8,399 research outputs found

    Risk Factors for Hepatitis C Infection Among Sexually Transmitted Disease-Infected, Inner City Obstetric Patients

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    Objective: To test the hypothesis that our inner city obstetric patients who have been infected with sexually transmitted diseases (STDs) will have a higher prevalence of hepatitis C virus infection than the general population and to identify specific risk factors and high-risk groups. Methods: All patients in our prenatal clinic (July 1997–April 1999) who tested positive for one or more STDs were asked to return for hepatitis C antibody testing. Medical charts of all patients who returned for hepatitis C testing were reviewed. Results: A total of 106 patients with STDs were tested for hepatitis C. Positive screening tests for anti-hepatitis C antibody were found in 6.6% (7/106) of the patients (95% CI = 2.7–13.1%). This frequency is significantly higher than the hepatitis C prevalence (1.8%) in the general United States population (p = 0.006). Multiple logistic regression analysis confirmed only older age (p = 0.016) and positive HIV status (p = 0.023) to be significant predictors of hepatitis C infection. Conclusions: Inner city STD-infected obstetric patients are at high risk for hepatitis C infection compared with the general population. Increasing age and HIV-positive status are risk factors which are significantly associated with hepatitis C infection

    Prevalence of Hepatitis C Virus Infection among Chronic Kidney Disease Patients on Regular Hemodialysis

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    OBJECTIVES To determine the frequency of the Hepatitis C Virus in patients with chronic kidney disease receiving regular hemodialysis. METHODOLOGY At a tertiary care hospital in Peshawar, 211 patients were observed to ascertain the frequency of the Hepatitis C Virus in chronic kidney disease patients receiving regular hemodialysis. The technique of non-probability sequential sampling was employed to acquire samples. SPSS version 26.0 was used. RESULTSAmong the CKD patients with Hepatitis C Virus (HCV) infection, a higher proportion of males (48.5%) tested positive compared to females (28.1%). Furthermore, the prevalence of HCV infection was significantly higher in CKD patients residing in urban areas (98.5%) compared to those in rural areas (1.5%). The statistical analysis indicated a significant association between the prevalence of Hepatitis and the factors of gender and residency (P value = 0.002). Out of 211, hepatitis C-positive patients 66.2% were diabetics and hypertensive were 77.9%. CONCLUSION Hospitalized CKD patients have a considerably higher frequency of hepatitis C infection. To stop the spread of the hepatitis C virus, nephrology wards should undertake strict universal infection control procedures

    Factors affecting hepatitis C treatment intentions among Aboriginal people in Western Australia: A mixed-methods study

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    Objective: The aim of this study was to identify the hepatitis C treatment intentions of Aboriginal people living with hepatitis C virus (HCV) in Western Australia. Methods: This study used a mixed-methods design. In the cross-sectional survey, 123 Aboriginal people who inject drugs and self-report as living with hepatitis C completed a purpose-designed questionnaire. In the qualitative phase, 10 participants were interviewed about the factors influencing their future intentions to undertake hepatitis C treatment. Results: Analysis of the survey data revealed significant associations between an intention to undertake hepatitis C treatment and support, community attachment, stable housing and stigma. In addition, there was a high overall level of expressed intention to undertake HCV treatment, with 54% of participants responding positively. Analysis of the qualitative data supported quantitative findings, revealing concerns about stigma, lack of social support and unstable housing as factors affecting the intention to undertake hepatitis C treatment. Conclusion: This mixed methods study with Aboriginal people living with self-reported HCV indicates interventions focused on reducing stigma and unstable housing could positively affect hepatitis C treatment intentions. These findings have implications for developing holistic programs to promote and support people on hepatitis C treatment. What is known about the topic? Substantial knowledge gaps need to be resolved if HCV elimination among Aboriginal Australians is to be achieved. Current research has prioritised non-Aboriginal communities. What does this paper add? This study found that stigma and unstable housing require attention if Aboriginal Australians are to obtain the full benefits of direct acting antiviral (DAA) hepatitis C treatment. What are the implications for practitioners? Reducing stigma (in the primary healthcare setting) and providing access to stable housing are vital components of supportive, non-judgemental and culturally appropriate care for Aboriginal people. This study highlights the importance of education for nurses and other primary care providers to increase engagement in the hepatitis cascade of care. To achieve this, scaling-up of HCV treatment engagement, trained Aboriginal community healthcare workers and HCV treatment advocates must mobilise and support Aboriginal people to avoid the negative effects of stigma, build positive and enabling relationships and reinforce positive attitudes towards DAA hepatitis C treatment

    Hepatitis C virus molecular evolution: Transmission, disease progression and antiviral therapy

