilling treatment criteria. CONCLUSIONS Treatment uptake rates have been increasing over time. Normal platelet count, which reflects less advanced liver disease, precludes patients from receiving antiviral treatment even if treatment indication is fulfilled. Hence, the importance to identify non-cirrhotic patients with significant liver fibrosis should be emphasized.
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Affiliation(s)
- Jimmy C-T Lai
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.,Medical Data Analytics Centre (MDAC), The Chinese University of Hong Kong, Hong Kong
| | - Vincent W-S Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.,Medical Data Analytics Centre (MDAC), The Chinese University of Hong Kong, Hong Kong.,Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Terry C-F Yip
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.,Medical Data Analytics Centre (MDAC), The Chinese University of Hong Kong, Hong Kong
| | - Vicki W-K Hui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.,Medical Data Analytics Centre (MDAC), The Chinese University of Hong Kong, Hong Kong
| | - Yee-Kit Tse
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.,Medical Data Analytics Centre (MDAC), The Chinese University of Hong Kong, Hong Kong
| | - Hye-Won Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Lilian Y Liang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - Grace C-Y Lui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - Henry L-Y Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.,Medical Data Analytics Centre (MDAC), The Chinese University of Hong Kong, Hong Kong.,Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Grace L-H Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.,Medical Data Analytics Centre (MDAC), The Chinese University of Hong Kong, Hong Kong.,Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
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Li Y, Yin S, Issa R, Tong X, Wang G, Xia J, Huang R, Chen G, Weng D, Chen C, Wu C, Chen Y. B Cell-mediated Humoral Immunity in Chronic Hepatitis B Infection. J Clin Transl Hepatol 2021; 9:592-597. [PMID: 34447690 PMCID: PMC8369012 DOI: 10.14218/jcth.2021.00051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/24/2021] [Accepted: 05/06/2021] [Indexed: 12/12/2022] Open
Abstract
B cell-mediated humoral immunity plays a vital role in viral infections, including chronic hepatitis B virus (HBV) infection, which remains a critical global public health issue. Despite hepatitis B surface antigen-specific antibodies are essential to eliminate viral infections, the reduced immune functional capacity of B cells was identified, which was also correlated with chronic hepatitis B (CHB) progression. In addition to B cells, T follicular helper (Tfh) cells, which assist B cells to produce antibodies, might also be involved in the process of anti-HBV-specific antibody production. Here, we provide a comprehensive review of the role of various subsets of B cells and Tfh cells during CHB progression and discuss current novel treatment strategies aimed at restoring humoral immunity. Understanding the mechanism of dysregulated B cells and Tfh cells will facilitate the ultimate functional cure of CHB patients.
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Affiliation(s)
- Yang Li
- School of Environmental and Biological Engineering, Nanjing University of Science & Technology, Nanjing, Jiangsu, China
| | - Shengxia Yin
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Rahma Issa
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xin Tong
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Guiyang Wang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Juan Xia
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Rui Huang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Guangmei Chen
- Department of Infectious Diseases, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China
| | - Dan Weng
- School of Environmental and Biological Engineering, Nanjing University of Science & Technology, Nanjing, Jiangsu, China
| | - Chen Chen
- Department of Clinical Pharmacology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chao Wu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
- Correspondence to: Yuxin Chen, Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu 210008, China. ORCID: https://orcid.org/0000-0001-5955-687X. Tel: +86-25-8968-3827, Fax: +86-25-8330-7115, E-mail: ; Wu Chao, Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu 210008, China. ORCID: https://orcid.org/0000-0002-1657-010X. Tel: +86-25-8310-5890, Fax: +86-25-8330-7115, E-mail:
| | - Yuxin Chen
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
- Correspondence to: Yuxin Chen, Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu 210008, China. ORCID: https://orcid.org/0000-0001-5955-687X. Tel: +86-25-8968-3827, Fax: +86-25-8330-7115, E-mail: ; Wu Chao, Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu 210008, China. ORCID: https://orcid.org/0000-0002-1657-010X. Tel: +86-25-8310-5890, Fax: +86-25-8330-7115, E-mail:
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PNPLA3 and TM6SF2, but Not MBOAT7, Are Associated with Steatosis and HBV Viral Persistence in Pakistani Population. Jundishapur J Microbiol 2020. [DOI: 10.5812/jjm.97397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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