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Han Y, Zheng M, Meng H, Han J, Chen J, Wang Y. Elimination of hepatitis C in a hospital characterized by infectious diseases. Front Public Health 2023; 11:1093578. [PMID: 37006527 PMCID: PMC10061059 DOI: 10.3389/fpubh.2023.1093578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
BackgroundThe World Health Organization has proposed to eliminate hepatitis C by 2030, yet there is still a large gap to the goal. Screening for hepatitis C is cost-effective and efficient in medical institutions. The aim of this study was to identify the key populations for HCV antibody screening in hospital characterized by infectious diseases, and provide estimates of the proportion of HCV-infected persons in the Beijing Ditan hospital completing each step along a proposed HCV treatment cascade.MethodsA total of 105,112 patients who underwent HCV antibody testing in Beijing Ditan hospital between 2017 and 2020 were included in this study. HCV antibody and HCV RNA positivity rate were calculated and compared by chi-square test.ResultsThe positivity rate of HCV antibody was 6.78%. The HCV antibody positivity rate and the proportion of positive patients showed an upward trend along with age in the five groups between 10–59 years. In the contrary, a decreasing trend was observed in the three groups above 60 years. Patients with positive HCV antibody were mainly from the Liver Disease Center (36.53%), the Department of Integrative Medicine (16.10%), the Department of Infectious Diseases (15.93%) and the Department of Obstetrics and Gynecology (9.44%). Among HCV antibody positive patients, 6,129 (85.95%) underwent further HCV RNA testing, of whom 2097 were HCV RNA positive, the positivity rate was 34.21%. Of the patients who were HCV RNA positive, 64.33% did not continue with HCV RNA testing. The cure rate for HCV antibody positive patients was 64.98%. Besides, there was a significant positive correlation between HCV RNA positivity rate and HCV antibody level (r = 0.992, P < 0.001). The detection rate of HCV antibody among inpatients showed an upward trend (Z = 5.567, P < 0.001), while the positivity rate showed a downward trend (Z = 2.2926, P = 0.0219).ConclusionsWe found that even in hospitals characterized by infectious diseases, a large proportion of patients did not complete each step along a proposed HCV treatment cascade. Besides, we identified key populations for HCV antibody screening, namely: (1) patients over 40 years of age, especially those aged 50–59 years; (2) the Department of Infectious Diseases and the Department of Obstetrics and Gynecology patients. In addition, HCV RNA testing was highly recommended for patients with HCV antibody levels above 8 S/CO.
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Marjenberg Z, Wright C, Pooley N, Cheung KW, Shimakawa Y, Vargas-Zambrano JC, Vidor E. Hepatitis B surface antigen prevalence and the rates of mother-to-child transmission of hepatitis B virus after the introduction of infant vaccination programs in South East Asia and Western Pacific regions: a systematic review. Int J Infect Dis 2022; 124:65-75. [PMID: 36089151 DOI: 10.1016/j.ijid.2022.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Infant vaccination against the hepatitis B virus began in the World Health Organization South East Asia Region and the Western Pacific Region between 1983 and 2016. This systematic review examined the seroprevalence of hepatitis B surface antigen (HBsAg) in children and the rate of mother-to-child transmission (MTCT) in these regions between 1990 and 2020. METHODS MEDLINE and EMBASE were searched for articles published between January 1990 and September 2020, which reported seroprevalence of HBsAg in children aged 0-15 years and/or the rate of MTCT in the South East Asia Region and Western Pacific Region. A pragmatic review identified supporting information. This review was registered in the International Prospective Register of Systematic Reviews (#CRD42020211707). RESULTS Of 115 included studies, 77 (24 countries) reported HBsAg prevalence, and 38 (nine countries) reported MTCT. The seroprevalence of HBsAg ranged between 0.0% and 27.4%, with a decreasing trend over time in each country. MTCT rates were 0.0-5.2% in infants of mothers who are hepatitis B e antigen-negative and 2.7-53.0% in infants of mothers who are hepatitis B e antigen-positive. CONCLUSION After the introduction of infant hepatitis B virus vaccination programs, the countries in South East Asia Region and Western Pacific Region observed a reduction in HBsAg seroprevalence in children. Nevertheless, the risk of MTCT persists, emphasizing the importance of antenatal screening to identify high-risk pregnancies.
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Affiliation(s)
| | - Ciara Wright
- Maverex Limited, Newcastle upon Tyne, United Kingdom.
| | - Nick Pooley
- Maverex Limited, Newcastle upon Tyne, United Kingdom.
| | - Ka Wang Cheung
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
| | - Yusuke Shimakawa
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France.
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Prevalence of Viral Hepatitis B, C, and D in Kazakhstan. ScientificWorldJournal 2022; 2022:9102565. [PMID: 35492864 PMCID: PMC9054462 DOI: 10.1155/2022/9102565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 03/14/2022] [Accepted: 03/31/2022] [Indexed: 02/06/2023] Open
Abstract
Background Viral hepatitis is a major burden for the healthcare system worldwide. Up to date, a comprehensive analysis of the prevalence of viral hepatitis in Kazakhstan and Central Asia has not been carried out yet. Our epidemiological study aimed at investigating the frequency and spread of viral hepatitis B, C, and D depending on age and sex in Kazakhstan (5-year period). Materials and Methods We utilized the data from the primary registration of the incidence of hepatitis B, C, and D in 18 regions of Kazakhstan (period: from 2015 to 2020). Age indicators, gender, and territorial characteristics of registered cases were determined and analysed. The data were obtained from the state information system “Electronic Register of Dispensary Patients”, based on the International Classification of Diseases-10 for coding diseases. Results During the period studied, 268 975 cases of hepatitis B, C, and D were detected in Kazakhstan. Hepatitis B was registered in n = 109 734 cases. In women, the incidence rate was 40.6% of all cases (n = 44545), and in men it was 59.4% (n = 65189) of all cases (p ≤ 0.01). Hepatitis D was detected in 8 656 cases, of which 58.3% (n = 5049) were in men and 41.7% (n = 3607) in women (p ≤ 0.01). Hepatitis C was registered in n = 159 585 cases. The rate was higher in the male population (54.6%; n = 82 203) compared to women 45.4% (n = 68382) (p ≤ 0.01). In 2020 (in comparison with 2015), there was a significant increase in the incidence of hepatitis D by 68.3%, hepatitis B by 49.8%, and hepatitis C by 46.4%. The largest prevalence of hepatitis D was recorded in 2016 which is 22.3% higher compared to 2020. A significant increase in hepatitis C was recorded in 2019 compared to 2015, where indicators were 49.2% higher. Conclusion An analysis of the prevalence of hepatitis B, C, and D showed an increase in new cases in Kazakhstan. These findings indicate the need to develop effective preventive measures and screening strategies among people in a high-risk group. The results of the study can be used for the development of a national program to combat the spread of viral hepatitis.
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Ismail F, Haq S, El-Garawani I, Abdelsameea E. Hepatitis C Virus Infection in Eastern Libya: Efforts Needed to Improve HCV Testing and Linkage to Care in the Resource-Limited Setting. Trop Med Infect Dis 2022; 7:tropicalmed7020014. [PMID: 35202210 PMCID: PMC8878151 DOI: 10.3390/tropicalmed7020014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/15/2022] [Accepted: 01/17/2022] [Indexed: 02/04/2023] Open
Abstract
Hepatitis C virus (HCV) is a significant public health problem, and the elimination of its infection by 2031 is a global goal. However, due to insufficient testing, lack of linkage to care (LTC) and treatment, Libya may be far from achieving this goal. This study aimed to explore HCV testing, the care and treatment of infected people, and to assess the burden of the infection among individuals who visited the main Medical Centre in Tobruk region, eastern Libya, for various medical and surgical conditions. A research team interviewed public health officials in Tobruk Medical Center, inspected available equipment, and obtained data available for people who were positive for antibodies to HCV (anti-HCV) as part of their routine pre-invasive procedures and pre-donation screening tests from January 2005 to April 2020. HCV antibody tests were positive for 612 cases out of 368,392 (0.17%). Of those who tested positive for anti-HCV antibodies, no one had followed up by RNA test for identifying individuals with chronic HCV infection, and there are no links to outpatient care and treatment. Our findings highlight the critical need for an up-to-date HCV diagnosis and linkage to care guidelines, which includes a follow-up RNA test for anti-HCV positive patients and early linkage to care for confirmed cases to accelerate the elimination of HCV infection from the community.
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Affiliation(s)
- Faisal Ismail
- Department of Laboratory, Faculty of Medical Technology, University of Tobruk, Tobruk 1074, Libya;
- Blood Transmitted Diseases Department, National Centre for Disease Control, Tobruk 2654, Libya
- Infectious Diseases Department, Libyan Medical Research Centre, Kambut, Tobruk 2623, Libya
- Correspondence: (F.I.); (I.E.-G.); Tel.: +21-89-2614-0979 (F.I.); +20-10-6445-5948 (I.E.-G.)
| | - Soghra Haq
- Department of Laboratory, Faculty of Medical Technology, University of Tobruk, Tobruk 1074, Libya;
| | - Islam El-Garawani
- Zoology Department, Faculty of Science, Menoufia University, Shebin El-Kom 32512, Egypt
- Correspondence: (F.I.); (I.E.-G.); Tel.: +21-89-2614-0979 (F.I.); +20-10-6445-5948 (I.E.-G.)
| | - Eman Abdelsameea
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shebin El-Kom 32511, Egypt;
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Worldwide prevalence, genotype distribution and management of hepatitis C. Acta Gastroenterol Belg 2021; 84:637-656. [PMID: 34965046 DOI: 10.51821/84.4.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Hepatitis C virus (HCV) is one of the leading causes of chronic liver disease, cirrhosis, and hepatocellular carcinoma, resulting in major global public health concerns. The HCV infection is unevenly distributed worldwide, with variations in prevalence across and within countries. The studies on molecular epidemiology conducted in several countries provide an essential supplement for a comprehensive knowledge of HCV epidemiology, genotypes, and subtypes, along with providing information on the impact of current and earlier migratory flows. HCV is phylogenetically classified into 8 major genotypes and 57 subtypes. HCV genotype and subtype distribution differ according to geographic origin and transmission risk category. Unless people with HCV infection are detected and treated appropriately, the number of deaths due to the disease will continue to increase. In 2015, 1.75 million new viral infections were mostly due to unsafe healthcare procedures and drug use injections. In the same year, access to direct-acting antivirals was challenging and varied in developing and developed countries, affecting HCV cure rates based on their availability. The World Health Assembly, in 2016, approved a global strategy to achieve the elimination of the HCV public health threat by 2030 (by reducing new infections by 90% and deaths by 65%). Globally, countries are implementing policies and measures to eliminate HCV risk based on their distribution of genotypes and prevalence.
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Li H, Zhang Y, Ma Z, Liu Z, Ikram A, Liu L, Zhao G, Pan Q, Baloch Z. HEV prevalence and potential risk factors in a large multi-ethnic youth cohort in China. Virol J 2021; 18:3. [PMID: 33407606 PMCID: PMC7789705 DOI: 10.1186/s12985-020-01470-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 12/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This cohort study was designed to investigate the prevalence of and potential risk factors of HEV infection in a large multi-ethnic youth cohort in China. METHODS Blood samples were collected from participants (n = 6269) and serum was isolated. All serum samples were tested for anti-HEV IgG, anti-HEV IgM antibodies using commercial enzyme immunoassay kits (Wantai Biological Pharmacy Enterprise, Beijing, China). RESULTS The overall rate of anti-HEV IgG and anti-HEV IgM prevalence was 4.78% and 0.14%, 0.03% were positive for both anti-HEV IgG and anti-HEV IgM antibodies. Anti-HEV IgG positivity is significantly higher in females (5.27%) compared to males (4.14%) (P = 0.028). Anti-HEV IgG prevalence is significantly (P = 0.0001) higher in Dong (17.57%), Miao (12.23%), Yi (11.04%), Gelao (9.76%), and Bai (10.00%) compared to other ethnic groups. It is significantly higher in Guizhou (11.4%), Sichuan (10.1%), Yunnan (9.3%), and Guangxi (6.9%) than that other province. We found that ethnicity and provincial background are significantly associated with HEV infection in this cohort. CONCLUSION This study provides comprehensive information on HEV prevalence in multi-ethnic populations in China. However, our study only focused on a youth population from different provinces of China. Future studies are recommended to investigate HEV prevalence in other age groups of the ethnic populations.
