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Preston R, Christmass M, Lim E, McGough S, Heslop K. Diagnostic Overshadowing of Chronic Hepatitis C in People With Mental Health Conditions Who Inject Drugs: A Scoping Review. Int J Ment Health Nurs 2024. [PMID: 39101240 DOI: 10.1111/inm.13396] [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] [Received: 03/30/2024] [Revised: 06/28/2024] [Accepted: 07/01/2024] [Indexed: 08/06/2024]
Abstract
Diagnostic overshadowing refers to a phenomenon whereby people with mental health conditions encounter inadequate or delayed medical attention and misdiagnosis. This occurs when physical symptoms are mistakenly attributed to their mental health condition. This paper presents a scoping review focusing on direct causes and background factors of diagnostic overshadowing in the context of hepatitis C infection in people who inject drugs and have concurrent mental health conditions. Despite significant strides in hepatitis C treatment with direct-acting antiviral drugs, the complex interplay of mental health conditions and physical symptoms necessitates a nuanced approach for accurate diagnosis and effective screening. This review was conducted using Joanna Briggs Institute's methodology for scoping reviews. The databases searched included Medline, Embase, PsycInfo, Global Health, CINAHL and Scopus. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The search strategies identified 1995 records. Overall, 166 studies were excluded. Forty-two (42) studies met the inclusion criteria. Three (n = 3) studies represented direct causes, and 39 (n = 39) with background factors related to diagnostic overshadowing. Studies highlighted six key themes encompassing diagnostic overshadowing, with communication barriers, stigma and knowledge deficiencies being the most prominent. Recognising and addressing diagnostic overshadowing in chronic hepatitis C will lead to increased screening, diagnosis and timely administration of life-saving antiviral therapy, resulting in profound enhancements in well-being and health outcomes. Moreover, this proactive approach will play a pivotal role in advancing the global effort towards eliminating hepatitis C by 2030.
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Affiliation(s)
- Regan Preston
- Curtin School of Nursing, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
| | - Michael Christmass
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
| | - Eric Lim
- Curtin School of Nursing, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
| | - Shirley McGough
- Curtin School of Nursing, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
| | - Karen Heslop
- Curtin School of Nursing, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
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Wodajo FA, Gebru DM, Alemneh HT. Mathematical model analysis of effective intervention strategies on transmission dynamics of hepatitis B virus. Sci Rep 2023; 13:8737. [PMID: 37253760 DOI: 10.1038/s41598-023-35815-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 05/24/2023] [Indexed: 06/01/2023] Open
Abstract
Hepatitis B is one of the world's most common and severe infectious diseases. Worldwide, over 350 million people are currently estimated to be persistent carriers of the hepatitis B virus (HBV), with the death of 1 million people from the chronic stage of HBV infection. In this work, developed a nonlinear mathematical model for the transmission dynamics of HBV. We constructed the mathematical model by considering vaccination, treatment, migration, and screening effects. We calculated both disease-free and endemic equilibrium points for our model. Using the next-generation matrix, an effective reproduction number for the model is calculated. We also proved the asymptotic stability of both local and global asymptotically stability of disease-free and endemic equilibrium points. By calculating the sensitivity indices, the most sensitive parameters that are most likely to affect the disease's endemicity are identified. From the findings of this work, we recommend vaccination of the entire population and screening all the exposed and migrants. Additionally, early treatment of both the exposed class after screening and the chronically infected class is vital to decreasing the transmission of HBV in the community.
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Gutiérrez-Rojas L, de la Gándara Martín JJ, García Buey L, Uriz Otano JI, Mena Á, Roncero C. Patients with severe mental illness and hepatitis C virus infection benefit from new pangenotypic direct-acting antivirals: Results of a literature review. GASTROENTEROLOGIA Y HEPATOLOGIA 2023; 46:382-396. [PMID: 35718017 DOI: 10.1016/j.gastrohep.2022.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/25/2022] [Accepted: 06/07/2022] [Indexed: 05/09/2023]
Abstract
INTRODUCTION Hepatitis C virus (HCV) infection is a global health problem that can results in cirrhosis, hepatocellular carcinoma and even death. HCV infection is 3-20-fold more prevalent among patients with versus without severe mental illness (SMI), such as major depressive disorder, personality disorder, bipolar disorder and schizophrenia. Treatment options for HCV were formerly based on pegylated interferon alpha, which is associated with neuropsychiatric adverse events, and this contributed to the exclusion of patients with SMI from HCV treatment, elimination programmes, and clinical trials. Moreover, the assumption of poor adherence, scant access to healthcare and the stigma and vulnerability of this population emerged as barriers and contributed to the low rates of treatment and efficacy. METHODS This paper reviews the literature published between December 2010 and December 2020 exploring the epidemiology of HCV in patients with SMI, and vice versa, the effect of HCV infection, barriers to the management of illness in these patients, and benefits of new therapeutic options with pangenotypic direct antiviral agents (DAAs). RESULTS The approval of DAAs has changed the paradigm of HCV infection treatment. DAAs have proven to be an equally efficacious and safe option that improves quality of life (QoL) in patients SMI. CONCLUSIONS Knowledge of the consequences of the HCV infection and the benefits of treatment with new pangenotypic DAAs among psychiatrists can increase screening, referral and treatment of HCV infection in patients with SMI.
