Frequency of hepatitis D virus infection in individuals with hepatitis B surface antigen-positive (HBS Ag) in Ardabil province

Frequency of hepatitis D virus infection in individuals with hepatitis B surface antigen-positive (HBS Ag) in Ardabil province Introduction: hepatitis D virus (HDV) and hepatitis B virus (HBV)co-infection is well known to induce a spectrum of acute and chronic liver disease which further advance to cirrhosis , fulminant hepatitis and hepatocellular carcinoma. Aims: The aim of the present study was to determine the Frequency of hepatitis D virus super-infection among hepatitis B surface antigen (HBsAg) positive individuals. Methods: The 200 HBsAg positive patients who had visited in liver clinic of Imam Khomeini Hospital were included in this study. Anti-HDV was measured by ELISA in the serum of these patients.patient demographic data and risk factors of transmission were recorded. Results: The study included 121 males(60.5%) and 79(39.5%) females. HDV infection was detected in 3.5% (7/200) of (HBsAg )positive patients. The mean age of individuals positive for antibody to HDV was 53.85-+13.3 years ,and the mean age of nonreactive individuals was 37.17-+12.73 years (p=0.001). HDV infection was equally distributed between sexes. Comparing HBV/HDV co-infection to HBV monoinfection patients, more had cirrhosis (42.58% vs. 5.18% ).(p=0.001) In this study ,previous surgical procedures and blood transfusions were the most frequent risk factors in patients with HDV antibody. Conclusion: The results show the endemicity of HDV infection in Ardabil. HDV infection increases the risk of severe liver fibrosis in this region

Integrating Viral Hepatitis Screening and Prevention Services into an Urban Chemical Dependency Treatment Facility for American Indians and Alaska Natives

American Indian/Alaska Natives (AI/AN) patients at an urban residential chemical dependency treatment center participated in a viral hepatitis prevention project. Project activities integrated into patients’ treatment programs included viral hepatitis and human immunodeficiency virus (HIV) risk factor screening, education and counseling, laboratory testing, and hepatitis A and B vaccination. Of 928 AI/AN admissions, 585 (63%) completed risk factor screening assessment. Of these, 436 (75%) received at least one vaccination, viral hepatitis testing, or both. Of 322 patients tested, 91 (28%) were hepatitis C virus (HCV) antibody positive. Lack of pre-existing immunity to vaccine-preventable viral hepatitis infection was common: 132 (45%) were susceptible to hepatitis A and 224 (70%) were susceptible to hepatitis B infection. Chemical dependency treatment centers serving urban AI/AN provide important opportunities for implementing viral hepatitis prevention programs for high-risk populations and for improving ongoing efforts to reduce the disparate impact of chronic liver disease in AI/ AN people

The prevalence of hepatitis B surface antigen and anti-hepatitis B core antibody in Iran: A population-based study

Background: Hepatitis B virus infection is a very common cause of chronic liver disease worldwide. It is estimated that 3 of Iranians are chronically infected with hepatitis B virus. Current population-based studies on both rural and urban prevalence of hepatitis B virus infection in Iran are sparse with results that do not always agree. We performed this study to find the prevalence of hepatitis B surface antigen, anti-hepatitis B core antibody, and associated factors in the general population of three provinces of Iran. Methods: We randomly selected 6,583 subjects from three provinces in Iran, namely Tehran, Golestan, and Hormozgan. The subjects were aged between 18 and 65 years. Serum samples were tested for hepatitis B surface antigen and anti-hepatitis B core antibody. Various risk factors were recorded and multivariate analysis was performed. Results: The prevalence of hepatitis B surface antigen and anti-hepatitis B core antibody in Iran was 2.6 and 16.4, respectively. Predictors of hepatitis B surface antigen or anti-hepatitis B core antibody in multivariate analysis included older age, not having high-school diploma, living in a rural area, and liver disease in a family member. We did not find any significant differences between males and females. Conclusion: In spite of nationwide vaccination of newborns against hepatitis B virus since 1992, hepatitis B virus infection remains a very common cause of chronic liver disease in Iran which should be dealt with for at least the next 30-50 years

