Determinants for persistent fibrosis during nucleoside analogue therapy in chronic hepatitis B

This journal suppl. entitled: Conference Abstracts: 25th Annual Conference of APASL, February 20–24, 2016, Tokyo, JapanPoster Presentation: P-0398BACKGROUND: Changes in liver stiffness measurements (LSM) during long-term nucleoside analogue therapy in chronic hepatitis B (CHB) have not been well-investigated. METHODS: We recruited CHB patients on long-term nucleoside analogue therapy with persistent virologic suppression (HBV DNA20 IU/mL on 3 occasions of at least 6 months apart) and with previous LSM indicating significant liver fibrosis, as defined by EASL-ALEH Guidelines ([9.0 kPa for normal alanine aminotransferase [ALT] and[12.0 kPa for ALT[1–5 9 upper limit of normal). Assessment included anthropometric measurements, HBV virology, and reassessment transient elastography and controlled attenuation parameter (CAP) measurements by FibroScan (Echosens, Paris, France). Hepatic steatosis was defined as CAP C222 dB/m. RESULTS: In this interim analysis, 119 CHB patients (77.3 % male) were recruited. Mean age at reassessment and mean duration of nucleoside analogue therapy was 56.1 (±10.4) years and 8.5 (±3.1) years, respectively. 38 patients (31.9 %) had persistent liver fibrosis. Patients with persistent liver fibrosis, when compared to patients with fibrosis reversal, had a significantly higher mean body-mass index (26.0 and 23.6 kg/m2, respectively, p = 0.040), mean systolic blood pressure (144 and 136 mmHg, respectively, p = 0.029) and mean diastolic blood pressure (82 and 77 mmHg, respectively, p = 0.046). There was no significant difference in the presence of hepatic steatosis among the two groups (65.8 % and 55.6 % respectively, p = 0.290). CONCLUSION: Metabolic parameters, including body-mass index and blood pressure, could influence fibrosis reversibility during long-term nucleoside analogue therapy. Recruitment is ongoing and the influence of other metabolic parameters (e.g. metabolic syndrome) will be analyzed.Link_to_subscribed_fulltex

A population-based study on the seroprevalence of viral hepatitis in Hong Kong, China

This journal suppl. entitled: Conference Abstracts: 25th Annual Conference of APASL, February 20–24, 2016, Tokyo, JapanPoster Presentation: P-0305BACKGROUND: Viral hepatitis remains a major health burden in the Asia-Pacific region. Reliable virus prevalence data influencing countrywide health policies can only be obtained by population-based study which requires intensive efforts to conduct. We aimed to document the territorial seroprevalence of viral hepatitis A to E in Hong Kong. METHODS: Questionnaires containing demographics, family history of hepatitis infection, previous hepatitis vaccination and risks of hepatitis exposure are collected in different townships over Hong Kong. Sera are tested for antibodies to HAV, HCV and HEV, hepatitis B panel including HBsAg, HBeAg, anti-HBs and anti-HBc and anti-HDV for HBsAg positive subjects. RESULTS: We aim to recruit 10,000 subjects. Since study commencement in February 2015, a total of 4371 subjects (M:F, 32 vs. 68 %) were recruited. Mean age were comparable in both gender (male 53.0 ± 14.6 vs female 53.6 ± 14.1). Interim analysis of overall seroprevalence data of 4371 subjects were shown in figure 1. Significantly more patients are anti-HAV and anti-HEV positive in older age groups when compared to younger age groups (p\0.001) as shown in Figure 1. Among 3983 HBsAg-negative subjects, 1593 subjects (59.9 %) were positive for anti-HBc, with statistically higher proportion of anti-HBc positivity in older age groups (p\0.001) as shown in Figure 2. CONCLUSIONS: Prevalence of HBV remained high. More than half of the HBsAg negative population had HBV exposure evidenced by anti-HBc positivity. Anti-HAV and anti-HEV were significantly higher in older age groups More than 85 and 40 % of patients older than 55 years had positive anti-HAV and anti-HEV respectively.Link_to_subscribed_fulltex

A territory-wide study on the seroprevalence of hepatitis B virus in the general population after universal hepatitis B immunization era in Hong Kong, China

Poster Presentations: Viral hepatitis: Hepatitis A, B, D, E – clinical (except therapy): no. THU-162BACKGROUND AND AIMS: Chronic hepatitis B (CHB) remains a major health burden in the Asia-Pacific region. No population-based study has been carried out to assess the territorial prevalence of CHB after the introduction of universal hepatitis B vaccination program in1988 in Hong Kong. We aimed to document the point prevalence of viral hepatitis B in Hong Kong …Link_to_subscribed_fulltex

Outbreak of human metapneumovirus infection in psychiatric inpatients: implications for directly observed use of alcohol hand rub in prevention of nosocomial outbreaks

Nosocomial outbreaks of infectious diseases in psychiatric facilities are not uncommon but the implementation of infection control measures is often difficult. Here, we report an outbreak of an acute respiratory illness in a psychiatric ward between 29 July and 20 August 2005 involving 31 patients. Human metapneumovirus was detected in seven (23%) patients by reverse transcription-polymerase chain reaction and nucleotide sequencing. A review of outbreak surveillance records showed that six nosocomial outbreaks occurred in the year 2005, of which four (67%) were confirmed or presumably related to a respiratory viral infection. Directly observed deliveries of alcohol hand rub 4-hourly during daytime to all psychiatric patients was instituted in December 2005. Only one nosocomial respiratory viral outbreak occurred in the following year. The total number of patients and staff involved in nosocomial outbreaks due to presumed or proven respiratory virus infections decreased significantly from 60 to six (P < 0.001), whereas those due to all types of nosocomial outbreaks also decreased from 70 to 24 (P = 0.004). Alcohol hand rub has been shown to have potent bactericidal and virucidal activity against a wide range of nosocomial pathogens. Regular use of directly observed alcohol hand rub may decrease the incidence and scale of nosocomial outbreaks due to enveloped respiratory viruses especially in mentally incapacitated patients. © 2007 The Hospital Infection Society.link_to_subscribed_fulltex