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Affiliation(s)
| | | | - Luisa García Buey
- Gastroenterology Department, Liver Unit, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, Madrid, Spain
| | - Juan I Uriz Otano
- Gastroenterology Department, Liver Unit, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Álvaro Mena
- Infectious Diseases Unit, Internal Medicine Service, Clinical Virology Group, Instituto de Investigación Biomédica de A Coruña (INIBIC)-Complejo Hospitalario Universitario de A Coruña (CHUAC), Universidade da Coruña, Coruña, Spain
| | - Carlos Roncero
- Psychiatry Service, University of Salamanca Health Care Complex and Psychiatric Unit, School of Medicine, Institute of Biomedicine, University of Salamanca, Salamanca, Spain
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Rabaan AA, Al-Ahmed SH, Bazzi AM, Alfouzan WA, Alsuliman SA, Aldrazi FA, Haque S. Overview of hepatitis C infection, molecular biology, and new treatment. J Infect Public Health 2019; 13:773-783. [PMID: 31870632 DOI: 10.1016/j.jiph.2019.11.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 07/08/2019] [Accepted: 11/18/2019] [Indexed: 12/13/2022] Open
Abstract
The World Health Organization estimates that 71 million people worldwide have chronic hepatitis C viral infection. A major challenge is overall lack of public awareness of hepatitis C, particularly among infected people of their infection status. Chronic hepatitis C infection is associated with advanced liver disease, is the main cause of hepatocellular carcinoma and causes many extra-hepatic manifestations. The existence of seven viral genotypes complicates targeting of treatment. Recent years have seen the approval of many direct acting antivirals targeted at hepatitis C virus non-structural proteins. These have revolutionized therapy as they allow achievement of extremely high sustained virologic responses. Of great significance is the development of pan-genotypic drug combinations, including the NS3/4A-NS5A inhibitor combinations sofosbuvir-velpatasvir and glecaprevir-pibrentasvir. However, resistance-associated mutations can result in failure of these treatments in a small number of patients. This, combined with the high costs of treatment, highlights the importance of continued research into effective anti-hepatitis C therapies, for example aimed at viral entry. Recent developments include identification of the potential of low-cost anti-histamines for repurposing as inhibitors of hepatitis C viral entry. In this review we focus on molecular biology of hepatitis C virus, and the new developments in hepatitis C treatment.
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Affiliation(s)
- Ali A Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.
| | - Shamsah H Al-Ahmed
- Specialty Paediatric Medicine, Qatif Central Hospital, Qatif, Saudi Arabia
| | - Ali M Bazzi
- Microbiology Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Wadha A Alfouzan
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat 13110, Kuwait; Faculty of Medicine, Kuwait University, Dasma 35153, Kuwait
| | - Shahab A Alsuliman
- Internal Medicine and Infectious Disease Department, Dammam Medical Complex, Dammam, Saudi Arabia
| | - Fatimah A Aldrazi
- Infection Control Department, Dammam Medical Complex, Dammam, Saudi Arabia
| | - Shafiul Haque
- Research and Scientific Studies Unit, College of Nursing & Allied Health Sciences, Jazan University, Saudi Arabia
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Pericàs JM, Bromberg DJ, Ocampo D, Schatz E, Wawer I, Wysocki P, Safreed-Harmon K, Lazarus JV. Hepatitis C services at harm reduction centres in the European Union: a 28-country survey. Harm Reduct J 2019; 16:20. [PMID: 30898122 PMCID: PMC6429787 DOI: 10.1186/s12954-019-0290-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 03/06/2019] [Indexed: 12/21/2022] Open
Abstract
Background In the context of the WHO’s 2016 Viral Hepatitis Strategy and the introduction of treatment that can cure more than 95% of cases with hepatitis C virus (HCV) infection, the European Joint Action on HIV and Co-infection Prevention and Harm Reduction (HA-REACT) undertook a study in the member states of the European Union (EU). It aimed to determine service providers’ understanding of the current services in their respective countries and the barriers experienced by PWID in accessing HCV testing, care and treatment services in their country. Methods In 2017, 38 purposively selected harm reduction service providers completed a 26-item English-language online survey addressing the availability, accessibility and funding of HCV services at harm reduction centres. HCV-related data and reported findings were extracted by country or by responding organization. Results Responses were received from all EU member states. Respondents from 23 countries reported that HCV tests are offered by harm reduction services in their countries, and eight countries reported that addiction specialists in their countries are able to prescribe HCV therapy. Almost half of the respondents (45%) said that their respective organizations had established referral systems with centres providing HCV treatment. Conclusions Not all EU member states have harm reduction services that provide HCV tests, and many do not have established referral systems with treatment providers. Moreover, the inability of addiction specialists to prescribe HCV treatment points to missed opportunities to make treatment more accessible. Further, discrepancies were noted between the available HCV services and stakeholders’ knowledge about their availability.
