scholarly journals Screening a nation for hepatitis C virus elimination: a cross-sectional study on prevalence of hepatitis C and associated risk factors in the Rwandan general population

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029743 ◽  
Author(s):  
Justine Umutesi ◽  
Carol Yingkai Liu ◽  
Michael J Penkunas ◽  
Jean Damascene Makuza ◽  
Corneille K Ntihabose ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
General Population ◽  
Hcv Rna ◽  
Age Group ◽  
Older Individuals ◽  
Virus Elimination ◽  
Cross Sectional ◽  
Hcv Prevalence ◽  
Targeted Screening

ObjectivesWe analysed data collected during programmatic screening activities conducted in 2017 to describe hepatitis C virus (HCV) seroprevalence in the general population and identify associated factors.DesignWe analysed data collected between June and September 2017. For both seroprevalence and viraemia, variations across demographic and geographic factors were assessed and multivariate regression models were fit to identify factors independently associated with each marker. Geospatial data were examined for visualisation.SettingHCV screening was organised within each of the 30 districts in Rwanda. One designated location in each district was selected as the screening site and screening took place for 1 week at each site.ParticipantsThis study included 124 223 male and female volunteers. Anti-HCV-positive individuals were followed up with HCV RNA viral load (VL) testing for infection confirmation.Main outcome measuresTwo markers were examined: the presence of HCV antibodies and HCV RNA VL.ResultsAmong 124 223 individuals screened, 11 003 (8.86%, 95% CIs: 8.70% to 9.02%) were positive for anti-HCV. Anti-HCV prevalence varied by age with the oldest age group (>55 year olds) having a prevalence of 16.46% (95% CIs: 16.14% to 16.80%) and the youngest age group (<25 year olds) having a prevalence of 2.20% (95% CIs: 1.93% to 2.50%) (crude OR=8.78). After adjustment for covariates, an association remained between anti-HCV prevalence and age (p<0.001), province (p<0.001) and socioeconomic status (p<0.001). Of the 3771 anti-HCV-positive individuals who had an available HCV RNA VL result, 2099 (55.66%, 95% CI: 54.06% to 57.25%) had a detectable HCV RNA VL. Age was also associated with HCV viraemia (p<0.001).ConclusionResults suggest that over 55% of individuals who screened positive for HCV-antibodies were chronically infected. Targeted screening for HCV among older individuals is recommended, given the association between age and infection. Further geographical hotspots of HCV infection can also inform targeted screening as Rwanda moves towards HCV elimination.

scholarly journals Hepatitis C virus cascade of care in the general population, in people with diabetes, and in substance use disorder patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Olivera Djuric ◽  
Marco Massari ◽  
Marta Ottone ◽  
Giorgia Collini ◽  
Pamela Mancuso ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
General Population ◽  
Direct Method ◽  
Reggio Emilia ◽  
Reproductive Age ◽  
Hcv Rna ◽  
Cross Sectional ◽  
Cascade Of Care ◽  
Hcv Testing

Abstract Background The aim was to evaluate the hepatitis C virus (HCV) cascade of care in the general population (GP) and in two high-risk populations: patients with diabetes mellitus (DM) and substance users (AS) in treatment in Reggio Emilia Province, Italy. Methods A population-based cross-sectional study was conducted that included 534,476 residents of the Reggio Emilia Province, of whom 32,800 were DM patients and 2726 AS patients. Age-adjusted prevalence was calculated using the direct method of adjustment based on the age-specific structure of EU population. Results The prevalence of HCV testing was 11.5%, 13.8%, and 47.8% in GP, DM, and AS patients respectively, while HCV prevalence was 6.5/1000, 12.6/1000, and 167/1000, respectively. The prevalence of HCV RNA positivity was 4.4/1000, 8.7/1000, and 114/1000 in the three populations, respectively. The rates of HCV RNA-positive individuals not linked to care were 27.9%, 27.3%, and 26% in GP, DM, and AS patients, respectively, while the rates of those cured or cleared were 70.9%, 71%, and 69.9%, respectively. The prevalence of HCV testing was higher for females of reproductive age than for males the same age: 218.4/1000 vs. 74.0/1000, respectively. While more foreigners than Italians underwent the HCV test and were HCV positive, fewer foreigners than Italians received HCV treatment and were cured. Conclusions The low HCV testing and linkage to care rates remain an important gap in the HCV cascade of care in Northern Italy. The prevalence of cured/cleared residents remains lower among foreigners than among Italians.

scholarly journals CORRELATION OF VIROLOGICAL AND CLINICAL PROFILE OF PATIENTS WITH CHRONIC HEPATITIS B & C CO-INFECTION

1969 ◽  
Vol 4 (1) ◽  
pp. 463-468
Author(s):  
JAVED IQBAL FAROOQI ◽  
RUKHSANAJAVED FAROOQI ◽  
RIAZMUHAMMAD ◽  
ZAFAR ALI ◽  
ABDURREHMAN ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Abdominal Ultrasound ◽  
Cross Sectional Study ◽  
Clinical Profile ◽  
Hcv Rna ◽  
Cross Sectional

Background: Both HBV super-infection in patients with chronic hepatitis C and HCV super-infectionin patients with chronic hepatitis B have been reported. In case of co-infection, hepatitis B and C interactwith each other and affect immune responses resulting in active HCV with inactive HBV, active HBVwith inactive HCV, both active and both inactive. The objective of our study was to find out andcorrelate the virological and clinical profile in our patients with chronic hepatitis B and C co-infection.Material and Methods: This observational, descriptive and cross-sectional study was conducted atMedical ‘A’ Ward, PGMI, LRH Peshawar and Author’s Private Hepatology Clinic, from July 2010 toJune 2014. All patients with HBsAg and Anti-HCV Reactive by ELISA for more than six months wereincluded in the study. Following investigations were carried out in these patients: Serum ALT, HBeAg,anti-HBe, HBV DNA PCR, HCV RNA PCR, and abdominal ultrasound. Data was entered and analyzedusing SPSS version 16.0.Results: A total of 130 patients were included in the analysis, out of which 81 (62.3%) were males.Mean age of patients was 40.52±14.27 years. Majority of patients belonged to age-group of 21-30 years.Mean serum ALT of patients was 83.69±60.48 U/L. Majority of patients belonged to ALT-Group of 41-80 U/L. Hepatitis C Virus was the dominant virus in 53% of patients. Chronic Hepatitis was thedominant clinical profile in 73% of patients.Conclusion: Hepatitis C Virus is the dominant virus in our patients with BC co-infection. There is nostatistically significant association between virological and clinical profile of these patients.Key Words: Hepatitis B Virus, Hepatitis C Virus, BC Co-infection, Chronic Hepatitis, Cirrhosis,Hepatocellular Carcinoma

scholarly journals Prevalence of Hepatitis B and Hepatitis C Virus in Rahim Yar Khan; A Hospital Based Study.

2020 ◽  
Vol 27 (10) ◽  
pp. 2129-2132
Author(s):  
Muhammad Zubair ◽  
Mohsin Ur Rashid ◽  
Muhammad Azam ◽  
Hassan Tariq ◽  
Syed Salman Ali ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
General Population ◽  
Hepatitis B ◽  
Early Diagnosis ◽  
Observational Study ◽  
Military Hospital ◽  
Cross Sectional ◽  
High Prevalence ◽  
Study Setting

Objectives: This study was performed to determine the prevalence of Hepatitis B and C virus in general population of Rahim Yar Khan. Study Design: Cross Sectional and Observational study. Setting: Combined Military Hospital Rahim Yar Khan. Period: 1st Jan 2018 to 30th June 2019. Material & Methods: Patients of both genders and all ages were included in the study. HBV and HCV were analysed using Kit method and positive cases confirmed by ELISA. Results: A total number of 4635 people were screened for Hepatitis B, and C. Among 2325 individuals screened for HCV, 365 (15.6%) were positive for Anti HCV. Among 2310 individuals screened for HBV, 82 (3.5%) were found positive. Positive cases were later confirmed by ELISA. Conclusion: High prevalence of HBV and HCV in this area warrants serious efforts to prevent the spread of these viruses. Screening facilities should be provided at community level to assess the real burden and for early diagnosis and prevention of complications.

scholarly journals A comparison of two biological markers of recent hepatitis C virus (HCV) infection: implications for the monitoring of interventions and strategies to reduce HCV transmission among people who inject drugs

2018 ◽  
Vol 23 (47) ◽  
Author(s):  
Vivian D Hope ◽  
Ross J Harris ◽  
Peter Vickerman ◽  
Lucy Platt ◽  
Justin Shute ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Biological Markers ◽  
People Who Inject Drugs ◽  
Credible Interval ◽  
Accurate Estimate ◽  
Hcv Rna ◽  
Recent Infection ◽  
Cross Sectional ◽  
Hcv Transmission

