Universal blood-borne virus screening in patients with severe mental illness managed in an outpatient clozapine clinic: uptake and prevalence

Objective: Patients with a severe mental illness have higher rates of infection with blood-borne viruses (BBVs) but are less likely to access testing and treatment. Enhanced testing of this population is therefore warranted. Methods: In this single centre, prospective study, we sought to offer testing for BBVs to all patients who attended an appointment in the clozapine clinic (CC) over a six-month period. Those who consented were tested for HIV antigen/antibody, hepatitis C virus (HCV) antibody and hepatitis B virus surface antigen (HBsAg). Results: During the study period, 192 patients attended an appointment, of which 164 were offered testing. Of those, 134 (81.7%) accepted and 30 declined. Among patients who agreed to be tested, results were returned for 96 (71.6%). There were no positive results for HBsAg or HIV. Seven patients (7.2%) were positive for HCV antibody. Of those, three were newly identified exposures of which two were found to be chronically infected and were referred for treatment. Conclusion: A routine offer of BBV testing for people with severe mental illness in the outpatient setting is feasible and may detect treatable infections.

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Universal HIV and Birth Cohort HCV Screening in San Diego Emergency Departments

Scientific Reports ◽

10.1038/s41598-019-51128-6 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 3

Author(s):

Martin Hoenigl ◽

Kushagra Mathur ◽

Jill Blumenthal ◽

Jesse Brennan ◽

Miriam Zuazo ◽

...

Keyword(s):

Emergency Departments ◽

San Diego ◽

Hiv Infections ◽

Hcv Rna ◽

Newly Diagnosed ◽

Opt Out ◽

Hiv Antigen ◽

Hcv Antibody ◽

Hcv Screening ◽

Antigen Antibody

Abstract Universal HIV and HCV screening in emergency departments (ED) can reach populations who are less likely to get tested otherwise. The objective of this analysis was to evaluate universal opt-out HIV and HCV screening in two EDs in San Diego. HIV screening for persons aged 13–64 years (excluding persons known to be HIV+ or reporting HIV testing within last 12 months) was implemented using a 4th generation HIV antigen/antibody assay; HCV screening was offered to persons born between 1945 and 1965. Over a period of 16 months, 12,575 individuals were tested for HIV, resulting in 33 (0.26%) new HIV diagnoses, of whom 30 (90%) were successfully linked to care. Universal screening also identified 74 out-of-care for >12-months HIV+ individuals of whom 50 (68%) were successfully relinked to care. Over a one-month period, HCV antibody tests were conducted in 905 individuals with a seropositivity rate of 9.9% (90/905); 61 seropositives who were newly identified or never treated for HCV had HCV RNA testing, of which 31 (51%) resulted positive (3.4% of all participants, including 18 newly identified RNA positives representing 2% of all participants), and 13/31 individuals (42%) were linked to care. The rate of newly diagnosed HCV infections exceeded the rate of newly diagnosed HIV infections by >7-fold, underlining the importance of HCV screening in EDs.

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Hepatitis B Immunoglobulin Inhibits The Secretion of HBV Via Antigen-Antibody Precipitation in The Multivesicular Body

10.21203/rs.3.rs-1129983/v1 ◽

2021 ◽

Author(s):

Kyung Chul Yoon ◽

Sooin Seo ◽

Kwang-Woong Lee ◽

Seung Cheol Oh ◽

Min Young Park ◽

...

Keyword(s):

Hepatitis B ◽

Cell Lines ◽

Culture Medium ◽

Multivesicular Body ◽

Virus Surface ◽

B Virus ◽

Main Action ◽

Hepatitis B Immunoglobulin ◽

Antigen Antibody ◽

Related Proteins

Abstract Although the main action of human hepatitis B immunoglobulin (HBIG) of neutralizing the hepatitis B virus surface antigen (HBsAg) in the serum is known, HBIG is known to be localized in the cell. However, the effect of intracellularly located HBIG is not well elucidated due to the low purity of conventional plasma-derived HBIG (cHBIG). We attempted to clarify the mechanism of action of internalized HBIG using recombinant HBIG (lenvervimab). We used HBsAg cell lines, non-HBsAg cell lines and human HBsAg-producing hepatocytes. Autophagosome lysis pathway related proteins and Rab5, calnexin, giantin, and Rab7 were used to localize HBsAg and anti-HBs-IgG in the cytoplasm with Western blot and confocal microscopy.Intracellular anti-HBs-IgG (lenvervimab and cHBIG) transported by Fc receptor-mediated endocytosis increased the autophagosomes, but there was no change in autolysis. HBsAg and anti-HBs-IgG precipitated in the cytoplasm and co-localized in the multivesicular body. HBsAg secretion in the culture medium was decreased after lenvervimab. Simultaneously, the amount of cellular HBsAg increased in the cell lines but decreased in the human hepatocytes. Furthermore, intracellular lenvervimab was not easily washed out only in the HBsAg cell lines.Lenvervimab decreases the secretion of HBsAg, and HBsAg-antibody precipitation in the multivesicular body might play an important role.

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Comparison of a Chemiluminescent Immunoassay with Two Microparticle Enzyme Immunoassays for Detection of Hepatitis B Virus Surface Antigen

Clinical and Diagnostic Laboratory Immunology ◽

10.1128/cdli.7.6.865-866.2000 ◽

2000 ◽

Vol 7 (6) ◽

pp. 865-866 ◽

Cited By ~ 9

Author(s):

Robert J. A. Diepersloot ◽

Yvonne van Zantvliet-van Oostrom ◽

Curt A. Gleaves

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Surface Antigen ◽

Comparative Evaluation ◽

Virus Surface ◽

Virus Surface Antigen ◽

B Virus ◽

Chemiluminescent Immunoassay ◽

Positive Results ◽

Additional Sample

ABSTRACT A comparative evaluation of the following commercial immunoassays for the detection of hepatitis B virus surface antigen (HBsAg) was performed: the Abbott AxSYM, Abbott IMx, and DPC IMMULITE assays. The specificity was 100% for all assays. Twelve samples were identified and were confirmed to be positive for HBsAg by all three methods. One additional sample was identified as reactive and was confirmed to be positive by the Abbott AxSYM assay only. Prior to confirmation testing the DPC IMMULITE assay produced significantly fewer false-positive results than the Abbott AxSYM assay (P < 0.05).

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Hepatitis B virus surface antigen (HBsAg) and antibody (anti-HBs) forming immune complexes in fulminant hepatitis

Revista da Sociedade Brasileira de Medicina Tropical ◽

10.1590/s0037-86821999000300012 ◽

1999 ◽

Vol 32 (3) ◽

pp. 295-297

Author(s):

Manoel C.P. Soares ◽

Gilberta Bensabath ◽

Paulo R.B. Cartágenes ◽

Max M. Alves ◽

Fernando A.A. Silveira ◽

...

Keyword(s):

Electron Microscopy ◽

Immune Complexes ◽

Fulminant Hepatitis ◽

Amazon Basin ◽

Serum Samples ◽

Virus Surface ◽

Transmission Electron ◽

B Virus ◽

Antigen Antibody ◽

Delta Virus

This paper reports an unusual pattern of serological HBV markers and the presence of HBsAg/anti-HBs immune complexes in serum samples from two patients with fulminant hepatitis from the Brazilian Western Amazon Basin. The diagnosis was made by both serologic tests and demonstration of antigen/antibody complexes by transmission electron microscopy. Concurrent Delta virus superinfection is also discussed.

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