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Seroprevalence of hepatitis B,hepatitis c,human immunodeficiency virus,Treponema pallidum,and co-infections among blood donors in Kyrgyzstan:a retrospective analysis(2013-2015)

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Infectious Diseases of Poverty 2017年第1期6卷 401-409页

作者： Bakyt B.Karabaev Nurgul J.Beisheeva Aiganysh B.Satybaldieva Aikul D.Ismailova Frank Pessler Manas K.Akmatov Republican Blood centre BishkekKyrgyzstanChingiz Aitmatov Ave 60720044 BishkekKyrgyzstan Republican AIDS centre BishkekKyrgyzstanLogvinenko Str.8720040 BishkekKyrgyzstan TWINcORE Centre for Experimental and Clinical Infection ResearchFeodor-Lynen-Str.730625 HannoverGermany Helmholtz centre for Infection Research Inhoffenstr.738124 BraunschweigGermany centre for Individualized Infection Medicine c/o CRC HannoverFeodor-Lynen-Str.1530625 HannoverGermany

Background:Post-Soviet Kyrgyzstan has experienced a major surge in blood-borne infections,but data from adequately powered,up-to-date studies are *** thus examined a)the seroprevalences of hepatitis B virus surface antigen(HBsAg),HIV-1 p24 antigen and antibodies against hepatitis c virus(anti-HcV),human immunodeficiency viruses(anti-HIV-1/2,HIV-1 group O),and Treponema pallidum among blood donors in Kyrgyzstan and assess their distribution according to sex,age,and provinces of residence;b)trends in the respective seroprevalences;and c)co-infection rates among the pathogens ***:Serological screening was performed on 37165 blood donors at the Republican Blood centre in Bishkek,Kyrgyzstan,between January 2013 and December *** applied poststratification weights to control for sampling bias and used logistic regression analyses to examine the association of seropositivity and co-infections with sex,age,provinces of residence,and year of blood ***:Twenty nine thousand and one hundred forty-five(78%)donors were males and 8020(22%)were *** median age was 27 years(range:18-64).The prevalences of HBsAg,anti-HcV,HIV(p24 Ag and anti-HIV),and *** were 3.6%(95%cI:3.4-3.8%),3.1%(3.0-3.3%),0.78%(0.69-0.87%),and 3.3%(3.1-3.5%),*** were more likely to be seropositive for HBsAg than females(OR:1.63;95%cI:1.40-1.90),but less likely to be seropositive for anti-HcV(0.85;0.74-0.98)and HIV(0.65;0.49-0.85).Prevalences were lower in the capital than in the other *** was a decreasing trend in the seroprevalences of HBsAg,anti-HcV,and *** from 2012 to 2015(P-value for trend,P=0.01,Pctively),while the seroprevalence of HIV increased(P=0.049).One hundred eighty donors(0.48%)were seropositive for multiple *** highest co-infection rate was observed between *** and HBsAg(6.0%),followed by anti-HcV and ***(5.2%),and HIV and anti-HcV(4.9%).conclusions

关键词： hepatitis B hepatitis c Human immunodeficiency virus T.pallidum co-infections Prevalence Blood donors Kyrgyzstan

Predictive factors for survival and score application in liver retransplantation for hepatitis c recurrence

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World Journal of Gastroenterology 2016年第18期22卷 4547-4558页

作者： Alice Tung Wan Song Rodolphe Sobesky carmen Vinaixa Jérome Dumortier Sylvie Radenne Francois Durand Yvon calmus Géraldine Rousseau Marianne Latournerie cyrille Feray Valérie Delvart Bruno Roche Stéphanie Haim-Boukobza Anne-Marie Roque-Afonso Denis castaing Edson Abdala Luiz Augusto carneiro D’Albuquerque Jean-charles Duclos-Vallée Marina Berenguer Didier Samuel INSERM Unit 785 Villejuif 94800France Liver and Digestive Organ Transplantation Division Gastroenterology DepartmentUniversity of Sao Paulo Medical SchoolSao Paulo 05403-900Brazil Universite Paris-Sud Villejuif 94800France Liver Transplantation Laboratory LIM-37 Sao Paulo 01246-903Brazil AP-HP Hopital Paul Brousse Villejuif 94800France La Fe Hospital University of Valencia and CiberehdValencia 46026Spain Hopital Edouard Herriot Lyon 69003France Hopital croix Rousse Lyon 69004France AP-HP Hopital Beaujon Clichy 92110France AP-HP Hopital St Antoine Paris 75011France AP-HP Hopital Salpetriere Paris 75013France cHU Pontchaillou Rennes 35000France AP-HP Hopital Henri Mondor Creteil 94010France Viral hepatitis Laboratory LIM-47 Sao Paulo 01246-903Brazil

AIM: To identify risk factors associated with survival in patients retransplanted for hepatitis c virus(HcV) recurrence and to apply a survival score to this ***: We retrospectively identified 108 patients retransplanted for HcV recurrence in eight European liver transplantation centers(seven in France, one in Spain). Data collection comprised clinical and laboratory variables, including virological and antiviral treatment data. We then analyzed the factors associated with survival in this population. A recently published score that predicts survival in retransplantation in patients with hepatitis c was applied. Because there are currently no uniform recommendations regarding selection of the best candidates for retransplantation in this setting, we also described the clinical characteristics of 164 patients not retransplanted, with F3, F4, or fibrosing cholestatic hepatitis(FcH) post-first graft presenting with hepatic decompensation. RESULTS: Overall retransplantation patient survival rates were 55%, 47%, and 43% at 3, 5, and 10 years, respectively. Patients who were retransplanted for advanced cirrhosis had survival rates of 59%, 52%, and 49% at 3, 5, and 10 years, while those retransplanted for FcH had survival rates of 34%, 29%, and 11%, respectively. Under multivariate analysis, and adjusting for the center effect and the occurrence of FcH, factors associated with better survival after retransplantation were: negative HcV viremia before retransplantation, antiviral therapy after retransplantation, non-genotype 1, a Model for End-stage Liver Disease(MELD) score ced on the waiting list, and a retransplantation donor age context of the new antivirals era, we showed that outcomes in patientswho underwent retransplantation with undetectable HcV viremia did not depend on donor age and MELD score. The Andrés score was applied to 102 patients for whom all score variables were available,

关键词： Antivirals hepatitis c Mortality Prognosis Retransplantation Risk factors

Expanding the donor pool: hepatitis c, hepatitis B and human immunodeficiency virus-positive donors in liver transplantation

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World Journal of Gastroenterology 2019年第47期25卷 6799-6812页

作者： James F crismale Jawad Ahmad Division of Liver Diseases Icahn School of Medicine at Mount Sinai

Liver transplantation(LT)remains the best option for patients with end-stage liver disease but the demand for organs from deceased donors continues to outweigh the available *** advent of highly effective anti-viral treatments has reduced the number of patients undergoing LT for hepatitis c(HcV)and hepatitis B(HBV)related liver disease and yet the number of patients waiting for LT continues to increase,driven by an increase in the patients listed with a diagnosis of cirrhosis due to non-alcoholic steatohepatitis and alcoholrelated liver *** addition,human immunodeficiency virus(HIV)infection,which was previously a contra-indication for LT,is no longer a fatal disease due to the effectiveness of HIV therapy and patients with HIV and liver disease are now developing indications for *** rising demand for LT is projected to increase further in the future,thus driving the need to investigate potential means of expanding the pool of potential *** mechanism for doing so is utilizing organs from donors that previously would have been discarded or used only in exceptional circumstances such as HcV-positive,HBV-positive,and HIVpositive *** advent of highly effective anti-viral therapy has meant that these organs can now be used with excellent outcomes in HcV,HBV or HIV infected recipients and in some cases uninfected recipients.

关键词： hepatitis c hepatitis B Human immunodeficiency virus Liver transplantation

Second-generation direct-acting-antiviral hepatitis c virus treatment: Efficacy, safety, and predictors of SVR12

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World Journal of Gastroenterology 2016年第35期22卷 8050-8059页

作者： christoph R Werner Julia M Schwarz Daniel P Egetemeyr Robert Beck Nisar P Malek Ulrich M Lauer christoph P Berg Department of Gastroenterology Hepatology and Infectiology University Hospital Tübingen Institute of Medical Virology University Hospital Tübingen

AIM To gather data on the antiviral efficacy and safety of second generation direct acting antiviral(DAA) treatment with respect to sustained virological response(SVR) 12 wk after conclusion of treatment, and to determine predictors of SVR12 in this *** Two hundred and sixty patients treated with SOF combination partners PR(n = 51), R(n = 10), SMV(n = 30), DcV(n = 81), LDV(n = 73), or 3D(n = 15).144/260 were pre-treated, 89/260 had liver cirrhosis, 56/260 had portal hypertension with platelets core ≥ 10 and 17/260 were postliver transplantation patients. 194/260 had HcV GT1, 44/260 HcV *** Two hundred and forty/256(93.7%) patients achieved SVR12(m ITT); 4/260 were lost to follow-up. SVR12 rates for subgroups were: 92% for SOF/DcV, 93% for each SOF/SMV, SOF/PR, 94% for SOF/LDV, 100% for 3D, 94% for pretreated, 87% for liver cirrhosis, 82% for patients with platelets continued treatment, of which 4 died. Negative predictors of SVR12 were a platelet count core ≥ 10(P cirrhosis(P = 0.005) at baseline. In Interferonfree treatment GT3 had significantly lower SVR rates than GT1(P = 0.016). Side effects were mild. cONcLUSION Excellent SVR12 rates and the favorable side-effect profile of DAA-combination therapy can be well translated into "real-world". Patients with advanced liver disease, signs of portal hypertension, especially with platelets cial need for further research efforts to overcome comparatively higher rates of virological failure.

