[Comparison of the clinical performance of the ECLusys HBsAg II assay with the Lumipulse f and HISCL 2000-i HBsAg screening assays].

Science.gov (United States)

Sugiura, Aya; Iwahara, Kunihiro; Suga, Yasuyuki; Uchiyama, Sachinori; Maekawa, Masato

2012-02-01

We compared the ECLusys HBsAgII (ECL HBsAg) assay to the Lumipulse Forte (LPf HBsAg) and HISCL (HIS HBsAg) assays. Measurement of dilution panels for which the WHO HBsAg international reference panel was the parent specimen revealed that the ECL and HIS assays enabled detection to a theoretical level of 0.04 IU/mL, whereas the LPf assay enabled detection to a level of 0.08 IU/mL. In a specificity test using high RF positive specimens (n = 33), pregnancy specimens (n = 35), cytomegalovirus antibody positive specimens (n = 36), and high M protein positive specimens (n = 21) that were confirmed negative for HBsAg by the LPf assay, negative results were obtained for all specimens on the HIS assay, but the ECL assay yielded a positive result for one of the high RF positive specimens. This individual was suggested on further testing to be an HBV carrier who was strongly positive for HBc antibody. In HBsAg mutants detection test, the detection rate was 92.3% with the ECL assay and 69.2% with the HIS assay. In a correlation test using routinely collected clinical specimens (n = 155), including positive stock specimens, aside from the one case where the LPf assay gave a negative result but both the ECL and HIS assays gave positive results, all of the results were consistent for all specimens. The above results confirmed that the ECL assay is both highly sensitive and specific, and also enables a high rate of HBsAg mutant detection.

GAMBARAN ANTI HBc POSITIF PADA DONOR DARAH DENGAN HbsAG NEGATIF

Directory of Open Access Journals (Sweden)

Susila Sastri

2009-09-01

negatif dan antiHbc positif untuk memastikan darah donor tersebut tidak boleh ditransfusikan.Kata kunci: Skrining, HBV, HBsAg, Anti-HBc, donor darah  Abstract            HBsAg examination alone to screen for hepatitis B (HBV has not been able to guarantee freedom from HBV blood donor so that blood donors have not fulfilled the requirements to be transfused. Blood donors will be transfused donors should qualify them have never suffered from HBV. Screening of blood donors against HBV in the PMI only with HBsAg alone where the HBsAg test is negative at certain stages of HBV, in terms of donors suffering or recovering in HBV. Anti-HBc can provide information on HBV trip when combined with other HBV markers and anti-HBc last longer in the blood compared with other markers. HBsAg negative blood donors with anti-HBc positive than some previous research is still exist that contain HBV-DNA and can transmit HBV.Has done research on blood donors with anti-HBc test descriptively against HBsAg negative blood donors (n = 100 on the UTD PMI Branch of Padang in cross sectional study. Samples taken by proportional random sampling. Blood samples were HBsAg negative blood VDRL, HCV, HIV negative, all examined by the ELISA. The aim is to see the picture of positive anti-HBc in blood donors with HBsAg negative and look at the relationship between the index of HBsAg with anti-HBc index. Examination of anti-HBc by ELISA, equipment and reagents the same output. The results showed the frequency of positive anti-HBc in HBsAg negative blood donors by 27%, especially in men aged between 20-29 years (44.4%. There is a positive correlation between the index of negative HBsAg with anti-HBc index (r = 0.02. Anti-HBc positive are found in HBsAg negative index of 0.21 to 0.60 (76%. In conclusion, blood donors with negative HBsAg have been considered safe for transfusion is still likely to transmit HBV proven by the discovery of anti-HBc positive. Because it needs a further examination of HBV

Frequency of anti-HCV, Hbsag and related risk factors in pregnant women at Nishtar Hospital, Multan

International Nuclear Information System (INIS)

Taseer, I.H.; Ishaq, F.; Hussain, L.; Safdar, S.; Mirbahar, A.M.; Faiz, S.A.

2010-01-01

Background: Viral hepatitis is a global issue. Among the hepatitis viruses hepatitis B and C are important in South Asia including Pakistan. There are various modes of transmission of these viruses. Vertical transmission is also gaining importance. Antepartum screening for HBV and HCV would help the infected women for appropriate antiviral therapy at appropriate time as well as for taking proper care of the newborns. The present study was designed to see the frequency of HBsAg and anti-HCV in pregnant women at Nishtar Hospital, Multan. Methods: This was a cross-sectional study carried out using non-probability purposive sampling technique. The period of the study was from June 2006 to August 2007. Five hundred (500) pregnant women attending outpatient department of Gynaecology and Obstetrics were included. Informed consent was taken. A specially designed proforma was filled in. Anti-HCV and HBsAg were tested by device method. Data were analyzed on SPSS-11. Results: Out of 500 pregnant women 35 (7.00%) were found to be anti-HCV positive and 23 (4.60%) were positive for HBsAg. Mean age was 26.7+-4.8 years. Majority of the patients 263 (52.60%) were in the age group 26-35 years. 138 (27.60%) women were nulliparous and 282 (56.40%) were para 1-4 and anti-HCV and HBsAg were common in this parity group. Only 80 (16.00%) women were para 5 or more. All anti-HCV and HBsAg positive women were house-wives. Most of them were belonging to rural areas having poor socio-economic status. Among 35 anti-HCV positive women, 20 (57.14%) had history of previous surgery, while 13 (37.14%) had history of multiple injections, 5 (14.28%) received blood transfusion, 4 (11.42%) had ear/nose piercing while tattooing was seen in only 2 (5.71%). Among 23 HBsAg positive women, 10 (43.47%) had history of previous surgery. History of multiple injections was present in 6 (26.08%) patients, 4 (17.39%) patients had history of blood transfusion, tattooing, ear/nose piercing, history of dental

Hepatitis B Virus Infection and Anti-HBc (Total Positivity in CKD Patients before Dialysis

Directory of Open Access Journals (Sweden)

Fareha Jesmin Rabbi

2016-09-01

Full Text Available Background: CKD patients are associated with HBV infection both as a cause and complication of treatment. CKD patients before starting dialysis therapy are considered as a high risk group because of impaired immune response compared with healthy individuals and also other risk factors related with treatment and management. Only HBsAg marker does not always follow the presence or absence of HBV infection. Anti-HBc (total alone positivity indicates previous exposure to HBV infection, window period and even after reactivation of resolved HBV infection. In some cases only anti-HBc positivity is interpreted as possible chronic low dose HBV infection (chronic carriage. Predialytic CKD patients were tested with three serological markers [HBsAg, anti-HBc (total and anti-HBs] for screening HBV infection. Proper diagnosis before dialysis and knowing the infection status would help both the patient and doctor to choose proper treatment approach. Objective: This cross-sectional study was done in the CKD patients before starting dialysis therapy to find out the HBV infection and to evaluate the infection by minimal serological markers as for screening. Materials and Methods: A total of 211 patients with chronic kidney disease stage five (CKD-V before starting dialysis therapy were included as subjects of this cross-sectional study. Among the CKD patients HBsAg was tested to see the prevalence. Other serological markers, i.e., anti-HBc (total and anti-HBs were tested in combination with HBsAg in 89 randomly selected patients among the subjects. The patients were also tested for anti-HCV to assess co-infection. After collecting all the data of different test results analyses were done by SPSS version 15.0. Results: Among total study population 10 (4.7% patients were found HBsAg positive. No patient was found positive for both HBsAg and anti-HCV. Among the 89 CKD patients only 2 (2.2% patients were HBsAg positive, and only one patient (0.9% was found positive

Low occurrence of HBsAg but high frequency of transient occult HBV infection in vaccinated and HBIG-administered infants born to HBsAg positive mothers.

Science.gov (United States)

Zhou, Shan; Li, Tingting; Allain, Jean-Pierre; Zhou, Bin; Zhang, Yuming; Zhong, Mei; Fu, Yongshui; Li, Chengyao

2017-12-01

The status of chronic and occult HBV infection (OBI) in neonatal hepatitis B vaccine and immunoglobulin (HBIG) vaccinated infants born to HBsAg+ mothers was investigated at a major hospital in China. Seventy-seven and 15 blood samples were collected in first or second follow-up detection from the vaccinated babies aged 3-36 months born to 43 HBsAg+ or plus 25 HBeAg+ mothers. HBV infection was analyzed between the paired baby and mother by serology and DNA analysis. Among 77 children born to 68 HBsAg+ mothers, 3.9% (3/77) were HBsAg+, and 36.4% (28/77) were HBV DNA+/HBsAg- (OBIs) by a single PCR, respectively. Thirteen of 28 HBV DNA+/HBsAg- samples were conformed by two PCRs or S sequence, which accounted for 16.9% (13/77) of children. Three HBsAg+ and six OBIs were genotyped in consistent with their mother's HBV strains. Of 77 babies' blood samples, anti-HBs reactivity varied slightly according to age groups, while passively transmitted anti-HBc reactivity declined from 100% high reactivity at age 3-5 months to mostly negative at age ≥12 months. Babies with apparent OBI had higher levels of anti-HBc and lower levels of anti-HBs than those without OBI but all eight OBI babies with second follow-up samples became HBV DNA negative beyond 1 year of age. The vaccinated infants born to HBsAg+ mothers presented the low rate of HBsAg occurrence as vaccination failure and high frequency of viral persistence in the form of transient OBIs since no evidence of active HBV infection occurred beyond 1 year of age. © 2017 Wiley Periodicals, Inc.

HBsAg level and hepatitis B viral load correlation with focus on pregnancy

Science.gov (United States)

Belopolskaya, Maria; Avrutin, Viktor; Firsov, Sergey; Yakovlev, Alexey

2015-01-01

Background Viral load measurement is necessary to estimate mother-to-child transmission risk for women with chronic hepatitis B (CHB), however, it is expensive. The present study aimed to investigate the relationship between HBsAg and hepatitis B virus (HBV) DNA levels, and to determine potential applications of HBsAg level monitoring for estimating viral load. Methods 85 patients with CHB (31 pregnant women, 26 non-pregnant women, 28 men) were included in the study. HBV DNA level was measured by real-time PCR, and HBsAg level by chemiluminescent immunoassay method. Dependency between viral load and HBsAg level was determined by Spearman correlation coefficient ρ. Results The correlation between HBsAg and HBV DNA levels was significant for all patients [ρ=0.3762 (P<0.0005; n=85)]. In the group of pregnant women, a low (unmeasurable) HBV DNA level led to a decrease in the Spearman coefficient ρ. In almost all cases a low level of the HBsAg corresponded to a low HBV DNA level. Only 2 patients had a low level of HBsAg and a relatively high viral load. By contrast, a high HBsAg level was observed in patients both with high and low viral load. Conclusions Correlation between HBsAg and HBV DNA levels is significant. In most cases, a low level of HBsAg indicates a low HBV DNA level, whereas a high HBsAg level does not always correspond to a high viral load. The measurement of HBV DNA level is necessary for pregnant women with a high HBsAg level. PMID:26127004

Comparison of serum HBsAg quantitation by four immunoassays, and relationships of HBsAg level with HBV replication and HBV genotypes.

