Long-Term Monitoring of Patients with Hematological Malignancies and Hepatitis B and Hepatitis C Virus Infections

Abstract INTRODUCTION. Patients (pts) with hematological malignancies are at high risk of infection by Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) due to multiple transfusions and the large number of invasive procedures. The aim of the study was to evaluate the presentation rate of clinical hepatitis, pt survival and how hepatitis infection influenced survival. RESULTS. The study group was comprised of all pts admitted to the hematology department from Feb 2004 to June 2006. The pts were followed until June 2008. All pts were monitored by testing of HBsAg, anti-HCV, DNA-HBV, RNA-HCV, HBeAg, anti-HBs, anti-HBc, anti-HBe approximately every 3 weeks. Liver biopsy was performed on 64 pts, 23 pts each with HBV and HCV immunohistology. A total of 7800 biological samples were collected for HBV and HCV testing; of these, 4000 were tested by PCR methods. Acute leukemias (AL) and aplastic anemias (AA) constituted 77% (205/265) of all pts. The median age was 38 years (range, 15 to 79), Male; 47% (n=125), female; 53% (n=140). Median transfusion load (the number of donors per pt for the study period) was 45 (range, 0 to 418). When patients new to the hematology dept were examined: HBV was detected in 15% (39/265) of new pts and HCV in 7% (19/265) of new pts respectively. We postulated that the rate of infection is extremely high in the hematology clinic. For the entire study period from Feb 2004 to Jun 2006, 51% (135/265) pts had positive markers for HBV infection, 19% (51/265) pts had positive markers for HCV, and 14% (37/265) pts had positive markers for both HBV+HCV. We have shown that up to 95% of HCV-positive pts and up to 60% of HBV-positive pts developed clinical and biochemical symptoms and signs of viral hepatitis with 3 years of initial detection of HBV and HCV markers. 154 (58%) pts survived, 111 (42%) pts died. Of these, 2 pts developed fulminant liver failure due to severe hepatitis B. The analysis of survival risk factors demonstrates that the expected life duration significantly decreases after HBV infection. For AL pts RR=1.8 (p=0,034), for AA pts RR=4.3 (p=0,022). There was no significant association between the expected life duration and HCV infection. Proportional hazard regression model with time dependent covariates (PHREG SAS) was used for the analysis. CONCLUSION. The majority of pts infected by HBV and HCV developed clinically recognizable viral hepatitis within 3 years from the first detection of viral markers. Pts with severe immunosupression often do not manifest obvious features of acute viral hepatitis. Pts with hematological malignances should be monitored regularly (at least once in a month) for HBV and HCV markers during all period of treatment and for 1–2 years after completion of therapy. Viral hepatitis B is a risk factor associated with survival risk factor for AL and AA pts.

Download Full-text

High prevalence of occult hepatitis C virus infection in patients with chronic hepatitis B virus infection

Journal of Medical Microbiology ◽

10.1099/jmm.0.058297-0 ◽

2013 ◽

Vol 62 (8) ◽

pp. 1235-1238 ◽

Cited By ~ 6

Author(s):

Inmaculada Castillo ◽

Javier Bartolomé ◽

Juan Antonio Quiroga ◽

Vicente Carreño

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Hepatitis B Virus ◽

Virus Infection ◽

Hepatitis B ◽

Hcv Infection ◽

Hbv Infection ◽

Chronic Hepatitis B Virus ◽

B Virus

Hepatitis C virus (HCV) infection in the absence of detectable antibodies against HCV and of viral RNA in serum is called occult HCV infection. Its prevalence and clinical significance in chronic hepatitis B virus (HBV) infection is unknown. HCV RNA was tested for in the liver samples of 52 patients with chronic HBV infection and 21 (40 %) of them were positive for viral RNA (occult HCV infection). Liver fibrosis was found more frequently and the fibrosis score was significantly higher in patients with occult HCV than in negative ones, suggesting that occult HCV infection may have an impact on the clinical course of HBV infection.

