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

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

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

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

Era of direct acting anti-viral agents for the treatment of hepatitis C.

Hepatitis C infection is universal and the most common indication of liver transplantation in the United States. The period of less effective interferon therapy with intolerable side effects has gone. Now we have stepped into the era of direct acting anti-viral agents (DAAs) against hepatitis C virus. Treatment of hepatitis C is now extremely effective, tolerable and requires a short duration of intake of oral agents. Less monitoring is required with the current therapy and drug-drug interactions are less than the previous regimen. The current treatment options of chronic hepatitis C with various DAAs are discussed in this article

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

‘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

Hepatitis C and ageing: a community brief

Executive summary: An estimated 226,700 people in Australia are living with chronic hepatitis C. While the numbers of people estimated to have been infected with hepatitis C has reduced over the past 15 years, the number of people with hepatitis C-related liver disease is increasing. Growing older and duration of infection are significant determinants in the progression to cirrhosis amongst people with hepatitis C. There is a lack of social research describing the experiences of people with hepatitis C as they grow older. Australia’s population is ageing with an increasing number and proportion of people over 65. Government programmatic responses to the ageing population are of a health promotion approach focussing on maintaining older people’s health and independence. Less than five percent of older people in Australia live or will live in aged care facilities with a greater emphasis from government policy on keeping people at home: home based aged care services will have an increasingly important role into the future. This qualitative, interview-based research conducted with key clinical, community and bureaucratic stakeholders in the Australian hepatitis C sector aimed to identify key issues and challenges relating to ageing and hepatitis C to inform future research directions. While all participants recognised ageing and hepatitis C as a significant issue for Australia, they acknowledged that there was a lack of specific services (clinical and/or community-based) targeting older people with hepatitis C. The lack of services resulted from the limited contact participants had with older people with hepatitis C, and participants expressed concern of their limited understanding of the needs of older people with hepatitis C. The lack of services is compounded by the variety of definitions of ageing between the research literature, national policy and stakeholder perspectives. For example, the Australia government considers people over 65 years to be “older”, whereas in the context of people with hepatitis C, participants described ageing as older than 55 years. An Australian Injecting & Illicit Drug Users League investigation into ageing in 2010 describes people who inject drugs who are over 40 years as ageing. During interviews, significant attention was directed towards discussing whether “age” is a proxy for “severity of liver disease” or whether there are specific-age related issues associated with mild liver disease. Participants acknowledged that older people with hepatitis C often experience co-morbidities related to ageing, in addition to extrahepatic manifestations of hepatitis C infection, which often complicate the management and treatment of hepatitis C. While the clinical management of hepatitis C is changing and new treatments promise a shorter treatment course with fewer side effects, several clinicians expressed guilt in advising older people to wait for interferon-free regimes because of concern about pre-existing comorbidities, while being concerned that advising older people to wait for three to five years for the new treatments may be too late. Older people with hepatitis C are not identified as a priority population nor are their needs discussed in the National Hepatitis C Strategy 2010-2013. Therefore, it is not surprising that hepatitis C and ageing are not identified as a priority in either the national or state health agenda of the aged care sector. In order to articulate the impact and issues associated with hepatitis C and ageing, the issue of ageing in Australia needs to be examined broadly and the impact of hepatitis C considered in the current context. Exploring the needs of people with hepatitis C as they age needs to occur as a matter of urgency, as older people with hepatitis C are a hidden population. A comprehensive, strategic approach to hepatitis C and ageing is needed to ensure that the needs of older people with hepatitis C do not continue to go unrecognised

Mathematical Model and Analysis of Transmission Dynamics of Hepatitis B Virus

Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus (HBV). In this paper, the transmission dynamics of hepatitis B is formulated with a mathematical model with considerations of different classes of individuals, namely immunized, susceptible, latent,infected and recovered class. The role of vaccination of new born babies against hepatitis B and the treatment of both latently and actively infected individuals in controlling the spread are factored into the model. The model in this study is based on the standard SEIR model. The disease-free equilibrium state of the model was established and its stability analyzed using the Routh-Hurwitz theorem. The result of the analysis of the stability of the disease-free equilibrium state shows that hepatitis B can totally be eradicated if effort is made to ensure that the sum of the rate of recovery of the latent class, the rate at which latently infected individuals become actively infected and the rate of natural death must have a lower bound.Comment: 9 pages, 1 figur

Hepatitis induced by noni juice from Morinda citrifolia: A rare cause of hepatotoxicity or the tip of the iceberg?

A 24-year-old female patient presented to her community hospital with mild elevations of serum transaminase and bilirubin levels. Because of multiple sclerosis, she was treated with interferon beta-la for 6 weeks. After exclusion of viral hepatitis due to hepatitis A-E, interferon beta-la was withdrawn under the suspicion of drug-induced hepatitis. One week later, she was admitted again to her community hospital with severe icterus. The transaminase and bilirubin levels were highly elevated, and a beginning impairment of the liver synthesis was expressed by a reduced prothrombin time. The confinement to our department occurred with a fulminant hepatitis and the suspicion of beginning acute liver failure. There was no evidence for hepatitis due to potentially hepatotoxic viruses, alcoholic hepatitis, Budd-Chiari syndrome, hemochromatosis, and Wilson's disease. In her serum there were high titers of liver-kidney microsomal type 1 autoantibody; the serum gamma globulin levels were in the normal range. Fine-needle aspiration biopsy of the liver ruled out an autoimmune hepatitis but showed signs of drug-induced toxicity. During the interview, she admitted that for `general immune system stimulation' she had been drinking Noni juice, a Polynesian herbal remedy made from a tropical fruit (Morinda citrifolia), during the past 4 weeks. After cessation of the Noni juice ingestion, her transaminase levels normalized quickly and were in the normal range within 1 month. Copyright (c) 2006 S. Karger AG, Basel