Directory of Open Access Journals (Sweden)

Edouard Tuaillon

Full Text Available BACKGROUND: The decline in hepatitis B virus surface antigen (HBsAg may be an early predictor of the viral efficacy of Hepatitis B virus (HBV therapy. The HBsAg levels obtained by different immunoassays now need comparing and the relationships between levels of HBsAg and HBV DNA alongside HBsAg and genotype must be evaluated. METHODOLOGY/PRINCIPAL FINDINGS: HBsAg levels were compared among 80 patients using the Abbott Architect assay, a commercial immunoassay approved for HBsAg detection and quantitation, and three other assays derived from immunoassays approved for HBsAg detection (manufactured by Diasorin, Bio-Rad and Roche. Good correlation was found between the Abbot vs. Diasorin, Bio-Rad and Roche assays with narrow 95% limits of agreement and small mean differences: -0.06 to 0.11, -0.09 log(10 IU/mL; -0.57 to 0.64, -0.04 log(10 IU/mL; -0.09 to 0.45, -0.27 log(10 IU/mL, respectively. These agreements were not affected by genotypes A or D. HBsAg was weakly correlated with HBV DNA, whatever the HBsAg assay used: Abbott, ρ = 0.36 p = 0.001, Diasorin ρ = 0.34, p = 0.002; Bio-Rad ρ = 0.37, p<0.001; or Roche ρ = 0.41, p<0.001. This relationship between levels of HBsAg and HBV DNA seemed to depend on genotypes. Whereas HBsAg (Abbott assay tended to correlate with HBV DNA for genotype A (ρ = 0.44, p = 0.02, no such correlation was significant for genotypes D (ρ = 0.29, p = 0.15. CONCLUSION/SIGNIFICANCE: The quantitation of HBsAg in routine clinical samples is comparable between the reference assay and the adapted assays with acceptable accuracy limits, low levels of variability and minimum discrepancy. While HBsAg quantitation is not affected by HBV genotype, the observed association between levels of HBsAg and HBV DNA seems genotype dependent.

Detection of hepatitis B virus infection in HBsAg-negative patients by monoclonal antibodies against HBsAg

Energy Technology Data Exchange (ETDEWEB)

Fujita, Y K

1986-11-01

The technique of producing antibody secreting hybridomas has made available high-affinity antibodies of predefined specificity for use as diagnostic reagents. Recently, high-affinity monoclonal antibodies to hepatitis B surface antigens (HBsAg) were produced and characterized. Immunoassay was developed using these antibodies for the detection of HBsAg-associated determinants. The present study indicated the significance of the enhanced detection by monoclonal radioimmunoassay (M-RIA) of HBsAg in sera of patients with hepatitis B virus infection. The M-RIA detected HBsAg in sera of hemodialysis patients and blood donor defined as HBsAg-negative by polyclonal RIA (2.2 %, 0.14 %, respectively). Furthermore, individuals with chronic liver diseases were reactive only in the M-RIA (chronic hepatitis 4.8 %, liver cirrhosis 10.0 %, hepatocellular carcinoma 22.2 %). It is noteworthy that some of these patients were diagnosesed as so-called non-A non-B hepatitis because of no serological markers of hepatitis B virus infection such as HBsAb and HBcAb. The enhanced performance of the monoclonal RIA compared to conventional RIA was due to the increased sensitivity of the assay (55 pg vs 230 pg/ml). In immunohistochemical study, one of the monoclonal antibody named 5C3 was applied for detection of HBsAg in the formalin-fixed paraffin-embedded liver. HBsAg was detected in 6 out of 41 HBsAg-seronegative liver specimen. Thus, the studies showed the importance of the clinical application of monoclonal antibodies such as immunoassay and immunohistochemical study in the diagnosis of hepatitis B virus infection.

Detection of hepatitis B virus infection in HBsAg-negative patients by monoclonal antibodies against HBsAg

International Nuclear Information System (INIS)

Fujita, Y.K.

1986-01-01

The technique of producing antibody secreting hybridomas has made available high-affinity antibodies of predefined specificity for use as diagnostic reagents. Recently, high-affinity monoclonal antibodies to hepatitis B surface antigens (HBsAg) were produced and characterized. Immunoassay was developed using these antibodies for the detection of HBsAg-associated determinants. The present study indicated the significance of the enhanced detection by monoclonal radioimmunoassay (M-RIA) of HBsAg in sera of patients with hepatitis B virus infection. The M-RIA detected HBsAg in sera of hemodialysis patients and blood donor defined as HBsAg-negative by polyclonal RIA (2.2 %, 0.14 %, respectively). Furthermore, individuals with chronic liver diseases were reactive only in the M-RIA (chronic hepatitis 4.8 %, liver cirrhosis 10.0 %, hepatocellular carcinoma 22.2 %). It is noteworthy that some of these patients were diagnosesed as so-called non-A non-B hepatitis because of no serological markers of hepatitis B virus infection such as HBsAb and HBcAb. The enhanced performance of the monoclonal RIA compared to conventional RIA was due to the increased sensitivity of the assay (55 pg vs 230 pg/ml). In immunohistochemical study, one of the monoclonal antibody named 5C3 was applied for detection of HBsAg in the formalin-fixed paraffin-embedded liver. HBsAg was detected in 6 out of 41 HBsAg-seronegative liver specimen. Thus, the studies showed the importance of the clinical application of monoclonal antibodies such as immunoassay and immunohistochemical study in the diagnosis of hepatitis B virus infection. (author)

[Clinical evaluation of a novel HBsAg quantitative assay].

Science.gov (United States)

Takagi, Kazumi; Tanaka, Yasuhito; Naganuma, Hatsue; Hiramatsu, Kumiko; Iida, Takayasu; Takasaka, Yoshimitsu; Mizokami, Masashi

2007-07-01

The clinical implication of the hepatitis B surface antigen (HBsAg) concentrations in HBV-infected individuals remains unclear. The aim of this study was to evaluate a novel fully automated Chemiluminescence Enzyme Immunoassay (Sysmex HBsAg quantitative assay) by comparative measurements of the reference serum samples versus two independent commercial assays (Lumipulse f or Architect HBsAg QT). Furthermore, clinical usefulness was assessed for monitoring of the serum HBsAg levels during antiviral therapy. A dilution test using 5 reference-serum samples showed linear correlation curve in range from 0.03 to 2,360 IU/ml. The HBsAg was measured in total of 400 serum samples and 99.8% had consistent results between Sysmex and Lumipulse f. Additionally, a positive linear correlation was observed between Sysmex and Architect. To compare the Architect and Sysmex, both methods were applied to quantify the HBsAg in serum samples with different HBV genotypes/subgenotypes, as well as in serum contained HBV vaccine escape mutants (126S, 145R). Correlation between the methods was observed in results for escape mutants and common genotypes (A, B, C) in Japan. Observed during lamivudine therapy, an increase in HBsAg and HBV DNA concentrations preceded the aminotransferase (ALT) elevation associated with drug-resistant HBV variant emergence (breakthrough hepatitis). In conclusion, reliability of the Sysmex HBsAg quantitative assay was confirmed for all HBV genetic variants common in Japan. Monitoring of serum HBsAg concentrations in addition to HBV DNA quantification, is helpful in evaluation of the response to lamivudine treatment and diagnosis of the breakthrough hepatitis.

Prevalence of HBsAg and anti-HBs among delivering women.

Science.gov (United States)

Sabău, M; Căpîlnă; Kiss, E

1979-01-01

A survey of 2,500 delivering women revealed a 7.6% incidence of past infection with hepatitis B virus (HBV) (HBsAg or anti-HBs). Only 5.9% of the anti-HBs-positive mothers had a possible history of parenteral exposure to hepatitis B and none of the 55 HBsAg carriers had such a history. The findings suggest that HBV is endemic and that it is probably spread in part by nonparenteral means. The high rates of HBsAg and anti-HBs point to the possible preventive value of routine screenings for this system among pregnant women.

Screening of HBsAg and anti HCV from tertiary care, private and public sector hospitals

International Nuclear Information System (INIS)

Khan, R.A.W.; Ahmed, W.; Alam, S.E.; Arif, A

2011-01-01

Objectives: To find out the frequency of hepatitis B surface antigen and hepatitis C antibodies in patients referred from a tertiary care public sector hospital, other public sector and private hospitals of Karachi. Settings and duration: Pakistan Medical Research Council's Specialized Research Centre for Gastroenterology and Hepatology, at Jinnah Postgraduate Medical Centre Karachi from January to December 2009. Patients and Methods: A cross sectional study was conducted where patients were referred from different departments of Jinnah Postgraduate Medical Centre (tertiary care public sector hospital), other public sector hospitals, private hospitals and clinics for the screening of hepatitis B and C virus infection. Three ml blood was collected from each patient, serum separated and tested for HBsAg and Anti HCV using Abbott Murex fourth Generation ELISA kits. Results: A total of 2965 cases were referred in a year. Overall sero prevalence of HBsAg and Anti-HCV was 5.9% and 12.8% respectively. HBsAg positivity in patient referred from public sector hospitals was 5.8%, those from private hospitals/clinics were 7.2%, and self-referred patients was 5.6%. Anti HCV positivity rates amongst these cases were 12.5%, 16.7% and 8.5% respectively. Co-infection of hepatitis B virus and hepatitis C virus was seen in 0.9, 2.5 and 1.4% cases respectively. Breakdown of viral positivity within different departments of Jinnah Postgraduate Medical Centre Karachi showed HBsAg positivity of 7.1% in Medical department, 5.2% in Surgical department, 5.0% in Gynaecology department, 6.6% in other departments of Jinnah Postgraduate Medical Centre while, only 1.7% were positive from Pakistan Railway, hospital Anti HCV positivity was maximally (20.3%) seen in medical department followed by 14% in other departments, 10.9% in surgical department, 7.9% in gynaecology and 5.1% in railway hospital. Co-infection of HBV and HCV was seen in 2% cases referred from medical department, while rest of the

Positive hepatitis B surface antigen tests due to recent vaccination: a persistent problem

Directory of Open Access Journals (Sweden)

Rysgaard Carolyn D

2012-09-01

Full Text Available Abstract Background Hepatitis B virus (HBV is a common cause of viral hepatitis with significant health complications including cirrhosis and hepatocellular carcinoma. Assays for hepatitis B surface antigen (HBsAg are the most frequently used tests to detect HBV infection. Vaccination for HBV can produce transiently detectable levels of HBsAg in patients. However, the time course and duration of this effect is unclear. The objective of this retrospective study was to clarify the frequency and duration of transient HBsAg positivity following vaccination against HBV. Methods The electronic medical record at an academic tertiary care medical center was searched to identify all orders for HBsAg within a 17 month time period. Detailed chart review was performed to identify all patients who were administered HBV vaccine within 180 days prior to HBsAg testing and also to ascertain likely cause of weakly positive (grayzone results. Results During the 17 month study period, 11,719 HBsAg tests were ordered on 9,930 patients. There were 34 tests performed on 34 patients who received HBV vaccine 14 days or less prior to HBsAg testing. Of these 34 patients, 11 had grayzone results for HBsAg that could be attributed to recent vaccination. Ten of the 11 patients were renal dialysis patients who were receiving HBsAg testing as part of routine and ongoing monitoring. Beyond 14 days, there were no reactive or grayzone HBsAg tests that could be attributed to recent HBV vaccination. HBsAg results reached a peak COI two to three days following vaccination before decaying. Further analysis of all the grayzone results within the 17 month study period (43 results out of 11,719 tests revealed that only 4 of 43 were the result of true HBV infection as verified by confirmatory testing. Conclusions Our study confirms that transient HBsAg positivity can occur in patients following HBV vaccination. The results suggest this positivity is unlikely to persist beyond 14 days

Low serum hyaluronic acid levels associated with spontaneous HBsAg clearance

NARCIS (Netherlands)

Harkisoen, S.; Arends, J. E.; van den Hoek, A.; van Erpecum, K. J.; Boland, G. J.; Hoepelman, A. I. M.