Download Full-text

Epidemiology of Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) Related Hepatocellular Carcinoma

The Open Virology Journal ◽

10.2174/1874357901812010026 ◽

2018 ◽

Vol 12 (1) ◽

pp. 26-32 ◽

Cited By ~ 66

Author(s):

Arnolfo Petruzziello

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Hbv Infection ◽

Sub Saharan Africa ◽

Liver Cancers ◽

B Virus

Introduction:Hepatocellular carcinoma (HCC) is one of the most prevalent primary malignant tumors and accounts for about 90% of all primary liver cancers. Its distribution varies greatly according to geographic location and it is more common in middle and low- income countries than in developed ones especially in Eastern Asia and Sub Saharan Africa (70% of all new HCCs worldwide), with incidence rates of over 20 per 100,000 individuals.Explanation:The most important risk factors for HCC are Hepatitis B Virus (HBV) infection, Hepatitis C Virus (HCV) infection, excessive consumption of alcohol and exposition to aflatoxin B1. Its geographic variability and heterogeneity have been widely associated with the different distribution of HBV and HCV infections worldwide.Chronic HBV infection is one of the leading risk factors for HCC globally accounting for at least 50% cases of primary liver tumors worldwide. Generally, while HBV is the main causative agent in the high incidence HCC areas, HCV is the major etiological factor in low incidence HCC areas, like Western Europe and North America.Conclusion:HBV-induced HCC is a complex, stepwise process that includes integration of HBV DNA into host DNA at multiple or single sites. On the contrary, the cancerogenesis mechanism of HCV is not completely known and it still remains controversial as to whether HCV itself plays a direct role in the development of tumorigenic progression.

Download Full-text

Seroprevalence and Knowledge of Viral Hepatitis and HIV Among People Who Use Drugs Attending Methadone Therapy Clinic in Tanzania: A Cross-sectional Study.

10.21203/rs.3.rs-116781/v1 ◽

2020 ◽

Author(s):

Semvua Kilonzo ◽

Daniel W. Gunda ◽

David C. Majinge ◽

Hyasinta Jaka ◽

Paulina M. Manyiri ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Viral Hepatitis ◽

Hepatitis B Surface Antigen ◽

People Who Use Drugs ◽

Infection Rates ◽

Cross Sectional ◽

B Virus

Abstract Background: Methadone therapy clinics have been recently introduced in Tanzania, aiming at reducing risk behaviors and infection rates of viral hepatitis and HIV among people who use drugs. The objective of this study was to estimate the prevalence, associated factors and knowledge level of these conditions among people who use drugs attending a methadone clinic in Tanzania.Methods: We enrolled 253 People who using drugs receiving Methadone therapy. Clinical data was retrospectively collected from the medical records and face-to face interviews were conducted to determine the behavioral risk factors and respondents’ knowledge on viral hepatitis and HIV.Results: An overall seroprevalence of viral hepatitis (either hepatitis B surface antigen or anti-hepatitis C virus) was 6.3%, while that of hepatitis B virus mono infection was 3.5% and anti-hepatitis C virus mono infection was 3.5%. Seroprevalence of HIV was 12.6%. Viral hepatitis was strongly predicted by advanced age (>35 years) (p=0.02) and staying at Kirumba area (p=0.004), and HIV infection was predicted by increased age (>37 years) (p=0.04) and female sex (p<0.001). Regarding the knowledge of viral hepatitis, majority of the respondents were unaware of the transmission methods and availability of hepatitis B virus vaccines and only 17% were classified as well informed (provided ≥ 4 correct answers out of 7 questions). Good knowledge was highly predicted by higher education level of the individual (p=0.001).Conclusions: Despite the efforts to curb viral hepatitis and HIV infections through Methadone clinics, infection rates among people who use drugs are still high and the general knowledge on preventive measures is inadequate.

