The ongoing impacts of hepatitis C - a systematic narrative review of the literature

Extent: 13p.BackgroundMany countries have developed, or are developing, national strategies aimed at reducing the harms associated with hepatitis C infection. Making these strategies relevant to the vast majority of those affected by hepatitis C requires a more complete understanding of the short and longer term impacts of infection. We used a systematic approach to scope the literature to determine what is currently known about the health and psychosocial impacts of hepatitis C along the trajectory from exposure to ongoing chronic infection, and to identify what knowledge gaps remain.MethodsPubMed, Current Contents and PsychINFO databases were searched for primary studies published in the ten years from 2000-2009 inclusive. Two searches were conducted for studies on hepatitis C in adult persons focusing on: outcomes over time (primarily cohort and other prospective designs); and the personal and psychosocial impacts of chronic infection. All retrieved studies were assessed for eligibility according to specific inclusion/exclusion criteria, data completeness and methodological coherence. Outcomes reported in 264 included studies were summarized, tabulated and synthesized.ResultsInjecting drug use (IDU) was a major risk for transmission with seroconversion occurring relatively early in injecting careers. Persistent hepatitis C viraemia, increasing age and excessive alcohol consumption independently predicted disease progression. While interferon based therapies reduced quality of life during treatment, improvements on baseline quality of life was achieved post treatment--particularly when sustained viral response was achieved. Much of the negative social impact of chronic infection was due to the association of infection with IDU and inflated assessments of transmission risks. Perceived discrimination was commonly reported in health care settings, potentially impeding health care access. Perceptions of stigma and experiences of discrimination also had direct negative impacts on wellbeing and social functioning.ConclusionsHepatitis C and its management continue to have profound and ongoing impacts on health and social well being. Biomedical studies provided prospective information on clinical aspects of infection, while the broader social and psychological studies presented comprehensive information on seminal experiences (such as diagnosis and disclosure). Increasing the focus on combined methodological approaches could enhance understanding about the health and social impacts of hepatitis C along the life course.Emma R Miller, Stephen McNally, Jack Wallace, Marisa Schlichthors

Response of PGPR and AM fungi toward growth and secondary metabolite production in medicinal and aromatic plants

Plant growth-promoting rhizobacteria (PGPRs) are a group of naturally occurring beneficial soil bacteria that colonize with the plant root system and promote growth by triggering the production of growth-regulating substances and facilitate the plants in the uptake of essential nutrients from the surrounding environments. Similarly, arbuscular mycorrhizal (AM) fungi also enhanced the growth, water and nutrient uptake, and especially available phosphate through their specialized hyphae. In addition, PGPR and AM fungi are known to stimulate the accumulation of secondary metabolites in plants. For several years, they are commonly employed to increase the plant yield and productivity especially in agricultural practices. The medicinal and aromatic plants are gaining popularity worldwide due to high therapeutic properties with negligible toxic side effects. To fulfill the global demand and supply gap for medicinal and aromatic plants and their products, farmers are encouraged to cultivate these plants on a large scale. However, there is a need to understand and implement a better cultivation practices in order to improve the quality of medicinal and aromatic plants. In this regard, the utilization of PGPRs and AM fungi as biofertilizers instead of chemical fertilizers could be a promising approach to the development of medicinal and aromatic plants under the sustainable production system. The aim of this chapter is to describe the potentiality of PGPRs and AM fungi to improve growth and development of medicinal and aromatic plants and accumulation of secondary metabolites having high therapeutic worth and also pave a way in the development of new biotechnological products as biofertilizers