2015-01-01

Purpose The pathophysiological underlying mechanism of spontaneous HBsAg clearance in hepatitis B virus (HBV) infected patients is largely unknown. However, serum hyaluronic acid (sHA) plays a role in liver fibrosis progression and reversely could serve as a potential biomarker for HBsAg clearance.

Comparative study of methods of detection of hepatitis ′B′ surface antigen (HBsAg.

Directory of Open Access Journals (Sweden)

Parab V

1989-04-01

Full Text Available The serum samples were collected from 52 patients of acute viral hepatitis and 235 hospital staff from Kasturba Hospital for Infectious Diseases. HBsAg was detected in their sera by counter-immuno-electrophoresis (CIEP, reverse passive hemogglutination (RPHA and by micro-enzyme-linked-immunosorbent assay (ELISA technique. Among the patients, HBsAg was detected in 12 cases (23% by CIEP, in 18 cases (34% by RPHA and in 23 patients (45% by ELISA. In the hospital staff, HBsAg was detected in 4 samples (1.7% by CIEP, in 8 samples (3.5% by RPHA and in 32 samples (13.5% by ELISA. Thus ELISA was found to be the most sensitive technique in detecting HBsAg.

HBsAg carrier status and the association between gestational diabetes with increased serum ferritin concentration in Chinese women.

Science.gov (United States)

Lao, Terence T; Tse, Ka-Yu; Chan, Louis Y; Tam, Kar-Fai; Ho, Lai-Fong

2003-11-01

To determine whether the high prevalence of hepatitis B surface antigen (HBsAg) carriage in our population can explain the previous observation of an association between increased maternal serum ferritin concentration and gestational diabetes in Hong Kong Chinese women. A retrospective study was performed on 767 nonanemic women with singleton pregnancy who had iron status assessed at 28-30 weeks. The result of the routine antenatal HBsAg screening was retrieved from patient records. The HBsAg-positive and -negative groups were compared for maternal characteristics, prevalence of gestational diabetes in the third trimester, prevalence of high serum ferritin and iron concentrations, and transferrin saturation, which is defined as a value in the highest quartile established by the measurements obtained from the HBsAg-negative group. The incidences of oral glucose tolerance test and gestational diabetes were significantly increased in the HBsAg-positive group. The HBsAg-positive women with gestational diabetes had significantly increased prevalence of high serum ferritin compared with the HBsAg-negative women, irrespective of the latter's gestational diabetes status. Multiple logistic regression analysis confirmed the independent association between HBsAg carrier status with gestational diabetes (relative risk 3.51, 95% CI 1.83-6.73) but excluded high ferritin as an independent factor. Our results indicate that maternal HBsAg carriage could explain in part the association between increased serum ferritin concentration with gestational diabetes in Hong Kong Chinese women, and that HBsAg carrier status is an independent risk factor for gestational diabetes.

Factors Predicting HBsAg Seroclearance and Alanine Transaminase Elevation in HBeAg-Negative Hepatitis B Virus-Infected Patients with Persistently Normal Liver Function.

Directory of Open Access Journals (Sweden)

Tai-Long Chien

Full Text Available A certain proportion of hepatitis B virus (HBV-infected patients with persistently normal alanine transaminase (ALT levels have significant fibrosis. Using liver stiffness measurements (Fibroscan® and laboratory data, including serum ALT, quantitative HBsAg (qHBsAg, and HBV DNA, we attempted to predict the natural histories of these patients.Non-cirrhotic HBeAg-negative chronic hepatitis B patients with persistently normal ALT were followed up prospectively with the end points of HBsAg seroclearance and ALT elevation above the upper limit of normal. The factors that were predictive of the end points were identified.A total of 235 patients with an average age of 48.1 +/- 10.7 years were followed up for 7 years. Eight patients (3.4% lost HBsAg, and 15 patients (6.4% experienced ALT elevation. The overall cumulative HBsAg seroclearances were 0.4%, 1.3% and 2.3% at years 1, 3 and 5, respectively. Regarding HBsAg seroclearance, the qHBsAg (< 30 IU/ml cutoff resulted in a hazard ratio (HR of 19.6 with a 95% confidence interval (CI of 2.2-166.7 (P = 0.008. The baseline ALT level (odd ratio (OR 1.075, 95% CI 1.020-1.132, P = 0.006 and a qHBsAg above 1000 IU/ml (3.7, 1.1-12.4, P = 0.032 were associated with ALT elevation. Limited to men, the baseline liver stiffness (1.6, 1.0-2.5, P = 0.031 and a qHBsAg above 1000 IU/ml (10.4, 2.1-52.4, P = 0.004 were factors that were independently associated with ALT elevation.A low qHBsAg level predicted HBsAg clearance. Baseline ALT and a qHBsAg above 1000 IU/ml were independent predictive factors for ALT elevation. Among the men, the independent predictive factors for ALT elevation were qHBsAg and liver stiffness.

Frequency of pregnant women with HBsAg in a Brazilian community Freqüência de gestantes portadoras do HBsAg em uma comunidade brasileira

Directory of Open Access Journals (Sweden)

Geraldo Duarte

1997-01-01

Full Text Available The work reported here points up the real benefits provided by neonatal immunoprophylaxis of newborns delivered by mothers who are seropositive for the hepatitis B virus surface antigen HBsAg and underscores the need to properly identify such mothers in Brazil so that immunoprophylaxis can be undertaken. To help determine levels of hepatitis B virus (HBV infection and seropositivity for various HBV markers among pregnant women in Southeast Brazil, investigators studied 7992 pregnant women delivering at the Clinical Hospital of the University of São Paulo's Ribeirão Preto School of Medicine in Ribeirão Preto, Brazil. Seroreactivity for HBsAg was determined first by serologic screening with an enzyme-linked immunosorbent assay (ELISA procedure in which the sera were incubated for 2 hours and then by confirmation with another ELISA in which the sera were incubated for 18 hours. Subsequently, tests for anti-HBsAg, HBeAg, anti-HBeAg, and anti-HBcAg markers were conducted using confirmed positive samples. Initial screening found 84 of the 7992 samples (1.05%, 95% CI: 0.84-1.30 to be positive for HBsAg; however, this HBsAg positivity was confirmed in only 76 (0.95%, 95% CI: 0.75-1.19. The positivity rate was significantly higher among subjects whose pregnancies terminated in miscarriage (1.84% than among those with live births (0.83% (chi2, Yates correction = 7.6; P = 0.005. Anamnesis was able to identify HBV risk factors in only 27.6% of the confirmed HBsAg-positive subjects or close household contacts. However, 21.3% (95% CI: 1.04-30.56 of the confirmed HBsAg-positive subjects were found positive for HBeAg, indicating a high risk of vertical transmission of the virus. These results demonstrate a need to conduct specific serologic research at term, in order to provide effective neonatal immunoprophylactic benefits.Visando aferir a tasa de reatividade sérica do HBsAg e de outros marcadores da infecção pelo VHB em parturientes, além de avaliar

Differing results of direct and indirect solid phase radioimmunoassay for HBsAg in acute hepatitis

International Nuclear Information System (INIS)

Strohm, W.D.; Legler, K.; Gerlich, W.; Stamm, B.; Zimmer, S.; Biotest-Serum-Institut G.m.b.H., Frankfurt am Main; Goettingen Univ.

1978-01-01

In 54 patients suffering from active viral hepatitis the indirect solid phase radioimmunoassay (ind-SPRIA) for HBsAg was positive in 9 cases the direct solid phase radioimmunoassay (d-SPRIA) being negative. In 2 further cases ind-SPRIA was positive during several weeks but d-SPRIA only once. AntiHBc could be detected in 9 of these patients. In 7 patients the usual decrease of the transaminase activity was followed by a second elavation with prolongation of the disease. The unknown factor detected by ind-SPRIA suggests a special of acute hepatitis. (orig.) [de

Differing results of direct and indirect solid phase radioimmunoassay for HBsAg in acute hepatitis

Energy Technology Data Exchange (ETDEWEB)

Strohm, W D; Legler, K; Gerlich, W; Stamm, B; Zimmer, S [Frankfurt Univ. (Germany, F.R.). Abt. fuer Gastroenterologie; Biotest-Serum-Institut G.m.b.H., Frankfurt am Main (Germany, F.R.); Goettingen Univ. (Germany, F.R.). Hygiene-Institut)

1978-09-01

In 54 patients suffering from active viral hepatitis the indirect solid phase radioimmunoassay (ind-SPRIA) for HBsAg was positive in 9 cases the direct solid phase radioimmunoassay (d-SPRIA) being negative. In 2 further cases ind-SPRIA was positive during several weeks but d-SPRIA only once. AntiHBc could be detected in 9 of these patients. In 7 patients the usual decrease of the transaminase activity was followed by a second elavation with prolongation of the disease. The unknown factor detected by ind-SPRIA suggests a special of acute hepatitis.

Breaking tolerance in hepatitis B surface antigen (HBsAg) transgenic mice by vaccination with cross-reactive, natural HBsAg variants

DEFF Research Database (Denmark)

Schirmbeck, Reinhold; Dikopoulos, Nektarios; Kwissa, Marcin

2003-01-01

Processing exogenous hepatitis B surface antigen (HBsAg) of the hepatitis B virus (HBV) generates the K(b)-binding S(208-215) epitope 1; processing endogenous HBsAg generates the K(b)-binding S(190-197) epitope 2. Cross-reactive CD8(+) T cell responses were primed to epitope 1 but not epitope 2...... HBs-tg mice showed reduced antigenemia. Hence, vaccination with natural HBsAg variants from different HBV sero/genotypes can prime cross-reactive, specific CD8(+) T cell immunity that breaks tolerance to HBsAg....

Prevalence of hepatitis b virus surface antigens (HBsag) and ...

African Journals Online (AJOL)

The prevalences of hepatitis B virus surface antigen (HBsAg) and hepatitis C virus (HCV) antibodies were determined in 560 blood donors sera using ELISA kits (DIALAB., Austria). Forty eight (8.57%) of these were positive for hepatitis B virus infection, while 33(5.89%) were positive to hepatitis C virus antibodies. The sex ...

[Relationship between HBeAg from HBsAg positive mothers and regulatory T cells in neonates and its influence on HBV intrauterine transmission].

Science.gov (United States)

Hao, H Y; Yang, Z Q; Xu, X X; Wang, X F; Wang, B; Shi, X H; Fu, Z D; Wang, B; Wang, S P

2017-10-10

Objective: To explore the relationship between HBeAg in HBsAg positive mothers and CD(4)(+)CD(25)(+) Foxp3 (+)regulatory T cells (Treg) in newborns, as well as how they would influence the increasing risk on HBV intrauterine transmission. Methods: We collected information on general demographic characteristics and delivery on 270 HBsAg positive mothers and their newborns from the Third People's Hospital of Taiyuan. Fluorescence quantitative polymerase chain reaction (FQ-PCR) and chemiluminescence immunoassay (CLIA) were used to detect HBV DNA and HBV serological markers in peripheral blood from both mothers and neonates. The expression of Treg and other immune cells in peripheral blood of neonates were detected with flow cytometry (FCM). Results: Maternal HBeAg positive rates were associated with an increased risk of intrauterine transmission ( OR =4.08, 95 %CI : 1.89-8.82). Rates of Treg in newborns born to HBsAg-positive mothers were higher than that of the negative group ( Z =2.29, P =0.022). Each pair of the subjects was assigned to five different groups according to the HBeAg titers of mothers. Frequencies of both Treg and HBeAg in newborns and HBV DNA in mothers between the above said 5 groups showed similar trends of changing patterns and the differences between groups were statistically significant(χ(2)=18.73, P mother's HBeAg titers were positively related to the percentage of Treg in their newborns ( r(s) =0.19, P =0.039). In addition, the frequencies of Treg were negatively correlated with pDC and CD(4)(+) T cell in their newborns ( r(s) =-0.21, P =0.017; r(s) =-0.23, P =0.009). Conclusion: HBeAg from HBsAg positive mothers might have inhibited the function of neonatal DC cells and T cells to reduce the immune response to HBV by up-regulating the proportion of Treg and finally increased the risk of HBV intrauterine transmission.