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Affiliation(s)
- Huixia Li
- Key Laboratory of Biotechnology and Bioengineering of State Ethnic Affairs Commission, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Yinxia Zhang
- Key Laboratory of Biotechnology and Bioengineering of State Ethnic Affairs Commission, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Zhongren Ma
- Key Laboratory of Biotechnology and Bioengineering of State Ethnic Affairs Commission, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Zewen Liu
- Key Laboratory of Biotechnology and Bioengineering of State Ethnic Affairs Commission, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Aqsa Ikram
- Key Laboratory of Biotechnology and Bioengineering of State Ethnic Affairs Commission, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Lijiang Liu
- Key Laboratory of Biotechnology and Bioengineering of State Ethnic Affairs Commission, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Guoqin Zhao
- Key Laboratory of Biotechnology and Bioengineering of State Ethnic Affairs Commission, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Qiuwei Pan
- Key Laboratory of Biotechnology and Bioengineering of State Ethnic Affairs Commission, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Zulqarnain Baloch
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, Yunnan, China.
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Prevalence of Hepatitis C Virus Infection in a Surgical Population of Southeast China: A Large-Scale Multicenter Study. Can J Gastroenterol Hepatol 2020; 2020:8219536. [PMID: 32377514 PMCID: PMC7180502 DOI: 10.1155/2020/8219536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 01/30/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Chronic HCV infection affects 80 million people globally and may progress to advanced liver disease. The present study aims to investigate the present epidemiology of HCV infection in a southeastern Chinese surgical patient cohort. METHODS Blood samples obtained from 78,484 surgical patients from 18 different city and county hospitals were enrolled. The incidence of serum HCV antibody positivity, HCV RNA load, and HCV genotyping, as well as demographics and relevant clinical history, were investigated. Data were stratified using the multistage cluster random sampling method and further analyzed using the SPSS-20 package. RESULTS HCV antibody positivity was detected in 0.15% of the population (95% confidence interval (CI): 0.12%-0.18%). Genotype 1b (55.74%) was the dominant type. The HCV infection peaked in the age groups of 16-20, 41-50, and 61-65 years, and it was higher in males than in females (0.19% vs. 0.13%, P < 0.05). The geographical distribution of infection rates differed: 0.19% (95% CI: 0.14%-0.24%), 0.18% (95% CI: 0.13%-0.23%), and 0.06% (95% CI: 0.03-0.09%) in plain areas, islands, and valley regions, respectively. Patients with transfusion history and urban residence were associated with high HCV RNA levels (adjusted odds ratio = 11.24 and 6.20, P < 0.05). CONCLUSION The prevalence of HCV infection in this cohort from southeast China was 0.17%, which is lower than the reported 0.43% infection rate in China in 2006. This result can be (partially) explained by the improvement of blood donor screening and the successful campaign for the use of disposable syringes and needles.
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Shen L, Zhou H, Wei F, Shuai J. The hepatitis B core antibody positive/hepatitis B surface antigen negative pattern is associated with the increased risk of intracranial atherosclerotic stenosis. Medicine (Baltimore) 2020; 99:e18752. [PMID: 31914096 PMCID: PMC6959876 DOI: 10.1097/md.0000000000018752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The high prevalence of hepatitis B virus (HBV) infection and intracranial atherosclerotic stenosis (ICAS) in Asia raises the question as to whether HBV infection is associated with ICAS. To answer this question, we tested the association between HBV infection and ICAS. Totally, 3072 in-hospital subjects were retrospectively enrolled. All subjects underwent computed tomography angiography (CTA) and serological testing for HBV infection. Based on the results of CTA, all subjects were categorized into 4 groups including ICAS, extracranial atherosclerotic stenosis (ECAS), ICAS/ECAS (both ICAS and ECAS), and normal. HBV infection was divided into 4 patterns including hepatitis B core antibody (anti-HBc) positive/hepatitis B surface antigen (HBsAg) positive, anti-HBc-positive/HBsAg-negative, anti-HBc-negative/HBsAg-positive, and anti-HBc-negative/HBsAg-negative. Risk factors for atherosclerosis were collected based on medical records. Multiple logistic regression models were used to determine the association between infection patterns and ICAS. We found that the anti-HBc-positive / HBsAg-negative pattern was associated with the increased risk of ICAS (OR = 1.462) and not associated with ECAS or ICAS / ECAS. The HBc-positive/HBsAg-positive pattern was not associated with ICAS, ECAS or ICAS/ECAS. In conclusions, the anti-HBc-positive/HBsAg-negative pattern was associated with the increased risk of ICAS. Anti-HBc should be employed to investigate the association between HBV infection and cerebrovascular diseases.
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Zhang JY, Li ZB, Zhang L, Wang J, Huang LP, Zhan GL, Li Z, Du J, Zhao M. DOES IT WORK? -a randomized controlled trial to test the efficacy of HCV and HIV-related education on drug users in MMT, China. BMC Infect Dis 2019; 19:774. [PMID: 31488064 PMCID: PMC6727322 DOI: 10.1186/s12879-019-4421-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 08/28/2019] [Indexed: 01/01/2023] Open
Abstract
Background HCV (Hepatitis C virus) is a prevalent chronic disease with potentially deadly consequences, especially for drug users. However, there are no special HCV or HIV (human immunodeficiency virus)-related intervention programs that are tailored for drug users in China; to fill this gap, the purpose of this study was to explore HCV and HIV-related knowledge among drug users in MMT (methadone maintenance treatment) sites of China and to investigate the effectiveness of HCV and HIV-related education for improving the knowledge of IDUs (injection drug users) and their awareness of infection. Methods The study was a randomized cluster controlled trial that compared a usual care group to a usual care plus HCV/HIV-REP (HCV/HIV-Reduction Education Program) group with a 24-week follow-up. The self-designed questionnaires, the HCV- and HIV-related knowledge questionnaire and the HIV/HCV infection awareness questionnaire, were used to collect the data. Four MMT clinics were selected for this project; two MMT clinics were randomly assigned to the research group, with subjects receiving their usual care plus HCV/HIV-REP, and the remaining two MMT clinics were the control group, with subjects receiving their usual care over 12 weeks. Sixty patients were recruited from each MMT clinic. A total of 240 patients were recruited. Follow-up studies were conducted at the end of the 12th week and the 24th week after the intervention. Results At baseline, the mean score (out of 20 possible correct answers) for HCV knowledge among the patients in the group receiving the intervention was 6.51 (SD = 3.5), and it was 20.57 (SD = 6.54) for HIV knowledge (out of 45 correct answers) and 8.35 (SD = 2.8) for HIV/HCV infection awareness (out of 20 correct answers). At the 12-week and 24-week follow-up assessments, the research group showed a greater increase in HCV−/HIV-related knowledge (group × time effect, F = 37.444/11.281, P < 0.05) but no difference in their HIV/HCV infection awareness (group × time effect, F = 2.056, P > 0.05). Conclusion An MMT-based HCV/HIV intervention program could be used to improve patient knowledge of HCV and HIV prevention, but more effort should be devoted to HIV/HCV infection awareness. Trial registration Protocols for this study were approved by institution review board (IRB) of Shanghai Mental Health Center (IRB:2009036), and registered in U.S national institutes of health (http://www.clinicaltrials.gov, NCT01647191). Registered 23 July 2012.
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Affiliation(s)
- Jing Ying Zhang
- Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China
| | - Zhi Bin Li
- Mental Health Center of Jiading District in Shanghai, Shanghai, China
| | - Lei Zhang
- Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China
| | - Jun Wang
- Mental Health Center of Yangpu District in Shanghai, Shanghai, China
| | - Le Ping Huang
- Mental Health Center of Hongkou District in Shanghai, Shanghai, China
| | - Gui Lai Zhan
- Mental Health Center of Xuhui District in Shanghai, Shanghai, China
| | - Zhu Li
- Songnan Community Health Service Center, Baoshan District, Shanghai, China
| | - Jiang Du
- Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China. .,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China.
| | - Min Zhao
- Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China. .,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China.
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Liu L, Xu H, Hu Y, Shang J, Jiang J, Yu L, Zhao C, Zhang D, Zhang X, Li J, Li W, Wu Y, Hu D, Wang X, Zhao Q, Zhang Q, Luo W, Chen J, Zhang D, Zhou W, Niu J. Hepatitis C screening in hospitals: find the missing patients. Virol J 2019; 16:47. [PMID: 30992019 PMCID: PMC6469068 DOI: 10.1186/s12985-019-1157-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/02/2019] [Indexed: 12/11/2022] Open
Abstract
Background Hepatitis C virus (HCV) infection is one of the leading causes of liver cancer, creating enormous economic and social burdens. The Chinese government recommends routine screening of inpatients for HCV before invasive procedures to prevent iatric infections. However, the diagnosis and treatment rates for HCV remain low. The aim of this study was to use available routine screening data to understand the HCV screening of inpatients in different regions of China. Methods Inpatient information and HCV screening results were collected from January 2016 to December 2016 at eight tertiary hospitals in different regions of China to compare the HCV-positivity of hospitalized patients among different regions and age groups. Results The HCV screening rate of inpatients was more than 50%. A total of 467,008 inpatients were enrolled in the study (51.20% were male), and the HCV antibody (anti-HCV) -positive rate was 0.88% (95% confidence interval [CI], 0.85–0.91%) among the total population. This rate was significantly higher among all males compared with all females (0.91% vs 0.85%). Moreover, the HCV antibody-positive rate increased with age and was highest for the 60–64-year age group. Notably, 90.14% (3722/4129) of the anti-HCV seropositive patients were 40 years of age or older. HCV screening for people over 40 years old is recommended. Conclusions This study highlights the key role of routine examination for HCV infection in hospitalized patients. Full use of inpatient screening results to manage HCV antibody-positive patients and a screening strategy targeting inpatients 40 years and older were found to be low-cost and effective, which will help to find the missing millions of yet unaware patients and also accelerate the elimination of HCV in China.
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Affiliation(s)
- Lili Liu
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin, 130021, China
| | - Hongqin Xu
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin, 130021, China
| | - Yue Hu
- Department of Phase I Clinical trial Center, The First Hospital of Jilin University, Changchun, Jilin, 130021, China
| | - Jia Shang
- Department of Infectious Disease, Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China
| | - Jianning Jiang
- Department of Infectious Disease, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Lei Yu
- Department of Infectious Disease, The Fourth Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, China
| | - Caiyan Zhao
- Department of Infectious Disease, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, China
| | - Dazhi Zhang
- Department of Infectious Diseases, Institute of Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Xinxin Zhang
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - Junfeng Li
- Department of Infectious Diseases, The First Hospital of Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Wei Li
- Department of Infectious Disease, Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China
| | - Yanan Wu
- Department of Infectious Disease, Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China
| | - Diefei Hu
- Department of Infectious Disease, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Xiaofang Wang
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 31000, China
| | - Qian Zhao
- Department of Infectious Disease, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, China
| | - Qiongfang Zhang
- Department of Infectious Diseases, Institute of Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Wenqiang Luo
- Department of Infectious Diseases, Institute of Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Jia Chen
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - Donghua Zhang
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - Wei Zhou
- Department of Infectious Diseases, The First Hospital of Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Junqi Niu
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin, 130021, China.
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Kmush BL, Yu H, Huang S, Zhang X, Wu T, Nelson KE, Labrique AB. Long-term Antibody Persistence After Hepatitis E Virus Infection and Vaccination in Dongtai, China. Open Forum Infect Dis 2019; 6:ofz144. [PMID: 31024978 PMCID: PMC6475590 DOI: 10.1093/ofid/ofz144] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 03/25/2019] [Indexed: 01/25/2023] Open
Abstract
Background Hepatitis E virus (HEV) is of global significance. HEV is a common cause of acute hepatitis in China. One of the major unanswered questions about HEV is the persistence of antibodies after infection and vaccination. Methods We examined antibody persistence 6.5 years after HEV exposures through natural infection and vaccination. Ninety-seven vaccine recipients and 70 individuals asymptomatically infected with HEV enrolled in the phase III HEV239 vaccine trial in Dongtai, China, were revisited. Results Antibody loss was 23.4% (95% confidence interval [CI], 17.1%-30.5%), with a nonsignificantly higher percentage of loss among those naturally infected (30.0%; 95% CI, 19.6%-42.1%) than those vaccinated (18.6%; 95% CI, 11.4%-27.7%; P = .085). Age and gender were not associated with antibody persistence. Only 2 people (1.2%) self-reported medically diagnosed jaundice or hepatitis-like illness in the last 10 years, both of whom had persistent antibodies. Contact with a jaundice patient and injectable contraceptive use were marginally associated with loss of detectable anti-HEV antibodies (P = .047 and .082, respectively), whereas transfusion was marginally associated with antibody persistence (P = .075). Conclusions Antibody loss was more common among those naturally infected compared with those vaccinated. However, none of the characteristics examined were strongly associated with antibody loss, suggesting that factors not yet identified may play a more important role in antibody loss. Long-term postvaccination antibody persistence is currently unknown and will be an important consideration in the development of policies for the use of the highly efficacious HEV vaccine. ClinicalTrials.gov registration. NCT01014845.
