Hepatitis B markers and vaccination-induced protection rate among Albanian pregnant women in Greece

Hepatitis B has long been a serious public health problem both in Greece and in Albania. In the February 2009 issue of World Journal of Gastroenterology, Resuli et al presented the interesting epidemiological data concerning hepatitis B virus infection in Albania. The results of this study were discussed and several data from our similar research were provided. © 2009 The WJG Press and Baishideng. All rights reserved

Importance of maternal and cord blood viremia in pregnant women with chronic hepatitis B virus infection

Background/aim: The spontaneous preterm birth (SPB) rates in a group of HBeAg-negative chronic HBV infected pregnant women without several known risk factors for preterm delivery as well as the mother to infant HBV transmission rates was evaluated. Moreover the role of maternal data during perinatal period as well as the role of HBsAg and/or HBV-DNA presence in cord blood in respect to preterm labour and vertical transmission of the infection was examined. Methods: 138 consecutive chronic HBV infected pregnant women were haematologically, serologically and virologically evaluated during the perinatal period. 102 women were finally evaluated and fifteen of them (14.7%) exhibited SPB. Overall, 44 infants who had completed the proposed vaccination schedule were evaluated at month 12 of their life. Results: A significant association between SPB and HBV-DNA presence in cord blood was observed (p = 0.007). HBV-DNA positivity in cord blood was significantly associated with maternal HBV-DNA levels (p = 0.002). The relative risk of HBV-DNA presence in cord blood was 6.43 times higher among women with serum HBV-DNA ≥ 10.000 copies/ml and lymphocyte count < 1500 compared to those with all the other combinations of both parameters (p = 0.001). All infants evaluated at month 12 were HBsAg-negative and exhibited undetectable HBV-DNA levels. Conclusion: The presence of HBV-DNA in cord blood is significantly associated with SPB in chronic HBV infected pregnant women. Maternal or cord blood viremia does not pose an additional risk factor for vertical transmission of HBV infection, in passive-active immunoprotected infants from HBeAg-negative chronic HBV infected mothers. © 2010 European Federation of Internal Medicine

Clinical significance of hepatitis b surface antigen in cord blood of hepatitis B e-antigen-negative chronic hepatitis B virus-infected mothers

Vertical transmission of hepatitis B virus (HBV) infection during the perinatal period is the major cause of HBV transmission. The aim of our study was to evaluate the serological and virological profiles of HBV infection in cord blood samples obtained from HBeAg-negative chronic HBV-infected women, at delivery, and to investigate their relationship with the clinical outcome (possible transmission of HBV) in neonates receiving the currently approved passive-active immunoprophylaxis schedule. Sixteen women (32%) exhibited HBsAg positivity in the cord blood but HBV-DNA has not been detected in any of the 50 cord blood samples evaluated. We conclude that HBsAg can be transferred through the placental barrier, as with other proteins, in about one third of HBeAg-negative chronic HBV-infected pregnant women, irrespective of the maternal viral load, the mode of delivery or the placenta HBV pathology. The clinical impact of this phenomenon on the intrauterine-transplacental or perinatal transmission of HBV infection and/or passive-active immunoprophylaxis failure does not seem to be important. © 2009 S. Karger AG, Basel

Serological profile of HBV infection and liver histopathology among injecting drug users with chronic HCV infection in Greece

Background: The aim of this study was to evaluate the serological status of HBV infection and liver histology in chronic HCV-infected injecting drug users (IDUs) and to correlate them with the possible time of infection and the principal HCV genotype. Methods: Some 130 prior IDUs with chronic HCV infection were consecutively evaluated for the serological status of HBV infection. Fifty-eight (44.62%) reported intravenous drug use beginning before 1992 (group A) and 72 (55.38%) after 1992 (group B). HCV genotyping was available in 86 patients (PCR). Liver biopsy was performed in 48 patients (Ishak scoring system). There was no available data about alcohol consumption in the study population. Statistical analysis was based on the t-test and the χ2 test (p < 0.05). Results: Some 82.8% of group A patients had previous HBV infection, whereas only 22.2% of group B patients did (p < 0.001). Among group A patients, 10.3% were HBV-seronegative whereas 61.1% of group B patients were (p < 0.001). Only 3.4% of group A patients were HBV-vaccinated compared to 16.7% in group B (p = 0.016). HCV genotype was not associated with HBV serological status. No significant differences were detected in age, sex, possible time of infection, HBV serological status, or HCV genotype among those with higher vs. lower total grading scores. Seventy-five percent of patients had mild or no detectable fibrosis unrelated to the possible period of infection, the HBV serological status, and the HCV genotype. Conclusions: The serological profile of HBV infection is changing among Greek chronic HCV-infected IDUs, while the percentages of successfully HBV-vaccinated IDUs are relatively low. Severe liver disease is an uncommon finding in these patients, irrespective of the possible time of infection, the HBV serological status, and the HCV genotype. © 2005 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved

Factors associated with delayed hospital arrival among patients with acute myocardial infarction: A cross-sectional study in Greece

Background: It is proven that early admission to hospital contributes significantly to the successful management of acute myocardial infarction (AMI). Aim: This study aimed to examine the factors associated with delayed hospital arrival among patients with AMI. Methods: A cross-sectional study among 477 AMI patients was conducted during a 2-year period in two large tertiary hospitals in Greece. Structured face-to-face interviews were conducted and information regarding their socio-demographic characteristics, medical history and factors that might be correlated with delayed hospital arrival were collected. Results: The main factors that were found to be correlated with delayed hospital arrival among AMI patients were the absence of companion/attendant/escort present during the AMI [odds ratio (OR) 2.1, 95% confidence interval (CI) 0.98-4.4, P=0.049], previous medical history of diabetes mellitus (OR 3.4, CI 1.6-7.2, P=0.002), absence of dyspepsia (OR 9.2, CI 3.6-23.3, P<0.001) and nausea/vomiting symptoms (OR 16.9, CI 4.1-69.1, P<0.001), and also being at a distance of more than 10km from the hospital (OR 19.6, CI 5.4-70.6, P<0.001). Conclusion: A number of factors that might delay hospital arrival among patients with AMI should be taken into account in healthcare service planning. Health policy actions that will improve the accessibility to healthcare services, the restructuring of the Greek primary healthcare system and the provision of effective patient education by nurses could reduce the pre-hospital delay. Limitations: The study was conducted in two hospitals which limits the generalization of the findings. Also, the onset of AMI symptoms relied on self-report by the patients. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses