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Tang Q, Chen Z, Li H, Zhang L, Peng M, Zeng Y, Liu X, Liu Z, Hu P. Molecular epidemiology of hepatitis C virus genotypes in different geographical regions of Chinese mainland and a phylogenetic analysis. Infect Dis Poverty 2023; 12:66. [PMID: 37430328 DOI: 10.1186/s40249-023-01106-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/16/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) infection remains a major public health problem in Chinese mainland. Investigation of the distribution of genotypes contributed to the prevention, diagnosis and treatment of HCV infection. Therefore, we conducted a study on the distribution of HCV genotypes and phylogenetic analysis to provide an up-to-date understanding of the molecular epidemiology of genotypes in Chinese mainland. METHODS Our retrospective multicenter study enrolled 11,008 samples collected between August 2018 and July 2019 from 29 provinces/municipalities (Beijing, Hebei, Inner Mongolia, Shanxi, Tianjin, Gansu, Ningxia, Shaanxi, Xinjiang, Heilongjiang, Jilin Liaoning, Henan, Hubei Hunan, Anhui, Fujian, Jiangsu, Jiangxi, Shandong, Shanghai Zhejiang, Guangdong, Guangxi, Hainan, Chongqing, Guizhou, Sichuan and Yunnan). Phylogenetic analysis of each subtype was performed to infer the evolutionary relationship of sequences from diverse regions. Two independent samples t tests were used for the comparison of continuous variables, and chi-square tests were used for the comparison of categorical variables. RESULTS Four genotypes (1, 2, 3 and 6) were found, including 14 subtypes. HCV genotype 1 was dominant, accounting for 49.2%, followed by genotypes 2, 3 and 6, accounting for 22.4%, 16.4%, and 11.9%, respectively. Additionally, the top five subtypes were 1b, 2a, 3b, 6a and 3a. Proportions of genotypes 1 and 2 decreased while genotypes 3 and 6 increased over past years (P < 0.001). Genotypes 3 and 6 were concentrated in the population aged 30 to 50 years, and male carriers had lower proportions of subtypes 1b and 2a than female carriers (P < 0.01). Genotypes 3 and 6 were more prevalent in southern parts of Chinese mainland. Nationwide spreads of subtypes 1b and 2a were associated with sequences from northern parts of Chinese mainland, while subtypes 3a, 3b and 6a were associated with sequences from southern parts of Chinese mainland. CONCLUSIONS HCV subtypes 1b and 2a remained the most common subtypes in Chinese mainland, and their proportions decreased over the past years, while the proportions of genotypes 3 and 6 increased. Our investigation provided an accurate epidemiological picture of the circulating viral strains in Chinese mainland, contributing to the prevention, diagnosis and treatment of HCV infection. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Qiao Tang
- Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Chinese Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, 74# Linjiang Road, Yuzhong District, Chongqing, 400000, China
| | - Zhiwei Chen
- Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Chinese Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, 74# Linjiang Road, Yuzhong District, Chongqing, 400000, China
| | - Hu Li
- Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Chinese Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, 74# Linjiang Road, Yuzhong District, Chongqing, 400000, China
| | - Li Zhang
- Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Chinese Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, 74# Linjiang Road, Yuzhong District, Chongqing, 400000, China
| | - Mingli Peng
- Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Chinese Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, 74# Linjiang Road, Yuzhong District, Chongqing, 400000, China
| | - Yi Zeng
- Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Chinese Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, 74# Linjiang Road, Yuzhong District, Chongqing, 400000, China
| | - Xiaoqing Liu
- Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Chinese Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, 74# Linjiang Road, Yuzhong District, Chongqing, 400000, China
| | - Zubi Liu
- Key Laboratory of Digital Technology in Medical Diagnostics of Zhejiang Province, Hangzhou, Zhejiang, China.
- Zhejiang University School of Medicine, Hangzhou, 310000, China.
| | - Peng Hu
- Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Chinese Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, 74# Linjiang Road, Yuzhong District, Chongqing, 400000, China.
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Dilbaz N, Kuloğlu M, Evren EC, Paltun SC, Bilici R, Noyan CO, Kulaksizoglu B, Karabulut V, Umut G, Unubol B, Ucbilek E. HCV Genotype Distribution Among People Who Inject Drug in Turkey: Findings from Multicenter and Cross-Sectional Study. Subst Abuse 2023; 17:11782218231157340. [PMID: 36865052 PMCID: PMC9972049 DOI: 10.1177/11782218231157340] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 01/29/2023] [Indexed: 03/03/2023]
Abstract
Background Hepatitis C virus (HCV) infection is very common in people who inject drugs (PWID). Studies about the prevalence and genotype distribution of the HCV among PWID are very crucial for developing strategies to manage HCV infection. This study's objective is to map the distribution of HCV genotypes among PWID from various regions of Turkey. Method This prospective, multicenter, cross-sectional study involved 197 PWID who tested positive for anti-HCV antibodies from 4 different addiction treatment facilities in Turkey. Interviews were done with people who had anti-HCV antibodies, and blood samples were taken to check the HCV RNA viremia load and genotyping. Results This study was conducted on 197 individuals with a mean age of 30.3 ± 8.6 years. 9.1% (136/197 patients) had a detectable HCV-RNA viral load. Genotype 3 was the most commonly observed genotype by 44.1%, followed by genotype 1a by 41.9%, genotype 2 by 5.1%, genotype 4 by 4.4%, and genotype 1b by 4.4%. Whereas genotype 3 was dominant with 44.4% at the central Anatolia region of Turkey, the frequencies of genotypes 1a and 3, which were predominantly detected in the south and northwest regions of Turkey, were very close to each other. Conclusion Although genotype 3 is the predominant genotype in the PWID population in Turkey, the prevalence of HCV genotype varied across the country. To eliminate HCV infection in the PWID, treatment and screening strategies that differ by genotype are essentially required. Especially identification of genotypes will be useful in developing individualized treatments and determining national prevention strategies.
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Affiliation(s)
- Nesrin Dilbaz
- Faculty of Medicine, Uskudar
University, İstanbul, Turkey
| | - Murat Kuloğlu
- Faculty of Medicine, Akdeniz
University, Antalya, Turkey
| | - Ekrem Cuneyt Evren
- Bakirkoy Prof. Dr. Mazhar Osman Mental
and Neurological Hospital, İstanbul, Turkey
| | | | - Rabia Bilici
- Erenkoy Mental and Neurological
Diseases Education and Research Hospital, İstanbul, Turkey
| | - Cemal Onur Noyan
- Faculty of Medicine, Uskudar
University, İstanbul, Turkey,Cemal Onur Noyan, Faculty of Medicine,
Uskudar University, İstanbul 34662, Turkey.
| | | | - Vahap Karabulut
- Bakirkoy Prof. Dr. Mazhar Osman Mental
and Neurological Hospital, İstanbul, Turkey
| | - Gokhan Umut
- Bakirkoy Prof. Dr. Mazhar Osman Mental
and Neurological Hospital, İstanbul, Turkey
| | - Basak Unubol
- Erenkoy Mental and Neurological
Diseases Education and Research Hospital, İstanbul, Turkey
| | - Enver Ucbilek
- Faculty of Medicine, Mersin University,
Mersin, Turkey
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Tsai TL, Jhou HM, Fan FS. Conspicuous Response to Direct-Acting Antivirals in Chronic Hepatitis C-related Immune Thrombocytopenia: A Case Report. Cureus 2022; 14:e24193. [PMID: 35592216 PMCID: PMC9110079 DOI: 10.7759/cureus.24193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2022] [Indexed: 11/22/2022] Open
Abstract
A 39-year-old man with a history of intravenous drug use was diagnosed to have a sudden onset of immune thrombocytopenia (ITP) in the background of a chronic hepatitis C infection with genotype 3a. Two courses of high-dose pulse dexamethasone therapy (40 mg daily for consecutive four days) failed to raise the platelet counts, but a combination direct-acting antiviral (DAA) regimen of sofosbuvir and velpatasvir, which had been proved to be effective for all hepatitis C virus (HCV) genotypes, successfully restored the platelets number to normal ranges after hepatitis C virus ribonucleic acid (RNA) was totally eliminated. Molecular mimicry of hepatitis C virus envelope proteins with platelet surface antigens is proposed to be the underlying cause of immune thrombocytopenia. An adequate direct-acting antiviral regimen is considered to be the most reliable therapy for hepatitis C-related immune thrombocytopenia.
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Sedeño-Monge V, Laguna-Meraz S, Santos-López G, Panduro A, Sosa-Jurado F, Jose-Abrego A, Meléndez-Mena D, Muñoz-Ramírez MA, Cosme-Chávez M, Roman S. A comprehensive update of the status of hepatitis C virus (HCV) infection in Mexico-A systematic review and meta-analysis (2008-2019). Ann Hepatol 2021; 20:100292. [PMID: 33259949 DOI: 10.1016/j.aohep.2020.100292] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 11/13/2020] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES HCV infection is targeted by the WHO's Global Health Sector Strategy on Viral Hepatitis to be reduced notably by 2030. However, renovated epidemiological data is needed to line up with such goals. Herein, we provide an updated review of incidence, prevalence, genotypes (GTs), and risk factors (RFs) of HCV infection in Mexico to build elimination strategies. MATERIAL AND METHODS HCV incidence was charted using the cumulative new cases/year at week 52. Prevalence, GTs, and RFs data from low-risk (LR-G) and high-risk (HR-Gs) groups were searched in PubMed/MEDLINE/Medigraphic/Scielo databases from January 2008 to December 2019 as per PRISMA guidelines. Weighted mean prevalence (WMP) was estimated; GTs and RFs were registered. RESULTS In this study, 25,247 new cases were reported. Ten states accumulated 76.32% of HCV incidence that peaked in men at 50-59 years and women at 60-64 years. Thirty-four studies revealed a WMP between 0.774%-2.5% in LR-Gs and 11.8%-39.6% in HR-Gs that included mainly prison inmates, drug users, and dialyzed patients. GT1 and GT2 were predominant; GT3a emerged. Subtypes 1a and 1b circulate differentially, whereas novel GT2 subtypes appeared. Unsafe blood transfusion was infrequent in younger groups, but parenteral/intravenous transmission through drug-related risk behaviors has arisen. CONCLUSIONS HCV transmission increased notably among LR-Gs and HR-Gs in Mexico. Novel genotypes/subtypes emerged as well as risky behavioral routes of transmission. A national elimination strategy will require pro-active screening in designated risk groups, research in molecular epidemiology, medical training, robust epidemiological databases, and antiviral treatment available to all eligible HCV-infected patients.