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Affiliation(s)
- Juan M Pericàs
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Carrer Rosselló, 132, 4th floor, ES-08036, Barcelona, Spain
| | - Daniel J Bromberg
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Carrer Rosselló, 132, 4th floor, ES-08036, Barcelona, Spain
| | - Denise Ocampo
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Carrer Rosselló, 132, 4th floor, ES-08036, Barcelona, Spain
| | - Eberhard Schatz
- Correlation Network, De Regenboog Groep, Amsterdam, The Netherlands
| | - Iwona Wawer
- National AIDS Centre, Ministry of Health of Poland, Warsaw, Poland
| | - Piotr Wysocki
- National AIDS Centre, Ministry of Health of Poland, Warsaw, Poland
| | - Kelly Safreed-Harmon
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Carrer Rosselló, 132, 4th floor, ES-08036, Barcelona, Spain
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Carrer Rosselló, 132, 4th floor, ES-08036, Barcelona, Spain. .,CHIP, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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Mansberg K, Kull K, Salupere R, Prükk T, Margus B, Kariis T, Remmel T, Suurmaa K, Ott K, Jaago K, Šmidt J. A Population-Based Surveillance Study on the Epidemiology of Hepatitis C in Estonia. ACTA ACUST UNITED AC 2018; 54:medicina54010009. [PMID: 30344240 PMCID: PMC6037246 DOI: 10.3390/medicina54010009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 03/20/2018] [Accepted: 03/21/2018] [Indexed: 02/07/2023]
Abstract
Background and objective: The hepatitis C virus (HCV)-infected patients serve as a reservoir for transmission of the disease to others and are at risk of developing chronic hepatitis C, cirrhosis, and hepatocellular carcinoma. Although the epidemiological data of high rate HCV infection have been obtained in many countries, such data are insufficient in Estonia. Therefore, the aim of the study was to analyze country-specific data on HCV patients. Materials and methods: Data about age, gender, diagnosis, possible risk factors, coinfections, HCV genotypes, liver fibrosis stages and extrahepatic manifestations were collected from 518 patients. Results: The most common risk factors for hepatitis C were injection drug use and tattooing in the 30–39 and 40–49 year age groups, and blood transfusion in the 50–59 and 60–69 year age groups. The other risk factors established were profession-related factors and sexual contact. The prevailing viral genotype among the HCV infected patients was genotype 1 (69% of the patients) followed by genotype 3 (25%). Genotypes 1 and 3 correlated with blood transfusions before 1994, drug injections and tattooing. Conclusions: Our study provides the best representation of genotype distribution across Estonia. As a result of the study, valuable data has been collected on hepatitis C patients in Estonia.
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Affiliation(s)
- Kairi Mansberg
- Department of Gastroenterology, Tartu University Hospital, University of Tartu, 51014 Tartu, Estonia.
- Internal Disease Clinic, Tartu University Hospital, University of Tartu, 51014 Tartu, Estonia.
| | - Karin Kull
- Department of Gastroenterology, Tartu University Hospital, University of Tartu, 51014 Tartu, Estonia.
- Internal Disease Clinic, Tartu University Hospital, University of Tartu, 51014 Tartu, Estonia.
| | - Riina Salupere
- Department of Gastroenterology, Tartu University Hospital, University of Tartu, 51014 Tartu, Estonia.
- Internal Disease Clinic, Tartu University Hospital, University of Tartu, 51014 Tartu, Estonia.
| | - Tiina Prükk
- Department of Gastroenterology, Tartu University Hospital, University of Tartu, 51014 Tartu, Estonia.
- Internal Disease Clinic, Tartu University Hospital, University of Tartu, 51014 Tartu, Estonia.
| | - Benno Margus
- Department of Gastroenterology, East Tallinn Central Hospital, 10138 Tallinn, Estonia.
| | - Toomas Kariis
- Department of Gastroenterology, East Tallinn Central Hospital, 10138 Tallinn, Estonia.
| | - Triin Remmel
- Department of Gastroenterology, East Tallinn Central Hospital, 10138 Tallinn, Estonia.
| | - Külliki Suurmaa
- Department of Gastroenterology and Infectios Diseases Clinic, West Tallinn Central Hospital, 10138 Tallinn, Estonia.
| | - Kristi Ott
- Department of Gastroenterology and Infectios Diseases Clinic, West Tallinn Central Hospital, 10138 Tallinn, Estonia.
| | - Krista Jaago
- Internal Disease Clinic, Pärnu Hospital, 80010 Pärnu, Estonia.
| | - Jelena Šmidt
- Internal Disease Clinic, East Viru Central Hospital, 31024 Kohtla-Järve, Estonia.
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McLeod A, Cullen BL, Hutchinson SJ, Roy KM, Dillon JF, Stewart EA, Goldberg DJ. Limited impact of awareness-raising campaigns on hepatitis C testing practices among general practitioners. J Viral Hepat 2017; 24:944-954. [PMID: 28502088 DOI: 10.1111/jvh.12724] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 04/20/2017] [Indexed: 12/21/2022]
Abstract
The global hepatitis strategy calls for increased effort to diagnose those infected, with a target of 90% diagnosed by 2030. Scotland's Action Plan on Hepatitis C included awareness-raising campaigns, undertaken during 2008-2011, to promote testing by general practitioners. We examined hepatitis C virus (HCV) testing practice among general practitioners before and following these campaigns. Scottish general practitioners were surveyed, using Dillman's method, in 2007 and 2013; response rates were 69% and 60%, respectively. Most respondents offer testing when presented with a risk history (86% in 2007, 88% in 2013) but only one-fifth actively sought out risk factors (19% in 2007, 21% in 2013). Testing was reportedly always/almost always/usually offered to people who inject drugs (84% in 2007, 87% in 2013). Significant improvements in the offer of testing were reported in patients with abnormal LFTs (41% in 2007, 65% in 2013, P<.001) and who had received medical/dental treatment in high prevalence countries (14% in 2007, 24% in 2013, P=.001). In 2013, 25% of respondents had undertaken HCV-related continued professional development. This group was significantly more likely to actively seek out risk factors (P=.009) but only significantly more likely to offer a test to patients who had received medical/dental treatment in high prevalence countries (P=.001). Our findings suggest that government-led awareness raising campaigns have limited impact on general practitioners' testing practices. If the majority of the HCV-infected population are to be diagnosed, practitioner-based or physician-centred interventions should be considered alongside educational initiatives targeted at professionals.