Download Full-text

Search for intrafamilial transmission of hepatitis C virus in hemophilia patients

Blood ◽

10.1182/blood.v81.4.1077.bloodjournal8141077 ◽

1993 ◽

Vol 81 (4) ◽

pp. 1077-1082

Author(s):

SA Brackmann ◽

A Gerritzen ◽

J Oldenburg ◽

HH Brackmann ◽

KE Schneweis

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Hepatitis B ◽

Second Generation ◽

Family Members ◽

Sexual Partners ◽

Hbv Infection ◽

Intrafamilial Transmission ◽

Household Contacts ◽

Percent Positivity

This study was performed to determine the risk of family members of anti-hepatitis C virus (HCV)-positive hemophilia patients (index patients) for infection with HCV compared with the risk of acquiring hepatitis B virus (HBV), human immunodeficiency virus (HIV), and hepatitis A virus (HAV) infection. All index patients (n = 141) were found to be positive by first and second generation anti-HCV enzyme immunoassays (EIAs). Among their household contacts (n = 228), 224 were negative and 1 positive by both assays. Three contacts gave positive results in first generation anti-HCV EIA and negative results in second generation assay. This latter result was confirmed by further tests (neutralization test, synthetic peptides, and supplemental assay). Percent positivity for anti-HBc was about the same in non-sexual household contacts and sexual partners (13 of 109 [12%] and 7 of 54 [13%], respectively). Percent prevalence of anti-HBc was higher in contacts of index patients with chronic hepatitis B than in those of index patients who had recovered from that disease (6 of 20 [30%] and 14 of 133 [10%], respectively; P < .05). The HBV infection rate of contacts participating in controlled self-treatment was not higher than that of controls (3 of 57 [5%] and 10 of 98 [10%], respectively). Of 44 sexual partners, 5 (11%) were found to be positive for anti-HIV. Prevalence of anti-HAV matched with the age-related distribution in the German population. These findings suggest that intrafamilial transmission of HCV to family members of hemophilia patients is uncommon. In contacts of hemophilia patients, the risk of acquiring HBV infection seems to be as high in household contacts as in sexual contacts. Participation in controlled self-treatment does not appear to be an additional risk for HCV and HBV infection. There is no doubt that sexual transmission of HCV is less common than that of HBV and HIV.

Download Full-text

Seroprevalences of Hepatitis B Virus and Hepatitis C Virus among Participants of an Asian Health Fair in the Lower Mainland, British Columbia

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2015/278198 ◽

2015 ◽

Vol 26 (4) ◽

pp. 196-200 ◽

Cited By ~ 3

Author(s):

Stephen Ip ◽

Jo-Ann Ford ◽

Kirby Lau ◽

Vladimir Marquez ◽

Marisa Guan ◽

...

Keyword(s):

British Columbia ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Vaccination Status ◽

Hbv Infection ◽

Clinical Issue ◽

B Virus ◽

Health Fair

BACKGROUND: The seroprevalences of hepatitis B virus (HBV) and hepatitis C virus (HCV) are 0.4% and 0.8%, respectively, in Canada, but varying rates have been reported in different populations.OBJECTIVES: To determine the seroprevalences of HBV and HCV among attendees of an Asian health fair in the Lower Mainland, British Columbia, as well as to correlate questionnaire answers regarding vaccination status to serological profiles.METHODS: Attendees at an Asian health fair were invited to participate in the present study on a voluntary basis. They provided answers to a questionnaire including ethnicity and vaccination status. Blood was then drawn for HBV and HCV serology. Active HBV was defined as HBV surface antigen (HBsAg) positive while HCV seroprevalence was defined as HCV antibody reactive. Previous exposure to HBV was defined as HBV core antibody (anti-HBc) positive and HBsAg negative. Nonimmunity was defined as anti-HBc negative and HBV surface antibody negative. Only those with correct demographic information matched to serological results were included in the study.RESULTS: There were 192 consenting attendees of the fair, of whom 112 were included in the study. Of the participants, 91% were Chinese. Active HBV infection was found in three participants (2.7% [95% CI 0.6% to 7.6%]) and HCV infection was found in two participants (1.8% [95% CI 0.2% to 6.3%]). More than 40% of participants had been previously exposed to HBV (42% [95% CI 33% to 51%]). Almost 20% demonstrated nonimmunity to HBV (19% [95% CI 12% to 27%]). There was significant discordance when questionnaire answers regarding vaccination status were compared with serological profiles.CONCLUSION: The seroprevalences of HBV and HCV in this cohort were 2.7% and 1.8%, respectively – higher than nationally reported rates. Our results highlight that the lack of knowledge of HBV infection and vaccination status remains a significant clinical issue in the Asian community of British Columbia.