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Affiliation(s)
- Brittany L Kmush
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Huan Yu
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Shoujie Huang
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Xuefang Zhang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Ting Wu
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Kenrad E Nelson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Alain B Labrique
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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12
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Seroepidemiology of hepatitis B virus infection in children 12 years after China's expanded program on immunization in Qamdo, Tibet. J Public Health Policy 2019; 39:446-453. [PMID: 30089882 DOI: 10.1057/s41271-018-0142-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Although hepatitis B vaccine (HepB1) was first recommended through China's Expanded Program on Immunization (EPI) in 1992, Tibet was able to offer universal HepB1 vaccination starting only in early 2004. This cross-sectional study was conducted to assess, 12 years after administration of HepB1, the seroepidemiology of hepatitis B virus (HBV) infection in children in Qamdo, Tibet. Focusing on a population of individuals ≤ 15 years of age living in Tibet, we analyzed serum samples from 261 healthy children for HBV status based on the presence of hepatitis B surface antigen (HBsAg), antibodies against HBV core antigen (anti-HBc), and antibodies against HBsAg (anti-HBs). Of all participants, 87.4% had received HepB1 vaccination. The overall anti-HBs-positive rate was 30.7%, with isolated anti-HBs in 75 participants (28.7%). Of all those studied, 13 (5.0%) were positive for HBsAg and 18 (6.9%) for anti-HBc. Participants who received vaccination in hospital at delivery had a lower prevalence of HBsAg than that of those born at home. By reducing HBV transmission, the EPI in Tibet protected most Tibetans younger than 15 years from becoming HBV carriers.
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13
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Chen ZW, Li Z, Wang QH, Wu XL, Li H, Ren H, Hu P. Large Disparity between Prevalence and Treatment Rates for Hepatitis C in Western China. J Clin Transl Hepatol 2018; 6:385-390. [PMID: 30637215 PMCID: PMC6328727 DOI: 10.14218/jcth.2018.00027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/30/2018] [Accepted: 08/07/2018] [Indexed: 12/11/2022] Open
Abstract
Background and Aims: Recently, the World Health Organization adopted the first-ever global hepatitis strategy with the dream of eliminating viral hepatitis as a public health threat by 2030. However, the epidemiology and treatment rates of hepatitis C virus (HCV) infection in Western China are still unknown. Methods: A total of 111,916 adult individuals (15-96 years) who underwent the HCV-antibody (HCV-Ab) test in the Second Affiliated Hospital of Chongqing Medical University between 2013 and 2015 were included in this study. We retrospectively analyzed the electronic medical records' data for each, and the positivity of HCV-Ab and the treatment of HCV RNA-positive patients were evaluated. Results: During 2013-2015, the crude prevalence of HCV-Ab was 1.4% (95%CI: 1.4-1.5; 1,611/111,916) and the adjusted prevalence of HCV-Ab was 1.7% (95%CI: 1.6-1.8), which was higher than in the 2006 national study (0.43%). The prevalence was 2-times higher in males than females (2.0% vs. 1.1%, p < 0.01). Notably, only 46% (434/951) of the HCV RNA-positive patients received standard peg-interferon plus ribavirin treatment, with 370 (82%) that completed treatment, of whom 272 (74%) achieved sustained virologic response (SVR). Particularly, 11% (32/292) of HCV RNA-positive patients were HBsAg-positive, and the SVR rate for them was lower than for the HBsAg-negative patients, but no significant difference was observed. Conclusions: HCV infection may have increased since 2006 in Western China. The SVR rate of peg-interferon plus ribavirin treatment was high, but the proportion of untreated HCV patients was large. Thus, more efforts need to be made by the government to create a scientific-based policy for HCV treatment and prevention.
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Affiliation(s)
| | | | | | | | | | | | - Peng Hu
- *Correspondence to: Peng Hu, Department of Infectious Diseases, Institute for Viral Hepatitis, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing 400010, China. Tel: +86-23-63693289, Fax: +86-23-63703790, E-mail:
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14
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Zhang Y, Bian S, Liu X, Xu S, Zhang L, Zhou B, Zhang W, Zhang Y, Xu Y, Deng G. Positive Rate of Different Hepatitis B Virus Serological Markers in Peking Union Medical College Hospital, a General Tertiary Hospital in Beijing. ACTA ACUST UNITED AC 2018; 31:17-2. [PMID: 28031083 DOI: 10.1016/s1001-9294(16)30017-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective s To investigate the positive rate of different hepatitis B virus (HBV) serological markers, and the demographic factors related to HBV infection.Methods We enrolled all patients tested for HBV serological markers, such as HBV surface antigen (HBsAg), HBV surface antibody (HBsAb), hepatitis B e antigen (HBeAg), hepatitis B e antibody (HBeAb), HBV core antibody (HBcAb), and HBV-DNA from July 2008 to July 2009 in Peking Union Medical College Hospital. The positive rate of each HBV serological marker was calculated according to gender, age, and de- partment, respectively. The positive rates of HBV-DNA among patients with positive HBsAg were also analyzed.Results Among 27 409 samples included, 2681 (9.8%) were HBsAg positive. When patients were divided into 9 age groups, the age-specific positive rate of HBsAg was 1.2%, 9.6%, 12.3%, 10.9%, 10.3%, 9.7%, 8.0%, 5.8%, and 4.3%, respectively. The positive rate of HBsAg in non-surgical department, surgical department, and health examination center was 16.2%,5.8%,and 4.7%, respectively. The positive rate of HBsAg of males (13.3%) was higher than that of females (7.3%, P=0.000). Among the 2681 HBsAg (+) patients, 1230 (45.9%) had HBV-DNA test, of whom 564 (45.9%) were positive. Patients with HBsAg (+), HBeAg (+), and HBcAg (+) result usually had high positive rate of HBV-DNA Results (71.8%, P=0.000).Conclusions Among this group of patients in our hospital, the positive rate of HBsAg was relatively high. Age group of 20-29, males, and patients in non-surgical departments were factors associated with high positive rate of HBsAg.
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Affiliation(s)
- Yueqiu Zhang
- Department of Infectious Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Sainan Bian
- Department of Infectious Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Xiaoqing Liu
- Department of Infectious Diseases,Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China; Clinical Epidemiology Unit, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Shaoxia Xu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Lifan Zhang
- Department of Infectious Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China; Clinical Epidemiology Unit, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Baotong Zhou
- Department of Infectious Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Weihong Zhang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Yao Zhang
- Clinical Epidemiology Unit, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Yingchun Xu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Guohua Deng
- Department of Infectious Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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Abstract
Increased economic interdependence, social integration, and other aspects of globalization are contributing to significant changes in hepatitis A epidemiology. Globally, the incidence of hepatitis A virus (HAV) infection is decreasing, the age at midpoint of population immunity (AMPI) is increasing, and the proportion of symptomatic cases is increasing as the average age at infection increases. In low-income countries, HAV remains endemic but improved water and sanitation systems are reducing transmission rates among young children. In high-income countries, most adults remain susceptible to HAV and foodborne outbreaks are becoming more frequent. Middle-income countries have diverse epidemiological profiles, and they play important roles in the global spread of HAV through international trade and travel. Future changes in the epidemiology of hepatitis A will be heavily influenced by globalization processes.
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Affiliation(s)
- Kathryn H Jacobsen
- College of Health and Human Services, George Mason University, Fairfax, Virginia 22030
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16
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Tosun S, Aygün O, Özdemir HÖ, Korkmaz E, Özdemir D. The impact of economic and social factors on the prevalence of hepatitis B in Turkey. BMC Public Health 2018; 18:649. [PMID: 29789002 PMCID: PMC5964685 DOI: 10.1186/s12889-018-5575-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 05/17/2018] [Indexed: 12/16/2022] Open
Abstract
Background Viral Hepatitis is one of the major global health problems, affecting millions of people every year. Limited information is available on the impact of social and economic factors on the prevalence of Hepatitis B virus (HBV) in Turkey. This study, contrary to other studies in the literature, was undertaken with the aim of examining the Majority of the excluded data come from the volunteers. Methods There are medical and the social-economic factors affecting the prevalence of HBV. This research, while taking medical factors as control variables, clarify the social and economic factors affecting the prevalence of HBV by utilising clinical data with the use of the Binary Probit Model (BPM). The BPM estimation is a powerful tool to determine not only the factors but explain also the exact impacts of each factor. Results The estimations of the BPM shows that economic and social variables such as age, gender, migration, education, awareness, social welfare, occupation are very important factors for determining HBV prevalence. Compared to the youngest population, the 46 to 66+ age group has a higher prevalence of HBV. The male respondents were 5% more likely to develop HBV compared to females. When region-specific differences are taken into account, migrating from the poorest parts of the country such as the eastern and south-eastern regions of Turkey are approximately 16% more likely to be infected. The welfare indicators such as a higher number of rooms in the respondent’s house or flat decreases the probability of having HBV and, relatively higher income groups are less likely to develop HBV compared to labourers. The Self-employed/Business owner/Public sector worker category are approximately 10% less likely to develop HBV. When people are aware of the methods of prevention of HBV, they are 6% less likely to be infected. Previous HBV infection history increases the probability of having HBV again B by 17%. Conclusions These findings strongly suggest that the impact of social and economic factors on the prevalence of HBV is vital. Any improvements in these factors are likely to reduce prevalence of HBV.
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Affiliation(s)
- Selma Tosun
- Department of Clinical Microbiology and Infectious Diseases, University of Health Sciences, Bozyaka Education and Research Hospital, İzmir, Turkey
| | - Olgu Aygün
- Number 2 General Practioner Center, Bozyaka Education and Research Hospital, İzmir, Turkey
| | - Hülya Özkan Özdemir
- Department of Clinical Microbiology and Infectious Diseases, University of Health Sciences, Bozyaka Education and Research Hospital, İzmir, Turkey
| | - Elif Korkmaz
- Department of Economics, Yaşar University, Üniversite Caddesi No: 37-39, 35040 Bornova, İzmir, Turkey
| | - Durmuş Özdemir
- Department of Economics, Yaşar University, Üniversite Caddesi No: 37-39, 35040 Bornova, İzmir, Turkey.
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Zhu B, Liu J, Fu Y, Zhang B, Mao Y. Spatio-Temporal Epidemiology of Viral Hepatitis in China (2003-2015): Implications for Prevention and Control Policies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E661. [PMID: 29614809 PMCID: PMC5923703 DOI: 10.3390/ijerph15040661] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 03/19/2018] [Accepted: 03/30/2018] [Indexed: 12/18/2022]
Abstract
Viral hepatitis, as one of the most serious notifiable infectious diseases in China, takes heavy tolls from the infected and causes a severe economic burden to society, yet few studies have systematically explored the spatio-temporal epidemiology of viral hepatitis in China. This study aims to explore, visualize and compare the epidemiologic trends and spatial changing patterns of different types of viral hepatitis (A, B, C, E and unspecified, based on the classification of CDC) at the provincial level in China. The growth rates of incidence are used and converted to box plots to visualize the epidemiologic trends, with the linear trend being tested by chi-square linear by linear association test. Two complementary spatial cluster methods are used to explore the overall agglomeration level and identify spatial clusters: spatial autocorrelation analysis (measured by global and local Moran's I) and space-time scan analysis. Based on the spatial autocorrelation analysis, the hotspots of hepatitis A remain relatively stable and gradually shrunk, with Yunnan and Sichuan successively moving out the high-high (HH) cluster area. The HH clustering feature of hepatitis B in China gradually disappeared with time. However, the HH cluster area of hepatitis C has gradually moved towards the west, while for hepatitis E, the provincial units around the Yangtze River Delta region have been revealing HH cluster features since 2005. The space-time scan analysis also indicates the distinct spatial changing patterns of different types of viral hepatitis in China. It is easy to conclude that there is no one-size-fits-all plan for the prevention and control of viral hepatitis in all the provincial units. An effective response requires a package of coordinated actions, which should vary across localities regarding the spatial-temporal epidemic dynamics of each type of virus and the specific conditions of each provincial unit.
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Affiliation(s)
- Bin Zhu
- School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xianning West Road, Xi'an 710049, China.
- Department of Public Policy, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, China.
| | - Jinlin Liu
- School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xianning West Road, Xi'an 710049, China.
| | - Yang Fu
- College of Management, Shenzhen University, Nanhai Ave 3688, Shenzhen 518060, China.
| | - Bo Zhang
- School of Human Settlements and Civil Engineering, Xi'an Jiaotong University, 28 Xianning West Road, Xi'an 710049, China.
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xianning West Road, Xi'an 710049, China.