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Affiliation(s)
- A McLeod
- Health Protection Scotland, Glasgow, UK
| | | | - S J Hutchinson
- Health Protection Scotland, Glasgow, UK.,School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - K M Roy
- Health Protection Scotland, Glasgow, UK
| | - J F Dillon
- NHS Tayside and Medical Research Institute, University of Dundee, Dundee, UK
| | - E A Stewart
- Department of Public Health, NHS Lothian and Bonnyrigg Health Centre, Edinburgh, UK
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Czerwinski M, Grabarczyk P, Stepien M, Kubicka-Russel D, Tkaczuk K, Brojer E, Rosinska M. What weighs more-low compliance with self-deferral or minor medical procedures? Explaining the high rate of hepatitis C virus window-period donations in Poland. Transfusion 2017; 57:1998-2006. [PMID: 28555775 DOI: 10.1111/trf.14163] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 03/20/2017] [Accepted: 04/04/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Since the introduction of nucleic acid testing (NAT) for routine blood donor screening, hepatitis C virus (HCV) RNA-only detection rates reported from Poland have been higher than in most other European countries. STUDY DESIGN AND METHODS To examine factors that likely contribute to these window-period donations, we conducted a case-control study among 47 recently HCV-infected blood donors (cases), who gave blood between July 2002 and June 2014, and 141 controls matched by age, sex, and donation dates. Firth-corrected, conditional logistic regression models were fitted to estimate adjusted odds ratios and 95% confidence intervals. Adjusted population-attributable fractions were calculated based on the distribution of exposure among the cases. RESULTS On multivariate analysis, recent exposures in health care environments not routinely ascertained through predonation questionnaires were strongly associated with recently acquired HCV infection. These exposures included minor medical and dental procedures in the preceding 6 months (adjusted odds ratio, 5.77; 95 % confidence interval, 2.01-18.53). However, based on the population-attributable fraction, more important were behavioral deferrable risks that went unreported at the time of donation, such as high-risk sexual behaviors in the preceding 6 months (population-attributable fraction, 34%) or lifetime histories of drug use (population-attributable fraction, 28%). CONCLUSIONS This study raises questions about the effectiveness of deferral policy in excluding high-risk individuals. In addition, it provides further evidence supporting short, temporal deferrals for small medical procedures and dental treatments in Poland.
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Affiliation(s)
- Michal Czerwinski
- Department of Epidemiology, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland
| | - Piotr Grabarczyk
- Department of Virology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Malgorzata Stepien
- Department of Epidemiology, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland
| | - Dorota Kubicka-Russel
- Department of Virology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Katarzyna Tkaczuk
- Department of Virology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Ewa Brojer
- Department of Virology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Magdalena Rosinska
- Department of Epidemiology, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland
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Lazarus JV, Sperle I, Spina A, Rockstroh JK. Are the testing needs of key European populations affected by hepatitis B and hepatitis C being addressed? A scoping review of testing studies in Europe. Croat Med J 2017; 57:442-456. [PMID: 27815935 PMCID: PMC5141462 DOI: 10.3325/cmj.2016.57.442] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Aim To investigate whether or not key populations affected by hepatitis B and hepatitis C are being tested sufficiently for these diseases throughout the European region. Methods We searched MEDLINE and EMBASE for studies on HBV and HCV testing in the 53 Member States of the World Health Organization European Region following PRISMA criteria. Results 136 English-language studies from 24 countries published between January 2007 and June 2013 were found. Most studies took place in 6 countries: France, Germany, Italy, the Netherlands, Turkey, and the United Kingdom. 37 studies (27%) addressed HBV, 46 (34%) HCV, and 53 (39%) both diseases. The largest categories of study populations were people who use drugs (18%) and health care patient populations (17%). Far fewer studies focused on migrants, prison inmates, or men who have sex with men. Conclusions The overall evidence base on HBV and HCV testing has considerable gaps in terms of the countries and populations represented and validity of testing uptake data. More research is needed throughout Europe to guide efforts to provide testing to certain key populations.
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Affiliation(s)
- Jeffrey V Lazarus
- Jeffrey V Lazarus, CHIP, Rigshospitalet, University of Copenhagen, Oster Allé 56, 5th floor, DK-2100 Copenhagen O, Denmark,
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García-Alonso FJ, Bonillo-Cambrodón D, Bermejo A, García-Martínez J, Hernández-Tejero M, Valer López Fando P, Piqueras B, Bermejo F. Acceptance, yield and feasibility of attaching HCV birth cohort screening to colorectal cancer screening in Spain. Dig Liver Dis 2016; 48:1237-42. [PMID: 27481585 DOI: 10.1016/j.dld.2016.06.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 05/22/2016] [Accepted: 06/29/2016] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The US Centers for Disease Control recommends hepatitis C virus (HCV) screening for baby boomers. Spain presents a similar distribution of infected patients. We performed a cross sectional prospective study to evaluate the prevalence of undiagnosed HCV infection in subjects born between 1949 and 1974. METHODS All out-patients within the age range, both symptomatic and screening procedures, undergoing colonoscopy between December 2014 and June 2015 were offered a HCV antibody blood test and a survey including risk factors for HCV infection and attitude toward HCV screening. Patients with chronic HCV or with a previous negative HCV antibody test were excluded. RESULTS A total of 570 subjects, 50% screening procedures, were analyzed. The median age was 55.7, 94.6% were born in Spain and 54.6% were women. Antibodies against HCV were found in 1.6% (95% CI: 0.8-3%) and HCV-RNA in 0.4% (0.1-1.3%). We found no statistically significant differences regarding HCV prevalence, risk factors or socioeconomic characteristics between subjects undergoing colorectal cancer screening and symptomatic subjects. CONCLUSION Symptomatic and screening subjects undergoing colonoscopy support HCV screening and present a similar HCV risk profile. Results suggest linking colorectal and HCV screening would yield good results.
