Successful Control of Hepatitis B Surface Antigenemia in a Dialysis Unit Without Geographic or Machine Isolation

1981 ◽  
Vol 2 (2) ◽  
pp. 101-104
Author(s):  
Victor S. Ostrower ◽  
Meyer D. Lifschitz ◽  
Philip C. Craven ◽  
Dwight M. Williams
Keyword(s):  
Hepatitis B ◽  
Parallel Plate ◽  
Control Measures ◽  
Temporal Isolation ◽  
Dialysis Unit ◽  
Hbsag Positivity ◽  
Successful Control ◽  
Prospective Trials ◽  
The Mean ◽  
Geographic Separation

AbstractPersistent hepatitis B infections among patients and frequent new hepatitis B infections among both patients and staff were a major problem in our dialysis unit during its first two and one-half years of operation. During this time the mean quarterly rate of conversion to HBsAg positivity among patients ranged from 0-60% (mean 12%); in staff it ranged from 0-13%. Control efforts, including strict temporal isolation, improved sanitary measures, and use of parallel plate dialyzers without geographic or machine isolation, were begun late in 1976. After a four-month lag, new HBsAg conversions ceased among the 30 patients and staff at risk, despite continued dialysis of eight HBsAg-positive patients (at least four of whom were HBeAg-positive). Over the succeeding three years the conversion rate was zero in both patients and staff. This experience suggests that conservative control measures without geographic separation of patients may be sufficient to control an established outbreak of hemodi-alysis-related hepatitis B. Controlled prospective trials of this hypothesis are warranted.

scholarly journals AB0277 PREVALENCE OF HEPATITIS MARKERS IN PATIENTS TREATED WITH BIOLOGICAL DISEASE-MODIFYING ANTIRHEUMATIC DRUGS: RESULTS OF THE TUNISIAN REGISTRY BINAR

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1437.1-1438
Author(s):  
A. Fazaa ◽  
H. Boussaa ◽  
S. Miladi ◽  
K. Ouenniche ◽  
L. Souabni ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Liver Function ◽  
Disease Activity ◽  
Liver Function Tests ◽  
Hbv Dna ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
The Mean ◽  
Disease Modifying ◽  
Hbs Ag

Background:In the recent decades, biological disease-modifying antirheumatic drugs (bDMARDs) have significantly improved management and quality of life in patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA).However, bDMARDs have also a strong influence on the immune system, leading to a risk of serious infection. Reactivation of hepatitis B (HBV) and C (HCV) virus is one of the most redoubtable complications of these immunosuppressive agents.Objectives:The aims of this study were to determine the screening rate for hepatitis B and C before starting a biological treatment and to examine the prevalence of their markers in patients with RA or SpA.Methods:Our study evaluated all patients included in the Tunisian registry BINAR (Biologic National Registry) since 2018 who had RA (ACR/EULAR 2010) or SpA (ASAS criteria) aged with more than eighteen years old and receiving their first bDMARDs during the two past years.The following information were retrieved from the registry: demographic data on the patients, disease parameters, medication, HBV surface antigen (HBs Ag), antibody to HBs Ag (Anti HBs), antibody to HBV core antigen (Anti HBc), HBV-DNA, antibody to HCV (anti HCV) status and liver function tests (AST: aspartate aminotransferase; ALT:alanine aminotransferase).Results:A total of 298 patients was included, 111 men and 178 women, with a mean age of 49.2 ± 14.1 years old [18-79]. Among them, 58.7% were diagnosed with RA and 41.3% were diagnosed with SpA. The mean disease duration was 6.7±3.5 years [1-12] in patients with RA and 6.5±3 [1-12] in patients with SpA. The mean Disease Activity Score (DAS28) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were respectively of 4.9±1.5 [1-8] and 4.1±1.8 [0-9].Therapeutically, 167 patients (56%) were on Prednisone at a mean daily posology of 8.2±5.4 mg [4-60] and 70.3% on conventional synthetic disease modifying antirheumatic drug (csDMARD) in association with bDMARDs. It was about Tumor Necrosis Factor alpha antibodies (anti TNF a) in 87.9% of cases, Tocilizumab in 10.4% of cases and Rituximab in 5% of cases.A screening of HBV was performed in 286 patients (96%). Ag HBs was positive in two cases (0.7%), and anti-HBc was positive in 16 cases (6.4%) which indicate a prior HBV infection. Fifteen patients (6%) were immunized with positive anti HBs. HBV-DNA was measured in 177 cases (66.8%) and was positive in 15 patients (6%).HCV infection was searched in 282 patients (94.6%) and anti-HCV was negative in all cases.AST and ALT mean rates were respectively of 18.3 [2-108] and 17.9 UI/l [2-74]. A perturbation of these liver function tests was observed in 13 patients (4.4%).Conclusion:Screening for hepatitis B and C were performed respectively in 96% and 94% of our Tunisian patients before receiving any bDMARDs. This should be systematic to avoid HBV reactivation which can lead to fulminant hepatic failure with a severe prognosis.Disclosure of Interests:None declared