Background Monitoring hepatitis C virus (HCV) incidence is important for assessing intervention impact. Longitudinal studies of people who inject drugs (PWID), using repeated biological tests, are costly; alternatively, incidence can be estimated using biological markers of recent infection in cross-sectional studies. Aim We aimed to compare incidence estimates obtained from two different biological markers of recent infection in a cross-sectional study to inform monitoring approaches for HCV elimination strategies. Method Samples from an unlinked anonymous bio-behavioural survey of PWID were tested for two recent infection markers: HCV RNA with anti-HCV negative (‘RNA’) and low-avidity anti-HCV with HCV RNA present (‘avidity’). These two markers were used separately and in combination to estimate HCV incidence. Results Between 2011 and 2013, 2,816 anti-HIV-negative PWID (25% female) who had injected during the preceding year were either HCV-negative or had one of the two markers of recent infection: 57 (2.0%) had the RNA marker and 90 (3.2%) the avidity marker. The two markers had similar distributions of risk and demographic factors. Pooled estimated incidence was 12.3 per 100 person-years (pyrs) (95% credible interval: 8.8–17.0) and not significantly different to avidity-only (p = 0.865) and RNA-only (p = 0.691) estimates. However, the RNA marker is limited by its short duration before anti-HCV seroconversion and the avidity marker by uncertainty around its duration. Conclusion Both markers have utility in monitoring HCV incidence among PWID. When HCV transmission is high, one marker may provide an accurate estimate of incidence; when it is low or decreasing, a combination may be required.

scholarly journals Hepatitis C Virus Infection in Indigenous Populations in the United States and Canada

2019 ◽  
Vol 41 (1) ◽  
pp. 158-167 ◽  
Author(s):  
Veronica Bruce ◽  
Jonathan Eldredge ◽  
Yuridia Leyva ◽  
Jorge Mera ◽  
Kevin English ◽  
...  
Keyword(s):  
United States ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
General Population ◽  
Indigenous People ◽  
Aboriginal People ◽  
The United States ◽  
Indigenous Populations ◽  
Hcv Prevalence ◽  
Wide Range

Abstract American Indian/Alaska Native (AI/AN) and Canadian Indigenous people are disproportionally affected by hepatitis C virus (HCV) infection yet are frequently underrepresented in epidemiologic studies and surveys often used to inform public health efforts. We performed a systematic review of published and unpublished literature and summarized our findings on HCV prevalence in these Indigenous populations. We found a disparity of epidemiologic literature of HCV prevalence among AI/AN in the United States and Indigenous people in Canada. The limited data available, which date from 1995, demonstrate a wide range of HCV prevalence in AI/AN (1.49%–67.60%) and Indigenous populations (2.28%–90.24%). The highest HCV prevalence in both countries was reported in studies that either included or specifically targeted people who inject drugs. Lower prevalence was reported in studies of general Indigenous populations, although in Canada, the lowest prevalence was up to 3-fold higher in Aboriginal people compared with general population estimates. The disparity of available data on HCV prevalence and need for consistent and enhanced HCV surveillance and reporting among Indigenous people are highlighted. HCV affects Indigenous peoples to a greater degree than the general population; thus we recommend tribal and community leaders be engaged in enhanced surveillance efforts and that funds benefitting all Indigenous persons be expanded to help prevent and cover health care expenses to help stop this epidemic.

scholarly journals Change in hepatitis C virus positivity among needle-stick injury source patients: a 10-year experience in a Japanese tertiary hospital

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kazuya Okushin ◽  
Rie Suzuki ◽  
Takeya Tsutsumi ◽  
Koh Okamoto ◽  
Kazuhiko Ikeuchi ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Liver Diseases ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Hcv Rna ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Needle Stick