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18
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Gu M, Qiu J, Guo D, Xu Y, Liu X, Shen C, Dong C. Evaluation of candidate genes associated with hepatitis A and E virus infection in Chinese Han population. Virol J 2018; 15:47. [PMID: 29558945 PMCID: PMC5859746 DOI: 10.1186/s12985-018-0962-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 03/12/2018] [Indexed: 01/13/2023] Open
Abstract
Background Recent GWAS-associated studies reported that single nucleotide polymorphisms (SNPs) in ABCB1, TGFβ1, XRCC1 genes were associated with hepatitis A virus (HAV) infection, and variants of APOA4 and APOE genes were associated with and hepatitis E virus (HEV) infection in US population. However, the associations of these loci with HAV or HEV infection in Chinese Han population remain unclear. Methods A total of 3082 Chinese Han persons were included in this study. Anti-HAV IgG and anti-HEV IgG were detected by enzyme-linked immunosorbent assay (ELISA). Genotypes in ABCB1, TGFβ1, XRCC1, APOA4 and APOE SNPs were determined by TaqMan MGB technology. Results In Chinese Han population, rs1045642 C to T variation in ABCB1 was significantly associated with the decreased risk of HAV infection (P < 0.05). However, the effect direction was different with the previous US study. Rs1001581 A to G variation in XRCC1, which was not identified in US population, was significantly associated with the protection against HAV infection in our samples (P < 0.05). In addition, our results suggested that rs7412 C to T variation in APOE was significantly associated with lower risk of HEV infection in males (adjusted OR < 1.0, P < 0.05) but not in females. Conclusions ABCB1 and XRCC1 genes variants are significantly associated with the protection against HAV infection. Additionally, Chinese Han males with rs7412 C to T variation in APOE gene are less prone to be infected by HEV. Electronic supplementary material The online version of this article (10.1186/s12985-018-0962-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maolin Gu
- Huai'an Forth Hospital, Huai'an, China
| | - Jing Qiu
- Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric Disease, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Daoxia Guo
- Department of Epidemiology, School of Public Health, Nanjing Medical University, 101 Longmian Road, Nanjing, 211166, China
| | | | | | - Chong Shen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, 101 Longmian Road, Nanjing, 211166, China.
| | - Chen Dong
- Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric Disease, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China.
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Huang SL, Lu Q, Fan SH, Zong ZY, Hou TY, Chen BY, Qin JA, Suo Y, Gao XD, Wang NN. Sharp instrument injuries among hospital healthcare workers in mainland China: a cross-sectional study. BMJ Open 2017; 7:e017761. [PMID: 28882927 PMCID: PMC5722084 DOI: 10.1136/bmjopen-2017-017761] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To determine the prevalence of sharp instrument injuries in hospital-based healthcare workers (HCWs) in mainland China and the contributing factors. DESIGN Cross-sectional study. SETTING The data were derived from public hospitals. PARTICIPANTS A total of 360 hospitals were recruited in the study, including 289 general hospitals and 71 specialised hospitals. Among them, 194 are tertiary-level hospitals and 166 are secondary level. The study population finally consisted of 223 149 hospital HCWs. PRIMARY OUTCOME MEASURES A questionnaire was designed based on the aim of the study. Profession of HCWs, workplace, circumstance and medical apparatus and instrument were covered in the survey. HCWs completed a self-administered questionnaire regarding details of sharp instrument injuries within the previous month. Prevalence estimates for the injuries were calculated for the overall HCWs and for subgroups according to profession, workplace, circumstance or instrument. RESULTS Within the included HCWs, the prevalence of sharp instrument injuries was 0.08 per person-month. Only 4.6% of the HCWs reported to their hospitals after injury. The highest number of injuries occurred in nursing staff (10.3%). Injuries took place most frequently on general wards (44.5%). The circumstances that involved most frequent injuries include surgical needle insertion, removing an arteriovenous needle from a patient and recapping the needle. Single-use syringe caused more injuries incidents than other instruments. CONCLUSIONS These results indicate that sharp instrument injuries have become a major occupational problem of HCWs in mainland China. Attentions need to be paid to the issue and strategies for preventing such injuries are needed.
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Affiliation(s)
- Sheng-Li Huang
- Department of Infection Control, Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
- Department of Orthopeadics, Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Qun Lu
- Department of Infection Control, Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Shan-Hong Fan
- Department of Infection Control, Tangdu Hospital, Fouth Military Medical University, Xi’an, China
| | - Zhi-Yong Zong
- Department of Infection Control, West China Hospital, Sichuan University, Chengdu, China
| | - Tie-Ying Hou
- Department of InfectionControl, Guangdong General Hospital, Guangzhou, China
| | - Bai-Yi Chen
- Department of Infection Control, First Hospital of China Medical University, Shenyang, China
| | - Jin-Ai Qin
- Department of Infection Control, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yao Suo
- Department of Infection Control, Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Xiao-Dong Gao
- Department of Infection Control, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ning-Ning Wang
- Department of Infection Control, Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
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Zhou Q, Li X, Wang Q, Shen H, Zhang Y, Zhang S, Acharya G. Hepatitis B Virus Infection in Preconception Period Among Women of Reproductive Age in Rural China - A Nationwide Study. Paediatr Perinat Epidemiol 2017; 31:484-484. [PMID: 28617973 DOI: 10.1111/ppe.12371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Hepatitis B virus (HBV) infection during pregnancy is associated with perinatal complications and poor maternal and fetal outcomes. There is a lack of reports on HBV infection screening, prophylaxis, and/or treatment in preconception period among women planning a pregnancy. This study is to investigate the prevalence and demographic characteristics of HBV infection among rural women of reproductive age planning pregnancy within 6 months, in different geographical regions of China. METHODS A population-based, cross-sectional, sero-survey of HBV infection among women intending to get pregnant within 6 months was carried out as a part of the National Free Preconception Health Examination Project covering 31 provinces in mainland China between 2010-12. General information (age, residence status, race, education, and occupation), HBV infection and vaccination history was collected. Results of HBV serological test panel were recorded for analysis. RESULTS Of 2 120 131 women, 2 028 361 (95.7%) samples of HBV serology were available for analysis. Participating women were of young age (median 28.1 years), mostly engaged in agricultural activities (78.1%), and had high school education or lower (89.6%). The overall prevalence of HBsAg sero-positivity was 4.9%, which corresponds to an intermediate epidemic, with a wide geographical variation that ranged from 1.1% in Shanxi to 13.0% in Tibet. 90.1% women were susceptible to HBV with a 24.5% self-reported HBV vaccination rate. CONCLUSIONS Significant regional differences in HBV prevalence, and a vast majority of women of childbearing age being susceptible to HBV, calls for a targeted HBV screening and vaccination strategy for women and their offspring in rural China.
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Affiliation(s)
- Qiongjie Zhou
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
- Department of Clinical Medicine, Women's Health and Perinatology Research Group, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Xiaotian Li
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
- Institute of Biomedical Sciences, Fudan University, Shanghai, China
| | - Qiaomei Wang
- Institute of Biomedical Sciences, Fudan University, Shanghai, China
| | - Haiping Shen
- Department of Maternal and Child Health, National Health and Family Planning Commission of the People's Republic of China, Beijing, China
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the People's Republic of China, Beijing, China
| | - Shikun Zhang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the People's Republic of China, Beijing, China
| | - Ganesh Acharya
- Department of Clinical Medicine, Women's Health and Perinatology Research Group, UiT - The Arctic University of Norway, Tromsø, Norway
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden
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Prevalence of hepatitis B and C and factors for infection and nonimmune in inflammatory bowel disease patients in China. Eur J Gastroenterol Hepatol 2017; 29:509-515. [PMID: 28350740 DOI: 10.1097/meg.0000000000000838] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aims of this study were to investigate the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in inflammatory bowel disease (IBD) patients and the risk factors related to the infection and nonimmune status. METHODS A retrospective study was carried out at two clinical centers. The prevalence of viral markers and risk factors related to HBV and HCV infection and nonimmune status were analyzed in IBD patients. Age-matched and sex-matched healthy individuals were recruited as the controls. RESULTS A total of 980 IBD patients were included in this study. Present and past HBV infection was detected in 41.21% of the IBD group, which was higher than that in the general population (P=0.003). Age older than 30 years (P=0.000), ulcerative colitis (P=0.002), and previous surgery (P=0.039) were found to be significant risk factors for HBV infection in the multivariate analysis. 36.43% of the patients in the IBD group had nonimmune status against HBV, and age less than 40 years (P=0.011) and Crohn's disease (P=0.002) were identified as independent risk factors in the multivariate analysis. The prevalence of HCV infection was low and similar to that of the general population. CONCLUSION The prevalence of HBV infection in IBD patients in China was higher than that in Europe, USA, and the general population in China, but the prevalence of HCV infection in IBD patients was similar to that in the general population in this study. The frequency of nonimmune status against HBV was high, especially in young Crohn's disease patients, and HBV vaccination should be intensified and have a targeted coverage.
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Lin H, Chen X, Zhu S, Mao P, Zhu S, Liu Y, Huang C, Sun J, Zhu J. Prevalence of Occult Hepatitis C Virus Infection among Blood Donors in Jiangsu, China. Intervirology 2017; 59:204-210. [PMID: 28208127 DOI: 10.1159/000455854] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 01/04/2017] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE In 2010, only 1 donor blood sample was found to be anti-hepatitis C virus (HCV) negative and HCV RNA positive, as detected by nucleic acid testing. In occult HCV infection (OCI), HCV RNA is found in peripheral blood mononuclear cells (PBMCs). We investigated the prevalence of OCI among blood donors. METHODS We collected 513 samples from 334 eligible and 179 deferred donors, including 55 anti-HCV-positive, 113 alanine aminotransferase (ALT)-elevated, and 11 hepatitis B virus surface antigen (HBsAg)-positive blood donors. PBMCs were isolated, the 5'-untranslated region of HCV RNA was amplified by reverse transcription nested PCR, and the genotype of the core region was determined. RESULTS No HCV RNA was detected among the eligible samples. Among the deferred donors, 15 (27.2%) had detectable HCV RNA in 55 anti-HCV PBMC specimens. HCV RNA was detected in 1 (9.1%) HBsAg-positive and 9 (8%) ALT-elevated samples. The prevalence of OCI in the blood donors was 2.2% (10/458). HCV genotypes were determined in 10 subjects, indicating that 2 (20.0%) were subtype 2a, 7 (70.0%) were 1b, and 1 (10%) was 6a. CONCLUSIONS This study showed that OCI does exist among Chinese blood donors. However, to determine the epidemiology and outcome of this HCV infection, further follow-up with more participants and patients receiving blood components with OCI is needed.
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Affiliation(s)
- Hong Lin
- Jiangsu Province Blood Center, Nanjing, China
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Clifford GM, Waterboer T, Dondog B, Qiao YL, Kordzaia D, Hammouda D, Keita N, Khodakarami N, Raza SA, Sherpa AT, Zatonski W, Pawlita M, Plummer M, Franceschi S. Hepatitis C virus seroprevalence in the general female population of 9 countries in Europe, Asia and Africa. Infect Agent Cancer 2017; 12:9. [PMID: 28168002 PMCID: PMC5288860 DOI: 10.1186/s13027-017-0121-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 01/19/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND New oral treatments with very high cure rates have the potential to revolutionize global management of hepatitis C virus (HCV), but population-based data on HCV infection are missing in many low and middle-income countries (LMIC). METHODS Between 2004 and 2009, dried blood spots were collected from age-stratified female population samples of 9 countries: China, Mongolia, Poland, Guinea, Nepal, Pakistan, Algeria, Georgia and Iran. HCV antibodies were detected by a multiplex serology assay using bead-based technology. RESULTS Crude HCV prevalence ranged from 17.4% in Mongolia to 0.0% in Iran. In a pooled model adjusted by age and country, in which associations with risk factors were not statistically heterogeneous across countries, the only significant determinants of HCV positivity were age (prevalence ratio for ≥45 versus <35 years = 2.84, 95%CI 2.18-3.71) and parity (parous versus nulliparous = 1.73, 95%CI 1.02-2.93). Statistically significant increases in HCV positivity by age, but not parity, were seen in each of the three countries with the highest number of HCV infections: Mongolia, Pakistan, China. There were no associations with sexual partners nor HPV infection. HCV prevalence in women aged ≥45 years correlated well with recent estimates of female HCV-related liver cancer incidence, with the slight exception of Pakistan, which showed a higher HCV prevalence (5.2%) than expected. CONCLUSIONS HCV prevalence varies enormously in women worldwide. Medical interventions/hospitalizations linked to childbirth may have represented a route of HCV transmission, but not sexual intercourse. Combining dried blood spot collection with high-throughput HCV assays can facilitate seroepidemiological studies in LMIC where data is otherwise scarce.