Serologic tracers (HBsAg and HBsAc) of hepatitis B virus in expectant mothers of the Perinatal Maternal Institute; Marcadores serologicos (HBsAg y HBsAc) del virus de la hepatitis B en mujeres gestantes del Instituto Materno Perinatal

Energy Technology Data Exchange (ETDEWEB)

Garcia G, B M

1997-07-01

A study on hepatitis B tracers, (HBsAg and HBsAc), was conducted in women with different months of pregnancy at the Perinatal Maternal Institute in Lima, Peru. A total of 1010 mothers were studied during the period of January to October 1996, establishing by radioimmunoassay (RIA) whether they were positive or not. The results showed a prevalence rate of 1,6 for HBsAc and 1,3 for HBsAg for every 100,000 inhabitants. The incidence rate was 0,332 for HBsAc and 0,07 for HBsAg for every 100,000 inhabitants. This means that 21 expectant mothers are HBsAc positive and 5 are HBsAg positive. According to the investigations, there were different ways of transmission; promiscuity must be highlighted, as well as age -most of the mothers who were positive were between 20 and 25 years old- and origin. Most of them were immigrants from different places and live in shantytowns, which indicates that most of them have limited economic resources and have not received any orientation on family planning.

[Predictive study of HBsAg in different stages of neonatal venous blood on failure of blocking HBV mother to infant transmission].

Science.gov (United States)

Yi, Wei; Li, Ming-Hui; Hu, Yu-Hong; Liu, Feng; Zhang, Yang-Li; Liu, Xue-Jing; Hao, Hong-Xiao; Song, Shu-Jing; Liu, Ying; Li, Xing-Hong; Sun, Ji-Yun; Liu, Min; Cheng, Jun; Xie, Yao

2011-10-01

In this study, we discuss the predictive value of different content of HBsAg in different stages of neotal venous blood on failure of blocking mother to infant transmission of HBV. 150 infants born of chronically HBV infected mothers who were positive of both HBsAg and HBeAg and who also had a HBV DNA virus load above 10(5) copies/ml were enrolled. These infants were given hepatitis B virus immune globin (HBIG) 200 IU immediately after birth and were given hepatitis B vaccine 10 or 20 microg at brith, 1 month and 6 months after birth. HBV serological index of these infants were test at birth, 1 month and 7 months after birth respectively. Different content of HBsAg in different stages of neonatal venus blood were analyzed to predict the failure of blocking mother to infant transmission of HBV. 11 infants failed in blocking of HBV mother to infant transmission. The positive rate of HBsAg at birth, 1 month and 7 months after birth were 41.26%, 10.49% and 7.69% respectively, and were 97.90%, 65.73% and 13.29% of HBeAg. The positive predictive value of HBsAg > or = 0.05 and HBsAg > or = 1 IU/ml at birth were 18.64% and 70% respectively, and were 73.33% and 100% one month after birth. Infants with HBsAg > or = 1 IU/ml at birth should be suspicious of failure on blocking HBV mother-to-infant transmission and it should be more credible if the infant has HBsAg > or = 1 IU/ml one month after birth. How to improve the blocking rate of neonates who were positive of HBsAg at birth and one month after birth should be the focus of our future research.

Clinical Characteristics and Correlation Analysis of Subjects with Chronic Hepatitis B Virus (HBV) Infection and Sustained Low Levels of Hepatitis B Surface Antigen (HBsAg)

Science.gov (United States)

Cheng, Jun; Dai, Yuzhu; Yan, Li; Zhou, Huajun; Xu, Xujian

2018-01-01

Background The aim of this study was to investigate the clinical characteristics of individuals with chronic hepatitis B virus (HBV) infection with persistent low levels of hepatitis B surface antigen (HBsAg) and to undertake a correlation analysis of the clinical characteristics. Material/Methods The study included 1,204 subjects with chronic HBV infection. Serum HBsAg, HBV envelope antigen (HBeAg), and HBV core antigen (HBcAg) levels were measured using the chemiluminescent microparticle immunoassay (CMIA) and the neutralization test. HBV DNA was measured using real-time fluorescence quantitative polymerase chain reaction (RT-FQ-PCR). Results There were 1,023 subjects in the high-level HBsAg group (HBsAg level ≥10 IU/mL) and 181 subjects in the low-level HBsAg group (HBsAg level HBV-M2), and the asymptomatic carrier (ASC) status was 98.34%. The low-level HBsAg group had a lower HBV DNA-positive rate compared with the high-level HBsAg group (40.33% vs. 75.07%), with a normal distribution across all age groups (P>0.05). The low-level HBsAg group included an older age group. A low-level of HBsAg was positively correlated with a low level of replication of HBV DNA (r=0.452). Conclusions The findings of this study showed that individuals with chronic HBV infection and sustained low-levels of HBsAg were an older population and had a lower level of replicating HBV DNA when compared with individuals with high levels of HBsAg, and the majority (93.7%) were also HBsAg and HBeAg and HBcAg-positive. PMID:29593208

Immune-escape mutations and stop-codons in HBsAg develop in a large proportion of patients with chronic HBV infection exposed to anti-HBV drugs in Europe

DEFF Research Database (Denmark)

Colagrossi, Luna; Hermans, Lucas E; Salpini, Romina

2018-01-01

structure of HBV genome, some immune-escape mutations or stop-codons in HBsAg can derive from drug-resistance mutations in RT. This study is aimed at gaining insight in prevalence and characteristics of immune-associated escape mutations, and stop-codons in HBsAg in chronically HBV-infected patients...

Hepatitis B and C virus co-infections in human immunodeficiency virus positive North Indian patients

Science.gov (United States)

Gupta, Swati; Singh, Sarman

2006-01-01

AIM: To determine the prevalence of hepatitis B and C virus infections in human immunodeficiency virus (HIV) -positive patients at a tertiary care hospital in New Delhi, India. METHODS: Serum samples from 451 HIV positive patients were analyzed for HBsAg and HCV antibodies during three years (Jan 2003-Dec 2005). The control group comprised of apparently healthy bone-marrow and renal donors. RESULTS: The study population comprised essentially of heterosexually transmitted HIV infection. The prevalence rate of HBsAg in this population was 5.3% as compared to 1.4% in apparently healthy donors (P < 0.001). Though prevalence of HCV co-infection (2.43%) was lower than HBV in this group of HIV positive patients, the prevalence was significantly higher (P < 0.05) than controls (0.7%). Triple infection of HIV, HBV and HCV was not detected in any patient. CONCLUSION: Our study shows a significantly high prevalence of hepatitis virus infections in HIV infected patients. Hepatitis viruses in HIV may lead to faster progression to liver cirrhosis and a higher risk of antiretroviral therapy induced hepatotoxicity. Therefore, it would be advisable to detect hepatitis virus co-infections in these patients at the earliest. PMID:17106941

Serologic tracers (HBsAg and HBsAc) of hepatitis B virus in expectant mothers of the Perinatal Maternal Institute

International Nuclear Information System (INIS)

Garcia G, B.M.

1997-01-01

A study on hepatitis B tracers, (HBsAg and HBsAc), was conducted in women with different months of pregnancy at the Perinatal Maternal Institute in Lima, Peru. A total of 1010 mothers were studied during the period of January to October 1996, establishing by radioimmunoassay (RIA) whether they were positive or not. The results showed a prevalence rate of 1,6 for HBsAc and 1,3 for HBsAg for every 100,000 inhabitants. The incidence rate was 0,332 for HBsAc and 0,07 for HBsAg for every 100,000 inhabitants. This means that 21 expectant mothers are HBsAc positive and 5 are HBsAg positive. According to the investigations, there were different ways of transmission; promiscuity must be highlighted, as well as age -most of the mothers who were positive were between 20 and 25 years old- and origin. Most of them were immigrants from different places and live in shantytowns, which indicates that most of them have limited economic resources and have not received any orientation on family planning

HBsAg d and y subtypes determined by inhibition radio-immunoassay

Energy Technology Data Exchange (ETDEWEB)

Wilkinson, R [Border Blood Transfusion Service, East London (South Africa)

1981-12-01

An inhibition radioimmunoassay for the detection of HBsAg/d and HBsAg/y antigens is described. A survey of 211 asymptomatic HBsAg positive blood donors showed 190 to be of type HBsAg/d and 3 to be of type HBsAg/y, while the remaining 18 could not be typed. Of 43 patients with acute hepatitis 39 were type HBsAg/d and 4 were type HBsAg/y. The statistically significant (p smaller than 0,01) increase in type HBsAg/y may reflect a changing pattern in offending viral strain with the passage of time.

Virus-specific immune response in HBeAg-negative chronic hepatitis B: relationship with clinical profile and HBsAg serum levels.

Directory of Open Access Journals (Sweden)

Elisabetta Loggi

Full Text Available BACKGROUND AIMS: The immune impairment characterizing chronic hepatitis B (cHBV infection is thought to be the consequence of persistent exposure to viral antigens. However, the immune correlates of different clinical stages of cHBV and their relation with different levels of HBsAg have not been investigated. The aim of the present study was to evaluate the relationship between HBV-specific T cells response and the degree of in vivo HBV control and HBsAg serum levels in HBeAg-HBeAb+ cHBV. METHODS: Peripheral blood mononuclear cells from 42 patients with different clinical profiles (treatment-suppressed, inactive carriers and active hepatitis of cHBV, 6 patients with resolved HBV infection and 10 HBV-uninfected individuals were tested with overlapping peptides spanning the entire HBV proteome. The frequency and magnitude of HBV-specific T cell responses was assessed by IFNγ ELISPOT assay. Serum HBsAg was quantified with a chemiluminescent immunoassay. RESULTS: The total breadth and magnitude of HBV-specific T cell responses did not differ significantly between the four groups. However, inactive carriers targeted preferentially the core region. In untreated patients, the breadth of the anti-core specific T cell response was inversely correlated with serum HBsAg concentrations as well as HBV-DNA and ALT levels and was significantly different in patients with HBsAg levels either above or below 1000 IU/mL. The same inverse association between anti-core T cell response and HBsAg levels was found in treated patients. CONCLUSIONS: Different clinical outcomes of cHBV infection are associated with the magnitude, breadth and specificity of the HBV-specific T cell response. Especially, robust anti-core T cell responses were found in the presence of reduced HBsAg serum levels, suggesting that core-specific T cell responses can mediate a protective effect on HBV control.

Quantitative HBsAg and HBeAg predict hepatitis B seroconversion after initiation of HAART in HIV-HBV coinfected individuals.