Incidence, prevalence, and clinical course of hepatitis C following liver transplantation

Hepatitis C virus (HCV) is the agent responsible for posttransfusion hepatitis. The incidence, timing, and clinical course of HCV positive hepatitis in liver transplant recipients are unknown. Three hundred and seventeen donor-recipient liver transplant pairs were grouped on the basis of their pretransplant HCV antibody status. The biopsy findings were examined. Four distinct groups were identified on the basis of HCV serology: group I, both were negative; group II, donor was negative and recipient was positive; group III, donor was positive and recipient was negative; group IV, both were positive. The prevalence of anti-HCV positivity in recipients was 13.6%. The rate of seroconversion was 9.2%. Histologic hepatitis not ascribable to any specific cause other than non-A, non-B (NANB) hepatitis occurred in 13.8%. The incidence of histologic chronic active hepatitis was 1.6%, and none progressed to cirrhosis. The concordance rate for a positive anti-HCV serology and NANB hepatitis was 2.8%. Of the 35 patients (group II and IV) with positive anti-HCV serology pretransplant, only 17 were positive posttransplantation. Based on these data it can be concluded that posttransplant NANB hepatitis occurred in 13.8% of liver recipients. Twenty percent of these were anti-HCV positive. Progression to histologic chronic active hepatitis occurs over a period of 1-5 years in 1.6% of cases. © 1992

Should patients with abnormal liver function tests in primary care be tested for chronic viral hepatitis: cost minimisation analysis based on a comprehensively tested cohort

Background Liver function tests (LFTs) are ordered in large numbers in primary care, and the Birmingham and Lambeth Liver Evaluation Testing Strategies (BALLETS) study was set up to assess their usefulness in patients with no pre-existing or self-evident liver disease. All patients were tested for chronic viral hepatitis thereby providing an opportunity to compare various strategies for detection of this serious treatable disease. Methods This study uses data from the BALLETS cohort to compare various testing strategies for viral hepatitis in patients who had received an abnormal LFT result. The aim was to inform a strategy for identification of patients with chronic viral hepatitis. We used a cost-minimisation analysis to define a base case and then calculated the incremental cost per case detected to inform a strategy that could guide testing for chronic viral hepatitis. Results Of the 1,236 study patients with an abnormal LFT, 13 had chronic viral hepatitis (nine hepatitis B and four hepatitis C). The strategy advocated by the current guidelines (repeating the LFT with a view to testing for specific disease if it remained abnormal) was less efficient (more expensive per case detected) than a simple policy of testing all patients for viral hepatitis without repeating LFTs. A more selective strategy of viral testing all patients for viral hepatitis if they were born in countries where viral hepatitis was prevalent provided high efficiency with little loss of sensitivity. A notably high alanine aminotransferase (ALT) level (greater than twice the upper limit of normal) on the initial ALT test had high predictive value, but was insensitive, missing half the cases of viral infection. Conclusions Based on this analysis and on widely accepted clinical principles, a "fast and frugal" heuristic was produced to guide general practitioners with respect to diagnosing cases of viral hepatitis in asymptomatic patients with abnormal LFTs. It recommends testing all patients where a clear clinical indication of infection is present (e.g. evidence of intravenous drug use), followed by testing all patients who originated from countries where viral hepatitis is prevalent, and finally testing those who have a notably raised ALT level (more than twice the upper limit of normal). Patients not picked up by this efficient algorithm had a risk of chronic viral hepatitis that is lower than the general population

‘It’s been a long haul, a big haul, but we’ve made it’: hepatitis C virus treatment in post-transplant patients with virus recurrence: An interpretative phenomenological analysis

The lived experience of both interferon-based and new interferon-free treatments in patients with hepatitis C virus remains understudied. To explore their journey through hepatitis C virus treatment, we interviewed seven post-transplant patients with recurrent hepatitis C virus. Three themes were identified using interpretative phenomenological analysis. Participants reported an ongoing sense of ontological uncertainty characterized by lack of control over their condition and treatment. Furthermore, an apposition of scepticism and hope accompanying each stage of hepatitis C virus treatment was described. A staged approach to psychological intervention tailored to the needs of the patient and their associated ‘stage’ of hepatitis C virus treatment was recommended