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Affiliation(s)
- Gary M. Clifford
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Tim Waterboer
- Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Bolormaa Dondog
- Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - You Lin Qiao
- Cancer Institute of the Chinese Academy of Medical Sciences, Beijing, China
| | | | | | - Namory Keita
- Department of Obstetrics and Gynaecology, Centre Hospitalier Universitaire de Donka, Conakry, Guinea
| | - Nahid Khodakarami
- Infertility and Reproductive Health Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Syed Ahsan Raza
- Department of Surgery, The Aga Khan University, Karachi, Pakistan
- Centre de Recherche du CHUM, Département de Médecine Sociale et Préventive Université de Montréal, Quebec, Canada
| | | | - Witold Zatonski
- The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Michael Pawlita
- Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Martyn Plummer
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Silvia Franceschi
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
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Hepatitis B Virus Infection and Exposure Among Foreign-Born Asian Americans in the U.S. HEPATITIS MONTHLY 2017. [DOI: 10.5812/hepatmon.43018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Aetiological characteristics of adult acute diarrhoea in a general hospital of Shanghai. Epidemiol Infect 2016; 145:545-552. [PMID: 27806735 DOI: 10.1017/s0950268816002533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Epidemic surveillance is an effective means to determine the characteristics of acute diarrhoea and the benefits of disease control and prevention. The epidemiological, clinical, and aetiological data of adult (aged ⩾15 years) acute diarrhoea in a general hospital in Shanghai were collected and analysed. Out of 2430 acute diarrhoea patients, 162 subjects were sampled (sample ratio 15:1). The sampled subjects had an average age (±s.d.) of 44 ± 18 years; 142 (87·7%) had a history that indicated ingestion of contaminated food; and 40 (24·7%), 54 (33·3%), and 73 (45·1%) patients had diarrhoea that was attributed to viral, bacterial, and unknown aetiological origins respectively. Viral diarrhoea is mainly prevalent during the winter and spring months, while bacterial and diarrhoea of unknown aetiology occur mainly in the summer months. The average age of the unknown aetiology group (48 ± 19 years) was significantly older than that of the viral diarrhoea group (39 ± 16 years). The number of patients with vomiting in the viral group (30·6%) was significantly higher than that in the bacterial (17·1%) and unknown aetiology (8·2%) groups. Viral and bacterial infections are the main cause of acute diarrhoea in Shanghai. However, further effective technological means are needed to improve the surveillance, control, and prevention of acute diarrhoea.
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Wu Z, Cui L, Zhao W, Yang D, Chen H, Wang R, Wang X, Zhang L, He T. Molecular epidemiology of hepatitis C infections in Ningxia, China: genotype, phylogeny and mutation analysis. Virol J 2016; 13:172. [PMID: 27756381 PMCID: PMC5070218 DOI: 10.1186/s12985-016-0635-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 10/12/2016] [Indexed: 02/07/2023] Open
Abstract
Background Current prevalence and genotype distribution of hepatitis C virus (HCV) infection remain unknown in Ningxia, northwest China. Methods From June to December 2013, 13,022 individuals were screened in Ningxia HIV/AIDS Sentinel Surveillance System, with their demographic features collected and serum samples tested for HCV antibody. Sero-positive drug users were further subjected to sequencing of NS5B and Core regions of HCV. Results The anti-HCV prevalence was 0.34 % among individuals without history of drug use, while it was 15.80 % among drug users. Of 79 NS5B sequences amplified from drug users, 64 (81.0 %) were male and 51 (64.0 %) were injection drug users (IDUs). Subtype 3a (40.5 %) and 1b (25.3 %) were the most predominant subtypes, followed in frequency by 3b (10.1 %) and 2a (7.6 %). Subtype distribution has no significant difference between injection and non-injection drug users. Based on phylogeographic analysis, HCV strains in Ningxia IDUs were mainly originated from two sites, Yunnan province (in southwest China bordering Myanmar, also known as Burma) and Xinjiang Autonomous Region (in northwest China on the border of Central Asia), which are the two major drug trafficking originates in China. Previously reported drug-resistance mutations were also scanned in this treatment-naïve population. Amino acid substitutions (C316N) associated with direct anti-viral agents (DAA) resistance were identified in the NS5B region in seven samples. Conclusion This study is the first to reveal the existence of multiple genotypes of HCV in Ningxia, an inland province in northwest China, suggesting the rapid spreading of the virus. Electronic supplementary material The online version of this article (doi:10.1186/s12985-016-0635-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zhonglan Wu
- Ningxia Center for Disease Control and Prevention, Ningxia, 750001, China
| | - Lijia Cui
- Tsinghua University School of Medicine, Beijing, 100084, China
| | - Weiming Zhao
- Ningxia Medical University School of Public Health and Management, Ningxia, 750001, China
| | - Dongzhi Yang
- Ningxia Center for Disease Control and Prevention, Ningxia, 750001, China
| | - Hui Chen
- Ningxia Center for Disease Control and Prevention, Ningxia, 750001, China
| | - Ruiqing Wang
- Wuzhong Center of Disease Control and Prevention, Ningxia, 751100, China
| | - Xuemin Wang
- Ningxia Center for Disease Control and Prevention, Ningxia, 750001, China
| | - Linqi Zhang
- Comprehensive AIDS Research Center, and Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Tsinghua University School of Medicine, Beijing, 100084, China
| | - Tianhua He
- Tsinghua University School of Medicine, Beijing, 100084, China.
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Seroepidemiological survey of hepatitis B virus infection among 764,460 women of childbearing age in rural China: A cross-sectional study. J Clin Virol 2016; 81:47-52. [DOI: 10.1016/j.jcv.2016.05.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 05/21/2016] [Accepted: 05/29/2016] [Indexed: 01/12/2023]
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Chen JH, Wang YY, Lv WB, Gan Y, Chang W, Tian NN, Huang XH, Liu L, Yu XF, Chen SD. Effects of interactions between environmental factors and KIF1B genetic variants on the risk of hepatocellular carcinoma in a Chinese cohort. World J Gastroenterol 2016; 22:4183-4190. [PMID: 27122668 PMCID: PMC4837435 DOI: 10.3748/wjg.v22.i16.4183] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 01/17/2016] [Accepted: 02/22/2016] [Indexed: 02/06/2023] Open
Abstract
AIM: To examine the effect of the potential interaction between KIF1B variants (rs17401966 and rs3748578) and environmental factors on the risk of hepatocellular carcinoma (HCC) in a high-risk region in China.
METHODS: Three hundred and six patients with HCC and 306 hospital-based control participants residing in the Shunde region of Guangdong Province, China were enrolled. Clinical characteristics were collected by reviewing the complete medical histories from the patient archives, and epidemiological data were collected using a questionnaire and clinical examination. Two single nucleotide polymorphisms (SNPs) of KIF1B (rs17401966 and rs3748578) were chosen for the current study. All subjects were genotyped using a TaqMan real-time polymerase chain reaction. Multiplicative and additive logistic regression models were used to evaluate various gene-environment interactions.
RESULTS: Smoking, frequent consumption of raw freshwater fish, hepatitis B virus (HBV) infection, and a family history of HCC were important risk factors for HCC in this population. Chronic infection with HBV was the most important environmental risk factor for HCC [odds ratio (OR) = 12.02; 95% confidence interval (95%CI): 6.02-24.00]. No significant association was found between the KIF1B variants alone and the risk of HCC. Nevertheless, a significant additive effect modification was observed between rs17401966 and alcohol consumption (P for additive interaction = 0.0382). Compared with non-drinkers carrying either the AG or GG genotype of rs17401966, individuals classified as alcohol consumers with the AA genotype of rs17401966 had a significantly increased risk of HCC (OR = 2.36; 95%CI: 1.49-3.74).
CONCLUSION: The gene-environment interaction between the KIF1B rs17401966 variant and alcohol consumption may contribute to the development of HCC in Chinese individuals.
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Zhou M, Li H, Ji Y, Ma Y, Hou F, Yuan P. Hepatitis C virus infection in the general population: A large community-based study in Mianyang, West China. Biosci Trends 2016; 9:97-103. [PMID: 25971694 DOI: 10.5582/bst.2015.01033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Hepatitis C virus (HCV) infection remains a major public health problem. The objective of the current study was to reveal the seroepidemiology of HCV in the general population in Mianyang City. This study collected 438,575 blood samples from participants who had enrolled in the National Science and Technology Development Project and their demographic information, and then evaluated HCV antibody and alanine aminotransferase (ALT) levels. The overall anti-HCV positive rate was 0.80% (3,491/438,575) in the Mianyang general population, and it was 1.19% in rural population and 0.20% in urban. Anti-HCV positive rate increased with age, peaked at 45-54 years (2.01%), and then decreased. Anti-HCV prevalence was higher in males (0.89%) than that in females (0.73%). The prevalence of anti-HCV in participants with a history of blood transfusion, surgery, or with a previous diagnosis of hypertension was higher. The abnormal ALT levels (> 40 IU/L) were observed in 50.11% and 7.74% of anti-HCV positive and negative groups, respectively. In anti-HCV positive groups, the rate of abnormal ALT levels was higher in 55-64 age groups, male, and rural population. Though Mianyang was a low endemic area for HCV infection, the alarming fact was the large number of abnormal ALT levels in patients related to hepatitis C. This revealed delayed diagnosis and treatment of HCV infections. It is a necessity to promote early diagnosis and timely treatment of HCV infections.
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Affiliation(s)
- Min Zhou
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University
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30
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Wang C, Shi CX, Rou K, Zhao Y, Cao X, Luo W, Liu E, Wu Z. Baseline HCV Antibody Prevalence and Risk Factors among Drug Users in China's National Methadone Maintenance Treatment Program. PLoS One 2016; 11:e0147922. [PMID: 26906025 PMCID: PMC4764346 DOI: 10.1371/journal.pone.0147922] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 01/11/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) is the most common viral infection among injecting drug users worldwide. We aimed to assess HCV antibody prevalence and associated risk factors among clients in the Chinese national methadone maintenance treatment (MMT) program. METHODS Data from 296,209 clients who enrolled in the national MMT program between March 2004 and December 2012 were analyzed to assess HCV antibody prevalence, associated risk factors, and geographical distribution. RESULTS Anti-HCV screening was positive for 54.6% of clients upon MMT entry between 2004 and 2012. HCV antibody prevalence at entry declined from 66.8% in 2005 to 45.9% in 2012. The most significant predictors of HCV seropositivity were injecting drug use (adjusted odds ratio [AOR]: 8.34, 95% confidence interval [CI]: 8.17-8.52, p<0.0001) and a history of drug use ≥9 years (AOR: 2.01, 95% CI: 1.96-2.06, p<0.0001). Being female, of Uyghur or Zhuang ethnicity, and unmarried were identified as demographic risk factors (all p-values<0.0001). Of the 28 provincial-level divisions included in the study, we found that 5 divisions had HCV antibody prevalence above 70% and 20 divisions above 50%. The HCV screening rate within 6 months after MMT entry greatly increased from 30.4% in 2004 to 93.1% in 2012. CONCLUSIONS The current HCV antibody prevalence remains alarmingly high among MMT clients throughout most provincial-level divisions in China, particularly among injecting drug users and females. A comprehensive prevention strategy is needed to control the HCV epidemic among MMT clients in China.
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Affiliation(s)
- Changhe Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Cynthia X. Shi
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Keming Rou
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yan Zhao
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaobin Cao
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wei Luo
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Enwu Liu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zunyou Wu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- * E-mail: ;
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Incidence and risk factors for hepatocellular carcinoma in primary biliary cirrhosis. Clin Rev Allergy Immunol 2016; 48:132-41. [PMID: 25762349 DOI: 10.1007/s12016-015-8483-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The incidence, risk factors, and clinical features of hepatocellular carcinoma (HCC) in primary biliary cirrhosis (PBC) have been a long-standing subject of interest. We took advantage of a large cohort of 1865 well-defined Chinese patients with PBC for whom follow-up was conducted for up to 20 years to study the incidence of HCC. Our goal was to address the incidence and prevalence of HCC in PBC and the risk factors, including hepatitis B virus (HBV) infection, and finally to compare the tumor characteristics of PBC-related HCC, including size, location, mortality, and long-term outcomes, to that of HBV-related HCC. In this cohort, HCC occurred in 70 of 1865 PBC patients with a prevalence of 3.75 % and an incidence of 0.66 cases per 100 patient-years. The 5- and 10-year cumulative incidences were 2.6 % (95 % confidence interval (CI) 1.8-3.4) and 8.9 % (95 % CI 5.5-12.3), respectively. Age >54 years (odds ratio [OR] = 5.5, 95 % CI 3.0-10.1, p = 0.001), male sex (OR = 2.2, 95 % CI 1.2-4.0, p = 0.001), co-existence of diabetes mellitus (DM) (OR = 3.1, 95 % CI 1.6-6.2, p = 0.002), and previous HBV infection (OR = 6.6, 95 % CI 3.7-11.9, p = 0.001) were independently associated with the development of HCC. The tumor size, number, location, and 5-year survival were not significantly different in PBC-related HCC compared to HBV-related HCC. Alpha-fetoprotein was elevated in only 20 % of the cases with PBC-related HCC. Although HCC was uncommon, occurring in fewer than 5 % of patients, the risk is significantly increased by age, sex, DM, and past HBV infection.
