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Waked I, Alsammany S, Tirmazy SH, Rasul K, Bani-Issa J, Abdel-Razek W, Omar A, Shafik A, Eid S, Abdelaal A, Hosni A, Esmat G. Multidisciplinary consensus recommendations for management of hepatocellular carcinoma in Middle East and North Africa region. Liver Int 2023; 43:2062-2077. [PMID: 37553777 DOI: 10.1111/liv.15685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/30/2023] [Accepted: 07/20/2023] [Indexed: 08/10/2023]
Abstract
Hepatocellular carcinoma (HCC) is a growing health concern projected to cross over a million cases worldwide by 2025. HCC presents a significant burden of disease in Middle East and North African (MENA) countries due to a high prevalence of risk factors such as hepatitis C and B infections and rising incidence of non-alcoholic steatohepatitis and non-alcoholic fatty liver disease. In August 2022, an advisory meeting consisting of experts from 5 MENA countries was convened in an attempt to provide consensus recommendations on HCC screening, early diagnosis, current treatment modalities and unmet medical needs in the region. Data were collected from a pre-meeting survey questionnaire and responses analysed and presented during the advisory meeting. This review summarizes the evidence discussed at the meeting and provides expert recommendations on the management of HCC. The 2022 update of Barcelona clinic liver cancer (BCLC) staging and treatment strategy and its implementation in the MENA region was extensively discussed. A key consensus of the expert panel was that multidisciplinary care is crucial to effective patient management that results in better clinical outcomes and overall survival of the patient. The panel recommended the use of predictive and early response biomarkers to guide clinicians in arriving at more effective therapeutic decisions. The experts also emphasized the role of robust screening/surveillance systems, population-based registries, effective referral pathways and standardization of guidelines to ensure the successful management of HCC in the region.
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Affiliation(s)
- Imam Waked
- Department of Medicine, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt
| | - Sherif Alsammany
- Department of Medical Oncology, King Abdullah Medical City, Mecca, KSA
| | | | - Kakil Rasul
- Department of Medical Oncology, GI Unit, National Centre for Cancer Care and Research, Doha, Qatar
| | - Jafar Bani-Issa
- Department of Interventional Radiology, King Hussein Cancer Center, Amman, Jordan
| | - Wael Abdel-Razek
- Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt
| | - Ashraf Omar
- Department of Endemic Medicine and Hepato-Gastroentrology, Cairo University, Cairo, Egypt
| | - Amr Shafik
- Department of Clinical Oncology, Ain Shams University, Cairo, Egypt
| | - Salem Eid
- Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Amr Abdelaal
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Ain Shams University, Cairo, Egypt
| | - Ahmed Hosni
- Department of Diagnostic and Interventional Radiology, Cairo University, Cairo, Egypt
| | - Gamal Esmat
- Department of Endemic Medicine and Hepato-Gastroentrology, Cairo University, Cairo, Egypt
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Liu W, Dong Z, Hu W, Li K, Sun L, Hou J, Jia S, Liu Y. Trends in hepatitis B notification rates in Guangzhou, China, between 2009 and 2020: an epidemiological study. BMC Infect Dis 2022; 22:913. [PMID: 36476118 PMCID: PMC9727992 DOI: 10.1186/s12879-022-07690-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/17/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although the prevalence of hepatitis B in Guangzhou, China, is high, the epidemiological trends are not well-documented. We aimed to analyse newly reported hepatitis B cases in Guangzhou between 2009 and 2020 to explore the epidemiological trends and provide insights for the development of control measures. METHODS Information on the population and new cases of hepatitis B in Guangzhou between 2009 and 2020 was obtained from the China Information System for Disease Control and Prevention, which was used to calculate the annual notification rates of hepatitis B by sex, age group (0-9; 10-19; 20-29; 30-39; 40-49; 50-59; ≥ 60 years), and location (urban or rural). Joinpoint regression analysis was used to analyse the temporal trends and calculate the average annual percentage change (AAPC) and annual percentage change (APC) for each identified trend line segment. RESULTS Between 2009 and 2020, 287,034 new cases of hepatitis B were cumulatively reported. The average annual notification rate was 181.13/100,000, and the notification rate showed a long-term downward trend during the period 2009-2020, with an annual decrease of 6.30% (APC - 6.30%; 95% CI - 7.56 to - 5.02%). Men had a significantly higher notification rate than women; however, the sex ratio decreased from a maximum of 2.34 in 2010 to a minimum of 1.54 in 2020. A downward trend in the notification rate was observed in urban areas and an upward trend was observed in rural areas, with an increase in the rural/urban ratio from 0.46 in 2012 to 1.57 in 2020. The notification rate for all age groups showed a decreasing trend from 2009, with the exception of the 50-59 years and ≥ 60 years groups, whose notification rates began to decrease from 2014 and 2015, respectively. CONCLUSIONS Although the overall notification rate of hepatitis B in Guangzhou decreased annually, it remained high. Further, in rural areas, the notification rate has been increasing, and effective measures should be taken to control hepatitis B infection in Guangzhou.
