Epidemiological, Clinical and Virological Characteristics of Patients with Hepatitis C in Morocco

Objectives: In Morocco, the exact and recent prevalence of Hepatitis C Virus (HCV) infection is not well-known, due to the lack of recent epidemiological studies of the general Moroccan population. The objective of this study was to determine the prevalence of HCV and to describe the epidemiological, clinical and virological characteristics of patients infected with HCV diagnosed at the Mohammed V Military Teaching Hospital in Rabat, Morocco. Methods: This was a prospective study, spread over a period of 3 years (April 2015 - April 2018). All patients with a positive anti-HCV serology were included in the study except those on hemodialysis. In addition to HCV serology, all patients included benefited from HIV serology as well as the Hbs antigen by a Chemiluminescent type Microparticle Immuno-Assay technique (Architect®, Abbott). RNA viral load and HCV genotyping was carried out using a real-time polymerase chain reaction. Results: We collected 14,944 samples, of which 269 had positive anti-HCV antibodies (1.8%). The average age of patients with positive HCV serology was 61 years, the sex ratio (Male/Female) was 1.4. Dental care was identified in 53% of the cases. Viral hepatitis C was identified in 82% of cases during a systematic check up. The main clinical signs reported in our series were asthenia (25% of cases) and subicterus (7% of cases). Conclusion and Implications for Translation: In Morocco, the exact prevalence of HCV infection is not well known, due to the lack of recent epidemiological studies of the general Moroccan population. Our study showed a prevalence of about 1.8% which is in accordance with the World Health Organization (WHO) estimation of between 1% and 2.49%.Our Epidemiological study provides important on the extent of the problem in Morocco, it raises the interest of mass screening and describes the populations at risk that will need to be identified as a priority. Key words: • Epidemiology • Diagnosis • Hepatitis C • Morocco • Risk factor • Military Hospital • Virology Copyright © 2020 Tagajdid et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Identification and treatment of viral hepatitis C in persons who use drugs: a prospective, multicenter outreach study in Flanders, Belgium

Harm Reduction Journal ◽

10.1186/s12954-021-00502-7 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Dana Busschots ◽

Cécile Kremer ◽

Rob Bielen ◽

Özgür Muhammet Koc ◽

Leen Heyens ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis C ◽

Mixed Model ◽

Linear Mixed Model ◽

Hcv Infection ◽

World Health ◽

Hcv Rna ◽

People Who Use Drugs ◽

Community Based ◽

Viral Hepatitis C

Abstract Background Targeted screening for hepatitis C viral (HCV) infection is not yet widely executed in Belgium. When performed in people who use drugs (PWUD), it is mainly focused on those receiving opiate agonist therapy (OAT). We wanted to reach out to a population of difficult to reach PWUD not on centralized OAT, using non-invasive screening as a bridge to re-integration in medical care supported by facilitated referral to a specialist. Methods This was a prospective, multicenter cohort study in PWUD not enrolled in a centralized OAT program in a community-based facility in Limburg or OAT program in a community-based facility in Antwerp, Belgium, from October 2018 until October 2019. Two study teams recruited participants using an outreach method at 18 different locations. Participants were tested for HCV antibodies (Ab) by finger prick, and risk factors were assessed through a face-to-face questionnaire. Univariate analyses were used to assess the association between HCV Ab and each risk factor separately. A generalized linear mixed model was used to investigate the association between the different risk factors and HCV. Results In total, 425 PWUD were reached with a mean age of 41.6 ± 10.8, and 78.8% (335/425) were men. HCV Ab prevalence was 14.8% (63/425). Fifty-six (88.9%) PWUD were referred, of whom 37 (66.1%) were linked to care and tested for HCV RNA. Twenty-nine (78.4%) had a chronic HCV infection. Treatment was initiated in 17 (58.6%) patients. The adjusted odds for HCV Ab were highest in those with unstable housing 6 months before inclusion (p < .001, AOR 8.2 CI 95% 3.2–23.3) and in those who had ever shared paraphernalia for intravenous drug use (p < .001, AOR 6.2 CI 95% 2.5–16.0). Conclusions An important part tested positive for HCV. Treatment could be started in more than half of the chronically infected referred and tested positive for HCV-RNA. Micro-elimination is necessary to achieve the World Health Organization goals by 2030. However, it remains crucial to screen and link a broader group of PWUD to care than to focus solely on those who inject drugs. Trial registration: clinicaltrials.gov NCT04363411, Registered 27 April 2020—Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT04363411?term=NCT04363411&draw=2&rank=1