关键词： Sofosbuvir Simeprevir Ledipasvir hepatitis c Liver transplant Sustained virological response Liver cirrhosis Side effects Resistance Daclatasvir

Non-invasive diagnosis of liver fibrosis in chronic hepatitis c

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World Journal of Gastroenterology 2014年第11期20卷 2854-2866页

作者： Leonardo de Lucca Schiavon Janaína Luz Narciso-Schiavon Roberto José de carvalho-Filho Gastroenterology Division Department of Internal MedicineFederal University of Santa CatarinaFlorianópolisSC 88040-900Brazil Gastroenterology Division Department of MedicineFederal University of Sao PauloSao PauloSP 04023-900Brazil

Assessment of liver fibrosis in chronic hepatitis c virus(HcV)infection is considered a relevant part of patient care and key for decision *** liver biopsy has been considered the gold standard for staging liver fibrosis,it is an invasive technique and subject to sampling errors and significant intra-and inter-observer *** the last decade,several noninvasive markers were proposed for liver fibrosis diagnosis in chronic HcV infection,with variable *** the clear advantage of being noninvasive,a more objective interpretation of test results may overcome the mentioned intra-and inter-observer variability of liver *** addition,these tests can theoretically offer a more accurate view of fibrogenic events occurring in the entire liver with the advantage of providing frequent fibrosis evaluation without additional ***,in general,these tests show low accuracy in discriminating between intermediate stages of fibrosis and may be influenced by several hepatic and extrahepatic *** methods are either serum markers(usually combined in a mathematical model)or imaging modalities that can be used separately or combined in algorithms to improve *** this review we will discuss the different noninvasive methods that are currently available for the evaluation of liver fibrosis in chronic hepatitis c,their advantages,limitations and application in clinical practice.

关键词： Liver fibrosis Liver cirrhosis hepatitis c Diagnosis Elasticity imaging techniques

Emergency department targeted screening for hepatitis c does not improve linkage to care

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World Journal of Gastroenterology 2020年第32期26卷 4878-4888页

作者： Inbal Houri Noya Horowitz Helena Katchman Yael Weksler Ofer Miller Liat Deutsch Oren Shibolet Department of Gastroenterology and Hepatology Tel-Aviv Medical CenterTel-Aviv 6423906Israel Sackler Faculty of Medicine Tel-Aviv UniversityTel-Aviv 6997801Israel

BAcKGROUND hepatitis c virus(HcV)infection is a leading cause of chronic liver disease *** treatments for HcV revolutionized management and prompted the world health organization to set the goal of viral elimination by *** developments strengthen the need for HcV screening in order to identify asymptomatic carriers prior to development of chronic liver disease and its *** screening strategies have been attempted,most targeting high-risk *** studies focusing on patients arriving at emergency departments showed a higher prevalence of HcV compared to the general *** To identify previously undiagnosed HcV carriers among high risk emergency room attendees and link them to care for anti-viral *** In this single center prospective study,persons visiting the emergency department in an urban hospital were screened by a risk factor-specific *** risk factors screened for were exposure to blood products or organ transplantation before 1992;origins from countries with high prevalence of HcV;intravenous drug use;human immunodeficiency virus carriers;men who have sex with men;those born to HcV-infected mothers;prior prison time;and chronic kidney *** with at least one risk factor were tested for HcV by serum for HcV antibodies,a novel oral test from saliva(OraQuick®)or *** Five hundred and forty-one participants had at least one risk factor and were tested for *** four percent of all study participants had only one risk *** five percent of participants underwent OraQuick®testing,34%were tested for serum anti-HcV antibodies,and 25%had both tests.3.1%of patients(17/541)had a positive result,compared to local population incidence of 1.96%.Of these,82%were people who inject drugs(current or former),and 64%served time in *** patient had a negative HcV-RNA,and two patients died from non-HcV related *** review of past medical records,12 patients w

关键词： Screening Emergency departments Israel Saliva hepatitis c Liver

Pulmonary hypertension,nephrotic syndrome,and polymyositis due to hepatitis c virus infection:A case report

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World Journal of Gastroenterology 2023年第19期29卷 3040-3047页

作者： Ya-Nan Zhao Guo-Hui Liu chang Wang Yi-Xuan Zhang Ping Yang Ming Yu Department of cardiology China-Japan Union Hospital of Jilin UniversityChangchun 130033Jilin ProvinceChina