Abstract Background As a blood-borne pathogen, hepatitis C virus (HCV) has long been a major threat associated with needle-stick injuries (NSIs) mainly because no vaccine is available for HCV. Following an NSI, we usually test the source patient for HCV antibody (HCV-Ab). Since HCV-Ab positivity does not necessarily indicate current infection, HCV RNA is further examined in patients positive for HCV-Ab. Direct-acting antivirals (DAAs) have enabled us to treat most HCV-infected patients; therefore, we speculate that the rate of HCV RNA positivity among HCV-Ab-positive patients decreased after the emergence of DAAs. This cross-sectional study was performed to investigate the change in the actual HCV RNA positivity rate in source patients before and after the interferon (IFN)-free DAA era. Methods This was a cross-sectional study of NSI source patients at a tertiary academic hospital in Japan from 2009 to 2019. IFN-free DAA regimens were first introduced in Japan in 2014. Accordingly, we compared HCV status of NSI source patients that occurred between 2009 and 2014 (the era before IFN-free DAAs) with those that occurred between 2015 and 2019 (the era of IFN-free DAAs) in a tertiary care hospital in Japan. Results In total, 1435 NSIs occurred, and 150 HCV-Ab-positive patients were analyzed. The proportion of HCV RNA-positive patients significantly changed from 2009 through 2019 (p = 0.005, Cochran–Armitage test). Between 2009 and 2014, 102 source patients were HCV-Ab-positive, 78 of whom were also positive for HCV RNA (76.5%; 95%CI, 67.4–83.6%). Between 2015 and 2019, 48 patients were HCV-Ab-positive, 23 of whom were also positive for HCV RNA (47.9%; 95%CI, 34.5–61.7%; p = 0.0007 compared with 2009–2014). In the era of IFN-free DAAs, 9 of 23 HCV RNA-negative patients (39.1%) and 2 of 22 HCV RNA-positive patients (9.1%) were treated with an IFN-free combination of DAAs (p = 0.0351). Regarding the departments where NSIs occurred, HCV RNA-negative patients were predominant in departments not related to liver diseases in the era of IFN-free DAAs (p = 0.0078, compared with 2009–2014). Conclusions Actual HCV RNA positivity in source patients of NSIs decreased after the emergence of IFN-free DAAs. IFN-free DAAs might have contributed to this reduction, and HCV RNA-negative patients were predominant in departments not related to liver diseases in the era of IFN-free DAAs.

scholarly journals Seroprevalance of hepatitis-c infection in multi-transfused thalassemic children: study from a West Indian tertiary care center

2017 ◽  
Vol 4 (5) ◽  
pp. 1871 ◽  
Author(s):  
Sheesham Agrawal ◽  
Pawan Kumar Sulaniya ◽  
Kapil Garg ◽  
Ramesh Choudhary ◽  
Chandrakanta Sulaniya
Keyword(s):  
Hepatitis C Virus ◽  
Viral Load ◽  
Hepatitis C ◽  
Serum Ferritin ◽  
Tertiary Care ◽  
Antibody Detection ◽  
P Value ◽  
Hcv Rna ◽  
Age Group ◽  
Hcv Antibody

Background: To study the prevalence of hepatitis-C virus infection in multi-transfused thalassemic children and to correlate these patients with age, number of transfusion, serum ferritin levels and transaminases levels.Methods: This study was conducted in the Department of Pediatrics of a Teaching Institute of Rajasthan. It was a hospital based cross sectional study, conducted over a period of 12 months (April 2016- March 2017). Blood sample for Ant-HCV antibody detection was taken at time of follow-up visit in the subspeciality clinic. These samples were processed in central laboratory for hep-C antibody, serum ferritin and transaminases levels. Anti-HCV antibody detection was done by BI-DOT machine. HCV RNA PCR was done to access viral load in all positive cases.Results: A total of 300 patients were enrolled in the study. There were 219 (73%) males and 81 (27%) females. The mean age of the study group was 7.59±3.6 years (range 1.5-18years). At the time of our study 277 (92.4%) cases were on one or the other chelating agent whereas 23 (7.6%) cases were not taking any kind of chelation therapy. Out of 300 patients, 72(24%) cases tested positive for anti HCV antibody. Out of 72 patients only 36(12%) patients had detectable viral load in RNA PCR.  Mean age of the HCV positive cases (9.58±3.28) years was higher as compared to HCV negative cases (6.98±3.54). Maximum HCV positivity 20/38 (52.6%) was seen in 12-18 year age group; followed by 33/76 (43.4%) in 9-12yr age group. Significant association was observed between advancing age and prevalence of hepatitis C in thalassemia major patients (p=0.002). The number of blood transfusions received by anti-HCV positive children (Avg. Transfusion 185±98.40 ml/kg/year) was significantly higher than that by anti-HCV negative patients (Avg. Transfusion 102.8±71.20) (p value<0.001). Maximum HCV positive cases 33 (45.83%) had total transfusions >200 in a year followed by 15 (20.83%) cases with 151-200 transfusions (p<0.001).Conclusions: Despite ELISA screening of blood donors, our study demonstrated high (24%) prevalence of transfusion transmitted hepatitis-C virus in thalassemic children which increases with increasing number of transfusions, it also correlates with rising serum ferritin level and SGPT level. 