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Hepatitis C Virus Prevalence and Risk Factors in a Village in Northeastern Romania—A Population-Based Screening—The First Step to Viral Micro-Elimination

Healthcare ◽

10.3390/healthcare9060651 ◽

2021 ◽

Vol 9 (6) ◽

pp. 651

Author(s):

Laura Huiban ◽

Carol Stanciu ◽

Cristina Maria Muzica ◽

Tudor Cuciureanu ◽

Stefan Chiriac ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Antiviral Treatment ◽

Population Based ◽

Hcv Infection ◽

World Health ◽

Hcv Rna ◽

Virus Eradication ◽

Tertiary Center

(1) Background: The World Health Organization adopted a strategy for the Global Health Sector on Viral Hepatitis in 2016, with the main objective of eliminating hepatitis C virus (HCV) by 2030. In this work, we aimed to evaluate the prevalence of HCV infection and risk factors in a Romanian village using population-based screening as part of the global C virus eradication program. (2) Methods: We conducted a prospective study from March 2019 to February 2020, based on a strategy as part of a project designed to educate, screen, treat and eliminate HCV infection in all adults in a village located in Northeastern Romania. (3) Results: In total, 3507 subjects were invited to be screened by rapid diagnostic orientation tests (RDOT). Overall, 2945 (84%) subjects were tested, out of whom 78 (2.64%) were found to have positive HCV antibodies and were scheduled for further evaluation in a tertiary center of gastroenterology/hepatology in order to be linked to care. In total, 66 (85%) subjects presented for evaluation and 55 (83%) had detectable HCV RNA. Of these, 54 (98%) completed antiviral treatment and 53 (99%) obtained a sustained virological response. (4) Conclusions: The elimination of hepatitis C worldwide has a higher chance of success if micro-elimination strategies based on mass screening are adopted.

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Evaluation of Cellular Proliferative Activity in Patients with Oral Lichen Planus and Hepatitis C through AgNOR Method

Brazilian Dental Journal ◽

10.1590/0103-6440201302379 ◽

2014 ◽

Vol 25 (6) ◽

pp. 461-465

Author(s):

João Paulo De Carli ◽

Soluete Oliveira da Silva ◽

Maria Salete Sandini Linden ◽

Carmen Silvia Busin ◽

Luiz Renato Paranhos ◽

...

Keyword(s):

Hepatitis C ◽

Lichen Planus ◽

Oral Mucosa ◽

Oral Lichen Planus ◽

Clinical Signs ◽

Hcv Infection ◽

Control Group ◽

Proliferative Potential ◽

Group 2 ◽

Oral Lichen

The objective of this study was to evaluate the cellular proliferative potential of oral lichen planus (OLP) lesions from patients without hepatitis C virus (HCV) by means of AgNOR method, as well as the cellular proliferative potential of the normal oral mucosa from patients with HCV, treated or untreated by interferon and ribavirin. A cross-sectional study was developed to investigate four groups: 10 HCV+ patients without clinical signs of OLP who had never been treated for HCV infection - Group 1; 10 HCV+ patients that were under interferon and ribavirin treatment - Group 2; 15 patients with reticular OLP lesions histopathologically confirmed, without HCV - Group 3; and 15 blood donors without HCV infection and no clinical signs of OLP GROUP 4 Control Group. The cytological material of all groups was collected by the liquid-based cytology technique. Then, the sedimented material from each patient was filled with the Nucleolar Organizer Regions impregnation by silver method (AgNOR). The count of NORs was performed on 100 epithelial cell nuclei per patient using the Image Tool(tm) software. The Tukey HSD test was used to compare the median value of NORs among the groups and showed that the oral mucosa of HCV+ patients previously treated with anti-HCV drugs (GROUP 2), presented a higher average number of NORs in relation to others (p<0.05). The anti-HCV treatment may be related to increased cell proliferation of oral mucosa, indicating a possible relationship between OLP and HCV+ patients treated with interferon and ribavirin.