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Affiliation(s)
| | - Daniel Bonillo-Cambrodón
- Gastroenterology Department, Fuenlabrada University Hospital, Fuenlabrada, Spain; Escuela Internacional de Doctorado, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain
| | - Andrea Bermejo
- Gastroenterology Department, Fuenlabrada University Hospital, Fuenlabrada, Spain
| | - Jesús García-Martínez
- Microbiology Area - Laboratory Medicine Department, Fuenlabrada University Hospital, Fuenlabrada, Spain
| | | | | | - Belén Piqueras
- Gastroenterology Department, Fuenlabrada University Hospital, Fuenlabrada, Spain
| | - Fernando Bermejo
- Gastroenterology Department, Fuenlabrada University Hospital, Fuenlabrada, Spain
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11
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Lima VD, Rozada I, Grebely J, Hull M, Lourenco L, Nosyk B, Krajden M, Yoshida E, Wood E, Montaner JSG. Are Interferon-Free Direct-Acting Antivirals for the Treatment of HCV Enough to Control the Epidemic among People Who Inject Drugs? PLoS One 2015; 10:e0143836. [PMID: 26633652 PMCID: PMC4669174 DOI: 10.1371/journal.pone.0143836] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 11/10/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Widely access to interferon-free direct-acting antiviral regimens (IFN-free DAA) is poised to dramatically change the impact of the HCV epidemic among people who inject drugs (PWID). We evaluated the long-term effect of increasing HCV testing, treatment and engagement into harm-reduction activities, focused on active PWID, on the HCV epidemic in British Columbia (BC), Canada. METHODS We built a compartmental model of HCV disease transmission stratified by disease progression, transmission risk, and fibrosis level. We explored the effect of: (1) Increasing treatment rates from 8 to 20, 40 and 80 per 1000 infected PWID/year; (2) Increasing treatment eligibility based on fibrosis level; (3) Maximizing the effect of testing by performing it immediately upon ending the acute phase; (4) Increasing access to harm-reduction activities to reduce the risk of re-infection; (5) Different HCV antiviral regimens on the Control Reproduction Number Rc. We assessed the impact of these interventions on incidence, prevalence and mortality from 2016 to 2030. RESULTS Of all HCV antiviral regimens, only IFN-free DAAs offered a high chance of disease elimination (i.e. Rc < 1), but it would be necessary to substantially increase the current low testing and treatment rates. Assuming a treatment rate of 80 per 1000 infected PWID per year, coupled with a high testing rate, the incidence rate, at the end of 2030, could decrease from 92.9 per 1000 susceptible PWID per year (Status Quo) to 82.8 (by treating only PWID with fibrosis level F2 and higher) or to 65.5 (by treating PWID regardless of fibrosis level). If PWID also had access to increased harm-reduction activities, the incidence rate further decreased to 53.1 per 1000 susceptible PWID per year. We also obtained significant decreases in prevalence and mortality at the end of 2030. CONCLUSIONS The combination of increased access to HCV testing, highly efficacious antiviral treatment and harm-reduction programs can substantially decrease the burden of the HCV epidemic among PWID. However, unless we increase the current levels of treatment and testing, the HCV epidemic among PWID in BC, and in other parts of the world with similar epidemiological background, will remain a substantial public health concern for many years.
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Affiliation(s)
- Viviane D. Lima
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Ignacio Rozada
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Jason Grebely
- The Kirby Institute, University of New South Wales Australia, Sydney, NSW, Australia
| | - Mark Hull
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Lillian Lourenco
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Bohdan Nosyk
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Mel Krajden
- Public Health Microbiology and Reference Laboratory, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Eric Yoshida
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Evan Wood
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Julio S. G. Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
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Abstract
The known human tumor viruses include the DNA viruses Epstein-Barr virus (EBV), Kaposi sarcoma herpesvirus (KSHV), Merkel cell polyomavirus (MCPyV), human papillomavirus (HPV), and hepatitis B virus (BV). RNA tumor viruses include human T-cell lymphotrophic virus type 1 (HTLV-1) and hepatitis C virus (HCV). The serological identification of antigens/antibodies in serum is a rapidly progressing field with utility for both scientists and clinicians. Serology is useful for conducting seroepidemiology studies and to inform on the pathogenesis and host immune response to a particular viral agent. Clinically, serology is useful for diagnosing current or past infection and for aiding in clinical management decisions. Serology is useful for screening blood donations for infectious agents and for monitoring the outcome of vaccination against these viruses. Serodiagnosis of human tumor viruses has improved in recent years with increased specificity and sensitivity of the assays, as well as reductions in cost and the ability to assess multiple antibody/antigens in single assays. Serodiagnosis of tumor viruses plays an important role in our understanding of the prevalence and transmission of these viruses and ultimately in the ability to develop treatments/preventions for these globally important diseases.
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Affiliation(s)
- Brian J Morrison
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD
| | - Nazzarena Labo
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Wendell J Miley
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD.
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Baden R, Rockstroh JK, Buti M. Natural history and management of hepatitis C: does sex play a role? J Infect Dis 2014; 209 Suppl 3:S81-5. [PMID: 24966194 DOI: 10.1093/infdis/jiu057] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Hepatitis C virus infection is a disease that disproportionately affects men more than women. After initial HCV infection, women are more likely to clear the virus spontaneously. Women also have slower rates of liver disease progression than men if they become chronically infected. However, this rate of disease progression changes over time in women. Postmenopausal women have increased rates of fibrosis compared with women of reproductive age because they have lost the protective effects of estrogen. Estradiol and estrogen receptors in the liver protect hepatocytes from oxidative stress, inflammatory injury, and cell death, which all contribute to fibrosis. As a consequence of the overall slower liver disease progression and increased viral clearance in women, the disease burden from HCV infection is found predominantly in men. Although some studies have suggested higher sustained virologic response rates in HCV-infected women receiving dual therapy for HCV infection, this seems to be less important in the direct-acting antiviral era, when response rates for HCV therapy have increased so substantially that baseline demographic factors seem to have less of an effect on overall rates of cure.