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Affiliation(s)
- Virginia Sedeño-Monge
- Decanato de Ciencias Médicas, Universidad Popular Autónoma del Estado de Puebla, Puebla, Puebla, Mexico
| | - Saul Laguna-Meraz
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, Fray Antonio Alcalde, Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Gerardo Santos-López
- Laboratorio de Biología Molecular y Virología, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Metepec, Atlixco, Puebla, Mexico
| | - Arturo Panduro
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, Fray Antonio Alcalde, Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Francisca Sosa-Jurado
- Laboratorio de Biología Molecular y Virología, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Metepec, Atlixco, Puebla, Mexico
| | - Alexis Jose-Abrego
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, Fray Antonio Alcalde, Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Daniel Meléndez-Mena
- Servicio de Gastroenterología, Unidad Médica de Alta Especialidad, Centro Médico Nacional "General de División Manuel Ávila Camacho", Instituto Mexicano del Seguro Social, Puebla, Puebla, Mexico; Centro Interdisciplinario de Posgrados, Facultad de Medicina, Universidad Popular Autónoma del Estado de Puebla, Mexico
| | - Marco A Muñoz-Ramírez
- Decanato de Ciencias Médicas, Universidad Popular Autónoma del Estado de Puebla, Puebla, Puebla, Mexico
| | - Monserrat Cosme-Chávez
- Decanato de Ciencias Médicas, Universidad Popular Autónoma del Estado de Puebla, Puebla, Puebla, Mexico
| | - Sonia Roman
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, Fray Antonio Alcalde, Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico.
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Akiyama MJ, Riback L, Reeves JD, Lie YS, Agyemang L, Norton BL, Arnsten JH, Litwin AH. Hepatitis C Resistance-Associated Substitutions Among People Who Inject Drugs Treated With Direct-Acting Antiviral-Containing Regimens. Open Forum Infect Dis 2021; 8:ofab474. [PMID: 34692891 PMCID: PMC8530260 DOI: 10.1093/ofid/ofab474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/17/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND Resistance-associated substitutions (RASs) to HCV direct-acting antivirals (DAAs) can contribute to virologic failure and limit retreatment options. People who inject drugs (PWID) are at highest risk for transmission of resistant virus. We report on RASs at baseline and after virologic failure in DAA-naive and protease inhibitor-experienced PWID. METHODS We sequenced the NS3/4A, NS5A, and NS5B regions from 150 PWID with genotype 1 (GT1) viruses; 128 (85.3%) GT1a, 22 (14.7%) GT1b. RESULTS Among the 139 (92.7%) DAA-naive PWID, 85 of 139 (61.2%) had baseline RASs-67 of 139 (48.2%) in NS3 (predominantly Q80K/L); 25 of 139 (18.0%) in NS5A; and 8 of 139 (5.8%) in NS5B. Of the 11 protease inhibitor-experienced participants, 9 had baseline NS3 RASs (V36L N = 1, Q80K N = 9) and 4 had baseline NS5A RASs (M28V N = 2, H58P N = 1, A92T N = 1). Among the 11 participants who had posttreatment samples with detectable virus (7 treatment failures, 1 late relapse, 3 reinfections), 1 sofosbuvir/ledipasvir failure had a baseline H58P. Two sofosbuvir/ledipasvir-treated participants developed new NS5A mutations (Q30H, Y93H, L31M/V). Otherwise, no RASs were detected. CONCLUSIONS Our results demonstrate RAS prevalence among DAA-naive PWID is comparable to that in the general population. Only 2 of 150 (1.3%) in our longitudinal cohort developed treatment-emergent RASs. Concern for transmission of resistant virus may therefore be minimal.
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Affiliation(s)
- Matthew J Akiyama
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NEW YORK, USA
| | - Lindsey Riback
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NEW YORK, USA
| | | | - Yolanda S Lie
- Monogram Biosciences, LabCorp, South San Francisco, California, USA
| | - Linda Agyemang
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NEW YORK, USA
| | - Brianna L Norton
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NEW YORK, USA
| | - Julia H Arnsten
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NEW YORK, USA
| | - Alain H Litwin
- Prisma Health, Greenville, South Carolina, USA
- University of South Carolina School of Medicine, Greenville, South Carolina, USA
- Clemson University, Clemson, South Carolina, USA
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6
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Foschi FG, Borghi A, Grassi A, Lanzi A, Speranza E, Vignoli T, Napoli L, Olivoni D, Sanza M, Polidori E, Greco G, Bassi P, Cristini F, Ballardini G, Altini M, Conti F. Model of Care for Microelimination of Hepatitis C Virus Infection among People Who Inject Drugs. J Clin Med 2021; 10:jcm10174001. [PMID: 34501448 PMCID: PMC8432451 DOI: 10.3390/jcm10174001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 12/31/2022] Open
Abstract
Background: People who inject drugs (PWID) are the largest group at risk for HCV infection. Despite the direct acting antivirals (DAA) advancements, HCV elimination has been hindered by real-life difficulties in PWID. Aims: This study aimed to assess the impact of a multidisciplinary intervention strategy where HCV screening, treatment and follow-up were performed at the same location on efficacy and safety of DAA-therapy in real-life PWID population. Methods: All HCV-infected PWID referred to five specialized outpatient centers for drug addicts (SerDs) in Northern Italy were prospectively enrolled from May 2015 to December 2019. Hepatologists and SerDs healthcare workers collaborated together in the management of PWID inside the SerDs. Sustained virologic response (SVR), safety of treatment, proportion of patients lost to follow-up and reinfection rate were evaluated. Results: A total of 358 PWID started antiviral treatment. About 50% of patients had advanced fibrosis/cirrhosis, 69% received opioid substitution treatment, and 20.7% self-reported recent injecting use. SVR was achieved in 338 (94.4%) patients. Two patients died during treatment; one prematurely discontinued, resulting in a non-responder; twelve were lost during treatment/follow-up; and five relapsed. No serious adverse events were reported. SVR was lower in recent PWID than in former ones (89.2% vs. 95.8%; p = 0.028). Seven reinfections were detected, equating to an incidence of 1.25/100 person-years. Reinfection was associated with recent drug use (OR 11.07, 95%CI 2.10–58.38; p = 0.005). Conclusion: Our embedded treatment model could be appropriate to increase the linkage to care of HCV-infected PWID. In this setting, DAA regimens are well tolerated and highly effective, achieving a lower rate of reinfection.
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Affiliation(s)
| | - Alberto Borghi
- Internal Medicine Department, Faenza Hospital, 48018 Faenza, Italy; (F.G.F.); (A.B.); (L.N.)
| | - Alberto Grassi
- Internal Medicine Department, Rimini Hospital, 47923 Rimini, Italy; (A.G.); (G.B.)
| | - Arianna Lanzi
- Mental Health and Pathological Addictions Department, Addiction Treatment Service of Cesena, 47521 Cesena, Italy; (A.L.); (M.S.)
| | - Elvira Speranza
- Mental Health and Pathological Addictions Department, Addiction Treatment Service of Faenza, 48018 Faenza, Italy;
| | - Teo Vignoli
- Mental Health and Pathological Addictions Department, Addiction Treatment Service of Lugo, 48121 Ravenna, Italy; (T.V.); (D.O.); (G.G.)
| | - Lucia Napoli
- Internal Medicine Department, Faenza Hospital, 48018 Faenza, Italy; (F.G.F.); (A.B.); (L.N.)
| | - Deanna Olivoni
- Mental Health and Pathological Addictions Department, Addiction Treatment Service of Lugo, 48121 Ravenna, Italy; (T.V.); (D.O.); (G.G.)
| | - Michele Sanza
- Mental Health and Pathological Addictions Department, Addiction Treatment Service of Cesena, 47521 Cesena, Italy; (A.L.); (M.S.)
| | - Edoardo Polidori
- Mental Health and Pathological Addictions Department, Addiction Treatment Service of Rimini and Forlì, 47121 Forlì, Italy;
| | - Giovanni Greco
- Mental Health and Pathological Addictions Department, Addiction Treatment Service of Lugo, 48121 Ravenna, Italy; (T.V.); (D.O.); (G.G.)
| | - Paolo Bassi
- Infectious Disease Department, Ravenna Hospital, 48121 Ravenna, Italy;
| | | | - Giorgio Ballardini
- Internal Medicine Department, Rimini Hospital, 47923 Rimini, Italy; (A.G.); (G.B.)
| | - Mattia Altini
- Local Healthcare Authority of Romagna, AUSL Romagna, 48121 Ravenna, Italy;
| | - Fabio Conti
- Internal Medicine Department, Faenza Hospital, 48018 Faenza, Italy; (F.G.F.); (A.B.); (L.N.)
- Correspondence: ; Tel.: +39-0546-601111
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7
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Chouikha A, Ghrabi A, Ghodbane A, Hammemi W, Khedhiri M, Sadraoui A, Touzi H, Hassine HB, Maatoug S, Bensaoud C, Abdelhak S, Bouarrouj S, Gdoura M, Chaouachi H, Triki H. Distribution of HCV Genotypes Among People Who Inject Drugs in Tunisia: New Evidence for Scaling Up Prevention and Treatment Toward National Elimination Goal. Front Microbiol 2021; 12:697859. [PMID: 34385988 PMCID: PMC8353188 DOI: 10.3389/fmicb.2021.697859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022] Open
Abstract
Little is known about the distribution of hepatitis C virus (HCV) genotypes among people who inject drugs (PWID) in North African countries, including Tunisia. This study aims to describe HCV genotypes circulating among Tunisian PWID. A cross-sectional study was conducted, and 128 HCV-positive PWID were recruited between 2018 and 2019 from community-based harm reduction centers. After informed consent, sociodemographic characteristics and risk behavior data were obtained using an interviewer-administrated questionnaire. Blood samples were collected for further serological and molecular testing. Overall, five women and 123 men were included. The median age was 39.5 years. The majority of PWID (56.3%) had less than a secondary level of education, were single (57%), were unemployed (65.6%), were incarcerated at least once (93.0%), and had a history of residency in at least one foreign country (50.8%). During the previous 12 months, 82.0% reported having reused syringes at least once, 43.8% shared syringes at least once, while 56.2% had at least one unprotected sexual relation, and 28.1% had more than two different sexual partners. Tattooing was reported among 60.2%. All positive results for HCV-infection by rapid testing were confirmed by enzyme-linked immunosorbent assay (ELISA). HCV-RNA was detectable in 79.7%. Genotyping showed a predominance of genotype 1 (52%) followed by genotype 3 (34%) and genotype 4 (10%). Four patients (4%) had an intergenotype mixed infection. Subtyping showed the presence of six different HCV subtypes as follows: 1a (53.2%), 1b (6.4%), 3a (33.0%), 4a (3.2%), and 4d (4.3%). This is the first study describing circulating HCV genotypes among PWID in Tunisia. The distribution of HCV genotypes is distinct from the general population with a predominance of subtypes 1a and 3a. These findings can be used to guide national efforts aiming to optimize the access of PWID to relevant HCV prevention and treatment measures including pangenotypic regimens for patients infected with HCV genotype 3.