Download Full-text

Long-term outcome of hepatitis B and hepatitis C virus co-infection and single HBV infection acquired in youth

Journal of Medical Virology ◽

10.1002/jmv.21560 ◽

2009 ◽

Vol 81 (12) ◽

pp. 2012-2020 ◽

Cited By ~ 9

Author(s):

Rosa Zampino ◽

Aldo Marrone ◽

Antonietta Merola ◽

Barbara Trani ◽

Grazia Cirillo ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Hepatitis B ◽

Hbv Infection ◽

Term Outcome ◽

Long Term Outcome

Download Full-text

Hepatitis B and Hepatitis C Co-Infection in Patients with Hematological Malignancies

Blood ◽

10.1182/blood.v118.21.2090.2090 ◽

2011 ◽

Vol 118 (21) ◽

pp. 2090-2090

Author(s):

Tatyana Ts Garmaeva ◽

Sergey M. Kulikov ◽

Elena A Michailova ◽

Andrei B Sudarikov ◽

Felix P Filatov ◽

...

Keyword(s):

Hepatitis C ◽

Hepatitis B ◽

Incidence Rate ◽

Hematological Malignancies ◽

Conflicts Of Interest ◽

Early Recognition ◽

Clinical Signs ◽

Acute Leukemias ◽

Single Marker ◽

Hcv Coinfection

Abstract Abstract 2090 BACKGROUND. Coinfection with hepatitis B virus (HBV) and hepatitis C virus (HCV) in immunocompromised patients (pts) with hematological malignancies is not well-studied problem. Early recognition of HBV and HCV infectioning incidence in such pts is difficult due to influence of cytostatic and immunosuppressive therapy and possible mutual HBV or HCV inhibitions. Independence of HBV and HCV infection events has to be discussed. AIM. To determine the prevalence of HBV and HCV co-infection in pts with hematological malignancies to check the possible correlation between the incidence of the infections. PATIENTS AND METHODS. All 265 patients treated in hematology department during 2004–2006 years were prospectively continuously monitored and examined for markers HBV and HCV (HBsAg, anti-HCV, DNA HBV, RNA HCV, HBeAg, anti-HBs, anti-HBc, anti-HBe) in serum, plazma, blood cells, bone marrow, cerebrospinal fluid) and clinico-biochemical symptoms of liver dysfunction were registered approximately every 3 weeks until 2008 year. Liver biopsy was performed on 64 pts in 2004–2006 yy, 23 pts esch with HBV and HCV immunohistology. Approximately 80% of pts were with acute leukemias (AL) and aplastic anemias (AA). Male; 47% (n=125), female; 53% (n=140). The median age was 38 years (range, 15 to 79). RESULTS. At the beginning of treatment and monitoring 17 of 265 pts (6.4%) had positive markers of HCV and the number of pts with positive markers of HCV increased up to 70 (26%) to the end of monitoring, and for HBV markers increased from 23 pts (8.7%) to 174 pts (65.3%). We found, that many pts were co-infected with HBV and HCV, and their total number increased from 5 pts (1,9%) äî 37 pts (14%). Positive tests of HBV and HCV co-infection was found in 57 pts of 265, that is 32.8% of 174 HBV-positive pts and 81.4% of 70 HCV-positive pts, odds ratio (OR=2.9) (95%CI =1.5–5.7), xi square significance p=0.0012. More complicate longitude analysis did not show that the incidence rate of second infection is significantly higher than the first. That means that the correlation between first and second infections is still questionable. Coinfection with HBV and HCV resulted in clinical presentation of hepatitis B and/or hepatitis C in most cases and cumulative incidence rate rises up to 100% at 630 day after the first appearance of any positive marker. CONCLUSION. The high prevalence of HBV and HCV coinfection of pts with hematological malignancies is attributed to common risk factors for infection transmission after transfusions of blood components and parenteral medical procedures. For pts with hematological malignancies after first detection of positive test for single marker of HBV and/or HCV it is very reasonable to intensify the monitoring of HBV and HCV markers and to follow clinical signs. Disclosures: No relevant conflicts of interest to declare.