scholarly journals Resilience and vulnerability of maternity services in Zimbabwe: a comparative analysis of the effect of Covid-19 and lockdown control measures on maternal and perinatal outcomes, a single-centre cross-sectional study at Mpilo Central Hospital

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Clare Shakespeare ◽  
Handsome Dube ◽  
Sikhangezile Moyo ◽  
Solwayo Ngwenya
Keyword(s):  
Perinatal Outcomes ◽  
Control Measures ◽  
Central Hospital ◽  
Cross Sectional ◽  
Maternity Services ◽  
Before And After ◽  
The Mean ◽  
Significant Change ◽  
The Impact ◽  
Mpilo Central Hospital

Abstract Background On the 27th of March 2020 the Zimbabwean government declared the Covid-19 pandemic a ‘national disaster’. Travel restrictions and emergency regulations have had significant impacts on maternity services, including resource stock-outs, and closure of antenatal clinics during the lockdown period. Estimates of the indirect impact of Covid-19 on maternal and perinatal mortality was expected it to be considerable, but little data was yet available. This study aimed to examine the impact of Covid-19 and lockdown control measures on non-Covid outcomes in a government tertiary level maternity unit in Bulawayo, Zimbabwe, by comparing maternal and perinatal morbidity and mortality before, and after the lockdown was implemented. Methods This was a retrospective, observational study, using a cross-sectional design to compare routine monthly maternal and perinatal statistics three months before and after Covid-19 emergency measures were implemented at Mpilo Central Hospital. Results Between January-March and April-June 2020, the mean monthly deliveries reduced from 747.3 (SD ± 61.3) in the first quarter of 2020 to 681.0 (SD ± 17.6) during lockdown, but this was not statistically significant, p = 0.20. The Caesarean section rates fell from a mean of 29.8% (SD ± 1.7) versus 28.0% (SD ± 1.7), which was also not statistically significant, p = 0.18. During lockdown, the percentage of women delivering at Mpilo Central Hospital who were booked at the hospital fell from a mean of 41.6% (SD ± 1.1) to 35.8% (SD ± 4.3) which was statistically significant, p = 0.03. There was no significant change, however, in maternal mortality or severe maternal morbidity (such as post-partum haemorrhage (PPH), uterine rupture, and severe preeclampsia/eclampsia), stillbirth rate or special care baby unit admission. There was an increase in the mean total number of early neonatal deaths (ENND) (mean 18.7 (SD ± 2.9) versus 24.0 (SD ± 4.6), but this was not statistically significant, p = 0.32. Conclusions Overall, maternity services at Mpilo showed resilience during the lockdown period, with no significant change in maternal and perinatal adverse outcomes, with the same number of man-hours worked before and during the lockdown Maternal and perinatal outcomes should continue to be monitored to assess the impact of Covid-19 and the lockdown measures as the pandemic in Zimbabwe unfolds. Further studies would be beneficial to explore women’s experiences and understand how bookings and deliveries at local clinics changed during this time.

scholarly journals High Dose of Lamivudine and Resistance in Patients with Chronic Hepatitis B

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Hamid Ullah Wani ◽  
Saad Al Kaabi ◽  
Manik Sharma ◽  
Rajvir Singh ◽  
Anil John ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Retrospective Study ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Standard Dose ◽  
High Dose ◽  
Lamivudine Therapy ◽  
Daily Dose ◽  
The Mean ◽  
Emergence Of Resistance

Background. Lamivudine is the most affordable drug used for chronic hepatitis B and has a high safety profile. With the daily dose of 100 mg there is progressive appearance of resistance to lamivudine therapy. In our study we used 150 mg of lamivudine daily as a standard dose which warrants further exploration for the efficacy of the drug. Aims of the Study. To assess the efficacy of lamivudine 150 mg daily on resistance in patients with chronic hepatitis B. Methods. This retrospective study consists of 53 patients with chronic hepatitis B treated with 150 mg of lamivudine daily. The biochemical and virological response to the treatment were recorded at a 1-year and 2-, 3-, 4-, and 5-year period and time of emergence of resistance to the treatment was noted. Results. The mean age of the patients was 54 years with 80% being males. The resistance to lamivudine 150 mg daily at 1 year and 2, 3, and 5 years was 12.5%, 22.5%, 37.5%, and 60%, respectively, which is much less compared to the standard dose of 100 mg of lamivudine. Conclusions. Lamivudine is safe and a higher dose of 150 mg daily delays the resistance in patients with chronic hepatitis B.