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Affiliation(s)
- Anissa Chouikha
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Amine Ghrabi
- Association Tunisienne d'Information et d'Orientation sur le SIDA et la Toxicomanie (Tunisian Association for Information and Orientation on HIV/AIDS and Toxicomania - ATIOST), Tunis, Tunisia
| | - Amira Ghodbane
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Walid Hammemi
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Marwa Khedhiri
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Amel Sadraoui
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Henda Touzi
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, Tunis El Manar University, Tunis, Tunisia
| | | | - Sonia Maatoug
- Science Shop, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Chaima Bensaoud
- Science Shop, Institut Pasteur de Tunis, Tunis, Tunisia.,Institute of Parasitology, Biology Centre, Czech Academy of Sciences, Ceske Budejovice, Czechia
| | | | - Samir Bouarrouj
- Association Tunisienne d'Information et d'Orientation sur le SIDA et la Toxicomanie (Tunisian Association for Information and Orientation on HIV/AIDS and Toxicomania - ATIOST), Tunis, Tunisia
| | - Mariem Gdoura
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Hedia Chaouachi
- Association Tunisienne d'Information et d'Orientation sur le SIDA et la Toxicomanie (Tunisian Association for Information and Orientation on HIV/AIDS and Toxicomania - ATIOST), Tunis, Tunisia
| | - Henda Triki
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, Tunis El Manar University, Tunis, Tunisia
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8
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Wang X, Wei L. Direct-acting Antiviral Regimens for Patients with Chronic Infection of Hepatitis C Virus Genotype 3 in China. J Clin Transl Hepatol 2021; 9:419-427. [PMID: 34221928 PMCID: PMC8237141 DOI: 10.14218/jcth.2020.00097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 03/20/2021] [Accepted: 03/24/2021] [Indexed: 12/20/2022] Open
Abstract
Hepatitis C virus (HCV) genotype (GT)3 infection is associated with a more rapid hepatic disease progression than the other genotypes. Hence, early HCV clearance slows down the disease progression and is important for improving prognosis in GT3-infected patients. Nevertheless, compared with other genotypes, GT3 is difficult-to-treat with direct-acting antivirals, especially in the presence of cirrhosis. Current guidelines recommend several regimens which have been proven to be effective in GT3-infected patients from the Western world (North America, Europe, and Oceania). In China, GT3 infection comprises 8.7-11.7% of the 10 million patients infected with HCV and has strikingly different characteristics from that in Western countries. Unlike the Western countries, where GT3a is the predominant subtype, GT3a and 3b each affect roughly half of Chinese GT3-infected patients, with 94-96% of the GT3b-infected patients carrying A30K+L31M double NS5A resistance-associated substitutions. Phase 3 clinical trials including GT3b-infected patients have suggested that GT3b infection is difficult to cure, making the regimen choice for GT3b-infected patients an urgent clinical gap to be filled. This review includes discussions on the epidemiology of HCV GT3 in China, recommendations from guidelines, and clinical data from both Western countries and China. The aim is to provide knowledge that will elucidate the challenges in treating Chinese GT3-infected patients and propose potential solutions and future research directions.
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Affiliation(s)
- Xiaozhong Wang
- Department of Hepatology, Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Lai Wei
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
- Correspondence to: Lai Wei, Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, 168 Litang Rd, Changping District, Beijing 102218, China. Tel: +86-10-56118881, Fax: +86-10-56118566, E-mail:
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9
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Akiyama MJ, Muller A, Huang O, Lizcano J, Nyakowa M, Riback L, Ross J, Bundi H, Kulabi ES, Mwangi AM, Musyoki H, Cherutich P, Kurth A. Hepatitis C-related knowledge, attitudes and perceived risk behaviours among people who inject drugs in Kenya: A qualitative study. Glob Public Health 2021; 17:1016-1028. [PMID: 33689563 DOI: 10.1080/17441692.2021.1896763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Despite disproportionately high rates of Hepatitis C (HCV) among people who inject drugs (PWID) in low- and middle-income countries (LMICs), understanding of HCV-related knowledge, attitudes and perceived risk behaviours among this population remains limited. We aimed to elucidate knowledge, attitudes and experiences that could minimise transmission risk and maximise HCV treatment engagement among PWID in Kenya following the integration of HCV screening and education with needle and syringe programmes in drop-in-centres (DICs). We recruited 40 PWID with chronic HCV attending DICs in Nairobi and Coastal Kenya. Semi-structured interviews revealed a general understanding of HCV and awareness of HCV risk behaviours among participants; however, many felt limited control over their transmission risk due to factors such as 'local doctors', or individuals who perform a high volume of high-risk injections. Financial barriers, distance to clinic, poor health status and HCV-related stigma were all noted as barriers to HCV treatment. In conclusion, basic knowledge of and motivation for HCV treatment among PWID accessing DICs in Kenya was high; however, structural barriers and stigma complicate access to care. Local education programmes can address knowledge gaps, and behavioural and structural interventions can maximise the impact of HCV care in LMICs.
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Affiliation(s)
- Matthew J Akiyama
- Department of Medicine, Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY, USA
| | - Abbe Muller
- Yale University, Yale School of Nursing, Orange, CT, USA
| | - Owen Huang
- Department of Medicine, Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY, USA
| | - John Lizcano
- Yale University, Yale School of Nursing, Orange, CT, USA
| | - Mercy Nyakowa
- Kenya Ministry of Health, National AIDS & STI Control Program (NASCOP), Nairobi, Kenya
| | - Lindsey Riback
- Department of Medicine, Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY, USA
| | - Jonathan Ross
- Department of Medicine, Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY, USA
| | - Henry Bundi
- Kenya Ministry of Health, National AIDS & STI Control Program (NASCOP), Nairobi, Kenya
| | | | - Ann Muthoni Mwangi
- Kenya Ministry of Health, National AIDS & STI Control Program (NASCOP), Nairobi, Kenya
| | - Helgar Musyoki
- Kenya Ministry of Health, National AIDS & STI Control Program (NASCOP), Nairobi, Kenya
| | - Peter Cherutich
- Kenya Ministry of Health, National AIDS & STI Control Program (NASCOP), Nairobi, Kenya
| | - Ann Kurth
- Yale University, Yale School of Nursing, Orange, CT, USA
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10
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Onorato L, Pisaturo M, Starace M, Minichini C, Di Fraia A, Astorri R, Coppola N. Virological Factors Associated with Failure to the Latest Generation of Direct Acting Agents (DAA) and Re-Treatment Strategy: A Narrative Review. Viruses 2021; 13:432. [PMID: 33800289 PMCID: PMC8000640 DOI: 10.3390/v13030432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 12/12/2022] Open
Abstract
The availability of all oral direct acting antiviral agents (DAAs) has revolutionized the management of HCV infections in recent years, allowing to achieve a sustained virological response (SVR) in more than 95% of cases, irrespective of hepatitis C Virus (HCV) genotype or staging of liver disease. Although rare, the failure to the latest-generation regimens (grazoprevir/elbasvir, sofosbuvir/velpatasvir, pibrentasvir/glecaprevir) represents a serious clinical problem, since the data available in the literature on the virological characteristics and management of these patients are few. The aim of the present narrative review was to provide an overview of the impact of baseline RASs in patients treated with the latest-generation DAAs and to analyze the efficacy of the available retreatment strategies in those who have failed these regimens.
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Affiliation(s)
| | | | | | | | | | | | - Nicola Coppola
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania L. Vanvitelli, 80138 Naples, Italy; (L.O.); (M.P.); (M.S.); (C.M.); (A.D.F.); (R.A.)
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11
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Liu C, Ma YL, Liu XH, Duan YR, Liu PL, Wang X, Yin P. Sociodemographic Factors Associated With HIV/HCV High-Risk Behaviors Among People Who Use Drugs on Methadone Maintenance Treatment: A 10-Year Observational Study. Front Psychiatry 2021; 12:707257. [PMID: 34594250 PMCID: PMC8477022 DOI: 10.3389/fpsyt.2021.707257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 08/13/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Sociodemographic factors have an impact worldwide on the behavior of people who use drugs (PWUD). This study attempts to clarify the sociodemographic factors related to HIV/HCV high-risk behaviors (injection drug use, syringe sharing, and multiple sex partners) among PWUD on methadone maintenance treatment (MMT) in the long term. Methods: The 13,300 PWUD recruited into the MMT program were followed during 2006-2015. Generalized estimating equations were used to examine the relationship between sociodemographic characteristics and HIV/HCV high-risk behaviors. Results: We found that male (vs. female), living alone (vs. living with family or relatives), temporary income, financial support from family/friends, and financial support from social welfare (vs. regular salary) were positively associated with injection drug use. Age of initial drug use was negatively associated with injection drug use and syringe sharing. For both genders, being unmarried (vs. married or in cohabitation), living with friends, living alone (vs. living with family or relatives), temporary income, financial supports from family/friends (vs. regular salary), being employed (vs. unemployed/between jobs) was positively associated. In contrast, age at baseline was negatively associated with having multiple sexual partners for both genders. Ethnic of non-Han (vs. Han) was positively associated with having multiple sexual partners simply for males. Being divorced or widowed (vs. married or cohabitated) was positively associated with having multiple sexual partners merely for females. Conclusion: HIV/HCV high-risk behaviors correlated with certain sociodemographic factors of PWUD receiving MMT. There is a need for improving the well-being, employment, and housing status of PWUD on MMT to reduce their HIV/HCV risk behaviors.