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Affiliation(s)
- Rachel Baden
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | | | - Maria Buti
- Hospital Universitario Valle Hebron and Ciberehd del Instituto Carlos III. Barcelona, Spain
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A comparative study of patients' knowledge about hepatitis C in the United States and in urban and rural China. Hepatol Int 2014; 9:58-66. [PMID: 25788380 DOI: 10.1007/s12072-014-9559-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 06/23/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Hepatitis C (HCV) is the predominant cause of chronic liver disease in the USA and is increasingly recognized as a common cause of liver disease in China. Studies of HCV patients in the US found major gaps in knowledge but little is known about HCV knowledge among patients in China. METHODS We conducted a survey in three cohorts of HCV patients in Ann Arbor, MI, US, and in Beijing and Hebei, China, between April and November 2012 to compare patient knowledge about HCV in the US and in urban and rural China. RESULTS A total of 525 patients (US 186; Beijing 186; Hebei 153) were enrolled. Mean ages of the three cohorts ranged from 52-56 years; 63% of US and 47% of Chinese patients were males; 63% of US and 39% of Beijing patients had college or postgraduate education compared to 0.7% in Hebei. More than half of the US and Beijing patients but only 13% of Hebei patients had received HCV treatment. The average HCV knowledge score out of a total of 16 in the US, Beijing, and Hebei was 12.7, 11.7, and 6.4, respectively (p < 0.001). Study site, education, gender, and prior HCV treatment were independent predictors of HCV knowledge. CONCLUSIONS Knowledge about HCV in the US and Beijing patients was similar and significantly better than in Hebei patients. Our data show that efforts to improve HCV knowledge are necessary for all three cohorts and should be tailored to the education level and health literacy of the patients.
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Perrett S, Hams P. Raising public awareness of hepatitis B and C through a testing road show. ACTA ACUST UNITED AC 2013; 22:1308, 1310-2. [PMID: 24335868 DOI: 10.12968/bjon.2013.22.22.1308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Over the past decade, as the profile of hepatitis B and C has been raised, a range of nurse-led services has been developed among substance misuse services, prisons and homeless services to reach those at the highest risk of infection. In the UK, it is estimated that up to two-thirds of people with hepatitis C are unaware of their infection (Cornberg et al, 2011). These patients represent those at the highest risk of developing cirrhosis and liver cancer, and many are unlikely to be in contact with services that offer routine testing. To help address this, the Welsh Hepatitis Nurse Forum (WHNF) carried out two road shows aimed at raising awareness of hepatitis B and C among the general public and offering testing. This paper describes the process, results and evaluation of the road shows that took place in 2011 and 2012. The road show is a unique way in which nurses can reach those who may not have regular contact with health services, and has proved useful for generally raising awareness. Further work is needed to evaluate the cost-effectiveness of the road shows.
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Affiliation(s)
- Stephanie Perrett
- Works for Public Health Wales as a blood-borne virus (BBV) prison nurse specialist
| | - Pam Hams
- Clinical nurse specialist for hepatology at Cwm Taf Health Board, Wales
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Akbar HO, Al Ghamdi A, Qattan F, Fallatah HI, Al Rumani M. Chronic hepatitis C in saudi arabia: three years local experience in a university hospital. HEPATITIS MONTHLY 2012; 12:e6178. [PMID: 23087760 PMCID: PMC3475025 DOI: 10.5812/hepatmon.6178] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 07/16/2012] [Accepted: 07/28/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND Chronic hepatitis C (CHC) is a global infection. In Saudi Arabia, the prevalence of CHC is declining due to the implementation of a blood screening program. However, CHC still remains a leading cause of liver cirrhosis and hepatocellular carcinoma. OBJECTIVES This is a retrospective study of CHC patients at the King Abdul Aziz University Hospital, Jeddah, Saudi Arabia. PATIENTS AND METHODS Out of a total of 291 CHC patients from the hepatology clinic at King Abdul Aziz University hospital, Jeddah, 279 patients were included in the present study. They were primarily male (152, 54.5%), with a mean age of 50.41 ± 1.72 years. The majority of patients were either Saudi (108, 38.7%) or Egyptian (60, 21.5%). A total of 61 patients received combination treatment with pegylated interferon and ribavirin, and one patient with sickle-cell anemia received pegylated INF monotherapy. Demographic, clinical and laboratory features of the CHC patients, and their responses to treatment were studied. RESULTS Decompensated cirrhosis was documented in 60 patients (21.5%), and hepatocellular carcinoma in 14 (5%). The mean level of serum alanine aminotransferase was 83.6 ± 231 u/L. The predominant genotype among the 70 patients tested, was genotype 4, followed by genotype 1 (39 and 18 patients, respectively). The sustained viral response (SVR) rate was 82.99%. The main predictive factors for SVR were baseline HCV viral load and rapid virologic response (RVR). The mean duration of follow-up was 4.2 ± .85 years. There were 24 patients who had liver disease-related mortality. CONCLUSIONS our data showed that 22% of CHC patients progress to cirrhosis and another 22% had treatment. Liver related mortality was more common in patients with advanced cirrhosis.