Directory of Open Access Journals (Sweden)

Gail V Matthews

Full Text Available OBJECTIVE: Anti-HBe seroconversion and HBsAg loss are important therapeutic endpoints in patients with hepatitis B virus (HBV infection. Quantitative measures of hepatitis B surface antigen (qHBsAg and e antigen (qHBeAg have been identified as potentially useful indicators of therapeutic response in HBV monoinfection. The aim of this study was to examine serological change including quantitative biomarkers in HIV-HBV coinfected patients initiating HBV active antiretroviral therapy (ART. METHODS: HIV-HBV coinfected individuals from Thailand were followed for up to 168 weeks post ART. Rates and associations of qualitative serological change were determined. Longitudinal changes in qHBsAg and qHBeAg were measured and their utility as predictors of response examined. RESULTS: Forty seven patients were included of whom 27 (57% were HBeAg positive at baseline. Median CD4 count was 48 cells/mm(3. Over a median follow-up of 108 weeks 48% (13/27 lost HBeAg, 12/27 (44% achieved anti-HBe seroconversion and 13% (6/47 HBsAg loss. Anti-HBe seroconversion was associated with higher baseline ALT (p = 0.034, lower qHBsAg (p = 0.015, lower qHBeAg (p = 0.031 and greater HBV DNA decline to week 24 (p = 0.045. Sensitivity and specificity for qHBsAg and qHBeAg decline of >0.5 log at week 12 and >1.0 log at week 24 were high for both anti-HBe seroconversion and HBsAg loss. CONCLUSIONS: Rates of serological change in these HIV-HBV coinfected individuals with advanced immunodeficiency initiating HBV-active ART were high. Baseline and on treatment factors were identified that were associated with a greater likelihood of subsequent anti-HBe seroconversion, including both quantitative HBsAg and HBeAg, suggesting these biomarkers may have utility in this clinical setting.

Primary immunization-like response without hepatitis following transfusion of HBeAg-positive blood

DEFF Research Database (Denmark)

Gluud, C; Aldershvile, J; Kryger, P

1983-01-01

An accidental transfusion of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) positive whole blood was given to a 19-yr-old male, bleeding after tonsillectomy. Serum obtained from the patient before the transfusion revealed no hepatitis B antigens or antibodies. After...... the transfusion the patient became HBsAg-positive, cleared this antigen and developed antibodies to both HBsAg and HBeAg. The transfusion blood was positive for total antibody and IgM antibody to hepatitis B core antigen (HBcAg). The patient's blood became positive for these antibodies after the transfusion...

Antigens of hepatitis B virus: failure to detect HBeAg on the surfaces of HBsAg forms

Energy Technology Data Exchange (ETDEWEB)

Gerin, J L [Oak Ridge National Lab., Rockville, MD; Shih, J W.K.; McAuliffee, V J; Purcell, R H

1978-01-01

The particulate forms of HBsAg were analysed for the presence of HBeAG on their surfaces. By immunodiffusion analysis, anti-HBe did not form precipitin bands with the purified forms of HBsAg and hyperimmune guinea pig antisera to these forms did not react with HBeAg. Lines of non-identity were observed between the HBeAg determinants (e/sub 1/ and e/sub 2/) and the Dane particles and filaments isolated from an HBeAg-positive serum. Finally, anti-HBe failed to precipitate the polymerase-positive subpopulation of Dane particles, indicating that anti-HBe has no direct role in virus neutralization.

Prevalence of hepatitis B virus infection in out-patient alcoholics

DEFF Research Database (Denmark)

Gluud, C; Gluud, B; Aldershvile, J

1984-01-01

Sera from 192 out-patient alcoholics attending a clinic for the treatment of alcoholism were tested for hepatitis B surface antigen (HBsAg) and for antibodies to HBsAg and to hepatitis B core antigen (HBcAg). Three sera (1.5%) were positive for HBsAg. Of the remaining 189 alcoholics, 29 (15%) were...... positive for one or both antibodies. This prevalence is not significantly different from that found in 137 hospitalized HBsAg-negative patients with alcoholic liver disease (35/137 [26%] were positive for one or both antibodies). However, the prevalence of hepatitis B antibodies in out-patient alcoholics...

Investigation of occult hepatitis B virus infection in anti-hbc positive patients from a liver clinic.

Science.gov (United States)

Martinez, Maria Carmela; Kok, Chee Choy; Baleriola, Cristina; Robertson, Peter; Rawlinson, William D

2015-01-01

Occult hepatitis B infection (OBI) is manifested by presence of very low levels (Hepatitis B viral DNA (HBV DNA) in the blood and the liver while exhibiting undetectable HBV surface antigen (HBsAg). The molecular mechanisms underlying this occurrence are still not completely understood. This study investigated the prevalence of OBI in a high-risk Australian population and compared the HBV S gene sequences of our cohort with reference sequences. Serum from HBV DNA positive, HBsAg negative, and hepatitis B core antibody (anti-HBc) positive patients (study cohort) were obtained from samples tested at SEALS Serology Laboratory using the Abbott Architect, as part of screening and diagnostic testing. From a total of 228,108 samples reviewed, 1,451 patients were tested for all three OBI markers. Only 10 patients (0.69%) out of the 1,451 patients were found to fit the selection criteria for OBI. Sequence analysis of the HBV S gene from 5 suspected OBI infected patients showed increased sequence variability in the 'a' epitope of the major hydrophilic region compared to reference sequences. In addition, a total of eight consistent nucleotide substitutions resulting in seven amino acid changes were observed, and three patients had truncated S gene sequence. These mutations appeared to be stable and may result in alterations in HBsAg conformation. These may negatively impact the affinity of hepatitis B surface antibody (anti-HBs) and may explain the false negative results in serological HBV diagnosis. These changes may also enable the virus to persist in the liver by evading immune surveillance. Further studies on a bigger cohort are required to determine whether these amino acid variations have been acquired in the process of immune escape and serve as markers of OBI.

HBV vaccination of HCV-infected patients with occult HBV infection and anti-HBc-positive blood donors

Directory of Open Access Journals (Sweden)

J.S.F. Pereira

2006-04-01

Full Text Available Anti-HBc positivity is a frequent cause of donation rejection at blood banks. Hepatitis B virus (HBV infection may also occur in HBsAg-negative patients, a situation denoted occult infection. Similarly, very low levels of HBV-DNA have also been found in the sera of patients with chronic hepatitis C virus (HCV infection, even in the absence of serum HBsAg. Initially we searched for HBV-DNA in serum of 100 blood donors and 50 HCV-infected patients who were HBsAg negative/anti-HBc positive by nested-PCR and by an HBV monitor commercial test for HBV-DNA. Anti-HBs seroconversion rates were measured in 100 blood donors and in 22 patients with chronic HCV infection after HBV vaccination to determine if the HBV vaccination could eliminate an occult HBV infection in these individuals. Occult HBV infection was detected in proportionally fewer blood donors (6/100 = 6% than chronic hepatitis C patients (12/50 = 24% (P 0.05. All subjects who were HBV-DNA(+ before the first dose of HBV vaccine (D1, became HBV-DNA(- after D1, D2, and D3. Among 22 HCV-positive patients, 10 HBV-DNA(+ and 12 HBV-DNA(-, seroconversion was observed in 9/10 (90% HBV-DNA(+ and in 9/12 (75% HBV-DNA(- subjects (P > 0.05. The disappearance of HBV-DNA in the majority of vaccinated patients suggests that residual HBV can be eliminated in patients with occult infection.

Membranous glomerulonephritis in a child asymptomatic for hepatitis B virus. Concomitant seropositivity for HBsAG and anti-HBs.

Science.gov (United States)

Hirsch, H Z; Ainsworth, S K; DeBeukelaer, M; Brissie, R M; Hennigar, G R

1981-04-01

The presence of hepatitis B surface antigen (HBsAg) in association with immunoglobulins and complement components within the glomerular basement membranes of adults having chronic active hepatitis has been well documented. In addition, investigators in Poland have demonstrated HBsAg immune complexes in glomeruli of children who did not have clinical evidence of hepatitis. More recently, a single case of childhood membranous glomerulonephritis in an asymptomatic carrier of hepatitis B virus was cited by observers in Canada. Reported here is the deposition of HBsAg immune complexes in the glomerular basement membranes of a 13-year-old black boy who had membranous glomerulopathy but not clinical evidence of hepatitis. This may be the first reported case in the United States of HbsAg-associated membranous glomerulonephritis in a child asymptomatic for hepatitis B virus, and only the second such case in North America. However, unlike previous studies of childhood glomerulopathy in association with hepatitis B virus, this patient is seropositive for both HBsAg and anti-HBs (antibody for hepatitis B surface antigen). Similar "rare" serologic findings were found for the patient's eldest male sib.

Clinical and virological factors associated with hepatitis B virus reactivation in HBsAg-negative and anti-HBc antibodies-positive patients undergoing chemotherapy and/or autologous stem cell transplantation for cancer.

Science.gov (United States)

Borentain, P; Colson, P; Coso, D; Bories, E; Charbonnier, A; Stoppa, A M; Auran, T; Loundou, A; Motte, A; Ressiot, E; Norguet, E; Chabannon, C; Bouabdallah, R; Tamalet, C; Gérolami, R

2010-11-01

We studied clinical outcome and clinico-virological factors associated with hepatitis B virus reactivation (HBV-R) following cancer treatment in hepatitis B virus surface antigen (HBsAg)-negative/anti-hepatitis B core antibodies (anti-HBcAb)-positive patients. Between 11/2003 and 12/2005, HBV-R occurred in 7/84 HBsAg-negative/anti-HBcAb-positive patients treated for haematological or solid cancer. Virological factors including HBV genotype, core promoter, precore, and HBsAg genotypic and amino acid (aa) patterns were studied. Patients presenting with reactivation were men, had an hepatitis B virus surface antibody (HBsAb) titre 1 line of chemotherapy (CT) significantly more frequently than controls. All were treated for haematological cancer, 3/7 received haematopoietic stem cell transplantation (HSCT), and 4/7 received rituximab. Using multivariate analysis, receiving >1 line of CT was an independent risk factor for HBV-R. Fatal outcome occurred in 3/7 patients (despite lamivudine therapy in two), whereas 2/4 survivors had an HBsAg seroconversion. HBV-R involved non-A HBV genotypes and core promoter and/or precore HBV mutants in all cases. Mutations known to impair HBsAg antigenicity were detected in HBV DNA from all seven patients. HBV DNA could be retrospectively detected in two patients prior cancer treatment and despite HBsAg negativity. HBV-R is a concern in HBsAg-negative/anti-HBcAb-positive patients undergoing cancer therapy, especially in males presenting with haematological cancer, a low anti-HBsAb titre and more than one chemotherapeutic agent. HBV DNA testing is mandatory to improve diagnosis and management of HBV-R in these patients. The role of specific therapies such as rituximab or HSCT as well as of HBV aa variability deserves further studies. © 2009 Blackwell Publishing Ltd.

Delayed clearance of serum HBsAg in compensated cirrhosis B

DEFF Research Database (Denmark)

Fattovich, G; Giustina, G; Sanchez-Tapias, J

1998-01-01

The aim of this study was to evaluate the incidence, prognostic factors and clinical significance of delayed clearance of serum HBsAg in compensated cirrhosis B.......The aim of this study was to evaluate the incidence, prognostic factors and clinical significance of delayed clearance of serum HBsAg in compensated cirrhosis B....

Purification of HBsAg produced by the human hepatoma cell line PLC/PRE/5 by affinity chromatography using monoclonal antibodies and application for ELISA diagnostic.

Science.gov (United States)

Merten, O W; Reiter, S; Scheirer, W; Katinger, H

1983-01-01

The human cell line PLC/PRF/5 (5) was used for the production of hepatitis B surface antigen subtype ad (HBsAg ad) and purified by affinity chromatography (AC) with monoclonal antibodies (mAb). mAb to HBsAg from mouse ascites have been purified by Protein A - AC prior coupling to AH-Sepharose 4B (Pharmacia). The combined procedure of ammonium-sulphate-precipitation of HBsAg from culture supernatants and immunosorbent-AC leads to approx. 700-fold purification. ELISA results using the mAb and the HBsAg for diagnostics of human serum, positive for anti-HBsAg-antibodies correlate with the RIA (AUSAB, Abbott).