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    Hepatitis C virus (HCV) infection represents an important public health problem worldwide. Reduction of HCV morbidity and mortality is a current challenge owned to several viral and host factors. Virus molecular evolution plays an important role in HCV transmission, disease progression and therapy outcome. The high degree of genetic heterogeneity characteristic of HCV is a key element for the rapid adaptation of the intrahost viral population to different selection pressures (e.g., host immune responses and antiviral therapy). HCV molecular evolution is shaped by different mechanisms including a high mutation rate, genetic bottlenecks, genetic drift, recombination, temporal variations and compartmentalization. These evolutionary processes constantly rearrange the composition of the HCV intrahost population in a staging manner. Remarkable advances in the understanding of the molecular mechanism controlling HCV replication have facilitated the development of a plethora of direct-acting antiviral agents against HCV. As a result, superior sustained viral responses have been attained. The rapidly evolving field of anti-HCV therapy is expected to broad its landscape even further with newer, more potent antivirals, bringing us one step closer to the interferon-free era.Fil: Preciado, María Victoria. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños ; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Valva, Pamela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños ; ArgentinaFil: Escobar Gutierrez, Alejandro. Instituto de Diagnóstico y Referencia Epidemiológicos; MéxicoFil: Rahal, Paula. Universidade Estadual Paulista Julio de Mesquita Filho; BrasilFil: Ruiz Tovar, Karina. Instituto de Diagnóstico y Referencia Epidemiológicos; MéxicoFil: Yamasaki, Lilian. Universidade Estadual Paulista Julio de Mesquita Filho; BrasilFil: Vazquez Chacon, Carlos. Instituto de Diagnóstico y Referencia Epidemiológicos; MéxicoFil: Martinez Guarneros, Armando. Instituto de Diagnóstico y Referencia Epidemiológicos; MéxicoFil: Carpio Pedroza, Juan Carlos. Instituto de Diagnóstico y Referencia Epidemiológicos; MéxicoFil: Fonseca Coronado, Salvador. Universidad Nacional Autónoma de México; MéxicoFil: Cruz Rivera, Mayra. Universidad Nacional Autónoma de México; Méxic

    Controlling and constraining the participation of the hepatitis C-affected community in Australia: A critical discourse analysis of the first national hepatitis C strategy and selected news media texts

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    The construction of texts that place hepatitis C-positive persons at social risk (Candlin, 1989, p. ix), informs this study of the ways in which public health policy makers and journalists in Australia communicate about hepatitis C. The institutions of public health and the news media form part of the cultural context within which persons construct their illness narratives. The privileged perspectives and framing of public health policy and news media discourses; the discursive practices associated with the institutions of public health and the media around hepatitis C and hepatitis C-positive persons, the “objects” of knowledge (Foucault, 1969/2002, p. 81); and the subject and social positions available to hepatitis C-positive people and spokespersons of non-government organisations (NGOs) representing the hepatitis C-affected community are examined. The place afforded the voices of individuals living with hepatitis C in these forums to discuss topics of public concern is considered

    Estimating economic and epidemiological burden of hepatitis C in Egypt, 2015-2025

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    Hepatitis C is the most pressing public health challenge in Egypt where Hepatitis C Virus (HCV) prevalence is the highest in the world. In 2015, Egypt Health Issues Survey showed that 10% of Egyptians between 15 – 59 years of age had been infected with HCV infection, while 7% are chronic active hepatitis C patients. This paper aims to estimate the current and future economic and epidemiological burden of HCV between 2015 and 2025. In addition, it compares the impact of different scenarios for management of this huge public health problem to identify the most cost effective strategy capable of reducing the economic and epidemiological burden of this disease at the country level. A Markov model representing hepatitis C progression was established showing the prognosis among HCV infected cohort within different age groups where the members of each group go through predefined states of health over one-year time cycles till 2025. The burden of hepatitis C will be estimated through calculating different transition probabilities and calculating the direct and indirect healthcare cost of the proportion of members who go through each stage of the disease and its complications. Under the current management strategy of 125,000 patients/year, it is estimated that chronic active HCV patients will show minimal decrease to reach about 4.1 million cases, with high economic burden of this strategy is very high where the direct costs are estimated 23.3billion,andthetotalcostsare23.3 billion, and the total costs are 48.3 billion between 2015-2025. While increasing the treatment rate to reach one million patient annually for 5 years in addition to decreasing the annual incidence in the coming 10 years will drop HCV cases to about 636 thousands by 2025, and with only 16.2billionasadirectcosts,andtotalcosts16.2 billion as a direct costs, and total costs 34.2 billion between 2015-2025 which is 29.2% lower than the current management scenario

    Cryoglobulinaemic vasculitis: classification and clinical and therapeutic aspects

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    Cryoglobulinaemia may cause cutaneous vasculitis and glomerulonephritis, potentially leading to end stage renal failure. An important proportion of cryoglobulinaemias are secondary to hepatitis C virus infection. Emerging antiviral treatment options offer a chance for causal therapy of these cases of cryoglobulinaemia. This review summarises the classification and clinical and therapeutic aspects of cryoglobulinaemic vasculitis and glomerulonephritis

    Hepatitis C infection: eligibility for antiviral therapies

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    Background Current treatments of chronic hepatitis C virus (HCV) are effective, but expensive and susceptible to induce significant side effects. Objectives To evaluate the proportion of HCV patients who are eligible for a treatment. Methods In a database comprising 1726 viraemic HCV patients, the files of 299 patients who presented to the same hepatologist for an initial appointment between 1996 and 2003 were reviewed. Results Patients' characteristics were age 43.1 +/- 15.6 years, 53% male and 92% Caucasian. The main risk factors were transfusion (43%) and drug use (22%). Genotypes were mostly genotype 1 (66%), genotype 3 (12%) and genotype 2 (10%). These characteristics were not different from those of the whole series of 1726 patients. A total of 176 patients (59%) were not treated, the reasons for non-treatment being medical contraindications (34%), non-compliance (25%) and normal transaminases (24%). In addition, 17% of patients declined therapy despite being considered as eligible, mainly due to fear of adverse events. Medical contraindications were psychiatric (27%), age (22%), end-stage liver disease (15%), willingness for pregnancy (13%), cardiac contraindication (7%) and others (16%). Only 123 patients (41%) were treated. A sustained viral response was observed in 41%. The treatment was interrupted in 16% for adverse events. Conclusions The majority of HCV patients are not eligible for treatment. This implies that, with current therapies, only 17% of patients referred for chronic HCV become sustained responders. Some modifications of guidelines could extend the rate of treatment (patients with normal transaminases), but an important barrier remains the patients' and the doctors' fear of adverse events
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