Lantana camara (lantana).

2021 ◽  
Author(s):  
Sarah E. Thomas ◽  
Julissa Rojas-Sandoval ◽  
Pedro Acevedo-Rodríguez
Keyword(s):  
South Africa ◽  
Biological Control ◽  
Control Measures ◽  
Economic Losses ◽  
Pests And Diseases ◽  
Control Programmes ◽  
Agricultural Weed ◽  
Successful Control ◽  
The Tropics ◽  
Ornamental Shrub

Abstract L. camara is a highly variable ornamental shrub, native of the neotropics. It has been introduced to most of the tropics and subtropics as a hedge plant and has since been reported as extremely weedy and invasive in many countries. It is generally deleterious to biodiversity and has been reported as an agricultural weed resulting in large economic losses in a number of countries. In addition to this, it increases the risk of fire, is poisonous to livestock and is a host for numerous pests and diseases. L. camara is difficult to control. In Australia, India and South Africa aggressive measures to eradicate L. camara over the last two centuries have been largely unsuccessful, and the invasion trajectory has continued upwards despite control measures. This species has been the target of biological control programmes for over a century, with successful control only being reported in a few instances.

scholarly journals Knowledge, Attitude and Behaviour among dental students concerning infection control measures.

2019 ◽  
Author(s):  
Aditi Sharma ◽  
Rajashri Kolte ◽  
Abhay Kolte
Keyword(s):  
Hepatitis B ◽  
Infection Control ◽  
Key Words ◽  
Dental Students ◽  
Control Measures ◽  
Key Words Infection ◽  
Infection Control Measures ◽  
Tetanus Vaccine ◽  
Study Results ◽  
Level Of Knowledge

Aim: The aim was to evaluate the knowledge, attitude and behaviour of dental students concerning infection control measures and to check the correlation, if any, among knowledge, attitude and behaviour of dental students concerning infection control measures in dental setups. Materials and Methods: A total of 1200 students from first to final year and interns from three different colleges were included in the study. Results: A total of 95.83% think isolation is important. Only 4.1% have been vaccinated with hepatitis B vaccine and 95% with tetanus vaccine. Conclusion: The level of knowledge and behaviour of infection control measures was average, for which the reasons could be inadequate training, supply of protective equipments and mainly carelessness. Key Words- Infection control, Vaccination, Isolation.

scholarly journals Hepatitis B reactivation in an Irish dialysis unit, 2005

2007 ◽  
Vol 12 (4) ◽  
pp. 7-8 ◽  
Author(s):  
L Thornton ◽  
F Fitzpatrick ◽  
D de la Harpe ◽  
S Brennan ◽  
N Murphy ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Viral Infections ◽  
Index Patient ◽  
Lessons Learned ◽  
Hbv Infection ◽  
Dialysis Patients ◽  
National Guidelines ◽  
Past Infection ◽  
Dialysis Unit ◽  
Hbv Vaccination

In April 2005, a case of reactivation of hepatitis B virus (HBV) infection occurred in a patient undergoing haemodialysis in an Irish hospital. This incident potentially affected patients attending hospitals throughout the country, so a national incident team was set up coordinate the response to the incident. A total of 306 dialysis patients, attending 17 different dialysis centres (14 in Ireland), were identified as having been potentially exposed to HBV as a result of this incident. A programme of HBV serological testing and HBV vaccination was instituted. There was no evidence that any patient acquired HBV infection as a result of cross-infection from the index patient, although 11 patients (3.6%) had evidence of past infection (anti-HBc positive, HBsAg negative). The majority of patients in this cohort were of unknown HBV vaccination status (62.7%), 13.4% were fully vaccinated, 4.6% partially vaccinated and 15.7% unvaccinated. Of 239 tested for anti-HBs, 183 (76.6%) had a titre <10 mIU/ml. Local incidents in dialysis units can have national implications due to the frequent patient transfer between units. This incident highlighted serious deficiencies in current structures and practices, and a lack of appropriate guidelines. However, there were positive outcomes from this incident. The majority of Irish dialysis patients have now been vaccinated against HBV, and lessons learned have been used to develop national guidelines on HBV vaccination and testing and on the management of incidents of blood-borne viral infections in dialysis units.