Operating in a Yellow Nation; the frequency of hepatitis B and hepatitis C positive at a tertiary care teaching hospital

International Nuclear Information System (INIS)

Waheed, A.; Zafar-ul-Ahsan; Zaeem, F.A.; Shariff, M.M.; Qayyum, A.

2010-01-01

Objects contaminated with blood and other body fluids of patients suffering from hepatitis B and C are an occupational health hazard to the health care personnel and a source of nosocomial spread. This descriptive cross sectional study estimated the frequency of hepatitis B surface antigen (HBsAg) and anti hepatitis C antibody (Anti HCV) positive patients among those undergoing a urological procedure in a tertiary care teaching hospital. A sample size of 550 patients was estimated using Stat Calc for Epi Info. A cluster off 558 patients were included. Ninety five (17%) were positive for serum HBsAg and/or anti HCV by Elisa. Gender/sex, admission year, urological diagnosis did not predict statistically significant relationship with the positive status. Past surgical history was marginally significant. In conclusion, all patients undergoing a urological procedure should be checked for anti HCV and HBsAg. A solid policy outlining the preventive practices is needed to stop this high burden of hepatitis turning into public health disaster. (author)

Expression of Hepatitis B virus surface antigen (HBsAg from genotypes A, D and F and influence of amino acid variations related or not to genotypes on HBsAg detection

Directory of Open Access Journals (Sweden)

Natalia M. Araujo

Full Text Available The impact of hepatitis B virus (HBV genotypes on the sensitivity of surface antigen (HBsAg detection assays has been poorly investigated. Here, plasmids carrying consensus or variant coding sequences for HBV surface proteins from genotypes A, D and F, were constructed. HBsAg levels were evaluated in medium and extracts of transfected CHO cells by a commercial polyclonal-based assay. We show that HBsAg detection values of consensus forms from genotypes D and F were, respectively, 37% and 30% lower than those obtained by genotype A. However, the presence of two single variations, T143M in genotype A, and T125M in genotype D, produced a decrease of 44% and an increase of 34%, respectively, on HBsAg mean values in comparison with their consensus forms. In conclusion, HBsAg detection levels varied among HBV genotypes. However, unique amino acid substitutions not linked to genotypes, such as T125M and T143M described here, should have more implications in HBV immunological diagnostics than the set of variations characteristic of each HBV genotype.

Molecular epidemiology and genotyping of hepatitis B virus of HBsAg-positive patients in Oman.

Science.gov (United States)

Al Baqlani, Said Ali; Sy, Bui Tien; Ratsch, Boris A; Al Naamani, Khalid; Al Awaidy, Salah; Busaidy, Suleiman Al; Pauli, Georg; Bock, C-Thomas

2014-01-01

Hepatitis B virus (HBV) infection is a major global health burden with distinct geographic public health significance. Oman is a country with intermediate HBV carrier prevalence; however, little is known about the incidence of HBV variants in circulation. We investigated the HBV genotype distribution, the occurrence of antiviral resistance, and HBV surface antigen (HBsAg) escape mutations in HBsAg-positive patients in Oman. Serum samples were collected from 179 chronically HBV-infected patients enrolled in various gastroenterology clinics in Oman. HBV genotypes were determined by sequencing and phylogenetic analysis. Mutations in the HBV polymerase and the HBsAg gene were characterized by mutational analysis. HBV genotypes D (130/170; 76.47%) and A (32/170; 18.28%) are predominant in Oman. The HBV genotypes C and E were less frequent (each 1.18%), while the HBV genotypes B, G, F, and H were not detected. Four patients revealed HBV genotype mixtures (HBV-A/D and D/C). The analyses of vaccine escape mutations yield that 148/170 (87.06%) HBV sequences were wild type. 22/170 (12.94%) HBV sequences showed mutations in the "a" determinant of the HBsAg domain. Two patients showed the described HBV vaccine escape mutation sP120T. 8/146 (5.48%) HBV isolates harbored mutations in the HBV polymerase known to confer resistance against antiviral therapy. Especially the lamivudine resistance mutations rtL180M/rtM204V and rtM204I were detected. This study shows the distribution of HBV genotypes, therapy resistance, and vaccine escape mutations in HBV-infected patients in Oman. Our findings will have a major impact on therapy management and diagnostics of chronic HBV infections in Oman to control HBV infection in this intermediate HBV-endemic country.

A Clinical study of HBsAg and Anti-HBs in the serum of patients with various liver diseases

Energy Technology Data Exchange (ETDEWEB)

Kim, Hak San; Kim, Jong Mann; Kim, Hwa Sook; Kim, Yul Ja; Lee, Hak Choong; Lee, Chong Suk [National Medical Center, Seoul (Korea, Republic of)

1981-09-15

Serum HBsAg and Anti-HBs obtained by radioimmunoassay were studied in 109 cases of various liver diseases who visited or were admitted to National Medical Center from December, 1980 to July, 1981. The results were as follows; 1) HBsAg was detected in 67.0% of total 109 cases; 71.9% of 32 cases with acute viral hepatitis, 71.4% of 14 cases with chronic hepatitis, 65.2% of 46 cases with liver cirrhosis and 58.8% of 17 cases with hepatoma. 2) Anti-HBs was detected in 32.1% of total 109 cases; 37.0% of 46 cases with liver cirrhosis, 29.4% of 17 cases with hepatoma, 28.6% of 14 cases with chronic hepatitis, 28.1% of 32 cases with acute viral hepatitis. 3) HBsAg or Anti-HBs, the markers of Hepatitis B virus was detected in 89.0% of total 109 cases; 93.6% of 32 cases with acute viral hepatitis, 89.1% of 46 cases with liver cirrhosis, 85.7% of 14 cases with chronic hepatitis and 82.4% of 17 cases with hepatoma, which strongly suggested that the various liver diseases were associated with hepatitis B virus infection.

A Clinical study of HBsAg and Anti-HBs in the serum of patients with various liver diseases

International Nuclear Information System (INIS)

Kim, Hak San; Kim, Jong Mann; Kim, Hwa Sook; Kim, Yul Ja; Lee, Hak Choong; Lee, Chong Suk

1981-01-01

Serum HBsAg and Anti-HBs obtained by radioimmunoassay were studied in 109 cases of various liver diseases who visited or were admitted to National Medical Center from December, 1980 to July, 1981. The results were as follows; 1) HBsAg was detected in 67.0% of total 109 cases; 71.9% of 32 cases with acute viral hepatitis, 71.4% of 14 cases with chronic hepatitis, 65.2% of 46 cases with liver cirrhosis and 58.8% of 17 cases with hepatoma. 2) Anti-HBs was detected in 32.1% of total 109 cases; 37.0% of 46 cases with liver cirrhosis, 29.4% of 17 cases with hepatoma, 28.6% of 14 cases with chronic hepatitis, 28.1% of 32 cases with acute viral hepatitis. 3) HBsAg or Anti-HBs, the markers of Hepatitis B virus was detected in 89.0% of total 109 cases; 93.6% of 32 cases with acute viral hepatitis, 89.1% of 46 cases with liver cirrhosis, 85.7% of 14 cases with chronic hepatitis and 82.4% of 17 cases with hepatoma, which strongly suggested that the various liver diseases were associated with hepatitis B virus infection.

Development of a digital droplet PCR assay to measure HBV DNA in patients receiving long-term TDF treatment.

Science.gov (United States)

Liu, Yang; Cathcart, Andrea L; Delaney, William E; Kitrinos, Kathryn M

2017-11-01

The COBAS TaqMan assay has a lower limit of quantification (LLOQ) of 169 HBV copies/mL and a lower limit of detection (LLOD) of 58 copies/mL. HBV DNA below the TaqMan LLOQ is classified as target not detected (TND) (HBV DNA to 8 copies/mL. HBV DNA levels in plasma from patients with or without HBsAg seroconversion were assessed by ddPCR. For patients who did not achieve HBsAg seroconversion, the majority of TD samples (33/58, 57%) were HBV DNA positive by ddPCR while (10/37, 27%) of TND samples were positive. In contrast, for patients who achieved HBsAg seroconversion, HBV DNA was rarely detected by ddPCR after HBsAg seroconversion (1/28, 3.6%). ddPCR is a sensitive method to evaluate low-level viral replication in plasma samples. Frequent detection of HBV DNA by ddPCR among patients who did not achieve HBsAg seroconversion suggests new agents may be needed to suppress low levels of replicating HBV. Copyright © 2017. Published by Elsevier B.V.

The prevalence of hepatitis B virus infection markers and socio-demographic risk factors in HIV-infected patients in Southern Brazil

Directory of Open Access Journals (Sweden)

Saulo Martins

2014-10-01

Full Text Available Introduction Hepatitis B virus (HBV and human immunodeficiency virus (HIV infections are two of the world's most important infectious diseases. Our objective was to determine the hepatitis B surface antigen (HBsAg and hepatitis B core antibody (anti-HBc prevalences among adult HIV-infected patients and identify the associations between socio-demographic variables and these HBV infection markers. Methods This study was performed from October 2012 to March 2013. Three hundred HIV-seropositive patients were monitored by the Clinical Analysis Laboratory of Professor Polydoro Ernani de São Thiago University Hospital, Santa Catarina, Brazil. The blood tests included HBsAg, anti-HBc immunoglobulin M (IgM and total anti-HBc. Patients reported their HIV viral loads and CD4+ T-cell counts using a questionnaire designed to collect sociodemographic data. Results The mean patient age was 44.6 years, the mean CD4 T-cell count was 525/mm3, the mean time since beginning antiretroviral therapy was 7.6 years, and the mean time since HIV diagnosis was 9.6 years. The overall prevalences of HBsAg and total anti-HBc were 2.3% and 29.3%, respectively. Among the individuals analyzed, 0.3% were positive for HBsAg, 27.3% were positive for total anti-HBc, and 2.0% were positive either for HBsAg or total anti-HBc and were classified as chronically HBV-infected. Furthermore, 70.3% of the patients were classified as never having been infected. Male gender, age >40 years and Caucasian ethnicity were associated with an anti-HBc positive test. Conclusions The results showed an intermediate prevalence of HBsAg among the studied patients. Moreover, the associations between the anti-HBc marker and socio-demographic factors suggest a need for HBV immunization among these HIV-positive individuals, who are likely to have HIV/HBV coinfection.

Historic and current hepatitis B viral DNA and quantitative HBsAg level are not associated with cirrhosis in non-Asian women with chronic hepatitis B.