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Affiliation(s)
- Hisham O Akbar
- Department of Internal Medicine, King Abdul Aziz University Hospital, Jeddah, Saudi Arabia
- Corresponding author: Hisham O Akbar, Department of Internal Medicine, King Abdul Aziz University Hospital, P. O. Box: 80215 Jeddah 21589, Jeddah, Saudi Arabia. Tel.: +96-626408435, Fax: +96-626408315, E-mail:
| | - Ahmad Al Ghamdi
- Molecular Biology Department, King Abdul Aziz University Hospital, Jeddah, Saudi Arabia
| | - Faten Qattan
- Molecular Biology Department, King Abdul Aziz University Hospital, Jeddah, Saudi Arabia
| | - Hind I Fallatah
- Department of Internal Medicine, King Abdul Aziz University Hospital, Jeddah, Saudi Arabia
| | - Maha Al Rumani
- Molecular Biology Department, King Abdul Aziz University Hospital, Jeddah, Saudi Arabia
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Gazdag G, Horváth G, Szabó O, Ungvari GS. Referral of intravenous drug users for antiviral treatment: effectiveness of hepatitis C case-finding programmes. Cent Eur J Public Health 2012; 20:223-5. [PMID: 23285525 DOI: 10.21101/cejph.a3747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Hepatitis C infection (HCI) case-finding programmes aim to identify infected persons in a well-defined population. This study assessed the effectiveness of three HCI case-finding programmes for intravenous drug users by examining the rate of their referral to antiviral treatment. METHODS The Hepatology Outpatient Clinic of Szent László Hospital examines and treats all intravenous drug users who are found positive in HCI case-finding programmes in Budapest. The medical records of patients who visited the Hepatology Outpatient Clinic of Szent László Hospital between 1 January 2006 and 31 December 2008 were screened and records indicating a history of drug abuse were selected. These records were matched against the databases of the hepatitis case-finding programmes and the records that appeared in both datasets were analyzed. RESULTS Of the 234 intravenous drug users identified as hepatitis C virus positive in the Budapest case-finding programmes, only 21 attended the Hepatology Outpatient Clinic of Szent László Hospital and only two started antiviral treatment, but their hepatitis C virus positive status had already been known at the time of screening. CONCLUSION In this study, not a single patient with drug abuse whose hepatitis C virus positive status was identified in one of the HCI case-finding programmes was referred for antiviral treatment.
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Affiliation(s)
- Gábor Gazdag
- Consultation-Liaison Psychiatric Service, Szent István and Szent László Hospitals, Budapest, Hungary.
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Abstract
OBJECTIVE Hepatitis C virus (HCV) affects 170 million patients worldwide and is the leading cause of liver cirrhosis and hepatocellular carcinoma. The aim of the current study is to examine the burden of HCV in the European Union (EU) from a patient perspective. METHODS Using data from the 2010 EU National Health and Wellness Survey, patients who reported a diagnosis of HCV (n=332) were compared with a propensity-score-matched non-HCV control group (n=332) on measures of quality of life (using the SF-12v2), work productivity, and healthcare resource utilization in the past 6 months. All analyses applied sampling weights to project to the respective country populations. RESULTS Projected prevalence estimates of HCV were 0.59% in France, 0.44% in Germany, 1.42% in Italy, 0.82% in Spain, and 0.35% in the UK. HCV patients reported significantly lower levels of emotional role limitations (means=66.4 vs. 70.6, P=0.040), physical functioning (means=63.8 vs. 71.9, P=0.001), general health (means=48.3 vs. 54.4, P=0.004), bodily pain (means=64.3 vs. 70.8, P=0.002), and physical component summary scores (means=42.9 vs. 45.3, P=0.002) than the matched controls. Patients with HCV also reported significantly higher levels of presenteeism (means=27.1 vs. 21.0%, P=0.044) and a greater number of physician visits in the past 6 months (means=9.9 vs. 6.7, P<0.001). CONCLUSION Using a population-based survey methodology and a propensity-score matching analysis, these results add to the literature by documenting the significant effect that HCV has on a variety of both humanistic and economic outcomes in the EU.
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Abstract
Oral Diseases (2012) Lichen planus (LP) is a common disorder affecting the oral cavity (OLP) and skin. Despite intensive research, LP/OLP etiology and treatment remain controversial. We investigated four controversial topics: (i) Is hepatitis C virus (HCV) infection associated with LP and involved in its pathogenesis? (ii) Should all patients with LP be screened for HCV? (iii) Should patients with OLP have all their amalgam restorations removed? (iv) Are there any new treatments for OLP? Results from extensive literature searches suggested that: (i) Robust evidence from three meta-analyses indicate that HCV is associated with LP and might be involved in OLP pathogenesis (ii) It would be prudent to screen patients with LP/OLP at significant risk with an ELISA for HCV antibodies using country-specific screening strategies (iii) There is no evidence that either OLP or oral lichenoid lesions patients would routinely benefit from having all their amalgam restorations replaced. Weak evidence from potentially very biased, small, non-randomized, unblinded studies suggests that a small fraction of patients may benefit from targeted amalgam replacement. (iv) There is weak evidence that, among new OLP treatments, topical pimecrolimus, aloe vera, and oral curcuminoids may be useful. The development of specific formulations for oral delivery of topical medications is a promising field.
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Affiliation(s)
- L Baccaglini
- Department of Epidemiology, University of Nebraska Medical Center, Omaha, NE, USA Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand Department of Oral Medicine, Centre for Oral Health Research, Newcastle University, Newcastle upon Tyne, UK Department of Dermatology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
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Awadalla HI, Ragab MH, Nassar NA, Osman MAH. Risk factors of hepatitis C infection among Egyptian blood donors. Cent Eur J Public Health 2012; 19:217-21. [PMID: 22432397 DOI: 10.21101/cejph.a3628] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Surveillance of infectious disease markers in the blood donor population is important in recognizing trends in prevalence and incidence of transfusion related infections in asymptomatic volunteer blood donors. SUBJECTS AND METHODS It was a cross sectional study. Samples were collected from volunteer blood donors and questionnaire was designed to collect the risk factors data. The prevalence of hepatitis C antibodies among 1,000 apparently healthy blood donors were determined. OBJECTIVE To estimate the prevalence of virus C hepatic infection and to illustrate the various socio-economic, behavioural and medical factors related to infection with Hepatitis C (HCV) among apparently healthy individuals. It contributed to analysis of the particularities of Egyptian blood donors and helped to better understand the challenges and solutions of blood safety. RESULTS The prevalence of HCV was 16.8%. There was an association of positive anti-HCV test with socio-demographic, medical and behavioural risk factors. CONCLUSION This study provided comprehensive and reliable information on the possible risk factors affecting spread of Hepatitis C in the area.