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Affiliation(s)
- Wei Liu
- grid.508371.80000 0004 1774 3337Operations Management Section, Guangzhou Center for Disease Control and Prevention, No. 1, Qide Road, Jiahe, Baiyun District, Guangzhou, 510440 China
| | - Zhiqiang Dong
- grid.508371.80000 0004 1774 3337Operations Management Section, Guangzhou Center for Disease Control and Prevention, No. 1, Qide Road, Jiahe, Baiyun District, Guangzhou, 510440 China
| | - Wensui Hu
- grid.508371.80000 0004 1774 3337Operations Management Section, Guangzhou Center for Disease Control and Prevention, No. 1, Qide Road, Jiahe, Baiyun District, Guangzhou, 510440 China
| | - Ke Li
- grid.508371.80000 0004 1774 3337Operations Management Section, Guangzhou Center for Disease Control and Prevention, No. 1, Qide Road, Jiahe, Baiyun District, Guangzhou, 510440 China
| | - Lili Sun
- grid.508371.80000 0004 1774 3337Operations Management Section, Guangzhou Center for Disease Control and Prevention, No. 1, Qide Road, Jiahe, Baiyun District, Guangzhou, 510440 China
| | - Jianrong Hou
- grid.508371.80000 0004 1774 3337Operations Management Section, Guangzhou Center for Disease Control and Prevention, No. 1, Qide Road, Jiahe, Baiyun District, Guangzhou, 510440 China
| | - Shijie Jia
- grid.413419.a0000 0004 1757 6778Department of Traditional Chinese Medicine, Guangzhou Eighth People’s Hospital Guangzhou Medical University, No.627, Dongfeng East Road, Yuexiu District, Guangzhou, 510060 China
| | - Yuan Liu
- grid.508371.80000 0004 1774 3337Operations Management Section, Guangzhou Center for Disease Control and Prevention, No. 1, Qide Road, Jiahe, Baiyun District, Guangzhou, 510440 China
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Human herpes simplex virus-6 (HHV-6) detection and seroprevalence among Qatari nationals and immigrants residing in Qatar. IJID REGIONS 2022; 2:90-95. [PMID: 35757074 PMCID: PMC9216376 DOI: 10.1016/j.ijregi.2021.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 11/30/2022]
Abstract
The prevalence of anti-human herpes virus-6 immunoglobulin G (IgG) was 71.7% among healthy donors in Qatar. One-quarter (24.3%) of healthy donors in Qatar had detectable viraemia. No strong association was found between viraemia and IgG positivity. A significant association was found between viraemia and the nationality of healthy donors.