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Xu S, Wang Q, Zhang W, Qiu Z, Cui J, Yan W, Ni A. Seroprevalence of the Hepatitis B, Hepatitis C, and Human Immunodeficiency Viruses and Treponema pallidum at the Beijing General Hospital from 2010 to 2014: A Cross-Sectional Study. PLoS One 2015; 10:e0140854. [PMID: 26502175 PMCID: PMC4621017 DOI: 10.1371/journal.pone.0140854] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 10/01/2015] [Indexed: 12/15/2022] Open
Abstract
Background The hepatitis B, hepatitis C, human immunodeficiency viruses and Treponema pallidum are important causes of infectious diseases concern to public health. Methods Between 2010 and 2014, we used an automated chemiluminescence microparticle immunoassay to detect the hepatitis B, hepatitis C, and human immunodeficiency viruses as well as Treponema pallidum (the rapid plasma regain test was used in 2010–2011). Positive human immunodeficiency virus tests were confirmed via western blotting. Results Among 416,130 subjects, the seroprevalences for hepatitis B virus, hepatitis C virus, human immunodeficiency virus, and Treponema pallidum were 5.72%, 1.23%, 0.196%, and 0.76%, respectively. Among 671 patients with positive human immunodeficiency virus results, 392 cases were confirmed via western blotting. Hepatitis B and human immunodeficiency virus infections were more frequent in men (7.78% and 0.26%, respectively) than in women (4.45% and 0.021%, respectively). The hepatitis B and C virus seroprevalences decreased from 6.21% and 1.58%, respectively, in 2010, to 5.37% and 0.988%, respectively, in 2014. The human immunodeficiency virus seroprevalence increased from 0.04% in 2010 to 0.17% in 2014, and was elevated in the Infectious Disease (2.65%), Emergency (1.71%), and Dermatology and Sexually Transmitted Diseases (1.12%) departments. The specificity of the human immunodeficiency virus screening was 71.4%. The false positive rates for the Treponema pallidum screening tests increased in patients who were 60–70 years old. The co-infection rates for the hepatitis C and human immunodeficiency viruses were 0.47% in hepatitis C virus-positive patients and 7.33% in human immunodeficiency virus-positive patients. Conclusions During 2010–2014, hepatitis B virus and human immunodeficiency virus infections were more frequent among men at our institution. Although the seroprevalences of hepatitis B and C viruses decreased, the seroprevalence of human immunodeficiency virus infection increased (with higher seroprevalences in high-risk departments). Older patients were more likely to exhibit false positive findings for syphilis.
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Affiliation(s)
- Shaoxia Xu
- Department of Clinical Laboratories, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiaofeng Wang
- Department of Clinical Laboratories, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Weihong Zhang
- Department of Clinical Laboratories, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhifeng Qiu
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingtao Cui
- Department of Clinical Laboratories, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenjuan Yan
- Department of Clinical Laboratories, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Anping Ni
- Department of Clinical Laboratories, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- * E-mail:
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Zhu SS, Zeng QL, Dong Y, Xu ZQ, Wang LM, Chen DW, Gan Y, Wang FC, Yan JG, Cao LL, Wang P, Han J, Zhang XX, Zhang Z, Zhang HF, Wang FS. Interferon-α plus ribavirin yields 98 % sustained virologic response in children aged 1-5 years with iatrogenic chronic hepatitis C. Hepatol Int 2015; 9:578-85. [PMID: 26449425 DOI: 10.1007/s12072-015-9671-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 07/19/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVES The clinical features and efficacies of antivirals for children with hepatitis C virus (HCV) infections that are acquired through different transmission routines are poorly understood worldwide. This study investigated the clinical characteristics of children who were infected via iatrogenic means and analyzed the efficacy of antiviral therapy in children with chronic hepatitis C (CHC). METHODS In total, 256 children with HCV infections aged 1 to 5 years were enrolled and surveyed. Interferon-α plus ribavirin was administered to 162 children with CHC for 24 or 48 weeks. The sustained virologic response (SVR) at 24 weeks post-treatment was determined. RESULTS The median duration of infection was 11.5 (range 6-24) months. The median age was 2.7 years, and 64.5 % of the subjects were male. Ninety-three children (36.3 %, 93/256) exhibited spontaneous resolution of the HCV infection. The remaining 163 (63.7 %) were HCV RNA-positive and had HCV genotypes 1b and 2a, which were identified in 42 and 58 %, respectively, of the 133 tested children. Liver biopsies were performed in all HCV RNA-detectable children. A total of 23.9 % cases exhibited grade 2 activity, and 30.1 % exhibited stage 2/3 liver fibrosis. The serum HCV RNA levels were positively correlated with the aminotransferases. Of the 162 treated CHC children, 158 (97.5 %) achieved SVR. The side effects were mild, and 158 (97.5 %) of the treated patients tolerated the treatment well. CONCLUSIONS This study revealed that histological liver disease can be present within 6-24 months of acquiring an HCV infection in children aged 1-5 years. Interferon-α plus ribavirin therapy is a highly effective and cost-effective means of managing children with early-stage chronic HCV infection.
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Affiliation(s)
- Shi-Shu Zhu
- Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China
| | - Qing-Lei Zeng
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.,The Institute of Translational Hepatology, Beijing 302 Hospital, Beijing, 100039, China
| | - Yi Dong
- Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China
| | - Zhi-Qiang Xu
- Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China
| | - Li-Min Wang
- Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China
| | - Da-Wei Chen
- Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China
| | - Yu Gan
- Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China
| | - Fu-Chuan Wang
- Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China
| | - Jian-Guo Yan
- Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China
| | - Li-Li Cao
- Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China
| | - Pu Wang
- Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China
| | - Jin Han
- Genetic Testing Center, Beijing 302 Hospital, Beijing, 100039, China
| | - Xue-Xiu Zhang
- The Institute of Translational Hepatology, Beijing 302 Hospital, Beijing, 100039, China
| | - Zheng Zhang
- The Institute of Translational Hepatology, Beijing 302 Hospital, Beijing, 100039, China
| | - Hong-Fei Zhang
- Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China.
| | - Fu-Sheng Wang
- The Institute of Translational Hepatology, Beijing 302 Hospital, Beijing, 100039, China.
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Liu J, Zhang S, Wang Q, Shen H, Zhang M, Zhang Y, Yan D, Liu M. Seroepidemiology of hepatitis B virus infection in 2 million men aged 21-49 years in rural China: a population-based, cross-sectional study. THE LANCET. INFECTIOUS DISEASES 2015; 16:80-86. [PMID: 26268687 DOI: 10.1016/s1473-3099(15)00218-2] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 07/03/2015] [Accepted: 07/10/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND Hepatitis B virus (HBV) infection is highly endemic (7-8% prevalence) in rural China, causing high mortality and societal burden. Data from men of reproductive age is scarce and last reported in 2006. We assessed the seroepidemiology of men in rural China, aiming to provide updated baseline data for the prevalence of HBV infection. METHODS We established prevalence of HBV infection from data gathered through a nationwide population-based study of Chinese rural men aged 21-49 years. Data were obtained from a physical check-up programme for couples of reproductive age, the National Free Preconception Health Examination Project, that covered 31 provinces from 2010-12. We tested serological samples with ELISA and categorised participants' HBV status based on presence of HBsAg, anti-HBV core antibody (anti-HBc), and anti-HBV surface antibody (anti-HBs). FINDINGS 2 030 083 men were recruited into the database from Jan 1, 2010, to Dec 31, 2012, and 1 966 013 men provided serum samples for analysis. 124 274 men (6%) tested positive for HBsAg, 178 559 (9%) tested positive for anti-HBc, and 583 923 (30%) tested positive for anti-HBs. Isolated anti-HBs (an indicator of vaccine-mediated immunity) were present in 527 566 men (27%). And 1 234 127 men (63%) were negative for all HBV makers (susceptible population). HBsAg prevalence was higher in men aged 25-39 years (6·35-6·47%) than in other age groups (5·54-5·78%; p<0·0001). HBV markers were all more prevalent in the eastern region of China than in the central or western regions (all p<0·0001). 32 326 (26%) of 124 274 HBsAg-positive men tested positive for HBeAg (suggesting high infectiousness); this decreased with increasing age (p<0·0001). INTERPRETATION HBV prevalence in men in rural China has changed from highly endemic into intermediate endemic in the past two decades. However, the absolute number of HBV-infected men and the susceptible population is still very large. FUNDING Chinese Association of Maternal and Child Health Studies.
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Affiliation(s)
- Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Shikun Zhang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China
| | - Qiaomei Wang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China
| | - Haiping Shen
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China
| | - Man Zhang
- Center for Clinical Laboratory, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China
| | - Donghai Yan
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
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35
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Sharma S, Carballo M, Feld JJ, Janssen HLA. Immigration and viral hepatitis. J Hepatol 2015; 63:515-22. [PMID: 25962882 DOI: 10.1016/j.jhep.2015.04.026] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 04/29/2015] [Accepted: 04/30/2015] [Indexed: 01/09/2023]
Abstract
WHO estimates reveal that the global prevalence of viral hepatitis may be as high as 500 million, with an annual mortality rate of up to 1.3 million individuals. The majority of this global burden of disease is borne by nations of the developing world with high rates of vertical and iatrogenic transmission of HBV and HCV, as well as poor access to healthcare. In 2013, 3.2% of the global population (231 million individuals) migrated into a new host nation. Migrants predominantly originate from the developing countries of the south, into the developed economies of North America and Western Europe. This mass migration of individuals from areas of high-prevalence of viral hepatitis poses a unique challenge to the healthcare systems of the host nations. Due to a lack of universal standards for screening, vaccination and treatment of viral hepatitis, the burden of chronic liver disease and hepatocellular carcinoma continues to increase among migrant populations globally. Efforts to increase case identification and treatment among migrants have largely been limited to small outreach programs in urban centers, such that the majority of migrants with viral hepatitis continue to remain unaware of their infection. This review summarizes the data on prevalence of viral hepatitis and burden of chronic liver disease among migrants, current standards for screening and treatment of immigrants and refugees, and efforts to improve the identification and treatment of viral hepatitis among migrants.
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Affiliation(s)
- Suraj Sharma
- Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Canada
| | - Manuel Carballo
- International Centre for Migration, Health and Development, Geneva, Switzerland
| | - Jordan J Feld
- Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Canada
| | - Harry L A Janssen
- Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Canada; Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
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Luo LF, Qiao K, Wang XG, Ding KY, Su HL, Li CZ, Yan HJ. Acute gastroenteritis outbreak caused by a GII.6 norovirus. World J Gastroenterol 2015; 21:5295-5302. [PMID: 25954103 PMCID: PMC4419070 DOI: 10.3748/wjg.v21.i17.5295] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 12/11/2014] [Accepted: 01/30/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To report an acute gastroenteritis outbreak caused by a genogroup 2 genotype 6 (GII.6) strain norovirus in Shanghai, China.
METHODS: Noroviruses are responsible for approximately half of all reported gastroenteritis outbreaks in many countries. Genogroup 2 genotype 4 strains are the most prevalent. Rare outbreaks caused by GII.6 strains have been reported. An acute gastroenteritis outbreak occurred in an elementary school in Shanghai in December of 2013. Field and molecular epidemiologic investigations were conducted.
RESULTS: The outbreak was limited to one class in an elementary school located in southwest Shanghai. The age of the students ranged from 9 to 10 years. The first case emerged on December 10, 2013, and the last case emerged on December 14, 2013. The cases peaked on December 11, 2013, with 21 new cases. Of 45 students in the class, 32 were affected. The main symptom was gastroenteritis, and 15.6% (5/32) of the cases exhibited a fever. A field epidemiologic investigation showed the pathogen may have been transmitted to the elementary school from employees in a delicatessen via the first case student, who had eaten food from the delicatessen one day before the gastroenteritis episodes began. A molecular epidemiologic investigation identified the cause of the gastroenteritis as norovirus strain GII.6; the viral sequence of the student cases showed 100% homology with that of the shop employees. Genetic relatedness analyses showed that the new viral strain is closely related to previously reported GII.6 sequences, especially to a strain reported in Japan.
CONCLUSION: This is the first report to show that norovirus strain GII.6 can cause a gastroenteritis outbreak. Thus, the prevalence of GII.6 noroviruses requires attention.
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Seropositivity of Antibodies Against Hepatitis A Virus in Mashhad, Northeast of Iran: A Cross-Sectional Community-Based Study During 2009. RAZAVI INTERNATIONAL JOURNAL OF MEDICINE 2015. [DOI: 10.5812/rijm.3(2)2015.27082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Qin Q, Smith MK, Wang L, Su Y, Wang L, Guo W, Wang L, Cui Y, Wang N. Hepatitis C virus infection in China: an emerging public health issue. J Viral Hepat 2015; 22:238-44. [PMID: 25131856 DOI: 10.1111/jvh.12295] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Hepatitis C virus now represents a global viral pandemic and is the fourth most commonly reported infectious disease in China. Information on China's national HCV epidemic was limited to cross -sectional seroprevalence studies of special populations, and a national surveillance effort had been launched to inform prevention and control. We analysed novel data from two national databases: (i) China's national medical HCV case report system and (ii) the national disease sentinel surveillance system. Between 1997 and 2012, reporting incidence of medical cases for HCV infection rose from 0.7 to 15.0 cases per 100 000 with the largest burden of disease concentrated among individuals over 35 years of age, rural residents and those tested as part of routine screening. Between 2010 and 2012, disease sentinel surveillance identified the highest HCV seropositive rates among persons who use drugs and haemodialysis patients, with far lower but not negligible rates among sexually active population. The concentration of cases among older age groups is consistent with past studies of age-specific prevalence rates in Asia. Differences across regions and testing modes suggest diverse biological and social forces driving the spread of HCV in China. Surveillance data show ongoing transmission, particularly among persons who use drugs and persons undergoing invasive medical treatments, particularly haemodialysis. Improvements in case detection and data reporting systems will be critical for understanding current drivers of transmission and identifying key areas for prevention.