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Affiliation(s)
- Cong Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Wuhan Centers for Disease Control and Prevention, Wuhan, China
| | - Yi-Lei Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xue-Han Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan-Ran Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pu-Lin Liu
- Wuhan Centers for Disease Control and Prevention, Wuhan, China
| | - Xia Wang
- Wuhan Centers for Disease Control and Prevention, Wuhan, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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12
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Pereson MJ, Martínez AP, Isaac K, Laham G, Ridruejo E, Garcia GH, Flichman DM, Di Lello FA. Seroprevalence of hepatitis B, hepatitis C and HIV infection among patients undergoing haemodialysis in Buenos Aires, Argentina. J Med Microbiol 2020; 70. [PMID: 33180017 DOI: 10.1099/jmm.0.001278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Introduction. Blood-borne infections are a major cause of harm in individuals on haemodialysis (HD). In particular, knowledge about hepatitis B (HBV), hepatitis C (HCV) and human immunodeficiency virus (HIV) status in HD patients is a major concern, since these infections may cause comorbidities in this setting. There is a paucity of data regarding this issue in Argentina.Hypothesis/Gap Statement. The epidemiological surveillance of HBV, HCV, and HIV is a fundamental tool for planning and implementing health strategies in order to prevent and control viral transmission of these viral agents.Aim. To determine the seroprevalence of HBV, HCV and HIV infections in HD patients in Buenos Aires, Argentina.Methodology. Seven hundred and forty-eight HD patients were included in a retrospective cross-sectional study. Serological assays were performed to determine HBV, HCV and HIV status. HBV HBsAg and anti-HBc IgG were analysed using AxSYM (samples before 2010) or the Architect Abbott system (samples since 2010), anti-HCV IgG testing was performed using the anti-HCV enzyme immunoassay AxSYM HCV V3.0 and ARCHITECT anti-HCV, while HIV was tested for using AxSYM HIV 1/2 gO and ARCHITECT HIV Ag/Ab Combination. HCV genotyping was carried out by phylogenetic analysis of the NS5B partial gene.Results. Infection with one of the viruses was detected in 31.1 % of patients [HBV in 82 (11.0 %), HCV in 179 (23.9 %) and HIV in 6 (0.8 %)]. Thirty-two (4.3 %) patients had 2 virus markers [27 (3.6 %) with HCV/HBV, 4 (0.5 %) with HCV/HIV and 1 (0.13 %) with HBV/HIV]. Finally, a single patient (0.13 %) presented all three markers. Time on dialysis was correlated with HCV but not with HBV infection. The HCV subtype distribution in HD patients was inverted with respect to that observed in the general population (HCV-1a 73.2 % and HCV-1b 26.8 % in HD vs HCV-1a 26.5 % and HCV-1b 73.5 % in the general population, P <0.001).Conclusion. Despite the implementation of universal precautionary biosafety standards for dialysis, infection with HBV and HCV continues to occur at very high rates in HD patients. The results emphasize the need to carry out proactive tasks for early diagnosis and treatment of infected individuals and to vaccinate those with non-protective antiHBs antibodies in order to reduce morbidity and mortality in HD patients.
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Affiliation(s)
- Matías J Pereson
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Argentina.,Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Buenos Aires, Argentina
| | - Alfredo P Martínez
- Virology Section, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno 'CEMIC', Buenos Aires, Argentina
| | - Katia Isaac
- Virology Section, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno 'CEMIC', Buenos Aires, Argentina
| | - Gustavo Laham
- Neprhology Section, Department of Medicine, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno 'CEMIC', Buenos Aires, Argentina
| | - Ezequiel Ridruejo
- Hepatology Section, Department of Medicine, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno 'CEMIC', Buenos Aires, Argentina
| | - Gabriel H Garcia
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Buenos Aires, Argentina
| | - Diego M Flichman
- Instituto de Investigaciones Biomédicas en Retrovirus y Síndrome de Inmunodeficiencia Adquirida (INBIRS)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Argentina
| | - Federico A Di Lello
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Argentina
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13
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Aziz H, Fatima S, Faheem M. Indeterminate Prediction of Hepatitis C Virus Genotype by Commercial Real-Time Polymerase Chain Reaction Assay Resolving by Sequencing to Avoid the Consequence of Inaccurate Typing. Viral Immunol 2020; 33:507-513. [PMID: 32429831 DOI: 10.1089/vim.2019.0162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Pakistan is ranked second highest after Egypt in hepatitis C virus (HCV) infection. Accurate typing is mandatory to be compliant with the World Health Organization strategy to eliminate HCV infection in 2030. We characterized the HCV genotypes using Abbott real-time polymerase chain reaction assay and indeterminate samples were sequenced. We also investigated the distribution of HCV genotype among different age groups and gender in chronic HCV patients. One thousand thirteen samples were tested for HCV genotyping using Abbott real-time HCV genotyping assay. RNA extraction from plasma was done using the m2000sp platform. The amplification and detection of genotypes was done on m2000rt instrument. The lower limit of detection assay is 500 IU/mL. The indeterminate genotypes were analyzed by sequencing of the NS5B region. We found genotype 1 in 1.68%, genotype 1b in 0.89%, genotype 1a in 0.79%, genotype 2 in 0.6, genotype 3 in 94.37%, genotype 4 in 0.4%, genotype 5 in 0.09%, and indeterminate genotype result were found in 1.18%. Abbott assay could not identify 12 samples of genotype 3 (1.18%) and gave the indeterminate result. It also fails to assign some of the samples of genotype 1 into 1a and 1b. The indeterminate genotypes were resolved by sequencing followed by phylogenetic analysis. Genotype 3 is the predominant genotype and significantly higher in females as compared with males. Genotype 1a is more common in males than in females. Indeterminate HCV genotypes on sequencing analysis identify as genotype 3a and likewise subtype of genotype1 as 1a.
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Affiliation(s)
- Hafsa Aziz
- Nuclear Medicine, Oncology, and Radiotherapy Institute, Islamabad, Pakistan
| | - Shazia Fatima
- Nuclear Medicine, Oncology, and Radiotherapy Institute, Islamabad, Pakistan
| | - Mohammad Faheem
- Nuclear Medicine, Oncology, and Radiotherapy Institute, Islamabad, Pakistan
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14
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Arasteh K, Des Jarlais DC, Feelemyer J, McKnight C. Hepatitis C incidence and prevalence among Puerto Rican people who use drugs in New York City. Glob Public Health 2020; 15:1789-1799. [DOI: 10.1080/17441692.2020.1768276] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Kamyar Arasteh
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY, USA
| | - Don C. Des Jarlais
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY, USA
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA
| | - Jonathan Feelemyer
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY, USA
| | - Courtney McKnight
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY, USA
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15
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Loureiro CL, Jaspe RC, Pujol FH. Variation in Hepatitis C Virus Subtype Distribution during 20 Years in Venezuela. Intervirology 2019; 62:191-197. [PMID: 31865350 DOI: 10.1159/000505065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/24/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Hepatitis C virus (HCV) infection is a public health problem and a major cause of chronic hepatitis. This virus exhibits a great genetic variability, with 8 genotypes and numerous subtypes. The aim of this study was to evaluate the fluctuations of HCV subtypes during 2 decades in Venezuela. METHODS HCV genotypes were determined by direct sequencing of the 5'-noncoding region in 392 isolates circulating in patients attended during the years 2014-2015. HCV subtype assignment was confirmed in a subset of samples (n = 24) by partial sequencing of the NS5B region. The genotype distribution was compared with the one observed in a previous study of patients followed up during the years 1994-1996 and 2005-2006. RESULTS Some variation was observed in the HCV genotype distribution over these 20 years. HCV genotype 1b prevalence was reduced significantly from 1994-1995 to 2004-2005, as previously described, and then remained constant. During the last 10 years, a significant decrease of HCV subtype 2b (36/237 in 2005-2006 vs. 24/392 in 2014-2015, p < 0.001) was observed. Patients infected with HCV G2acj were significantly older than the ones infected with G1 (53 vs. 47 years, p = 0.004), and male sex was significantly more prevalent among G3a-infected patients compared to the other ones (71 vs. 47%, p = 0.047). CONCLUSIONS Fluctuations in HCV subtype distribution have been observed over 2 decades in Venezuela. Different major mode of transmission and susceptibility to the available HCV treatment during each period might be playing a role in the observed fluctuations in HCV subtype distribution.