Background Human herpes simplex virus-6 (HHV-6) is the causative agent of exanthema subitum. Transmission mainly occurs through salivary secretions, yet blood transfusions and organ transplantations have also been reported as routes of transmission. Studies of seroprevalence of HHV-6 in the Middle East and North Africa (MENA) region and other parts of Asia are scarce. As such, this study aimed to estimate the seroprevalence of HHV-6 among healthy blood donors in Qatar. Methods In total, 620 healthy blood donors from different nationalities residing in Qatar, mainly from the MENA region and Southeast Asia, were tested using a commercial anti-HHV-6 immunoglobulin G (IgG) enzyme-linked immunosorbent assay kit. In addition, HHV-6 DNA from randomly selected samples was tested and quantified using quantitative reverse transcriptase polymerase chain reaction. Results Anti-HHV-6 IgG was detected in 71.7% (445/620) [95% confidence interval (CI) 68.2–75.3%] of the tested samples, while 24.3% (61/251) (95% CI 20.0–29.6%) had detectable HHV-6 viraemia. Only 22.5% of individuals with positive IgG status had detectable HHV-6 DNA in their blood, indicating a weak association between viraemia and IgG positivity (P=0.08). Furthermore, no significant difference was associated between HHV-6 viraemia and demographic characteristics, except for nationality. Conclusion The seroprevalence of HHV-6 in Qatar was found to be similar to rates reported in other parts of the world.
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Souan L, Siag M, Al-Salahat H, Al-Atrash T, Sughayer MA. Changing trends in seroprevalence rates of transfusion-transmitted diseases among blood donors in Jordan. BMC Infect Dis 2021; 21:508. [PMID: 34059011 PMCID: PMC8165764 DOI: 10.1186/s12879-021-06196-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 05/17/2021] [Indexed: 11/28/2022] Open
Abstract
Background Hepatitis B and C infections and transmission are a serious challenge to all healthcare systems. We studied seroprevalence rates of Transfusion Transmitted Diseases (TTD) among blood bank donors in Jordan from 2014 to 2019 as a follow-up study of our previously published work. In addition, we wanted to explore the efficacy of the mandatory vaccination of infants against hepatitis B virus (HBV) which was implemented by the Ministry of Health since 1995 for the eradication of HBV infection in Jordan. Methods We reviewed blood bank donors’ records at King Hussein Cancer Center (KHCC) from January 1st, 2014, until December 31st, 2019. Results of seropositivity prevalence rates for HBsAg, anti-HBcore, and anti-HCV, using Enzyme-Linked ImmunoSorbent Assay (ELISA) were compared to seropositivity rates from our previously published data. In addition, our results were compared to data obtained from other blood banks in Jordan, as well as compared to published information from blood banks in neighboring countries. Results The prevalence rates (%) of seropositive blood donors for viral hepatitis for the years 2014, 2015, 2016, 2017, 2018, and 2019, were as follows: HBsAg rates were 0.3386, 0.2108, 0.1801, 0.1898, 0.2068, and 0.2741; anti-HBcore rates were 4.1112, 3.2271, 2.9748, 2.8405, 2.6879 and 3.0986; and anti-HCV rates were 0.1129, 0.0486, 0.0548, 0.0654, 0.0782, and 0.0839, respectively. There was a significant increase in the prevalence of HBsAg, Anti-HBcore and Anti-HCV antibodies in 2019 (one sample z-score test, p < 0.00001). Conclusions Prevalence rates of hepatitis B and C infections among Jordanian blood bank donors showed a steady decline between 2009 and 2017, and these rates were much lower in Jordan than in neighboring countries. However, an increase in the prevalence rates of hepatitis B and C infections among blood bank donors was documented in 2019. While the reasons for this increase are not clear yet, these findings highlight the importance of renewed efforts to increase public health awareness of HBV and implement effective measures to prevent the transmission and infection with HBV, including national vaccination programs.