scholarly journals The Differences of T-Regulator Cells, Alanine Aminotransferase Serum and Aspartate Aminotranspherase Between Hepatitis B Chronic Patients with and without Liver Fibrosis

2021 ◽  
Vol 22 (2) ◽  
pp. 116-123
Author(s):  
Yostila Derosa ◽  
Nasrul Zubir ◽  
Raveinal Arnelis
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Alanine Aminotransferase ◽  
Chronic Patients ◽  
Cross Sectional ◽  
Medicine Department ◽  
The Mean ◽  
The Difference

Background: Hepatitis B is acute or chronic liver inflammation caused by hepatitis B viral and can progress to hepatic chirrosis or liver cancer. Chronic hepatitis B has a high risk for liver fibrosis. Chronic inflammation and liver fibrosis are interrelated processes. This study aimed to determine the differences in T-regulator cells, Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) between chronic hepatitis B patients with and without liver fibrosis.Method: This study used a cross-sectional method for patients diagnosed with chronic hepatitis B in the Inpatient and Outpatient Department of the Internal Medicine Department  DR. M. Djamil Padang and other hospitals in Padang city for 6 months. Samples were selected by consecutive sampling according to inclusion and exclusion criteria. Liver fibrosis is identified by fibroscan. Data were analyzed by SPSS 21.0.Results: thirty-two patients were diagnosed with chronic hepatitis B and 50% had liver fibrosis. The levels of T-regulator cells in chronic hepatitis B patients without liver fibrosis were 2.08% and liver fibrosis 2.25%, but this difference was not statistically significant (p 0.05). Mean ALT levels in the group without fibrosis were 19 IU/L (7IU/L-71IU/L) and liver fibrosis 61 IU / L (13IU/L-625IU/L). The mean AST level in the group without fibrosis were 15.5 IU/L (10IU/L-32IU/L) and liver fibrosis 35.5 IU/L (10IU/L-476IU/L). The difference between ALT and AST in the two groups was significant (p 0.05). Hepatitis B patients with liver fibrosis had higher ALT and AST levels than without fibrosis.Conclusion: There were differences levels of T-regulator cells in the two groups, but it was not statistically significant. ALT and AST levels were higher in the liver fibrosis group and statistically significant.

scholarly journals Seroprevalence of Malaria and Hepatitis B Coinfection among Pregnant Women in Tamale Metropolis of Ghana: A Cross-Sectional Study

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Gideon Kofi Helegbe ◽  
Paul Armah Aryee ◽  
Baba Sulemana Mohammed ◽  
Anthony Wemakor ◽  
David Kolbila ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Hiv Infection ◽  
Pregnant Women ◽  
Cross Sectional Study ◽  
Hbv Infection ◽  
Full Blood Count ◽  
Cross Sectional ◽  
Tamale Metropolis ◽  
The Mean ◽  
Glucose 6 Phosphate Dehydrogenase

Background. Coinfections are becoming common risk factors that may contribute to the increased burden of morbidity in pregnancy. The aim of this study was to assess the seroprevalence of coinfections of malaria, hepatitis B (HBV), human immunodeficiency virus (HIV), and syphilis among pregnant women attending antenatal clinics (ANC) in the Tamale Metropolis. Methods. By means of rapid diagnostic tests (RDTs), pregnant women attending the Tamale Teaching Hospital (TTH) were screened for malaria, HBV infection, HIV infection, and syphilis from March 2013 to February 2015. Haemoglobin (Hb) values, sickling, and glucose-6-phosphate dehydrogenase deficiency (G6PDd) statuses were also assessed using full blood count (FBC), sodium metabisulphite, and methaemoglobin reduction tests, respectively. Logistic regression analysis was performed to estimate the risks/odds ratios (ORs) for the coinfections and other variables (age, gravidity, and time of the first ANC visit) with 95% confidence intervals (CIs) and set p values for accepting any differences at <0.05. Results. Within the two-year study period, data were collected from 3,127 pregnant women. The mean age (SD) of the pregnant women was 28.5 (±5.0) years. Of the total number, seroprevalence was high for malaria (11.6%) and HBV infection (4.2%) and low for HIV infection (1.0%) and syphilis (0.4%) monoinfections. Mal/HBV coinfection was higher (0.7%) when compared with Mal/HIV (0.1%), Mal/syphilis (0.0%), HBV/HIV (0.0%), HBV/syphilis (0.1%), and HIV/syphilis (0.0%) coinfections. The mean Hb (g/dl) for the women with the four monoinfections was significantly different from one another (p=0.009). Pregnant women with malaria infection were about 2 times more likely to be coinfected with HBV even after adjusting for potential confounders (adjusted odds ratio (AOR) = 1.66, 95% CI = 1.04–2.65, p=0.031). Those in their third trimester and visiting the ANC for the first time were significantly less likely to be infected with HBV (AOR = 0.45, 95% CI = 0.28–0.73, p=0.001), with malaria/HBV coinfection (AOR = 0.09, 95% CI = 0.01–0.68, p=0.020), and with any coinfection (AOR = 0.19, 95% CI = 0.06–0.63, p=0.007). Conclusion. A comparatively high seroprevalence of malaria and its coinfection with HBV in pregnant women was observed in this study. Considering the effects that both malaria and HBV have on the liver, it would be expedient to conduct further studies to assess liver function among malaria/HBV-infected individuals, while interventions to prevent coinfections among pregnant women are intensified.