BAcKGROUND hepatitis c infection not only damages the liver but also often accompanies many extrahepatic *** of pulmonary hypertension(PH)caused by hepatitis c are rare,and incidences of concurrent nephrotic syndrome and polymyositis are even *** SUMMARY Herein we describe the case of a 57-year-old woman who was admitted to our department for intermittent chest tightness upon exertion for 5 years,aggravated with dyspnea for 10 *** relevant examinations she was diagnosed with PH,nephrotic syndrome,and polymyositis due to chronic hepatitis c infection.A multi-disciplinary recommendation was that the patient should be treated with sildenafil and macitentan in combination and *** treatment autoimmune symptoms,liver function,hepatitis c RNA levels,and cardiac parameters of right heart catheterization were monitored *** patient showed significant improvement in 6-min walking distance from 100 to 300 m at 3-mo follow-up and pulmonary artery pressure drops to 50 ***-term follow-up is needed to confirm further efficacy and *** Increasing evidence supports a relationship between hepatitis c infection and diverse extrahepatic manifestations,but it is very rare to have PH,nephrotic syndrome,and polymyositis in a single *** conducted a literature review on the management of several specific extrahepatic manifestations of hepatitis c.

关键词： hepatitis c Nephrotic syndrome Polymyositis Pulmonary hypertension case report

challenges of recurrent hepatitis c in the liver transplant patient

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World Journal of Gastroenterology 2014年第13期20卷 3391-3400页

作者： Renumathy Dhanasekaran Roberto J Firpi Division of Gastroenterology and Hepatology Mayo ClinicRochesterMN 55901United States Division of Gastroenterology Hepatology and NutritionUniversity of FloridaGainesvilleFL 32610United States

cirrhosis secondary to hepatitis c virus (HcV) is a very common indication for liver transplant. Unfortunately recurrence of HcV is almost universal in patients who are viremic at the time of transplant. The progression of fibrosis has been shown to be more rapid in the post-transplant patients than in the transplant naïve, hence treatment of recurrent HcV needs to be considered for all patients with documented recurrent HcV. Management of recurrent HcV is a challenging situation both for patients and physicians due to multiple reasons as discussed in this review. The standard HcV treatment with pegylated interferon and Ribavarin can be considered in these patients but it leads to a lower rate of sustained virologic clearance than in the non-transplanted population. Some of the main challenges associated with treating recurrent HcV in post-transplant patients include the presence of cytopenias; need to monitor drug-drug interactions and the increased incidence of renal compromise. In spite of these obstacles all patients with recurrent HcV should be considered for treatment since it is associated with improvement in survival and a delay in fibrosis progression. With the arrival of direct acting antiviral drugs there is renewed hope for better outcomes in the treatment of post-transplant HcV recurrence. This review evaluates current literature on this topic and identifies challenges associated with the management of post-transplant HcV recurrence.

关键词： cirrhosis hepatitis c Recurrence Transplant Interferon

Prevalence of hepatitis c virus infection among hemodialysis patients in the Middle-East: A systematic review and meta-analysis

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World Journal of Gastroenterology 2017年第1期23卷 151-166页

作者： Soheil Ashkani-Esfahani Seyed Moayed Alavian Mohammad Salehi-Marzijarani Baqiyatallah Research center for Gastro-enterology and Liver Diseases Baqiyatallah University of Medical Sciences Student Research committee Shiraz University of Medical Sciences Department of Biostatistics Shiraz University of Medical Sciences

AIM To determine hepatitis c virus(HcV)infection prevalence in each country of the Middle-East and the overall prevalence of the *** In this systematic review,we gathered all documents related to HcV infection prevalence among hemodialysis patients in 17 middle-east countries from April 2006 to March *** selected only cross-sectional studies that had proper sampling and measurement methods as well as a valid statistical *** After screening of 7311 documents,56 studies were selected reporting the prevalence of HcV infection among hemodialysis patients from 10 countries of the *** countries including United Arab Emirates,Afghanistan,Qatar,Bahrain,Kuwait,Oman,Israel,and cyprus did not have any relevant document;thus,their latest reports were just *** performed the meta-analysis and determined the prevalence rates for each country as well as the whole *** overall HcV infection prevalence among hemodialysis patients in the region was reported to be 25.3%;Egypt and Syria had the highest reported rates while Iran and Lebanon had the *** investigations are still needed to provide more reliable databases,find main risk factors,and to improve diagnosis and treatment plans,particularly in higher prevalent *** controlling the prevalence and improving the management methods of HcV infection among hemodialysis patients are of a great concern in the Middle-East region.

关键词： hepatitis c Hemodialysis Prevalence Middle-East Meta-Analysis Review