Download Full-text

Search for intrafamilial transmission of hepatitis C virus in hemophilia patients

Blood ◽

10.1182/blood.v81.4.1077.1077 ◽

1993 ◽

Vol 81 (4) ◽

pp. 1077-1082 ◽

Cited By ~ 29

Author(s):

SA Brackmann ◽

A Gerritzen ◽

J Oldenburg ◽

HH Brackmann ◽

KE Schneweis

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Hepatitis B ◽

Second Generation ◽

Family Members ◽

Sexual Partners ◽

Hbv Infection ◽

Intrafamilial Transmission ◽

Household Contacts ◽

Percent Positivity

Abstract This study was performed to determine the risk of family members of anti-hepatitis C virus (HCV)-positive hemophilia patients (index patients) for infection with HCV compared with the risk of acquiring hepatitis B virus (HBV), human immunodeficiency virus (HIV), and hepatitis A virus (HAV) infection. All index patients (n = 141) were found to be positive by first and second generation anti-HCV enzyme immunoassays (EIAs). Among their household contacts (n = 228), 224 were negative and 1 positive by both assays. Three contacts gave positive results in first generation anti-HCV EIA and negative results in second generation assay. This latter result was confirmed by further tests (neutralization test, synthetic peptides, and supplemental assay). Percent positivity for anti-HBc was about the same in non-sexual household contacts and sexual partners (13 of 109 [12%] and 7 of 54 [13%], respectively). Percent prevalence of anti-HBc was higher in contacts of index patients with chronic hepatitis B than in those of index patients who had recovered from that disease (6 of 20 [30%] and 14 of 133 [10%], respectively; P < .05). The HBV infection rate of contacts participating in controlled self-treatment was not higher than that of controls (3 of 57 [5%] and 10 of 98 [10%], respectively). Of 44 sexual partners, 5 (11%) were found to be positive for anti-HIV. Prevalence of anti-HAV matched with the age-related distribution in the German population. These findings suggest that intrafamilial transmission of HCV to family members of hemophilia patients is uncommon. In contacts of hemophilia patients, the risk of acquiring HBV infection seems to be as high in household contacts as in sexual contacts. Participation in controlled self-treatment does not appear to be an additional risk for HCV and HBV infection. There is no doubt that sexual transmission of HCV is less common than that of HBV and HIV.

Download Full-text

Hepatitis C Virus (HCV) and Hepatitis B Virus (HBV) Can Coinfect the Same Hepatocyte in the Liver of Patients with Chronic HCV and Occult HBV Infection

Journal of Virology ◽

10.1128/jvi.79.24.15578-15581.2005 ◽

2005 ◽

Vol 79 (24) ◽

pp. 15578-15581 ◽

Cited By ~ 37

Author(s):

E. Rodríguez-Íñigo ◽

J. Bartolomé ◽

N. Ortiz-Movilla ◽

C. Platero ◽

J. M. López-Alcorocho ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Hbv Infection ◽

Occult Hbv Infection ◽

Occult Hbv ◽

B Virus ◽

Chronic Hcv ◽

In Cells

ABSTRACT In this work, we have shown that hepatitis C virus (HCV) and hepatitis B virus (HBV) can coexist in the same hepatocyte using double fluorescent in situ hybridization in liver biopsy samples from patients with chronic HCV infection with occult HBV infection. Digital image analysis of hybridization signals showed that the HBV DNA levels in coinfected hepatocytes were lower than those in cells infected only with HBV. This finding supports the hypothesis of inhibition of HBV replication by HCV. Furthermore, HCV RNA levels were lower in coinfected cells than in cells infected only with HCV, suggesting that HBV may also inhibit HCV replication.

Download Full-text