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Affiliation(s)
- Carmen L Loureiro
- Laboratorio de Virología Molecular, Centro de Microbiología y Biología Celular, Instituto Venezolano de Investigaciones Científicas, Caracas, Venezuela
| | - Rossana C Jaspe
- Laboratorio de Virología Molecular, Centro de Microbiología y Biología Celular, Instituto Venezolano de Investigaciones Científicas, Caracas, Venezuela,
| | - Flor H Pujol
- Laboratorio de Virología Molecular, Centro de Microbiología y Biología Celular, Instituto Venezolano de Investigaciones Científicas, Caracas, Venezuela
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16
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Mehrabi Y, Etemad K, Noroozi A, Higgs P, Nasirian M, Sharhani A, Khademi N, Hajebi A, Noroozi M, Shakiba E, Hamzeh B, Azizmohammad Looha M. Correlates of injecting paraphernalia sharing among male drug injectors in Kermanshah, Iran: implications for HCV prevention. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1698670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Yadollah Mehrabi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Koorosh Etemad
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Noroozi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Peter Higgs
- Department of Public Health, La Trobe University, Bundoora, Australia
| | - Maryam Nasirian
- Faculty of Biostatistics and Epidemiology Department, Health School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Asaad Sharhani
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nahid Khademi
- CDC Department, Kermanshah Health Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ahmad Hajebi
- Research Center for Addiction & Risky Behaviors (ReCARB), Psychiatric Department, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Noroozi
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ebrahim Shakiba
- Department of Clinical Biochemistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Azizmohammad Looha
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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17
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Persico M, Aglitti A, Milella M, Coppola C, Messina V, Claar E, Gentile I, Sogari F, Pierri P, Surace LA, Morisco F, Tundo P, Brancaccio G, Serviddio G, Gatti P, Termite AP, Di Costanzo GG, Caroleo B, Cozzolongo R, Coppola N, Longo A, Fontanella L, Federico A, Rosato V, Terrenato I, Masarone M. Real-life glecaprevir/pibrentasvir in a large cohort of patients with hepatitis C virus infection: The MISTRAL study. Liver Int 2019; 39:1852-1859. [PMID: 31175707 DOI: 10.1111/liv.14170] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/30/2019] [Accepted: 06/03/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS It is paramount to identify predictors of treatment failure with direct antiviral agents in 'field-practice' patients, including people who inject drugs (PWID). Data on the efficacy of glecaprevir/pibrentasvir (GLE/PIB) in a field-practice scenario are scant. The multicentre MISTRAL study enrolled 1177 patients, including PWID, to assess real-life efficacy and safety of GLE/PIB and to identify the predictive factors for this treatment. METHODS This was a prospective, longitudinal study. The outcome variable was the rate of sustained virological response (SVR) at week 12. RESULTS A total of 123 patients (10%) were infected from hepatitis C virus (HCV) 3. METAVIR fibrosis score was F4 in 104 subjects (9%); 118 patients (10%) were PWID. Overall, 1163/1177 (99%) patients achieved SVR. The baseline clinical factors discriminating between treatment success and treatment failure were age at treatment (P = 0.031) and creatinine level (P = 0.034). SVR rates were not influenced by gender, substance abuse, previous treatment, treatment duration, fibrosis or chronic kidney disease stage. Compared with non-substance users, the 118 PWID exhibited a significantly different genotype pattern distribution (χ2 < 0.001). A total of 40/118 (33.9%) of substance users were HCV3 compared to 83/1056 (7.9%) non-substance users. Only 6 patients (0.5%) reported a serious adverse event. CONCLUSIONS The MISTRAL study provides evidence of GLE/PIB efficacy in a field-practice scenario in a highly epidemic HCV area in southern Italy; it unveiled significant differences in genotype distribution among the most underserved and difficult-to-treat patient subgroups including PWID.
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Affiliation(s)
- Marcello Persico
- Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy
| | - Andrea Aglitti
- Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy
| | - Michele Milella
- Clinic of Infectious Diseases, University of Bari, Bari, Italy
| | - Carmine Coppola
- Internal Medicine and Hepatology Unit, Hospital of Gragnano, Gragnano, Italy
| | | | - Ernesto Claar
- Hepatology Unit, "Villa Betania" Evangelical Hospital, Naples, Italy
| | - Ivan Gentile
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Fernando Sogari
- Internal Medicine Unit, "S.S. Annunziata" Hospital, Taranto, Italy
| | - Paola Pierri
- Infectious Diseases and Hepatology Unit, Cotugno Hospital, Naples, Italy
| | - Lorenzo A Surace
- Traveler and Migration Medicine Center, ASP Catanzaro, Catanzaro, Italy
| | - Filomena Morisco
- Department of Clinical Medicine and Surgery, Gastroenterology and Hepatology Unit, Federico II University, Naples, Italy
| | - Paolo Tundo
- S. Caterina Novella Hospital, Galatina, Lecce, Italy
| | | | | | | | | | | | | | | | - Nicola Coppola
- Infectious Diseases Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Luca Fontanella
- Liver Diseases Unit, Fatebenefratelli Hospital, Naples, Italy
| | - Alessandro Federico
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Valerio Rosato
- Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy.,Hepatology Unit, "Villa Betania" Evangelical Hospital, Naples, Italy
| | - Irene Terrenato
- Biostatistics-Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Mario Masarone
- Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy
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18
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High prevalence of occult hepatitis C virus infection in injection drug users with HIV infection. Arch Virol 2019; 164:2493-2504. [PMID: 31346769 DOI: 10.1007/s00705-019-04353-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 06/25/2019] [Indexed: 12/12/2022]
Abstract
One of the pathological forms of chronic hepatitis C is occult HCV infection (OCI), in which there is no detectable HCV RNA in plasma specimens but HCV RNA is present in PBMCs and liver biopsy specimens. The aim of this study is to estimate the prevalence of OCI in HIV-positive people who are injection drug users (IDUs). From April 2015 to August 2018, 161 Iranian IDUs with HIV infection enrolled in the study. Viral RNA was extracted from plasma and PBMC samples of participants, and the presence of HCV RNA was examined using RT nested PCR with primers from two conserved regions (5´-UTR and NS5B). HCV genotyping was performed using RFLP and sequencing methods. Of the 161 patients, 134 (83.2%) were positive for anti-HCV antibodies. All 27 patients who were negative for anti-HCV were also negative for HCV RNA in plasma, but five of them (18.5%) were positive for HCV RNA in PBMCs. Importantly, 9 out of 50 patients (18.0%) who apparently had recovered from HCV infection (i.e., were anti-HCV positive and HCV RNA negative) were positive for HCV RNA in PBMCs. Overall, 18.1% of the patients who had no signs of previous HCV infection or had apparently recovered from the disease had OCI. The HCV genotypes of the cases with OCI were as follows: five patients (35.7%) were infected with subtype 1a, eight patients (57.1%) were infected with subtype 3a, and one patient (7.1%) was infected with genotype 4. Thus, it seems that the prevalence of OCI in HIV-positive IDUs is extremely significant in Iran and is likely to delay the global eradication of HCV infection until 2030.
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19
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Murdock RM, Brizzi MB, Perez O, Badowski ME. Public Health Considerations among People who Inject Drugs with HIV/HCV Co-Infection: A Review. Infect Dis Ther 2019; 8:23-32. [PMID: 30607808 PMCID: PMC6374239 DOI: 10.1007/s40121-018-0228-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Indexed: 12/11/2022] Open
Abstract
Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) co-infection among persons who inject drugs (PWID) is a major public health concern. There are limited data in clinical trials on the use of direct-acting antiviral (DAA) therapy for treatment of HCV in co-infected PWID. It is critical for these patients to gain access to treatment in order to decrease progression of liver disease and decrease transmission of both HIV and HCV. Additional harm reduction interventions, including needle and syringe programs and opioid substitution treatment, should be made available to this vulnerable population. Despite the importance of DAA treatment, the cost of DAA therapy and access to medical care is still a barrier to appropriate therapy. The purpose of this review is to present available data on the use of DAAs in co-infected PWID, review guideline recommendations for treatment and retreatment of HCV in co-infected PWID, provide cost considerations for DAA therapy, and provide recommendations about caring for patients who continue to inject drugs.
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Affiliation(s)
- Rachel M Murdock
- College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - Marisa B Brizzi
- College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - Omar Perez
- College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - Melissa E Badowski
- College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.
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Hepatitis C virus genotype diversity and distribution among methadone maintenance treatment patients in Jiangsu, China. Drug Alcohol Depend 2019; 194:101-106. [PMID: 30419403 DOI: 10.1016/j.drugalcdep.2018.09.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/31/2018] [Accepted: 09/10/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Heroin users are vulnerable and represent a highly-infected reservoir for hepatitis C virus (HCV) infection. This study investigated HCV prevalence and genotypes distribution among heroin users who received methadone maintenance treatment (MMT) in Jiangsu. METHODS From June to December in 2016, a total of 534 patients among nine MMT clinics in six regions of Jiangsu were enrolled, with their demographic characteristics collected and serum samples tested for HCV antibody. 395 samples were seropositive and furthered to RNA extraction. HCV NS5B region fragments were amplified and subsequently sequenced. RESULTS Among HCV seropositive samples, 240 were characterized by NS5B partial sequences and classified into four genotypes (GPs) and eight subtypes. HCV GP3 predominated and accounted for 66.3%, followed by GP1 (27.5%), GP6 (4.2%) and GP2 (2.1%). HCV subtypes 3b (41.7%) and 3a (24.6%) were the most common subtypes. None of the demographic characteristics showed a significant difference when comparing with HCV genotypes. The geographic feature shown GPs in six regions were the same, but the frequency of subtypes exhibited regional divergence. Phylogenetic analyses demonstrated that 3b had become a local endemic in Jiangsu. CONCLUSION The distribution of HCV subtypes among heroin users in Jiangsu province was complex. The data could provide more precise estimates for HCV prevalence and genotype distribution as well as heroin users of Jiangsu province.
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Sagnelli E, Starace M, Minichini C, Pisaturo M, Macera M, Sagnelli C, Coppola N. Resistance detection and re-treatment options in hepatitis C virus-related chronic liver diseases after DAA-treatment failure. Infection 2018; 46:761-783. [DOI: 10.1007/s15010-018-1188-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 07/30/2018] [Indexed: 12/12/2022]
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CHIN‐YEE BENJAMIN, SUBRAMANIAN S, VERMA AMOLA, LAUPACIS ANDREAS, RAZAK FAHAD. Emerging Trends in Clinical Research: With Implications for Population Health and Health Policy. Milbank Q 2018; 96:369-401. [PMID: 29870114 PMCID: PMC5987824 DOI: 10.1111/1468-0009.12328] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Policy Points: Significant advances in clinical medicine that have broader societal relevance may be less accessible to population health researchers and policymakers because of increased specialization within fields. We describe important recent clinical advances and discuss their broader societal impact. These advances include more expansive strategies for disease prevention, the rise of precision medicine, applications of human microbiome research, and new and highly successful treatments for hepatitis C infection. These recent developments in clinical research raise important issues surrounding health care costs and equitable resource allocation that necessitate an ongoing dialogue among the fields of clinical medicine, population health, and health policy. CONTEXT Developments in clinical medicine have important implications for population health, and there is a need for interdisciplinary engagement among clinical medicine, the social sciences, and public health research. The aim of this article is to help bridge the divide between these fields by exploring major recent advances in clinical medicine that have important implications for population health. METHODS We reviewed the most cited articles published from 2010 to 2015 in 5 high-impact clinical journals and selected 5 randomized controlled trials and 2 related clinical practice guidelines that are broadly relevant to population health and policy. FINDINGS We discuss the following themes: (1) expanding indications for drug therapy and the inherent medicalization of the population as highlighted by studies and clinical guidelines supporting lower blood pressure targets or widespread statin use; (2) the tension in nutritional research between quantifying the impact of isolated nutrients and studying specific foods and dietary patterns, for example, the role of the Mediterranean diet in the primary prevention of cardiovascular disease; (3) the issue of high medication costs and the challenge of providing equitable access raised by the development of new and effective treatments for hepatitis C infection; (4) emerging clinical applications of research on the human microbiome as illustrated by fecal transplant to treat Clostridium difficile infections; and (5) the promise and limitations of precision medicine as demonstrated by the rise of novel targeted therapies in oncology. CONCLUSIONS These developments in clinical science hold promise for improving individual and population health and raise important questions about resource allocation, the role of prevention, and health disparities.