Science.gov (United States)

Harkisoen, S; Arends, J E; van den Hoek, J A R; Whelan, J; van Erpecum, K J; Boland, G J; Hoepelman, A I M

2014-12-01

Some studies done in Asian patients have shown that serum levels of hepatitis B virus (HBV) DNA predict the development of cirrhosis. However, it is unclear whether this also applies for non-Asian patients. This study investigated historic and current HBV DNA and quantitative hepatitis B surface antigen (HBsAg) levels as predictors of cirrhosis in non-Asian women with chronic HBV. A retrospective cohort study of non-Asian women with chronic HBV was performed. Among other variables, HBV DNA and quantitative HBsAg levels were measured in stored historic serum samples obtained during pregnancy (period 1990-2004) and current serum samples (period 2011-2012) to determine any association with liver cirrhosis by liver stiffness measurement (LSM). One hundred and nineteen asymptomatic, treatment-naïve non-Asian women were included; the median number of years between the historic sample and the current sample was 17 (interquartile range (IQR) 13-20). The median historic log HBV DNA and quantitative log HBsAg levels were 2.5 (IQR 1.9-3.4) IU/ml and 4.2 (IQR 3.6-4.5) IU/ml, respectively. LSM diagnosed 14 patients (12%) with F3-F4 fibrosis, i.e. stiffness >8.1kPa. No association of cirrhosis was found with historic HBV DNA (relative risk (RR) 0.34, 95% confidence interval (CI) 0.05-2.44) or with the quantitative HBsAg level (HBsAg level >1000 IU/ml, RR 0.35, 95% CI 0.11-1.11). Multivariable analysis identified alcohol consumption (odds ratio (OR) 6.4, 95% CI 1.3-30.1), aspartate aminotransferase >0.5 times the upper limit of normal (OR 15.4, 95% CI 1.9-122.6), and prothrombin time (OR 12.0, 95% CI 1.2-120.4), but not HBV DNA or quantitative HBsAg level, to be independent predictors of the presence of cirrhosis. Neither historic nor current HBV DNA or the quantitative HBsAg level is associated with the development of HBV-related cirrhosis in non-Asian women. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Clinical significance of isolated anti-HBc positivity in cases of chronic liver disease in New Delhi, India

Directory of Open Access Journals (Sweden)

Manisha Jain

2009-01-01

Full Text Available Background: The presence of anti-HBc IgG in the absence of HBsAg is usually indicative of a past self-limiting HBV infection. But it is frequently associated with co-infection with HCV which can worsen the existing status of chronic liver disease (CLD. Objectives: The present study was planned to evaluate the significance of isolated HBc IgG positivity in patients of CLD and look for the presence of HCV co-infection in such patients. Methods: Clinical profiles and biochemical tests were done for all the 77 CLD cases included in the study. Blood samples were taken from these patients and tested by the commercially available EIA for the presence of HBsAg, anti-HBc IgG, anti-HBs and anti-HCV. HBV DNA was detected by amplifying the surface region in all the cases. Results: Isolated anti-HBc IgG positivity defined as the presence of anti-HBc IgG in absence of any other serological markers of HBV infection was detected in 28 patients . Out of 64 patients positive for anti-HBc IgG 36 had the markers of HBV, either HBsAg, HBV DNA or anti-HBs alone or in combination. There was a significant association between isolated anti-HBc IgG positivity and HCV co-infection. Conclusion: Anti-HBc IgG should be tested in all patients with CLD as it is frequently the only marker of HBV infection in such patients and they should be monitored closely as such patients can develop CLD. Presence of co-infection with HCV should be actively searched for in such patients.

The impact of maternal HBsAg carrier status on pregnancy outcomes: a case-control study.

Science.gov (United States)

Tse, Ka Yu; Ho, Lai Fong; Lao, Terence

2005-11-01

To examine the impact of maternal HBsAg carrier status on pregnancy outcomes. Two hundred and fifty-three carriers of hepatitis B surface antigen (HBsAg) with singleton pregnancy, were retrospectively compared with 253 controls matched for age and parity and year of delivery. On univariable analysis, HBsAg carriers had higher incidences of threatened preterm labour at <37 weeks (11.9% vs. 6.3%, P=0.030), preterm birth at <34 weeks (4.7% vs. 1.2%, P=0.033), gestational diabetes mellitus (19.0% vs. 11.1%, P=0.012) and antepartum haemorrhage (11.5% vs. 5.5%, P=0.026). Their infants had lower Apgar scores at the 1st (8.47+/-1.67 vs. 8.87+/-1.07, P=0.001) and 5th minute (9.56+/-1.29 vs. 9.80+/-0.54, P=0.007), and increased incidence of intraventricular haemorrhage (4.7% vs. 0.8%, P=0.007). On multivariable analysis, the association between HBsAg carrier state with antepartum haemorrhage, gestational diabetes mellitus and threatened preterm labour were confirmed. HBsAg carriers have increased risk of gestational diabetes mellitus, antepartum haemorrhage, and threatened preterm labour. This may be related to the chronic inflammatory state in these subjects. The role of chronic HBV infection in pregnancy complications has to be further elucidated.

Evaluation of HBsAg and anti-HBc assays in saliva and dried blood spot samples according HIV status.

Science.gov (United States)

Flores, Geane Lopes; Cruz, Helena Medina; Potsch, Denise Vigo; May, Silvia Beatriz; Brandão-Mello, Carlos Eduardo; Pires, Marcia Maria Amendola; Pilotto, Jose Henrique; Lewis-Ximenez, Lia Laura; Lampe, Elisabeth; Villar, Livia Melo

2017-09-01

Influence of HIV status in HBV markers detection in saliva and dried blood spots (DBS) was not well established. This study aims to evaluate the performance of optimized commercial immunoassay for identifying HBsAg and anti-HBc in saliva and DBS according HIV status. A sum of 535 individuals grouped as HIV + , HBV + , HIV/HBV + and HIV/HBV- were recruited where 347 and 188 were included for HBsAg and anti-HBc evaluation, respectively. Serum, DBS collected in Whatman 903 paper and saliva obtained using salivette device were analyzed using EIA. Increased sample volume and ROC curve analysis for cut off determination were used for DBS and saliva testing. HBsAg detection in saliva and DBS exhibited sensitivities of 80.9% and 85.6% and specificities of 86.8% and 96.3%. Sensitivity of anti-HBc in saliva and DBS were 82.4% and 76.9% and specificities in saliva and DBS were 96.9% and 91.7%. Low sensitivities were observed for HBsAg (62%) and anti-HBc (47%) detection in saliva of HIV/HBV+ individuals. OD values were also lower for HBsAg detection in DBS and saliva of HIV/HBV+ individuals compared to their serum samples. Statistical significance was found for sensitivities in HBsAg detection between saliva and DBS demonstrating high sensitivity for DBS specimens. In conclusion, HIV status or antiretroviral treatment appears to interfere in the performance of HBsAg and anti-HBc detection in DBS and saliva samples using the adapted commercial EIA. Copyright © 2017 Elsevier B.V. All rights reserved.

Hepatitis B surface antigen concentrations in patients with HIV/HBV co-infection.

Directory of Open Access Journals (Sweden)

Jerzy Jaroszewicz

Full Text Available HBsAg clearance is associated with clinical cure of chronic hepatitis B virus (HBV infection. Quantification of HBsAg may help to predict HBsAg clearance during the natural course of HBV infection and during antiviral therapy. Most studies investigating quantitative HBsAg were performed in HBV mono-infected patients. However, the immune status is considered to be important for HBsAg decline and subsequent HBsAg loss. HIV co-infection unfavorably influences the course of chronic hepatitis B. In this cross-sectional study we investigated quantitative HBsAg in 173 HBV/HIV co-infected patients from 6 centers and evaluated the importance of immunodeficiency and antiretroviral therapy. We also compared 46 untreated HIV/HBV infected patients with 46 well-matched HBV mono-infected patients. HBsAg levels correlated with CD4 T-cell count and were higher in patients with more advanced HIV CDC stage. Patients on combination antiretroviral therapy (cART including nucleos(tide analogues active against HBV demonstrated significant lower HBsAg levels compared to untreated patients. Importantly, HBsAg levels were significantly lower in patients who had a stronger increase between nadir CD4 and current CD4 T-cell count during cART. Untreated HIV/HBV patients demonstrated higher HBsAg levels than HBV mono-infected patients despite similar HBV DNA levels. In conclusion, HBsAg decline is dependent on an effective immune status. Restoration of CD4 T-cells during treatment with cART including nucleos(tide analogues seems to be important for HBsAg decrease and subsequent HBsAg loss.

HBsAg seroprevalence in students for college entrance examination from 2006 to 2014 in Qidong of Jiangsu Province

Directory of Open Access Journals (Sweden)

NI Zhengping

2015-10-01

Full Text Available ObjectiveTo investigate the HBsAg seroprevalence in the young generation in Qidong of Jiangsu Province, China. MethodsA total of 15 534 students for college entrance examination from 2006 to 2014 were randomly selected from three secondary schools in Qidong as student group. Some of them had hepatitis B vaccination at birth. A total of 1208 adults who had their routine checkups in our hospital from 2007 to 2013 were selected as adult group. It was confirmed that all of them did not have hepatitis B vaccination at birth. Serum HBsAg levels of the two groups were measured using enzyme-linked immunosorbent assay and the seroprevalence was analyzed. Comparison of data between the two groups was made by chi-square test. Results In the 9 years from 2007 to 2013, the seroprevalence rates of HBsAg in the student group were 4.2%(75/1794, 4.3%(77/1797, 4.4%(82/1858, 4.3%(82/1903, 3.4%(56/1627, 2.6%(46/1768, 1.6%(29/1778, 1.6%(27/1642, and 1.8%(24/1367, respectively. The mean HBsAg seroprevalence of the student group was 3.2%(498/15534, significantly lower compared with 7.1% (86/1208 of the adult group (χ2= 59.986, P＜0.001. In both of the student group and the adult group, the males had a significantly higher HBsAg seroprevalence than the females (χ2=10.521, P=0.001; χ2=8.452, P=0.004 and the values were 3.7%(266/7236 vs 2.8%(229/8298 and 8.8%(66/750 vs 4.4%(20/458, respectively. Among male subjects, the HBsAg seroprevalence of the adult group was 2.4 times that of the student group; among female subjects, the HBsAg seroprevalence of the adult group was 1.6 times that of the student group. ConclusionIn the recent 9 years from 2006 to 2014, the HBsAg seroprevalence in students for college entrance examination declined continuously. The goal set by the World Health Organization Western Pacific Region in 2010 had been achieved ahead of the schedule that the HBsAg seroprevalence should be controlled below 2% in children aged less than 5.

HCV and HBV coexist in HBsAg-negative patients with HCV viremia; possibility of coinfection in these patients must be considered in HBV-high endemic area

Energy Technology Data Exchange (ETDEWEB)

Lee, Dong Soon [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

1998-01-01

Hepatocellular carcinoma (HCC) is one of the most common cancers and is highly associated with HBV infection in Korea. It has been suggested that HCV core protein may impair the polymerase activity of HBV in vitro, potentially lowering HBV titre in coinfected patients. The aim of this study was to confirm the coexistence of HBV viremia in HCV infected patients HCC who have apparent HBsAg seronegativity. The serological profiles of HBV and HCV in 616 patients with HCC were analysed and coinfection rate of HBV and HCV investigated. Sera were obtained from 16 patients who were both anti-HCV and HCV RNA positive but HbsAg negative, and tested for HBV BY PCR. As a control group, sera were obtained from 15 patients with HCC and 30 non-A abd non-B chronic hepatitis patients without HCC; both were anti-HCV, HCV-RNA, and HBsAg negative and tested for HBV PCR. Of 616 patients with HCC, 450 (73.1 %) had current HBV infection, 48 (7.8 %) had anti-HCV antibodies, and nine (1.5 %) had viral markers of both HCV abd HBV by serological profiles. Of 27 the patients with HCV viremia and HBsAg seronegativity, 14 (51.9 %) showed HBV viremia by PCR. In contrast, of the 75 patients in the control group who were both HCV PCR negative and HBsAg negative, five (11.1 %) showed HBV viremia by PCR. The PCR for HBV revealed coexistent HBV viremia in HCV viremia patients, despite HBsAg negativity by EIA. In HBV-endemic areas, the possibility of coinfection of HBV in HBsAg-negative patients with HCV viremia should be considered and molecular analysis for HBV-DNA performed. (author). 18 refs., 4 tabs.