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Affiliation(s)
- Qianqian Qin
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Hepatitis C virus infection and risk factors in the general population: a large community-based study in eastern China, 2011-2012. Epidemiol Infect 2015; 143:2827-36. [PMID: 25600557 PMCID: PMC9151013 DOI: 10.1017/s0950268814003719] [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] [Indexed: 12/20/2022] Open
Abstract
Limited information is available on the prevalence of hepatitis C virus (HCV) in the general population in China. A community-based epidemiological study was conducted in three counties in eastern China. A total of 149 175 individuals were investigated in 60 communities in three counties in Jiangsu province, eastern China, of whom 1175 subjects [0·79%, 95% confidence interval (CI) 0·74-0·83] were HCV antibody positive. The prevalence was low in children (0·09%, 95% CI 0·04-0·17), but increased progressively from adolescents (0·20%, 95% CI 0·15-0·28) to adults aged ⩾21 years (95% CI 0·15-1·64). Women had a higher prevalence of HCV infection than men in most age groups. In a multilevel regression analysis, age, sex, education, occupation, blood transfusion [odds ratio (OR) 2·91, 95% CI 1·09-5·37], invasive testing (OR 1·28, 95% CI 1·14-1·61), and dental therapy (OR 2·27, 95% CI 1·41-3·42) were associated with HCV infection. In conclusion, although the prevalence of HCV in this population was lower than reported from national levels, the total reservoir of infection is significant and warrants public health measures, such as health education to limit the magnitude of the problem.
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40
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Yang J, Li W, Long Y, Song S, Liu J, Zhang X, Wang X, Jiang S, Liao G. Reliability of pseudotyped influenza viral particles in neutralizing antibody detection. PLoS One 2014; 9:e113629. [PMID: 25436460 PMCID: PMC4249968 DOI: 10.1371/journal.pone.0113629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 10/28/2014] [Indexed: 11/25/2022] Open
Abstract
Background Current influenza control strategies require an active surveillance system. Pseudotyped viral particles (pp) together with the evaluation of pre-existing immunity in a population might satisfy this requirement. However, the reliability of using pp in neutralizing antibody (nAb) detection are undefined. Methodology/Principal Findings Pseudotyped particles of A(H1N1)pmd09 (A/California/7/2009) and HPAI H5N1 (A/Anhui/1/2005), as well as their reassortants, were generated. The reliability of using these pp in nAb detection were compared concurrently with the corresponding viruses by a hemagglutination inhibition test, as well as ELISA-, cytopathic effect-, and fluorescence-based microneutralization assays. In the qualitative detection on nAbs, the pp and their corresponding viruses were in complete agreement, with an R2 value equal to or near 1 in two different populations. In the quantitative detection on nAbs, although the geometric mean titers (95% confidence interval) differed between the pp and viruses, no significant difference was observed. Furthermore, humoral immunity against the reassortants was evaluated; our results indicated strong consistency between the nAbs against reassortant pp and those against naïve pp harboring the same hemagglutinin. Conclusion/Significance The pp displayed high reliability in influenza virus nAb detection. The use of reassortant pp is a safe and convenient strategy for characterizing emerging influenza viruses and surveying the disease burden.
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MESH Headings
- Adolescent
- Adult
- Animals
- Antibodies, Viral/immunology
- Cells, Cultured
- Dogs
- HEK293 Cells
- Hemagglutination Inhibition Tests
- Hemagglutinin Glycoproteins, Influenza Virus/immunology
- Humans
- Influenza A Virus, H1N1 Subtype/immunology
- Influenza A Virus, H1N1 Subtype/isolation & purification
- Influenza A Virus, H5N1 Subtype/immunology
- Influenza A Virus, H5N1 Subtype/isolation & purification
- Influenza, Human/blood
- Influenza, Human/immunology
- Influenza, Human/virology
- Madin Darby Canine Kidney Cells
- Middle Aged
- Reassortant Viruses/immunology
- Virion/immunology
- Young Adult
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Affiliation(s)
- Jinghui Yang
- Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, Yunnan, China
| | - Weidong Li
- Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, Yunnan, China
- * E-mail: (GL); (WL); (XW)
| | - Yunfeng Long
- Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, Yunnan, China
| | - Shaohui Song
- Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, Yunnan, China
| | - Jing Liu
- Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, Yunnan, China
| | - Xinwen Zhang
- Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, Yunnan, China
| | - Xiaoguang Wang
- Minhang District Center for Disease Control and Prevention, Shanghai, China
- * E-mail: (GL); (WL); (XW)
| | - Shude Jiang
- Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, Yunnan, China
| | - Guoyang Liao
- Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, Yunnan, China
- * E-mail: (GL); (WL); (XW)
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Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol 2014; 61:S45-57. [PMID: 25086286 DOI: 10.1016/j.jhep.2014.07.027] [Citation(s) in RCA: 1320] [Impact Index Per Article: 132.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 07/14/2014] [Accepted: 07/19/2014] [Indexed: 02/08/2023]
Abstract
The treatment of chronic hepatitis C virus (HCV) infection has the potential to change significantly over the next few years as therapeutic regimens are rapidly evolving. However, the burden of chronic infection has not been quantified at the global level using the most recent data. Updated estimates of HCV prevalence, viremia and genotypes are critical for developing strategies to manage or eliminate HCV infection. To achieve this, a comprehensive literature search was conducted for anti-HCV prevalence, viraemic prevalence and genotypes for all countries. Studies were included based on how well they could be extrapolated to the general population, sample size and the age of the study. Available country estimates were used to develop regional and global estimates. Eighty-seven countries reported anti-HCV prevalence, while HCV viraemic rates were available for fifty-four countries. Total global viraemic HCV infections were estimated at 80 (64-103) million infections. Genotype distribution was available for ninety-eight countries. Globally, genotype 1 (G1) was the most common (46%), followed by G3 (22%), G2 (13%), and G4 (13%). In conclusion, the total number of HCV infections reported here are lower than previous estimates. The exclusion of data from earlier studies conducted at the peak of the HCV epidemic, along with adjustments for reduced prevalence among children, are likely contributors. The results highlight the need for more robust surveillance studies to quantify the HCV disease burden more accurately.
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Affiliation(s)
- Erin Gower
- Center for Disease Analysis, Louisville, CO, USA
| | - Chris Estes
- Center for Disease Analysis, Louisville, CO, USA
| | - Sarah Blach
- Center for Disease Analysis, Louisville, CO, USA
| | | | - Homie Razavi
- Center for Disease Analysis, Louisville, CO, USA.
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Jia Z, Yi Y, Liu J, Cao J, Zhang Y, Tian R, Yu T, Wang H, Wang X, Su Q, Zhou W, Cui F, Liang X, Bi S. Epidemiology of hepatitis E virus in China: results from the Third National Viral Hepatitis Prevalence Survey, 2005-2006. PLoS One 2014; 9:e110837. [PMID: 25360522 PMCID: PMC4215996 DOI: 10.1371/journal.pone.0110837] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 08/29/2014] [Indexed: 12/20/2022] Open
Abstract
In China, hepatitis E virus (HEV) is prevalent and causes disease, but its epidemiological profile is not well understood. We used a commercial enzyme-linked immunosorbent assay to detect total antibodies to hepatitis E virus in 15,862 serum samples collected during the Third National Viral Hepatitis Prevalence Survey. The results were analyzed to calculate estimates of HEV seroprevalence and to examine the effects of some putative risk factors. The seroprevalence of HEV in the general Chinese population during the period from 2005 through 2006 was 23.46% (95% confidence interval [CI], 18.41%–28.50%). The farming population, the age group of 15–60 year olds, and those living in the Midwest or Mideast region and in Xinjiang province had the highest seroprevalence estimates. The prevalence of HEV is high in China. The seroprevalence rate of HEV shows an unbalanced distribution among areas with different geographic location and economic development levels. The characteristics of the distribution associated may be due to the route of HEV transmission (via contaminated water or animal reservoirs). Within the same region, the seroprevalence of HEV is generally increased with age.
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Affiliation(s)
- Zhiyuan Jia
- National Institute of Virology Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yao Yi
- National Institute of Virology Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jianhua Liu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Jingyuan Cao
- National Institute of Virology Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yong Zhang
- National Institute of Virology Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ruiguang Tian
- National Institute of Virology Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tao Yu
- National Institute of Virology Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hao Wang
- National Institute of Virology Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xinying Wang
- National Institute of Virology Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qiudong Su
- National Institute of Virology Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenting Zhou
- National Institute of Virology Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fuqiang Cui
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaofeng Liang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shengli Bi
- National Institute of Virology Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- * E-mail:
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43
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Goyal A, Murray JM. The impact of vaccination and antiviral therapy on hepatitis B and hepatitis D epidemiology. PLoS One 2014; 9:e110143. [PMID: 25313681 PMCID: PMC4196970 DOI: 10.1371/journal.pone.0110143] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 09/17/2014] [Indexed: 12/18/2022] Open
Abstract
The major cause of liver cancer around the globe is hepatitis B virus (HBV), which also contributes to a large number of deaths due to liver failure alone. Hepatitis delta virus (HDV) is as potentially alarming as HBV since life threatening cases are 10 times more likely with HBV-HDV dual infection compared to HBV monoinfection. So far, there is no established effective treatment against HDV and the only preventive action suggested by the World Health Organization is to introduce HBV vaccination for children immediately after birth (newborns) and thus reduce the available pool for HDV infection. Here the main objective is to understand the complex dynamics of HBV-HDV infection in a human population that can inform public health policy makers on the level of different preventive measures required to eliminate HBV and HDV infections. Model simulations suggest that HBV vertical transmission and HBV vaccination rates for newborns are instrumental in determining HBV and HDV prevalence. A decrease in HBV prevalence is observed as vaccination coverage increases and it is possible to eradicate both HBV and HDV using high vaccination coverage of ≥80% in the long term. We further found that HDV presence results in lower HBV prevalence. An application of our model to China revealed that vaccinating every newborn in China will further prevent 1.69 million new infections by 2028 as compared to the current 90% vaccination coverage. Although, higher vaccination coverage of newborns should eliminate both HBV and HDV over a long time period, any short term strategy to eradicate HDV must include additional preventive measures such as HBV adult vaccination. Implementation of HBV adult vaccination programs at a rate of 10% per year over 15 years will further prevent 39 thousand new HDV infections in China by 2028 as compared to HBV vaccination programs solely for newborns.
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Affiliation(s)
- Ashish Goyal
- School of Mathematics and Statistics, University of New South Wales, Sydney, Australia
- * E-mail:
| | - John M. Murray
- School of Mathematics and Statistics, University of New South Wales, Sydney, Australia
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Waning of anti-HAV immunity in Shijiazhuang prefecture, Hebei province, China: A comparison of seroprevalence between 1992 and 2011. Vaccine 2014; 32:6227-32. [DOI: 10.1016/j.vaccine.2014.09.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 08/28/2014] [Accepted: 09/08/2014] [Indexed: 11/18/2022]
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45
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Ansaldi F, Orsi A, Sticchi L, Bruzzone B, Icardi G. Hepatitis C virus in the new era: Perspectives in epidemiology, prevention, diagnostics and predictors of response to therapy. World J Gastroenterol 2014; 20:9633-9652. [PMID: 25110404 PMCID: PMC4123355 DOI: 10.3748/wjg.v20.i29.9633] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 04/18/2014] [Accepted: 05/19/2014] [Indexed: 02/06/2023] Open
Abstract
Despite the great successes achieved in the fields of virology and diagnostics, several difficulties affect improvements in hepatitis C virus (HCV) infection control and eradication in the new era. New HCV infections still occur, especially in some of the poorest regions of the world, where HCV is endemic and long-term sequelae have a growing economic and health burden. An HCV vaccine is still no available, despite years of researches and discoveries about the natural history of infection and host-virus interactions: several HCV vaccine candidates have been developed in the last years, targeting different HCV antigens or using alternative delivery systems, but viral variability and adaption ability constitute major challenges for vaccine development. Many new antiviral drugs for HCV therapy are in preclinical or early clinical development, but different limitations affect treatment validity. Treatment predictors are important tools, as they provide some guidance for the management of therapy in patients with chronic HCV infection: in particular, the role of host genomics in HCV infection outcomes in the new era of direct-acting antivirals may evolve for new therapeutic targets, representing a chance for modulated and personalized treatment management, when also very potent therapies will be available. In the present review we discuss the most recent data about HCV epidemiology, the new perspectives for the prevention of HCV infection and the most recent evidence regarding HCV diagnosis, therapy and predictors of response to it.