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Affiliation(s)
- Hala Ibrahim Awadalla
- Institute of Environmental Studies and Research, Ain Shams University, Cairo, Egypt.
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Cavlek TV, Marić J, Katicić L, Kolarić B. Hepatitis C virus antibody status, sociodemographic characteristics, and risk behaviour among injecting drug users in Croatia. Cent Eur J Public Health 2011; 19:26-9. [PMID: 21526652 DOI: 10.21101/cejph.a3602] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The study was conducted among 76 injecting drug users (IDU) from seven Croatian cities during a three-year period (2005-2007). Each participant completed a questionnaire on sociodemographic characteristics and potential risk factors for hepatitis C virurs (HCV) infection followed by anti-HCV and anti-HIV antibody testing. The mean patient age was 30. The majority of patients (69.8%) reported more than one potential exposure to HCV: 97.1% had shared injecting equipment, 75% reported risk sexual behaviour, and 56.3% reported a history of travelling abroad. The overall HCV seroprevalence was 51.3% (95% CI = 40-63%). HCV seroprevalence increased with increasing number of risk behaviours (p = 0.026). Needle sharing frequency was the most important risk factor for hepatitis C. The HCV seroprevalence rate ranged from 27.3% in IDUs who answered that they shared needles occasionally to 100% in IDUs who always shared needles (p < 0.001). No other risk factors (age, gender, educational level, marital and employment status, history of travelling abroad and sexual risk behaviour) were associated with HCV seropositivity.
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Mujtaba G, Jahan S, Khaliq S, Mahmood N, Javed F, Choudhry N, Aslam A, Bashir T, Faiz M. Current Status of Transmission Risk Factors and Genotypes of Hepatitis C Virus, In Punjabi Population of Pakistan. ACTA ACUST UNITED AC 2011. [DOI: 10.5455/ijavms.20110526102003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Lodi G, Pellicano R, Carrozzo M. Hepatitis C virus infection and lichen planus: a systematic review with meta-analysis. Oral Dis 2010; 16:601-12. [DOI: 10.1111/j.1601-0825.2010.01670.x] [Citation(s) in RCA: 143] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Faustini A, Colais P, Fabrizi E, Bargagli AM, Davoli M, Di Lallo D, Di Napoli A, Pezzotti P, Sorge C, Grillo R, Maresca C, Recchia O, Perucci CA. Hepatic and extra-hepatic sequelae, and prevalence of viral hepatitis C infection estimated from routine data in at-risk groups. BMC Infect Dis 2010; 10:97. [PMID: 20403169 PMCID: PMC2867994 DOI: 10.1186/1471-2334-10-97] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2009] [Accepted: 04/19/2010] [Indexed: 01/02/2023] Open
Abstract
Background Concerns about the hepatitis C virus (HCV) are due to the high risk of chronic liver disease and poor treatment efficacy. Synthesizing evidence from multiple data sources is becoming widely used to estimate HCV-infection prevalence. This paper aims to estimate the prevalence of HCV infection, and the hepatic and extrahepatic sequelae in at-risk groups, using routinely collected data in the Lazio region, Italy. Methods HCV laboratory surveillance and dialysis, hospital discharge, and drug-user registers were used as information sources to identify at-risk groups and to estimate HCV prevalence and sequelae. Full name and birth date were used as linkage keys for the various health registries. Prevalence was estimated as the percentage of cases within the general population and the at-risk groups, with 95% confidence intervals (95% CI) from 1997 to 2001. The risk of sequelae was estimated through a follow-up of hospital discharges up to December 31, 2004 and calculated as the prevalence ratio in HCV-positive and HCV-negative people, within each at-risk group, with 95% CI. Results There were 65,127 HCV-infected people in the study period; the prevalence was 1.24% (95%CI = 1.23%-1.25%) in the whole population, higher in males and older adults. Drug users (35.1%; 95%CI = 34.6-35.7) and dialysis patients (21.1%; 95%CI = 20.2%-22.0%) showed the highest values. Medical procedures with little exposure to blood resulted in higher estimates, ranging between 1.3% and 3.4%, which was not conclusively attributable to the surgical procedures. Cirrhosis, hepatocellular carcinoma and encephalopathy were the most frequent hepatic sequelae; cryoglobulinaemia and non-Hodgkin's lymphoma were the most frequent extrahepatic sequelae. Conclusions Synthesising data from multiple routine sources improved estimates of HCV prevalence and sequelae in dialysis patients and drug users, although prevalence validity should be assessed in survey and sequelae need a well-defined longitudinal approach.
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Affiliation(s)
- Annunziata Faustini
- Department of Epidemiology, Regional Health System - Lazio Region, Via S, Costanza 53, 00198, Rome, Italy.
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Vickery K, Tawk HM, Bisset L, Selby W, Cossart YE. Hepatitis C virus infection rates and risk factors in an Australian hospital endoscopy cohort. Aust N Z J Public Health 2009; 33:442-8. [DOI: 10.1111/j.1753-6405.2009.00426.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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