Safety, tolerability, and pharmacokinetics of the novel hepatitis B virus capsid assembly modulator GST-HG141 in healthy Chinese subjects: a first-in-human single- and multiple-dose escalation trial

2021 ◽  
Author(s):  
Cuiyun Li ◽  
Min Wu ◽  
Hong Zhang ◽  
Jiajia Mai ◽  
Lizhi Yang ◽  
...  
Keyword(s):  
Steady State ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Maximum Plasma ◽  
Capsid Assembly ◽  
Virus Capsid ◽  
B Virus ◽  
The Mean ◽  
Healthy Chinese ◽  
Chinese Subjects

Background: Hepatitis B virus capsid assembly modulators (HBV CAMs) are promising, clinically validated therapeutic agents for the treatment of chronic hepatitis B (CHB). The safety, tolerability, and pharmacokinetic (PK) profiles of GST-HG141, a novel HBV CAM, were evaluated in healthy Chinese volunteers. Method: This phase Ia study included two parts: a double-blinded, randomized, placebo-controlled single-ascending-dose (SAD) (50, 100, 200, 300, 400, or 500 mg) study comprising a food-effect investigation (300 mg), and a multiple-ascending-dose (MAD) (100 or 200 mg BID) study. Result: GST-HG141 reached the maximum plasma concentration (C max ) at 1.25–3.00 h (median T max ). The exposure exhibited a linear increase, while the mean half-life (t 1/2 ) ranged from 13.096 h to 22.121 h. The exposure of GST-HG141 (300 mg) was higher after food intake by about 2.4-fold. In the MAD study, steady-state was reached at around day 5, and the mean trough steady-state concentrations were 423 and 588 ng/mL for 50 and 100mg cohorts, respectively. The ratios of GST-HG141 accumulation were <1.5. GST-HG141 was well tolerated in healthy Chinese subjects. The rates of adverse events (AEs) in the GST-HG141 cohort did not differ from those of the placebo cohort. Conclusion: GST-HG141 was tolerated in healthy Chinese subjects. The safety and PK profiles of GST-HG141 support the further evaluation of its efficacy in individuals with CHB.

Chemical Composition and Repellency Effect of Ferulago Angulate Plant Against Malaria Vector, Anopheles Stephensi

2020 ◽  
Author(s):  
Masoumeh Pirmohammadi ◽  
Mansoureh Shayeghi ◽  
Mohammad Reza Abai ◽  
Hassan Vatandoost ◽  
Sara Rahimi ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Gas Chromatography ◽  
Chemical Composition ◽  
Malaria Vector ◽  
Anopheles Stephensi ◽  
Control Measures ◽  
Gas Chromatography Mass Spectrometry ◽  
Anopheles Mosquitoes ◽  
Protection Time ◽  
The Mean

Abstract BackgroundMalaria is a health problem globally. There are several vector control measures. Using repellent to protect human from biting of vectors is one of the best ways. The aim of this study is to evaluate the efficacy of plant against biting of malaria vector, An.stephensi under laboratory conditions.MethodsChemical constituents of Ferulago angulate plant were determined by using gas chromatography-mass spectrometry. Efficacy and the protection time of plant were evaluated on Anopheles stephensi . ResultsA total of 40 compounds were identified in plant. Flourensiadiol (17.4%) dehydro-sabina keton (13.3%), β-maaliene (8.8%) was the highest in the plant. The mean assessed protection time and efficacy for plant was 60 and 100 minutes respectively. ED50 and ED90 values for this plant were 18.12 and 93.19 µl /cm2 respectively.ConclusionResults showed that plant has an acceptable protection time, therefore, this plant could be considered as a good herbal repellent against anopheles mosquitoes.

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