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Affiliation(s)
- Lina Souan
- Department of Pathology Laboratory Medicine, King Hussein Cancer Center, Al-Jubeiha, Amman, Jordan.
| | - Mahmoud Siag
- Department of Pathology Laboratory Medicine, King Hussein Cancer Center, Al-Jubeiha, Amman, Jordan
| | - Hala Al-Salahat
- Department of Pathology Laboratory Medicine, King Hussein Cancer Center, Al-Jubeiha, Amman, Jordan
| | - Tareq Al-Atrash
- Department of Pathology Laboratory Medicine, King Hussein Cancer Center, Al-Jubeiha, Amman, Jordan
| | - Maher A Sughayer
- Department of Pathology Laboratory Medicine, King Hussein Cancer Center, Al-Jubeiha, Amman, Jordan
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Souan L, Siag M, Al-Salahat H, Al-Atrash T, Sughayer MA. Changing trends in seroprevalence rates of transfusion-transmitted diseases among blood donors in Jordan. BMC Infect Dis 2021. [PMID: 34059011 DOI: 10.1186/s12879-021-06196-3.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hepatitis B and C infections and transmission are a serious challenge to all healthcare systems. We studied seroprevalence rates of Transfusion Transmitted Diseases (TTD) among blood bank donors in Jordan from 2014 to 2019 as a follow-up study of our previously published work. In addition, we wanted to explore the efficacy of the mandatory vaccination of infants against hepatitis B virus (HBV) which was implemented by the Ministry of Health since 1995 for the eradication of HBV infection in Jordan. METHODS We reviewed blood bank donors' records at King Hussein Cancer Center (KHCC) from January 1st, 2014, until December 31st, 2019. Results of seropositivity prevalence rates for HBsAg, anti-HBcore, and anti-HCV, using Enzyme-Linked ImmunoSorbent Assay (ELISA) were compared to seropositivity rates from our previously published data. In addition, our results were compared to data obtained from other blood banks in Jordan, as well as compared to published information from blood banks in neighboring countries. RESULTS The prevalence rates (%) of seropositive blood donors for viral hepatitis for the years 2014, 2015, 2016, 2017, 2018, and 2019, were as follows: HBsAg rates were 0.3386, 0.2108, 0.1801, 0.1898, 0.2068, and 0.2741; anti-HBcore rates were 4.1112, 3.2271, 2.9748, 2.8405, 2.6879 and 3.0986; and anti-HCV rates were 0.1129, 0.0486, 0.0548, 0.0654, 0.0782, and 0.0839, respectively. There was a significant increase in the prevalence of HBsAg, Anti-HBcore and Anti-HCV antibodies in 2019 (one sample z-score test, p < 0.00001). CONCLUSIONS Prevalence rates of hepatitis B and C infections among Jordanian blood bank donors showed a steady decline between 2009 and 2017, and these rates were much lower in Jordan than in neighboring countries. However, an increase in the prevalence rates of hepatitis B and C infections among blood bank donors was documented in 2019. While the reasons for this increase are not clear yet, these findings highlight the importance of renewed efforts to increase public health awareness of HBV and implement effective measures to prevent the transmission and infection with HBV, including national vaccination programs.
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Affiliation(s)
- Lina Souan
- Department of Pathology Laboratory Medicine, King Hussein Cancer Center, Al-Jubeiha, Amman, Jordan.
| | - Mahmoud Siag
- Department of Pathology Laboratory Medicine, King Hussein Cancer Center, Al-Jubeiha, Amman, Jordan
| | - Hala Al-Salahat
- Department of Pathology Laboratory Medicine, King Hussein Cancer Center, Al-Jubeiha, Amman, Jordan
| | - Tareq Al-Atrash
- Department of Pathology Laboratory Medicine, King Hussein Cancer Center, Al-Jubeiha, Amman, Jordan
| | - Maher A Sughayer
- Department of Pathology Laboratory Medicine, King Hussein Cancer Center, Al-Jubeiha, Amman, Jordan
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Gençdal G, Yurdaydin C. Epidemiology of Hepatitis B Virus in the Middle East. LIVER CANCER IN THE MIDDLE EAST 2021:91-99. [DOI: 10.1007/978-3-030-78737-0_5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
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