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HCV Detection, Discrimination, and Genotyping Technologies

Sensors ◽

10.3390/s18103423 ◽

2018 ◽

Vol 18 (10) ◽

pp. 3423 ◽

Cited By ~ 7

Author(s):

Shrikant Warkad ◽

Satish Nimse ◽

Keum-Soo Song ◽

Taisun Kim

Keyword(s):

Hepatitis C ◽

Hcv Infection ◽

World Health ◽

Clinical Samples ◽

Infected People ◽

Advantages And Disadvantages ◽

Highly Sensitive ◽

The World ◽

Health Organization

According to the World Health Organization (WHO), 71 million people were living with Hepatitis C virus (HCV) infection worldwide in 2015. Each year, about 399,000 HCV-infected people succumb to cirrhosis, hepatocellular carcinoma, and liver failure. Therefore, screening of HCV infection with simple, rapid, but highly sensitive and specific methods can help to curb the global burden on HCV healthcare. Apart from the determination of viral load/viral clearance, the identification of specific HCV genotype is also critical for successful treatment of hepatitis C. This critical review focuses on the technologies used for the detection, discrimination, and genotyping of HCV in clinical samples. This article also focuses on advantages and disadvantages of the reported methods used for HCV detection, quantification, and genotyping.

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French hepatitis C care cascade: substantial impact of direct-acting antivirals, but the road to elimination is still long

BMC Infectious Diseases ◽

10.1186/s12879-020-05478-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Cécile Brouard ◽

Josiane Pillonel ◽

Marjorie Boussac ◽

Victor de Lédinghen ◽

Antoine Rachas ◽

...

Keyword(s):

Hepatitis C ◽

Antiviral Treatment ◽

Hcv Infection ◽

World Health ◽

Direct Acting Antivirals ◽

Substantial Impact ◽

Chronic Hcv Infection ◽

Chronic Hcv ◽

Direct Acting ◽

The Impact

Abstract Background Hepatitis C virus (HCV) elimination by 2030, as targeted by the World Health Organization (WHO), requires that 90% of people with chronic infection be diagnosed and 80% treated. We estimated the cascade of care (CoC) for chronic HCV infection in mainland France in 2011 and 2016, before and after the introduction of direct-acting antivirals (DAAs). Methods The numbers of people (1) with chronic HCV infection, (2) aware of their infection, (3) receiving care for HCV and (4) on antiviral treatment, were estimated for 2011 and 2016. Estimates for 1) and 2) were based on modelling studies for 2011 and on a virological sub-study nested in a national cross-sectional survey among the general population for 2016. Estimates for 3) and 4) were made using the National Health Data System. Results Between 2011 and 2016, the number of people with chronic HCV infection decreased by 31%, from 192,700 (95% Credibility interval: 150,900-246,100) to 133,500 (95% Confidence interval: 56,900-312,600). The proportion of people aware of their infection rose from 57.7 to 80.6%. The number of people receiving care for HCV increased by 22.5% (representing 25.7% of those infected in 2016), while the number of people on treatment increased by 24.6% (representing 12.1% of those infected in 2016). Conclusions This study suggests that DAAs substantially impact CoC. However, access to care and treatment for infected people remained insufficient in 2016. Updating CoC estimates will help to assess the impact of new measures implemented since 2016 as part of the goal to eliminate HCV.

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A Treatment-as-Prevention Trial to Eliminate Hepatitis C Among Men Who Have Sex With Men Living With Human Immunodeficiency Virus (HIV) in the Swiss HIV Cohort Study

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1124 ◽

2020 ◽

Cited By ~ 2

Author(s):

Dominique L Braun ◽

Benjamin Hampel ◽

Bruno Ledergerber ◽

Christina Grube ◽

Huyen Nguyen ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Cohort Study ◽

Hepatitis C ◽

Population Based ◽

Hcv Infection ◽

World Health ◽

Treatment As Prevention ◽

Hcv Rna ◽

Immunodeficiency Virus ◽

Sex With Men

Abstract Background In 2016, the World Health Organization (WHO) introduced global targets for the elimination of hepatitis C virus (HCV) by 2030. We conducted a nationwide HCV micro-elimination program among men who have sex with men (MSM) living with human immunodeficiency virus (HIV) from the Swiss HIV Cohort Study (SHCS) to test whether the WHO goals are achievable in this population. Methods During phase A (10/2015–06/2016), we performed a population-based and systematic screening for HCV-RNA among MSM from the SHCS. During phase B (06/2016–02/2017) we offered treatment with HCV direct-acting antiviral (DAA) agents to MSM identified with a replicating HCV infection. During phase C (03/2017–11/2017), we offered rescreening to all MSM for HCV-RNA and initiated DAA treatment in MSM with replicating infections. Results We screened 3715/4640 (80%) MSM and identified 177 with replicating HCV infections (4.8%); 150 (85%) of whom started DAA treatment and 149 (99.3%) were cured. We rescreened 2930/3538 (83%) MSM with a prior negative HCV-RNA and identified 13 (0.4%) with a new HCV infection. At the end of the micro-elimination program, 176/190 MSM (93%) were cured, and the HCV incidence rate declined from .53 per 100 patient-years (95% CI, .35–.83) prior to the intervention to .12 (95% CI, .03–.49) by the end of 2019. Conclusions A systematic, population-based HCV micro-elimination program among MSM living with HIV was feasible and resulted in a strong decline in HCV incidence and prevalence. Our study can serve as a model for other countries aiming to achieve the WHO HCV elimination targets. Clinical Trials Registration NCT02785666.