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Affiliation(s)
| | - S.V. SUBRAMANIAN
- Harvard Center for Population and Development StudiesHarvard University
- Harvard T.H. Chan School of Public Health
| | - AMOL A. VERMA
- University of Toronto
- St. Michael's Hospital
- Li Ka Shing Knowledge InstituteSt. Michael's Hospital
| | - ANDREAS LAUPACIS
- University of Toronto
- St. Michael's Hospital
- Li Ka Shing Knowledge InstituteSt. Michael's Hospital
- Institute of Health Policy, Management and EvaluationUniversity of Toronto
| | - FAHAD RAZAK
- University of Toronto
- St. Michael's Hospital
- Harvard Center for Population and Development StudiesHarvard University
- Li Ka Shing Knowledge InstituteSt. Michael's Hospital
- Institute of Health Policy, Management and EvaluationUniversity of Toronto
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Lunn RM, Jahnke GD, Rabkin CS. Tumour virus epidemiology. Philos Trans R Soc Lond B Biol Sci 2018; 372:rstb.2016.0266. [PMID: 28893933 DOI: 10.1098/rstb.2016.0266] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2017] [Indexed: 02/06/2023] Open
Abstract
A viral etiology of cancer was first demonstrated in 1911 by Peyton Rous who injected cell-free filtrate from a chicken sarcoma into healthy chickens and found it induced a tumour. Since the discovery over 50 years ago of the Epstein-Barr virus as the cause of Burkitt lymphoma, seven other human viruses or groups of viruses-hepatitis B virus, hepatitis C virus, human immunodeficiency virus type 1, some human papillomaviruses, human T-cell lymphotropic virus type 1, Kaposi sarcoma-associated herpesvirus and Merkel cell polyomavirus-have been linked to human cancer. Collectively, these eight viruses cause over 20 different types of cancer and contribute to 10-12% of all cancer, with a greater burden in low- and middle-income countries. For many viruses, immunosuppression greatly increases the risks of persistent infection, development of chronic sequelae and cancer. Although several viruses share similar routes of transmission (especially sexual activity, injection drug use and mother-to-child transmission), the predominant route of transmission varies across viruses, and for the same virus can vary by geographical location. In general, vulnerable populations at the greatest risk for viral infections and their associated diseases include people, especially children, living in low- to middle-income countries, men who have sex with men, people who use injection drugs and female sex workers.This article is part of the themed issue 'Human oncogenic viruses'.
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Affiliation(s)
- Ruth M Lunn
- Office of the Report on Carcinogens, Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA
| | - Gloria D Jahnke
- Office of the Report on Carcinogens, Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA
| | - Charles S Rabkin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892-9760, USA
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Low prevalence of HCV infection with predominance of genotype 4 among HIV patients living in Libreville, Gabon. PLoS One 2018; 13:e0190529. [PMID: 29385148 PMCID: PMC5791959 DOI: 10.1371/journal.pone.0190529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 12/15/2017] [Indexed: 11/24/2022] Open
Abstract
Background Gabon is an endemic area for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) and the risk of co-infection is high. Method Between November 2015 and April 2016, we conducted retrospective study on HCV infection among people living with HIV/AIDS (PLHA). A total of 491 PLHA were included in this study and tested for the presence of HCV infection. HIV viral loads were obtained using the Generic HIV viral Load® assay and the CD4+ T cells count was performed using BD FACSCount™ CD4 reagents. HCV screening was performed using the MP Diagnostics HCV ELISA 4.0 kit. HCV genotypes were determined by sequence analysis of NS5B and Core regions. The Mann-Whitney test was used to compare the groups. Chi-2 test and Fisher's Exact Test were used to compare prevalence. Results HCV seroprevalence was 2.9% (14/491), (95% confidence interval (CI):1.4–4.3%). The percentage of HCV viremic patients, defined by the detection of HCV RNA in plasma, was 57% (8/14), representing 1.6% of the total population. HCV seroprevalence and replicative infection were not statistically differ with gender. The percentage of co-infection increased with age. No correlation with CD4+ T cells count and HIV viral load level was registered in this study. Identified HCV strains were predominantly of genotype 4 (87.5%) including 4k, 4e, 4g, 4p, 4f and 4c subtypes. Only one strain belonged to genotype 2 (subtype 2q). Analysis of the NS5B region did not reveal the presence of resistance-associated substitutions for sofosbuvir. Conclusion A systematic screening of hepatitis C is therefore strongly recommended as well as genotyping of HCV strains in order to adapt treatments for the specific case of people living with HIV/AIDS in Central Africa.
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Al-Busafi SA, Al-Shuaili H, Omar H, Al-Zuhaibi H, Jeyaseelan L, Al-Naamani K. Epidemiology of Chronic Hepatitis C Infections at a Tertiary Care Centre in Oman. Sultan Qaboos Univ Med J 2018; 17:e404-e410. [PMID: 29372081 DOI: 10.18295/squmj.2017.17.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 08/26/2017] [Accepted: 09/28/2017] [Indexed: 12/24/2022] Open
Abstract
Objectives Chronic hepatitis C (CHC) is a leading cause of liver cirrhosis and hepatocellular carcinoma (HCC) worldwide. However, there is a lack of data regarding the epidemiology of CHC in Oman. This study aimed to describe the clinicopathological characteristics and outcomes of CHC-infected patients at a tertiary care hospital in Oman. Methods This retrospective descriptive hospital-based study included all CHC-infected patients who presented to the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman, between January 2010 and December 2015. The baseline demographic, clinical, laboratory and radiological data of the patients were analysed. Results A total of 603 CHC-infected patients were identified during the study period; of these, 65.8% were male and the mean age was 44.8 ± 16.5 years. The main risk factors associated with CHC infection were intravenous drug abuse (23.9%) and a history of blood transfusions (20.7%). The most prevalent virus genotypes were 1 and 3 (44.0% and 35.1%, respectively). Upon initial presentation, 33.0% of the cohort had liver cirrhosis; of these, 48.7% had decompensated cirrhosis and 23.1% had HCCs. Liver transplantation was only performed for 7.5% of the cirrhosis patients, mostly as a curative treatment for HCC. Conclusion The implementation of national policies to prevent hepatitis C transmission and encourage the early screening of at-risk patients is recommended to reduce the burden and consequences of this disease in Oman.
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Affiliation(s)
- Said A Al-Busafi
- Department of Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Halima Al-Shuaili
- Internal Medicine Residency Programme, Oman Medical Specialty Board, Muscat, Oman
| | - Heba Omar
- Department of Medicine, Armed Forces Hospital, Muscat, Oman
| | - Haifa Al-Zuhaibi
- Department of Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - L Jeyaseelan
- Department of Statistics & Health Information, Sultan Qaboos University Hospital, Muscat, Oman.,Department of Biostatics, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
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Massimo G, Annalisa R, Lorena VD, Cristina N, Andrea G. HCV and drug addiction in the historical scenario of infection entry in Italy. ACTA BIO MEDICA : ATENEI PARMENSIS 2018; 89. [PMCID: PMC6502082 DOI: 10.23750/abm.v89i10-s.7965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
Abstract
The objective of this revision is - through an analysis of the literature – to highlight the relevance and importance of drug addiction in the entry of Hepatitis C virus (HCV) and acquired immunodeficiency (HIV) in Italy, with a review of the history of the HCV various strains that have spread over time through this population (especially in relation to genotypes 3, 4 and in part 1), using the most advanced methods related to the phylogeny and geography of the virus. (www.actabiomedica.it)
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Affiliation(s)
- Galli Massimo
- Correspondence: Massimo Galli Department of Infectious Disease, ASST Fatebenefratelli Sacco, Milan, Italy E-mail:
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Kirdar S, Aydin N, Tiryaki Y, Ertugrul B, Coskun A, Bilgen M. Dynamics of HCV epidemiology in Aydin province of Turkey and the associated factors. APMIS 2017; 126:109-113. [PMID: 29271117 DOI: 10.1111/apm.12790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 10/01/2017] [Indexed: 01/08/2023]
Abstract
This paper gives an update on the local distributions of HCV genotypes in Aydin province of Turkey, provides a comparison with the previous records, and discusses the potential causal reasons shaping the evolving genotype profiles. Patient files from 2011 to 2016 were retrospectively analyzed, and newly detected cases were documented. Out of 286 patients, male and female ratios were determined to remain nearly the same (~50%). Genotype 1 was still the most common (90.2%), followed by genotype 3 (5.9%), genotype 2 (2.1%), and genotype 4 (1.4%) in frequency. There were international patients (4.50%). One patient had genotyped 2+3 together. Genotypes 4 and 2+3 were detected for the first time, and the patients with genotype 4 were interestingly all male and also domestic individuals. However, these patients traveled or lived abroad in the past due to occupational reasons, thereby likely acquired the infection while abroad. HCV surveillance system is currently inadequate and some infected patients may go undetected in the province. Remapping the regional distribution of HCV genotypes from time-to-time is required for identifying the local dynamics and causes leading to it. This process enhances the clinical preparation and readiness for the better management of the disease.