Development of Java based graphical user interface for Diagnosis of Hepatitis UsingI Mixture of Expert

Hepatitis is deadly, and the fifth leading cause of death after heart disease, stroke, chest disease and cancer. Worldwide, 1.5 million deaths per year have been estimated. Detection of hepatitis is a big problem for general practitioners. An expert doctor commonly makes decisions by evaluating the current test results of a patient or by comparing the patient with others with the same condition with reference to the previous decisions. Many machine learning and data mining techniques have been designed for the automatic diagnosis of hepatitis. However, no one tool is available to the general population for the diagnosis of Hepatitis. Hence, a graphical user interface-enabled tool needs to be developed, through which medical practitioners can feed patient data easily and find hepatitis diagnoses instantly and accurately. 
Methods: In this study a hepatitis dataset was taken from the UCI machine repository database with a total of 20 attributes of two classes, Affected and Not Affected. 
Results and Conclusion: The models have been generated with a mixture of experts as a classification method for the diagnosis of hepatitis. Very good accuracy has been observed in the generated models. Finally, the model having the least minimum square error was selected. This model was then linked with GUI for the design of tools for hepatitis prediction

Thrombocytopenia in end-stage renal disease and chronic viral hepatitis B or C

Objectives. We evaluated platelet counts in end-stage renal disease and chronic viral hepatitis. Materials and Methods. We studied 70 patients with end-stage renal disease and chronic viral hepatitis and compared them to a control group of 45 patients without hepatitis. Results. The presence of viral hepatitis was associated with a higher prevalence of thrombocytopenia. Correlations between age, C-reactive protein, liver stiffness measurement, and platelet count were observed. C-reactive protein levels \u3e 10 mg/dl were associated with a lower risk of thrombocytopenia in patients with end-stage renal disease and chronic viral hepatitis, yet age \u3e 60 years, dialysis vintage \u3e 10 years, aspartate and alanine aminotransferase levels \u3e 20 IU/L, albumin levels \u3c 3.5 g/dl, and fibrosis stage ≥ 3 were not related. Conclusions. Chronic viral hepatitis leads to a higher prevalence of thrombocytopenia. Platelet counts in these patients begin to decrease significantly once liver fibrosis reaches stage III

Hepatitis B

Viral hepatitis is a term commonly used for several clinically similar yet etiologically and epidemiologically distinct diseases. Hepatitis A (formerly called infectious hepatitis) and hepatitis B (formerly called serum hepatitis) have been recognized as separate entities since the early 1940s and can be diagnosed with specific serologic tests. Delta hepatitis is an infection dependent on the hepatitis B virus (HBV). It may occur as a coinfection with acute HBV infection or as superinfection of an HBV carrier. Epidemic jaundice was described by Hippocrates in the 5th century BCE. The first recorded cases of “serum hepatitis,” or hepatitis B, are thought to be those that followed the administration of smallpox vaccine containing human lymph to shipyard workers in Germany in l883. In the early and middle parts of the 20th century, serum hepatitis wa

Experiences of diagnosis, stigma, culpability, and disclosure in male patients with hepatitis C virus: an interpretative phenomenological analysis

The current study aimed to explore the lived experience of patients with hepatitis C virus infection. Semi-structured interviews were conducted with seven male participants living with hepatitis C virus and were analysed using interpretative phenomenological analysis. Two master themes were identified: (1) diagnosis and the search for meaning and (2) impact of stigma on disclosure. Participants reported fears of contaminating others, feelings of stigma and concerns of disclosing the condition to others. Response to diagnosis, stigma and disclosure among the participants appeared to be interrelated and directly related to locus of blame for virus contraction. More specifically, hepatitis C virus transmission via medical routes led to an externalisation of culpability and an openness to disclosure. Transmission of hepatitis C virus as a direct result of intravenous drug use led to internalised blame and a fear of disclosure. The inter- and intra-personal consequences of hepatitis C virus explored in the current study have potential implications for tailoring future psychological therapy and psychoeducation to the specific needs of the hepatitis C virus population