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High Prevalence of Serum Cryoglobulins in Multitransfused Hemophilic Patients With Chronic Hepatitis C

Blood ◽

10.1182/blood.v92.2.516 ◽

1998 ◽

Vol 92 (2) ◽

pp. 516-519 ◽

Cited By ~ 15

Author(s):

E. Santagostino ◽

M. Colombo ◽

D. Cultraro ◽

M. Muça-Perja ◽

A. Gringeri ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Rheumatoid Factor ◽

Chronic Hepatitis C ◽

Systemic Vasculitis ◽

Clinical Signs ◽

Hcv Infection ◽

Hcv Rna ◽

Hybridization Technique ◽

Serum Samples

Abstract The prevalence, clinical relevance, and risk factors of serum cryoglobulins in hemophilic patients with chronic hepatitis C virus (HCV) infection are unknown. We studied 135 consecutive hemophilic patients (median age, 31 years; range, 10 to 69 years) with chronic hepatitis C, exposed to the virus for 10 to 41 years. A total of 67 patients were coinfected with the human immunodeficiency virus (HIV), and 3 (2%) had signs of cirrhosis. Serum samples were tested for the presence of cryoglobulins, hepatitis B virus (HBV) markers, including HBV-DNA by hybridization assay, and antibody to HCV by enzyme immunoassay (EIA). Serum HCV-RNA was tested by polymerase chain reaction and typed with a hybridization technique. Samples were also tested for antitissue antibodies, immunoglobulins, rheumatoid factor, and C3 and C4 proteins of complement. Forty-two hemophiliacs (31%) circulated cryoglobulins (median levels, 166 mg/L; range, 66 to 480) predominantly type III (62%; and 29% type II). None of the patients had clinical signs or symptoms of systemic vasculitis. Cryoglobulinemic patients had more often serum HCV-RNA (95% v 80%, P < .05), rheumatoid factor (20% v 6%, P < .05), higher levels of IgG (2,354 ± 682 mg/dL v 1,928 ± 557 mg/dL,P < .0005) and IgM (323 ± 226 mg/dL v 244 ± 243 mg/dL, P < .05), and lower levels of serum C4 (19 ± 8 mg/dL v 24 ± 8 mg/dL, P < .05) than patients without cryoglobulins. The risk of producing cryoglobulins was greater for 114 patients circulating HCV-RNA than for 21 nonviremic patients (odds ratio [OR] = 4.9, 95% confidence interval [CI] = 1.1 to 22.0) and for the 31 patients with longer exposure to HCV (more than 26 years) than for the 24 patients with shorter (17 years or less) exposure (OR = 4.4 95% CI = 1.1 to 18.0). In conclusion a large number of multitransfused hemophiliacs with chronic HCV infection circulated serum cryoglobulins but none had clinical signs or symptoms of vasculitis. The risk of developing cryoglobulins parallels the duration of exposure to HCV.

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Worldwide prevalence, genotype distribution and management of hepatitis C

Acta Gastro Enterologica Belgica ◽

10.51821/84.4.015 ◽

2021 ◽

Vol 84 (4) ◽

pp. 633-652

Author(s):

P Guntipalli ◽

R Pakala ◽

S Kumari Gara ◽

F Ahmed ◽

A Bhatnagar ◽

...