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Affiliation(s)
- Sevin Kirdar
- Department of Medical Microbiology, School of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Neriman Aydin
- Department of Medical Microbiology, School of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Yasin Tiryaki
- Laboratory of Microbiology, Aydin State Hospital, Aydin, Turkey
| | - Bulent Ertugrul
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Adil Coskun
- Department of Gastroenterology, School of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Mehmet Bilgen
- Department of Biophysics, School of Medicine, Adnan Menderes University, Aydin, Turkey
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Bick J, Culbert G, Al-Darraji HA, Koh C, Pillai V, Kamarulzaman A, Altice F. Healthcare resources are inadequate to address the burden of illness among HIV-infected male prisoners in Malaysia. Int J Prison Health 2017; 12:253-269. [PMID: 27921633 DOI: 10.1108/ijph-06-2016-0017] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Purpose Criminalization of drug use in Malaysia has concentrated people who inject drugs (PWID) and people living with HIV into prisons where health services are minimal and HIV-related mortality is high. Few studies have comprehensively assessed the complex health needs of this population. The paper aims to discuss these issues. Design/methodology/approach From October 2012 through March 2013, 221 sequentially selected HIV-infected male prisoners underwent a comprehensive health assessment that included a structured history, physical examination, and clinically indicated diagnostic studies. Findings Participants were mostly PWID (83.7 percent) and diagnosed with HIV while incarcerated (66.9 percent). Prevalence of hepatitis C virus (90.4 percent), untreated syphilis (8.1 percent), active (13.1 percent), and latent (81.2 percent) tuberculosis infection was several fold higher than non-prisoner Malaysian adults, as was tobacco use (71.9 percent) and heavy drinking (30.8 percent). Most (89.5 percent) were aware of their HIV status before the current incarceration, yet few had been engaged previously in HIV care, including pre-incarceration CD4 monitoring (24.7 percent) or prescribed antiretroviral therapy (ART) (16.7 percent). Despite most (73.7 percent) meeting Malaysia's criteria for ART (CD4 <350 cells/ μL), less than half (48.4 percent) ultimately received it. Nearly one-quarter (22.8 percent) of those with AIDS (<200 cells/ μL) did not receive ART. Originality/value Drug addiction and communicable disease comorbidity, which interact negatively and synergistically with HIV and pose serious public health threats, are highly prevalent in HIV-infected prisoners. Interventions to address the critical shortage of healthcare providers and large gaps in treatment for HIV and other co-morbid conditions are urgently needed to meet the health needs of HIV-infected Malaysian prisoners, most of whom will soon transition to the community.
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Affiliation(s)
- Joseph Bick
- Infectious Diseases Unit, Department of Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia.,Centre of Excellence for Research in AIDS (CERiA), University of Malaya , Kuala Lumpur, Malaysia.,California Medical Facility, California Correctional Health Care Services, Vacaville, California, USA
| | - Gabriel Culbert
- Department of Health Systems Science, University of Illinois at Chicago , College of Nursing, Chicago, Illinois, USA
| | - Haider A Al-Darraji
- Infectious Diseases Unit, Department of Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia.,Centre of Excellence for Research in AIDS (CERiA), University of Malaya , Kuala Lumpur, Malaysia.,Centre for International Health, Department of Preventive and Social Medicine, University of Otago , Dunedin, New Zealand
| | - Clayton Koh
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya , Kuala Lumpur, Malaysia
| | - Veena Pillai
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya , Kuala Lumpur, Malaysia
| | - Adeeba Kamarulzaman
- Infectious Diseases Unit, Department of Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia.,Centre of Excellence for Research in AIDS (CERiA), University of Malaya , Kuala Lumpur, Malaysia
| | - Frederick Altice
- Infectious Diseases Unit, Department of Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia.,Centre of Excellence for Research in AIDS (CERiA), University of Malaya , Kuala Lumpur, Malaysia.,Department of Internal Medicine, Yale University School of Medicine , Section of Infectious Diseases, AIDS Program, New Haven, Connecticut, USA.,Division of Epidemiology of Microbial Diseases, Yale University School of Public Health , New Haven, Connecticut, USA
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Chen Y, Yu C, Yin X, Guo X, Wu S, Hou J. Hepatitis C virus genotypes and subtypes circulating in Mainland China. Emerg Microbes Infect 2017; 6:e95. [PMID: 29089588 PMCID: PMC5717081 DOI: 10.1038/emi.2017.77] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 06/19/2017] [Accepted: 07/18/2017] [Indexed: 02/07/2023]
Abstract
The hepatitis C virus (HCV) exhibits global genotypic diversity. HCV genotyping plays an important role in epidemiological studies and clinical management. Herein, we report the results of HCV genotype and subtype detection in a large number of clinical samples, as performed by an independent laboratory in China. In total, four HCV genotypes and 18 subtypes were identified among 32 030 patients from 29 provinces and municipalities in China. Five dominant subtypes were detected from 98.84% of the samples: 1b (n=16 713, 52.18%), 2a (n=9188, 28.69%), 3b (n=2261, 7.06%), 6a (n=2052, 6.41%) and 3a (n=1479, 4.62%). Twelve rare subtypes were detected, of which four (that is, 6b, 6j, 6q and 6r) are reported for the first time in the Chinese population. Genotypes 4, 5 and 7 were not detected. Mixed infections of the dominant subtypes were found in a small portion of samples (n=65, 0.203%), in the following combinations: 1b–2a, 1b–3b, 1b–6a, 3a–3b, 1b–3a and 2a–6a. No mixed infections with rare subtypes were found. Males, compared with females, showed higher HCV subtype diversity, a lower percentage of HCV1b and 2a and a higher percentage of rare subtypes and mixed infections. Our analyses revealed the comprehensive distribution patterns of HCV genotypes in the general population of mainland China. HCV genotypic patterns were differentially distributed on the basis of geography, sex and age.
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Affiliation(s)
- Ying Chen
- Guangzhou Kingmed Center for Clinical Laboratory, Guangzhou, China.,College of Laboratory Medicine, Tianjin Medical University, Tianjin, China
| | - Changshun Yu
- Guangzhou Kingmed Center for Clinical Laboratory, Guangzhou, China.,College of Laboratory Medicine, Tianjin Medical University, Tianjin, China
| | - Xueru Yin
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaolei Guo
- Guangzhou Kingmed Center for Clinical Laboratory, Guangzhou, China
| | - Shangwei Wu
- Guangzhou Kingmed Center for Clinical Laboratory, Guangzhou, China.,College of Laboratory Medicine, Tianjin Medical University, Tianjin, China
| | - Jinlin Hou
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Hepatitis C Virus Seroprevalence and Associated Risk Factors Among Male Drug Injectors in Kermanshah, Iran. HEPATITIS MONTHLY 2017. [DOI: 10.5812/hepatmon.58739] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Chronic hepatitis C and individuals with a history of injecting drugs in Spain: population assessment, challenges for successful treatment. Eur J Gastroenterol Hepatol 2017; 29:629-633. [PMID: 28230562 DOI: 10.1097/meg.0000000000000855] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
In Spain, there is a need to improve chronic hepatitis C care among people who inject drugs (PWID). Injecting drug use is an important risk behaviour for hepatitis C virus (HCV) infection. Review of 28 sources of the relevant published literature mapped the size of the addiction-HCV population in Spain. Experts in opioid use disorder (OUD) treatment in Spain completed a consensus to define the population size, HCV prevalence and access or barriers to hepatitis C treatment for PWID populations. In Spain, over 300 000 individuals have a lifetime history of injecting drugs. Currently, 150 000 individuals in Spain have OUD; many have injected drugs. Each year, 80 000 individuals engage with treatment services for OUD. A proportion of this group continues to inject drugs. There is a high HCV prevalence in PWID - estimates of 60-80% in Spain. Uptake of hepatitis C therapy in PWID in Spain is limited; barriers include awareness of treatment pathways, advocacy for regular screening and effective joint care. There is an urgent need to address barriers to effective hepatitis C care for PWID in Spain. Practical and specific strategies including peer-led solutions, patient buddy systems and joint working models at the local level can make important short-term differences.
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Burstow NJ, Mohamed Z, Gomaa AI, Sonderup MW, Cook NA, Waked I, Spearman CW, Taylor-Robinson SD. Hepatitis C treatment: where are we now? Int J Gen Med 2017; 10:39-52. [PMID: 28255252 PMCID: PMC5322849 DOI: 10.2147/ijgm.s127689] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Chronic hepatitis C infection affects millions of people worldwide and confers significant morbidity and mortality. Effective treatment is needed to prevent disease progression and associated complications. Previous treatment options were limited to interferon and ribavirin (RBV) regimens, which gave low cure rates and were associated with unpleasant side effects. The era of direct-acting antiviral (DAA) therapies began with the development of first-generation NS3/4A protease inhibitors in 2011. They vastly improved outcomes for patients, particularly those with genotype 1 infection, the most prevalent genotype globally. Since then, a multitude of DAAs have been licensed for use, and outcomes for patients have improved further, with fewer side effects and cure rates approaching 100%. Recent regimens are interferon-free, and in many cases, RBV-free, and involve a combination of DAA agents. This review summarizes the treatment options currently available and discusses potential barriers that may delay the global eradication of hepatitis C.
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Affiliation(s)
- Nicholas J Burstow
- Liver Unit, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Zameer Mohamed
- Liver Unit, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Asmaa I Gomaa
- National Liver Institute, Menoufiya University, Shbeen El Kom, Egypt
| | - Mark W Sonderup
- Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, Republic of South Africa
| | - Nicola A Cook
- Liver Unit, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Imam Waked
- National Liver Institute, Menoufiya University, Shbeen El Kom, Egypt
| | - C Wendy Spearman
- Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, Republic of South Africa
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Daw MA, El-Bouzedi AA, Ahmed MO, Dau AA, Agnan MM, Drah AM. Geographic integration of hepatitis C virus: A global threat. World J Virol 2016; 5:170-182. [PMID: 27878104 PMCID: PMC5105050 DOI: 10.5501/wjv.v5.i4.170] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 06/05/2016] [Accepted: 07/13/2016] [Indexed: 02/05/2023] Open
Abstract
AIM To assess hepatitis C virus (HCV) geographic integration, evaluate the spatial and temporal evolution of HCV worldwide and propose how to diminish its burden.
METHODS A literature search of published articles was performed using PubMed, MEDLINE and other related databases up to December 2015. A critical data assessment and analysis regarding the epidemiological integration of HCV was carried out using the meta-analysis method.
RESULTS The data indicated that HCV has been integrated immensely over time and through various geographical regions worldwide. The history of HCV goes back to 1535 but between 1935 and 1965 it exhibited a rapid, exponential spread. This integration is clearly seen in the geo-epidemiology and phylogeography of HCV. HCV integration can be mirrored either as intra-continental or trans-continental. Migration, drug trafficking and HCV co-infection, together with other potential risk factors, have acted as a vehicle for this integration. Evidence shows that the geographic integration of HCV has been important in the global and regional distribution of HCV.
CONCLUSION HCV geographic integration is clearly evident and this should be reflected in the prevention and treatment of this ongoing pandemic.