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46
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Goh GBB, Chow WC, Renwei-Wang, Yuan JM, Koh WP. Coffee, alcohol and other beverages in relation to cirrhosis mortality: the Singapore Chinese Health Study. Hepatology 2014; 60:661-9. [PMID: 24753005 PMCID: PMC4110174 DOI: 10.1002/hep.27054] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 02/03/2014] [Indexed: 12/15/2022]
Abstract
UNLABELLED Limited experimental and epidemiologic data suggest that coffee may reduce hepatic damage in chronic liver disease. The association between consumption of coffee and other beverages and risk of cirrhosis mortality was evaluated in the Singapore Chinese Health Study. This is a prospective population-based cohort of 63,275 middle-aged and older Chinese subjects who provided data on diet, lifestyle, and medical histories through in-person interviews using a structured questionnaire at enrollment between 1993 and 1998. Mortality from cirrhosis in the cohort was ascertained through linkage analysis with nationwide death registry. After a mean follow-up of 14.7 years, 114 subjects died from cirrhosis; 33 of them from viral hepatitis B (29%), two from hepatitis C (2%), and 14 from alcohol-related cirrhosis (12%). Compared to nondrinkers, daily alcohol drinkers had a strong dose-dependent positive association between amount of alcohol and risk of cirrhosis mortality. Conversely, there was a strong dose-dependent inverse association between coffee intake and risk of nonviral hepatitis-related cirrhosis mortality (P for trend = 0.014). Compared to non-daily coffee drinkers, those who drank two or more cups per day had a 66% reduction in mortality risk (hazard ratio [HR] = 0.34, 95% confidence interval [CI] = 0.14-0.81). However, coffee intake was not associated with hepatitis B-related cirrhosis mortality. The inverse relationship between caffeine intake and nonviral hepatitis-related cirrhosis mortality became null after adjustment for coffee drinking. The consumption of black tea, green tea, fruit juices, or soft drinks was not associated with risk of cirrhosis death. CONCLUSION This study demonstrates the protective effect of coffee on nonviral hepatitis-related cirrhosis mortality, and provides further impetus to evaluate coffee as a potential therapeutic agent in patients with cirrhosis.
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Affiliation(s)
- George Boon-Bee Goh
- Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore
| | - Wan-Cheng Chow
- Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore
- Duke-NUS Graduate Medical School Singapore, Singapore
| | - Renwei-Wang
- Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, USA
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Woon-Puay Koh
- Duke-NUS Graduate Medical School Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Dong C, Huang ZJ, Martin MC, Huang J, Liu H, Deng B, Lai W, Liu L, Yang Y, Hu Y, Qin G, Zhang L, Song Z, Wei D, Nan L, Wang Q, Deng H, Zhang J, Wong FY, Yang W. The impact of social factors on human immunodeficiency virus and hepatitis C virus co-infection in a minority region of Si-chuan, the People's Republic of China: a population-based survey and testing study. PLoS One 2014; 9:e101241. [PMID: 24988219 PMCID: PMC4079678 DOI: 10.1371/journal.pone.0101241] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Accepted: 06/04/2014] [Indexed: 11/30/2022] Open
Abstract
Background While many human immunodeficiency virus (HIV) studies have been performed in Liangshan, most were focused only on HIV infection and based on a sampling survey. In order to fully understand HIV and hepatitis C virus (HCV) prevalence and related risk factors in this region, this study implemented in 2009, included a survey, physical examination, HIV and HCV test in two towns. Methods All residents in two towns of the Butuo county were provided a physical examination and blood tests for HIV and HCV, and then followed by an interview for questionnaire. Results In total, 10,104 residents (92.4%) were enrolled and 9,179 blood samples were collected for HIV and HCV testing, 6,072 were from individuals >14 years old. The rates of HIV, HCV, and HIV/HCV co-infection were 11.4%, 14.0%, and 7.7%, respectively for >14-year-old residents. The 25–34 yr age group had the highest prevalence of HIV, HCV, and HIV/HCV co-infections, reaching 24.4%, 26.2% and 16.0%, respectively. Overall, males had a much higher prevalence of all infections than females (HIV: 16.3% vs. 6.8%, HCV: 24.6% vs. 3.9%, HIV/HCV co-infected: 14.7% vs. 1.1%, respectively; P = 0.000). Approximately half of intravenous drug users tested positive for HIV (48.7%) and 68.4% tested positive for HCV. Logistic regression analysis showed that five factors were significantly associated with HIV and HCV infection: gender (odds ratio [OR] = 5.8), education (OR = 2.29); occupation (student as reference; farmer: OR = 5.02, migrant worker: OR = 6.12); drug abuse (OR = 18.0); and multiple sexual partners (OR = 2.92). Knowledge of HIV was not associated with infection. Conclusion HIV and HCV prevalence in the Liangshan region is very serious and drug use, multiple sexual partners, and low education levels were the three main risk factors. The government should focus on improving education and personal health awareness while enhancing drug control programs.
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Affiliation(s)
- Caiting Dong
- Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China
| | - Z. Jennifer Huang
- Department of International Health, Georgetown University, Washington DC, United States of America
| | - Maria C. Martin
- Department of Pediatrics - Adolescent & Young Adult Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Jun Huang
- Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China
| | - Honglu Liu
- Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China
| | - Bin Deng
- Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China
| | - Wenhong Lai
- Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China
| | - Li Liu
- Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China
| | - Yihui Yang
- Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China
| | - Ying Hu
- Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China
| | - Guangming Qin
- Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China
| | - Linglin Zhang
- Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China
| | - Zhibin Song
- Department of HIV Control and Prevention, Liangshan Prefecture Health Bureau, Xichang, Si-chuan, China
| | - Daying Wei
- Department of HIV Control and Prevention, Lianshan Center for Disease Control and Prevention, Xichang, Si-chuan, China
| | - Lei Nan
- Department of HIV Control and Prevention, Lianshan Center for Disease Control and Prevention, Xichang, Si-chuan, China
| | - Qixing Wang
- Department of HIV Control and Prevention, Lianshan Center for Disease Control and Prevention, Xichang, Si-chuan, China
| | - Hongxia Deng
- Department of HIV Control and Prevention, Butuo Health Bureau, Butuo, Si-chuan, China
| | - Jianxun Zhang
- Department of HIV Control and Prevention, Butuo Health Bureau, Butuo, Si-chuan, China
| | - Frank Y. Wong
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, Georgia, United States of America
| | - Wen Yang
- Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China
- * E-mail:
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48
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Liu Y, Zeng P, Wang J, Liu G, Xu M, Ke L, He M, Liu Z. Hepatitis B virus infection in a cohort of HIV infected blood donors and AIDS patients in Sichuan, China. J Transl Med 2014; 12:164. [PMID: 24923206 PMCID: PMC4067527 DOI: 10.1186/1479-5876-12-164] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 05/09/2014] [Indexed: 12/15/2022] Open
Abstract
Background Co-infections of HBV and HIV are frequent due to similar routes of transmission. In that transmission through blood is an important route for both HBV and HIV, evaluation of the prevalence of HBV in HIV infected blood donors may be important for transfusion safety. In addition, because the epidemiological characteristics of HBV in HIV infected patients and blood donors may differ from each other, understanding of it could be significant for therapy and prevention of HBV in HIV infected adults. However, data reported on these in Chinese people remains limited. Methods 614 HIV confirmed positive samples were collected from blood donors and patients and were screened for HBsAg and HBV DNA. The samples screened reactive for HBsAg or positive for HBV DNA were tested for the other serological markers of HBV including anti-HBs, HBeAg, anti-HBe and anti-HBc. For the samples tested positive for HBV DNA, the S region of HBV was amplified by nested PCR and the HBV genotypes were determined. Results HBV coinfections were found in 12.9% (79/614) HIV infected individuals including 42/417(10.1%) blood donors and 37/197 (18.8%) AIDS patients. In the HBsAg positive individuals, 80.0% were HBeAg negative in which 10.0% were HBV DNA negative and 38.3% with HBV DNA lower than 2000 IU/ml. The average HBV DNA levels were lower in donors than in patients. In the HBV DNA positive populations, HBV genotypes B, A and C accounted for 48.1%, 22.8% and 8.86% respectively. Mutations related to the failure of HBsAg detection were found in 2 of the 4 HBsAg-/HBV DNA + subjects. Conclusions High prevalence of HBV in HIV infected individuals was found in this study. Hence, we recommend routine testing of HBV for patients newly diagnosed with HIV/AIDS in China. Some HIV-HBV co-infected patients remain undiagnosed if only conventional serological markers for HBV are used and it’s important to detect HBV DNA for HIV infected patients. HBV DNA levels were relatively low in HBeAg negative patients, thus this serologic marker may be useful in prioritizing patients on their need for HBV treatment in settings in which HBV DNA is not available.
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Affiliation(s)
| | | | | | | | | | | | - Miao He
- Experimental center of transfusion medicine, Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Hua Cai Road 26 Hao, Dong San Huan Road Er Duan, Chengdu, Sichuan, China.
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49
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Verghese VP, Robinson JL. A systematic review of hepatitis E virus infection in children. Clin Infect Dis 2014; 59:689-97. [PMID: 24846637 DOI: 10.1093/cid/ciu371] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
A systematic review was conducted, seeking all literature relevant to the epidemiology, clinical and laboratory features, and outcome of hepatitis E virus (HEV) infection in children. Transmission is thought to be primarily from fecal-oral transmission, with the role of transmission from animal reservoirs not being clear in children. Worldwide, seroprevalence is <10% up to 10 years of age, with the exception of 1 of 5 studies from India and the sole study from Egypt. Seroprevalence increases with age, but it is not clear if it is increasing over time. The clinical presentation of HEV infection has broad similarities to hepatitis A virus (HAV) infection, with most cases being subclinical. However, HEV differs from HAV in that infectivity is lower, perinatal transmission can result in neonatal morbidity and even mortality, and a chronic carrier state exists, accounting for chronic hepatitis in some pediatric solid organ transplant recipients.
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Affiliation(s)
| | - Joan L Robinson
- Stollery Children's Hospital and University of Alberta, Edmonton, Canada
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50
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Liang H, Su S, Deng S, Gu H, Ji F, Wang L, Liang C, Wang H, Zhang G. The prevalence of hepatitis E virus infections among swine, swine farmers and the general population in Guangdong Province, China. PLoS One 2014; 9:e88106. [PMID: 24520348 PMCID: PMC3919735 DOI: 10.1371/journal.pone.0088106] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 01/07/2014] [Indexed: 12/28/2022] Open
Abstract
Hepatitis E virus (HEV) infection is widespread in China, but few studies have been carried out in Guangdong Province. This study aimed to characterize the prevalence of HEV infections among swine, swine farmers and the general population in Guangdong Province. We conducted an epidemiological study that included swine, swine farmers and health examination attendees in Guangdong from 2011 to 2013. The overall seroprevalence of anti-HEV antibodies in swine was 64.7%. The results revealed that growing pigs, sows and boars (OR ranges from 3.5 to 21.5) have a higher risk than nursery pigs. HEV RNA in swine bile showed that HEV is epidemic in swine in the Pearl River Delta, with the highest prevalence of 22.73% in Foshan. Some genomes of HEV strains from each district were sequenced. Phylogenetic analysis of partial open reading frame 2 (ORF2) shows that they belong to genotype IV and are most closely related to isolates from China. In total, 307 participants were enrolled in the study, including 114 swine farmers and 193 attendees from hospitals. IgG anti-HEV was detected in 48.25% of swine farmers and in 38.34% of the general population. Seroprevalence rates were almost stratified by age, with a higher positive rate for males compared to females across all age groups. Women on swine farms appeared to have a lower risk of infection compared to the general population, revealing that the risk factors for HEV infection are not unique. The results suggested that there were other risk factors for HEV infection. HEV infection is prevalent in Guangdong, but due to the small sample sizes, more investigations are needed to assess the potential impact of HEV infection, and many additional risk factors should be considered.
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Affiliation(s)
- Huanbin Liang
- MOA Key Laboratory of Animal Vaccine Development, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Shuo Su
- MOA Key Laboratory of Animal Vaccine Development, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Shengchao Deng
- MOA Key Laboratory of Animal Vaccine Development, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Honglang Gu
- MOA Key Laboratory of Animal Vaccine Development, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Fangxiao Ji
- MOA Key Laboratory of Animal Vaccine Development, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Lifang Wang
- MOA Key Laboratory of Animal Vaccine Development, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Chumin Liang
- MOA Key Laboratory of Animal Vaccine Development, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Heng Wang
- MOA Key Laboratory of Animal Vaccine Development, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Guihong Zhang
- MOA Key Laboratory of Animal Vaccine Development, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
- * E-mail:
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