Keyword(s):

Public Health ◽

Hepatitis C ◽

Geographic Origin ◽

Global Strategy ◽

Hcv Infection ◽

Transmission Risk ◽

World Health ◽

Risk Category ◽

Genotype Distribution ◽

The Impact

Hepatitis C virus (HCV) is one of the leading causes of chronic liver disease, cirrhosis, and hepatocellular carcinoma, resulting in major global public health concerns. The HCV infection is unevenly distributed worldwide, with variations in prevalence across and within countries. The studies on molecular epidemiology conducted in several countries provide an essential supplement for a comprehensive knowledge of HCV epidemiology, genotypes, and subtypes, along with providing information on the impact of current and earlier migratory flows. HCV is phylogenetically classified into 8 major genotypes and 57 subtypes. HCV genotype and subtype distribution differ according to geographic origin and transmission risk category. Unless people with HCV infection are detected and treated appropriately, the number of deaths due to the disease will continue to increase. In 2015, 1.75 million new viral infections were mostly due to unsafe healthcare procedures and drug use injections. In the same year, access to direct-acting antivirals was challenging and varied in developing and developed countries, affecting HCV cure rates based on their availability. The World Health Assembly, in 2016, approved a global strategy to achieve the elimination of the HCV public health threat by 2030 (by reducing new infections by 90% and deaths by 65%). Globally, countries are implementing policies and measures to eliminate HCV risk based on their distribution of genotypes and prevalence.

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Perinatal viral hepatitis C and performance capabilities for its therapy

Epidemiology and Infectious Diseases (Russian Journal) ◽

10.17816/eid40803 ◽

2014 ◽

Vol 19 (3) ◽

pp. 4-8

Author(s):

L. G Goryacheva ◽

N. V Rogozina ◽

V. A Greshnyakova ◽

V. V Ivanova

Keyword(s):

Hepatitis C ◽

Clinical Symptoms ◽

Antiviral Drug ◽

Sustained Viral Response ◽

Hcv Infection ◽

Control Group ◽

Viral Hepatitis C ◽

Significant Difference ◽

And Performance ◽

Biochemical Indices

The aim of the study: to establish the rate of the vertical transmission of HCV infection and justify the usefulness of the drug a-IFN2b (Viferon®) in children with perinatal infection with hepatitis C virus (HCV) at the early stages of the disease. There were examined 465 children aged 2.5 months to 3 years old (at the time of the enrollment in the study), born to mothers with HCV infection and the frequency of transmission from mother to child was established to be is 7.1% (33 cases). In 54.5% the genotype 1b was recorded, in 3% - 1a, and in 6.0 % - 2 genotype. Viferon® drug in doses of 3х10 6IU/m 2 was introduced to 17 infants aged from 3 to 12 months (duration of the course: 6 months in cases with 3, 2 genotype and 12 months - in patients with genotype 1). The efficacy of therapy was 58.8 % (RNA HCV (-) 10 cases. In prescription the drug to children under 6 months the efficacy was 62.5%, under 6-12 months - 44.4%. In the control group (16patients) spontaneous viral clearance was established to be in 18.7% of cases. The medication did not cause adverse effects and was well tolerated by children. In none out of the 17 children treated with the drug Viferon®, we have not reported adverse events (clinical symptoms, abnormalities in the hemogram and biochemical indices). The obtained data confirm the expediency of the early use of antiviral drug Viferon® in the treatment of children with perinatal HCV. Nо significant difference in the efficacy of therapy in different genotypes of the virus was identified. Virtually in all children (9 out of 10 children) responded to Viferon® therapy, there was noted Sustained Viral Response

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The cardiovascular complications in COVID-19 infection: Focus on acute cardiac injury

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.3.4063 ◽

2021 ◽

Vol 37 (3) ◽

Author(s):

Sahrai Saeed ◽

Ronak Rajani

Keyword(s):

Virus Disease ◽

Severe Disease ◽

Cardiac Injury ◽

Case Fatality ◽

Epidemiological Studies ◽

Cardiovascular Complications ◽

World Health ◽

Creative Commons ◽

Obesity And Diabetes ◽

Infection Focus

At the end of 2019 a novel coronavirus was identified in Wuhan, China. The disease caused by the severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) was designated COVID-19 (corona virus disease 2019) by the World Health Organization in early 2020. Up to 80% of patients with COVID-19 experience mild symptoms with severe or critical disease occurring in the remaining 20%. Severe disease is manifested by the development of pneumonia, hypoxia and radiographic lung involvement while critical disease indicates multiorgan involvement with significant respiratory or cardiac compromise. The current estimated case fatality rate from COVID-19 is approximately 1%. Epidemiological studies have shown that advanced age, male gender, previous chronic lung disease, cardiovascular and kidney disease, obesity and diabetes are risk factors for the severity of disease course. In the current focused review, we present an overview of the acute cardiovascular complications of COVID-19, their detection and impact upon prognosis. doi: https://doi.org/10.12669/pjms.37.3.4063 How to cite this:Saeed S, Rajani R. The cardiovascular complications in COVID-19 infection: Focus on acute cardiac injury. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.4063 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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