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Fichter M, Piradashvili K, Pietrzak-Nguyen A, Pretsch L, Kuhn G, Strand S, Knuf M, Zepp F, Wurm FR, Mailänder V, Landfester K, Gehring S. Polymeric hepatitis C virus non-structural protein 5A nanocapsules induce intrahepatic antigen-specific immune responses. Biomaterials 2016; 108:1-12. [PMID: 27614817 DOI: 10.1016/j.biomaterials.2016.08.046] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 08/26/2016] [Accepted: 08/30/2016] [Indexed: 02/07/2023]
Abstract
Targeting antigen combined with adjuvants to hepatic antigen-presenting cells (APCs) is essential for the induction of intrahepatic T cellular immunity controlling and resolving viral infections of the liver. Intravenous injection of antigen-loaded nanoparticles is a promising approach for the delivery of antigens to liver APCs. Accordingly, polymeric nanocapsules (NCs) synthesized exclusively of hepatitis C virus non-structural protein 5A (NS5A) and the adjuvant monophosphoryl lipid A (MPLA) adsorbed to the nanocapsule surface were developed. Aim of the present study was the evaluation of the in vitro and in vivo behavior of MPLA-functionalized NS5A-NCs regarding the interaction with liver dendritic cells (DCs) and the potential to induce intrahepatic immune responses in a mouse model. Maturation of DCs was significantly increased by application of NS5A+MPLA-NCs compared to non-functionalized NS5A-NCs promoting a vigorous expression of CD40, CD80, CD86 and a strong secretion of the Th1-related cytokine IL-12. NS5A-NCs were preferentially deposited in DCs and Kupffer cells residing in the liver after intravenous administration. Immunization with NS5A-NCs induced intrahepatic antigen-specific CD4(+) T cellular immune responses determined by the secretion of IFNγ and IL-2. Furthermore, supplementation with MPLA induced significant levels of NS5A-specific antibodies. The application of polymeric nanocapsules synthesized exclusively out of antigen avoids the risk of unintended side effects caused by additional carrier substances. Functionalization with adjuvants like MPLA and the efficient targeting to liver-resident APCs inherits the potential for application of antigen nanocapsules in further vaccination approaches against pathogens affecting the liver.
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Affiliation(s)
- Michael Fichter
- Children's Hospital, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Keti Piradashvili
- Max Planck Institute for Polymer Research, Ackermannweg 10, 55128, Mainz, Germany
| | - Anette Pietrzak-Nguyen
- Children's Hospital, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Leah Pretsch
- Children's Hospital, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Gabor Kuhn
- Max Planck Institute for Polymer Research, Ackermannweg 10, 55128, Mainz, Germany; Department of Dermatology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Susanne Strand
- III. Department of Internal Medicine, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Markus Knuf
- Children's Hospital, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany; Children's Hospital, Dr. Horst-Schmidt-Kliniken, Ludwig-Erhard-Str. 100, 65199, Wiesbaden, Germany
| | - Fred Zepp
- Children's Hospital, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Frederik R Wurm
- Max Planck Institute for Polymer Research, Ackermannweg 10, 55128, Mainz, Germany
| | - Volker Mailänder
- Max Planck Institute for Polymer Research, Ackermannweg 10, 55128, Mainz, Germany; Department of Dermatology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Katharina Landfester
- Max Planck Institute for Polymer Research, Ackermannweg 10, 55128, Mainz, Germany
| | - Stephan Gehring
- Children's Hospital, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
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Schuermans W, Orlent H, Desombere I, Descheemaeker P, Van Vlierberghe H, Geerts A, Verhelst X, Reynders M, Padalko E. Heads or Tails: Genotyping of Hepatitis C Virus Concerning the 2k/1b Circulating Recombinant Form. Int J Mol Sci 2016; 17:E1384. [PMID: 27563879 PMCID: PMC5037664 DOI: 10.3390/ijms17091384] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 08/18/2016] [Accepted: 08/18/2016] [Indexed: 02/06/2023] Open
Abstract
As different hepatitis C virus (HCV) genotypes respond differently to initiated therapy, correct HCV genotyping is essential. A potential risk for misclassification of the intergenotypic HCV circulating recombinant form (CRF) 2k/1b strains exists, depending on the genotyping method used. The aim was to investigate the differences in HCV genotyping methods with regard to CRF 2k/1b and to gain insight in the prevalence of the CRF 2k/1b. Genotyping results by Versant HCV Genotype Assay were compared with nonstructural protein 5B (NS5B) sequencing. In total, from November 2001 until March 2015, 3296 serum samples were analyzed by Versant HCV Genotype Assay. As misclassified CRF is harbored among HCV genotype 2, we further focused our search on 142 (4.3%) samples positive for HCV genotype 2. On 116 (81.7%) retrieved samples, the NS5B sequencing was performed. Twelve out of the 116 retrieved samples (10.3%) were classified as CRF 2k/1b by sequencing of the NS5B region. Ten of these 12 samples were originally misclassified as genotype 2a or 2c, while 2 of them were misclassified as genotype 2. Our results show that the current prevalence of CRF 2k/1b is underestimated. The importance of correct HCV genotyping is emphasized, considering the tailored choice of treatment regimen and overall prognosis.
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Affiliation(s)
- Wim Schuermans
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University and Hospital, Ghent 9000, Belgium.
| | - Hans Orlent
- Department of Gastroenterology and Hepatology, AZ Sint-Jan Bruges-Ostend, Bruges 8000, Belgium.
| | - Isabelle Desombere
- Center for Vaccinology, Ghent University and Hospital, Ghent 9000, Belgium.
| | - Patrick Descheemaeker
- Department of Laboratory Medicine, Clinical Microbiology, AZ Sint-Jan Bruges-Ostend, Bruges 8000, Belgium.
| | - Hans Van Vlierberghe
- Department of Gastroenterology and Hepatology, Ghent University and Hospital, Ghent 8000, Belgium.
| | - Anja Geerts
- Department of Gastroenterology and Hepatology, Ghent University and Hospital, Ghent 8000, Belgium.
| | - Xavier Verhelst
- Department of Gastroenterology and Hepatology, Ghent University and Hospital, Ghent 8000, Belgium.
| | - Marijke Reynders
- Department of Laboratory Medicine, Clinical Microbiology, AZ Sint-Jan Bruges-Ostend, Bruges 8000, Belgium.
| | - Elizaveta Padalko
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University and Hospital, Ghent 9000, Belgium.
- School of Life Sciences, Hasselt University, Diepenbeek 3590, Belgium.
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Epidemiology of hepatitis C virus and genotype distribution in immigrants crossing to Europe from North and sub-Saharan Africa. Travel Med Infect Dis 2016; 14:517-526. [PMID: 27502972 DOI: 10.1016/j.tmaid.2016.05.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 04/07/2016] [Accepted: 05/04/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND The association between the prevalence of hepatitis C virus (HCV) and immigration is rarely studied, particularly for the immigrants crossing to the resettlement countries. Most of the published data are confined to those immigrants who were resident in European countries and rarely immigrated before they reach the final destination. Libya is a large country in North Africa with the longest coast of the Mediterranean Sea facing the European Union. It has been considered as the main transient station for African immigrants to Europe. The objectives of this study were to determine: (1) the prevalence of HCV in African immigrants gathered in Libya from different African countries on their way to Europe and (2) HCV genotype distribution in these immigrants and its correlation with different demographic factors. METHODS A total of 14 205 serum samples were collected in a 3-year period (2013-2015) from different immigrants from North and sub-Saharan Africa who resided in the African immigrant campus, Tripoli, Libya. The participants were interviewed, and relevant information was collected, including socio-demographic, ethnic, and geographic variables. Each serum sample was tested for anti-HCV antibody using ELISA. The genotypes were determined and assigned using a specific genotyping assay and correlated with demographic and potential risk factors of the recruited individuals. RESULTS Of the immigrants studied, 1078 (7.6%) were positive for HCV. The prevalence of HCV infection ranged from 1.4% to 18.7%; it was higher among individuals arriving from Nile river (3.6-18.7%) of North Africa, followed by those who arrived from the West African region (2.1-14.1%), Horn of Africa (HOA, 6.8-9.9%), and Maghreb countries (1.4-2.7%). The relative risk factor attributable to gender variation was not significant (95% Cl: 0.8513-1.2381). Five genotypes were detected in 911 African immigrants. Genotypic analysis showed that the predominant HCV genotypes in this group were genotypes 4, 1, and 2 that accounted for 329 (36.1%), 326 (35.8%), and 131 (14.4%) strains, respectively, followed by genotype 3 that accounted for 87 (9.5%) strains. Genotype 5 was isolated mainly from 18 HOA (2%) and 20 West African (2.2%) individuals. CONCLUSIONS The prevalence of HCV is considered high with a unique disparate distribution among African immigrants crossing to Europe. This indicated that the prevalence of HCV is high among these immigrants and thus may be reflected on the HCV prevalence in the guest countries. The broad genetic heterogeneity of HCV genotypes detected here may impact the efficacy of prevention and control efforts for HCV in both Europe and North and sub-Saharan Africa; hence, an integrated global policy of actions is needed.
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Ogbuagu O, Friedland G, Bruce RD. Drug interactions between buprenorphine, methadone and hepatitis C therapeutics. Expert Opin Drug Metab Toxicol 2016; 12:721-31. [DOI: 10.1080/17425255.2016.1183644] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
| | | | - R. Douglas Bruce
- Yale University School of Medicine, New Haven, CT, USA
- Department of Medicine, Cornell Scott-Hill Health Center, New Haven, CT, USA
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Coppola N, Minichini C, Starace M, Sagnelli C, Sagnelli E. Clinical impact of the hepatitis C virus mutations in the era of directly acting antivirals. J Med Virol 2016; 88:1659-71. [DOI: 10.1002/jmv.24527] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2016] [Indexed: 12/15/2022]
Affiliation(s)
- Nicola Coppola
- Department of Mental Health and Public Medicine; Section of Infectious Diseases; Second University of Naples; Naples Italy
| | - Carmine Minichini
- Department of Mental Health and Public Medicine; Section of Infectious Diseases; Second University of Naples; Naples Italy
| | - Mario Starace
- Department of Mental Health and Public Medicine; Section of Infectious Diseases; Second University of Naples; Naples Italy
| | - Caterina Sagnelli
- Department of Clinical and Experimental Medicine and Surgery; Second University of Naples; Naples Italy
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine; Section of Infectious Diseases; Second University of Naples; Naples Italy
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