scholarly journals Prevalence of hepatitis C virus genotypes in HIV positive patients referring to the consultation center for behavioral diseases, Sanandaj, Iran

2020 ◽  
Author(s):  
Samira Amini ◽  
Mazaher Khodabandehloo
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Melting Curve ◽  
Hcv Infection ◽  
Hiv Positive ◽  
Melting Curve Analysis ◽  
Hcv Rna ◽  
Cross Sectional ◽  
Infected People ◽  
Hcv Antibody

Background and Objectives: Co-infection of hepatitis C virus (HCV) with human immunodeficiency virus (HIV) is in- creasing due to similar transmission pathways. Chronic HCV infection is the most common complication among HIV-infect- ed individuals. Information on the frequency of HCV infection on Iranian HIV-infected individuals is scarce. The aim of this study was the detection of HCV prevalence and genotypes among HIV-infected people in Sanandaj, Iran. Materials and Methods: In this cross-sectional study, whole blood samples were taken from 185 HIV positive individuals referring to Consultation Center for Behavioral Diseases, Sanandaj, Iran. The ELISA test was done on samples for anti-HCV antibodies. RNA was extracted from only anti-HCV antibody positive samples. An RT-PCR test was conducted to detect HCV RNA. Genotypes of HCV were detected by melting curve analysis by specific primers and probes. Test results and demographic information were analyzed by SPSS software. Results: The mean age of individuals was 39.3 ± 9.4 years. Out of 185 individuals 99 (53.5%) were positive for anti-HCV antibodies. Out of 99 antibody positive individuals, 44 had HCV RNA. Among 44 RNA positive individuals, genotypes and subtypes of HCV were as 26 (59.1%) 1a, 17 (38.6%) 3a and one (2.2%) 4. There was a significant association between an- ti-HCV antibody and demographic variables including, age, gender, occupation, and CD4+ T-cell count (p = 0.0001). Conclusion: The present study reveals that HIV/HCV co-infection is high in the study population. It is recommended similar studies should be done in other HIV infected populations for management of HIV/HCV co-infection

scholarly journals Trends in drug consumption and risk of transmission of HIV and hepatitis C virus among injecting drug users in Switzerland, 1993-2006

2008 ◽  
Vol 13 (21) ◽  
Author(s):  
F Dubois-Arber ◽  
H Balthasar ◽  
T Huissoud ◽  
F Zobel ◽  
S Arnaud ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Drug Users ◽  
Risk Behaviour ◽  
Social Situation ◽  
Drug Consumption ◽  
Cross Sectional ◽  
Hcv Prevalence ◽  
Behavioural Surveillance ◽  
Preventive Behaviour

As a part of the HIV behavioural surveillance system in Switzerland, repeated cross-sectional surveys were conducted in 1993, 1994, 1996, 2000 and 2006 among attenders of all low threshold facilities (LTFs) with needle exchange programmes and/or supervised drug consumption rooms for injection or inhalation in Switzerland. Data were collected in each LTF over five consecutive days, using a questionnaire that was partly completed by an interviewer and partly self administered. The questionnaire was structured around three topics: socio-demographic characteristics, drug consumption, health and risk/preventive behaviour. Analysis was restricted to attenders who had injected drugs during their lifetime (IDUs). Between 1993 and 2006, the median age of IDUs rose by 10 years. IDUs are severely marginalised and their social situation has improved little. The borrowing of used injection equipment (syringe or needle already used by other person) in the last six months decreased (16.5% in 1993, 8.9% in 2006) but stayed stable at around 10% over the past three surveys. Other risk behaviour, such as sharing spoons, cotton or water, was reported more frequently, although also showed a decreasing trend. The reported prevalence of HIV remained fairly stable at around 10% between 1993 and 2006; reported levels of hepatitis C virus (HCV) prevalence were high (56.4% in 2006). In conclusion, the overall decrease in the practice of injection has reduced the potential for transmission of infections. However as HCV prevalence is high this is of particular concern, as the current behaviour of IDUs indicates a potential for further spreading of the infection. Another noteworthy trend is the significant decrease in condom use in the case of paid sex.

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