HCV and HBV coexist in HBsAg-negative patients with HCV viremia; possibility of coinfection in these patients must be considered in HBV-high endemic area

International Nuclear Information System (INIS)

Lee, Dong Soon

1998-01-01

Hepatocellular carcinoma (HCC) is one of the most common cancers and is highly associated with HBV infection in Korea. It has been suggested that HCV core protein may impair the polymerase activity of HBV in vitro, potentially lowering HBV titre in coinfected patients. The aim of this study was to confirm the coexistence of HBV viremia in HCV infected patients HCC who have apparent HBsAg seronegativity. The serological profiles of HBV and HCV in 616 patients with HCC were analysed and coinfection rate of HBV and HCV investigated. Sera were obtained from 16 patients who were both anti-HCV and HCV RNA positive but HbsAg negative, and tested for HBV BY PCR. As a control group, sera were obtained from 15 patients with HCC and 30 non-A abd non-B chronic hepatitis patients without HCC; both were anti-HCV, HCV-RNA, and HBsAg negative and tested for HBV PCR. Of 616 patients with HCC, 450 (73.1 %) had current HBV infection, 48 (7.8 %) had anti-HCV antibodies, and nine (1.5 %) had viral markers of both HCV abd HBV by serological profiles. Of 27 the patients with HCV viremia and HBsAg seronegativity, 14 (51.9 %) showed HBV viremia by PCR. In contrast, of the 75 patients in the control group who were both HCV PCR negative and HBsAg negative, five (11.1 %) showed HBV viremia by PCR. The PCR for HBV revealed coexistent HBV viremia in HCV viremia patients, despite HBsAg negativity by EIA. In HBV-endemic areas, the possibility of coinfection of HBV in HBsAg-negative patients with HCV viremia should be considered and molecular analysis for HBV-DNA performed. (author). 18 refs., 4 tabs

[Characteristics of HBV transmission in families with HBsAg-positive fathers and familial clustering of HBV infection].

Science.gov (United States)

Yang, Y; Jin, L; He, Y L; Liu, J F; Wang, J; Wang, K; Ma, X H; Li, Q; Feng, Y L; Yan, Z; Yi, R T; Chen, T Y; Zhao, Y R

2016-04-01

To investigate the characteristics of hepatitis B virus (HBV) transmission among family members in families with familial clustering of HBV infection and poor outcomes, as well as the prevalence and distribution characteristics of HBsAg in offspring with different parental HBsAg status. The general information of each member in families with poor outcomes were collected from 2007 to 2010, and serological test was performed to analyze the prevalence and distribution of HBsAg in family members. The chi-square test or Fisher's exact test was used to analyze and compare the sex of offspring and the prevalence of HBsAg in them in 266 nuclear families with different paternal and maternal HBsAg status. The positive rates of HBsAg in parents, siblings, children, and spouses of the probands were 20%, 88.2%, 76.8%, and 9.5%, respectively. The nuclear families with HBsAg-positive fathers and HBsAg-negative mothers had a significantly increased proportion of male offspring (male/female ratio = 2.02) compared with those with HBsAg-positive mothers and HBsAg-negative fathers (1.22) or those with HBsAg-negative fathers and mothers (0.96). In addition, in the nuclear families with HBsAg-positive fathers and HBsAg-negative mothers, the male offspring had a significantly higher HBsAg positive rate than female offspring (37.4% vs 13.8%), while in those with HBsAg-positive mothers and HBsAg-negative fathers or those with HBsAg-negative fathers and mothers, HBsAg positive rate showed no significant difference between male and female offspring. In families with familial clustering of HBV infection and poor outcomes, mother-to-child transmission is still the major route of HBV transmission, but father-to-child transmission also plays a role in HBV transmission in this special population. Positive HBsAg in fathers is associated with the increased proportion of male offspring, and father-to-son transmission of HBV is higher than father-to-daughter transmission.

Species specificity for HBsAg binding protein endonexin II

NARCIS (Netherlands)

deBruin, WCC; Leenders, WPJ; Moshage, H; vanHaelst, UJGM

Background/Aims: Hepatitis B virus displays a distinct species and tissue tropism, Previously we have demonstrated that a human liver plasma membrane protein,vith a molecular weight of approximately 34 kiloDalton specifically binds to HBsAg. This protein was identified as endonexin II, a Ca2+

Assessment of Growth and Development in Children With Hepatitis B Positivity.

Science.gov (United States)

Sari, Tugba; Eren, Erdal; Koruk, Suda Tekin

2014-12-01

Chronic infections and liver diseases may influence the growth and development of children by leading to malnutrition. In this study, demographic characteristics, anthropometric measurements and laboratory findings for children with hepatitis B positivity were analyzed. A total of 43 cases were admitted to our clinic between January 2012 and February 2013 and detected to have HBsAg positivity. Malnutrition was detected in 11 cases (25.6%) and obesity in three cases (6.9%). Aspartate aminotransferase (AST) levels were significantly higher in malnourished patients compared to those without malnutrition. The weight to height was significantly higher in patients with positive HBeAg compared to children with negative HBeAg. We found that the weight standard deviation scores (SDS) ratios dropped as alanine aminotransferase (ALT) and AST levels increased and height SDS ratios decreased. In addition, body mass index (BMI) decreased as AST and alpha feto protein (AFP) values increased. While a significant relationship was not detected between insulin-like growth factor binding protein-3 (IGFBP-3) and insulin-like growth factor-1 (IGF-1) and ALT, a significantly negative correlation was detected between IGFBP-3 and IGF-1 and AST. We found a malnutrition rate of 25.6% in children with HBsAg positivity. We also found that weight and height SDS rates decreased as ALT and AST levels increased. In addition, we detected that BMI decreased as AST and AFP values increased. We consider that hepatic inflammation is the factor that affects growth. Monitoring of growth and development during follow-up of children who are detected to have HBsAg positivity would be beneficial to determine the mechanism and causes of growth retardation.

Results of HBsAg examination with immunoelectrophoresis and radioimmunoassay in VPR, Laotian PDR and Cuban R

Energy Technology Data Exchange (ETDEWEB)

Michal, L; Szilagyiova, M; Zahradny, V; Holan, J; Krajnak, V [Komenskeho Univ., Martin (Czechoslovakia). Lekarska Fakulta; Padurova, J [Okresna Hygienicka Stanica, Zilina (Czechoslovakia)

1984-06-21

The results are compared of examining 112 Vietnamese, 30 Laotian and 50 Cuban citizens for HBsAg using IEP and RIA methods. Of the examined persons with no liver disorders HBsAg was found in 23 (31.5%) of the Vietnamese and 1 (2.5%) of the Cubans using the RIA method and only in 4 (5.5%) of the Vietnamese using the IEP method. Of the examined persons with liver disorders RIA found HBsAg in 12 (30.8%) of the Vietnamese, 5 (71.4%) of the Laotians and 2 (20.0%) of the Cubans while with IEP only in 3 (7.7%) Vietnamese 2 (28.6%) Laotians and 1 (10.0%) of the Cubans examined.

Results of HBsAg examination with immunoelectrophoresis a radioimmunoassay in VPR, Laotian PDR and Cuban R

International Nuclear Information System (INIS)

Michal, L.; Szilagyiova, M.; Zahradny, V.; Holan, J.; Krajnak, V.

1984-01-01

The results are compared of examining 112 Vietnamese, 30 Laotian and 50 Cuban citizens for HBsAg using IEP and RIA methods. Of the examined persons with no liver disorders HBsAg was found in 23 (31.5%) of the Vietnamese and 1 (2.5%) of the Cubans using the RIA method and only in 4 (5.5%) of the Vietnamese using the IEP method. Of the examined persons with liver disorders RIA found HBsAg in 12 (30.8%) of the Vietnamese, 5 (71.4%) of the Laotians and 2 (20.0%) of the Cubans while with IEP only in 3 (7.7%) Vietnamese 2 (28.6%) Laotians and 1 (10.0%) of the Cubans examined. (author)

Sero markers of hepatitis B and C in patients with cirrhosis

International Nuclear Information System (INIS)

Khan, A.A.; Khalil-ur-Rehman; Haider, Z.; Shafqat, F.

2002-01-01

Objective: To assess the role of hepatitis B virus (HBV) and hepatitis C virus (HCV) in pathogenesis of liver cirrhosis. Design: It was a prospective study. Place and duration of study: This study was done at two centers, Sheikh Zayed Hospital, Lahore and Jinnah Hospital, over a period of six months from June to December, 1997. Subjects and Methods: Ninety-four patients with liver cirrhosis were evaluated for sero markers of hepatitis B and C virus at two teaching hospitals in Lahore. Viral markers studied were anti-HCV, HBSAG, anti-HBclgG, anti-HBs, and HbeAg. Anti-HDV was done in HbsAg positive cases. Results: Twenty-two out of 94 (23%) patients were positive and 72(77%) negative for HbsAg. Anti-HCV was positive in 64 (68%) and no major sero markers for HBV or HCV were seen in 16 patients. Conclusion: It was evident from sero markers that exposure to hepatitis B and C had occurred but which one was responsible for cirrhosis, was hard to determine. Inasmuch as vaccine against hepatitis B virus is available, mass vaccination in the population may be a consideration to prevent cirrhosis due to hepatitis B virus. (author)

Patterns of hepatitis B virus infection in Brazilian human immunodeficiency virus infected patients: high prevalence of occult infection and low frequency of lamivudine resistant mutations

Directory of Open Access Journals (Sweden)

Michel VF Sucupira

2006-09-01

Full Text Available Hepatitis B virus (HBV molecular profiles were determined for 44 patients who were infected with human immunodeficiency virus (HIV type 1 and had antibodies to the hepatitis B core antigen (anti-HBc, with and without other HBV serological markers. In this population, 70% of the patients were under lamivudine treatment as a component of antiretroviral therapy. HBV DNA was detected in 14 (32% patients. Eight out of 12 (67% HBsAg positive samples, 3/10 (30% anti-HBc only samples, and 3/22 (14% anti-HBs positive samples were HBV DNA positive. HBV DNA loads, measured by real time polymerase chain reaction, were much higher in the HBsAg positive patients (mean, 2.5 × 10(9 copies/ml than in the negative ones (HBV occult infection; mean, 2.7 × 10(5 copies/ml. Nine out of the 14 HBV DNA positive patients were under lamivudine treatment. Lamivudine resistant mutations in the polymerase gene were detected in only three patients, all of them belonging to the subgroup of five HBsAg positive, HBV DNA positive patients. A low mean HBV load (2.7 × 10(5 copies/ml and an absence of lamivudine resistant mutations were observed among the cases of HBV occult infection.

Occult Hepatitis B Virus infection in ART-Naive HIV-Infected Patients seen at a Tertiary Care Centre in North India

Directory of Open Access Journals (Sweden)

Singh Sarman

2010-03-01

Full Text Available Abstract Background Co-infections of hepatitis B and C viruses are frequent with HIV due to shared routes of transmission. In most of the tertiary care health settings, HIV reactive patients are routinely tested for HBsAg and anti-HCV antibodies to rule out these co-infections. However, using the routine serological markers one can only detect active HBV infection while the occult HBV infection may be missed. There is insufficient data from India on HIV-HBV co-infection and even scarce on occult HBV infection in this group. Methods We estimated the burden of HBV infection in patients who were tested positive for HIV at a tertiary care centre in north India. We also attempted to determine the prevalence and clinical characteristics of occult HBV infection among these treatment-naïve patients and compare their demographic features with other HIV patients. During a period of 6 years between January 2002 to December 2007, 837 HIV positive patients (631 males and 206 females (M: F :: 3.06:1 were tested for serological markers of HBV (HBsAg and HCV (anti-HCV antibodies infections in our laboratory. For comparison 1000 apparently healthy, HIV-negative organ donors were also included in the study. Data on demographics, sexual behaviour, medical history, laboratory tests including the serum ALT and CD4 count of these patients were recorded. A sub-group of 53 HBsAg negative samples from HIV positive patients were assessed for anti-HBs, anti-HBc total (IgG+IgM and HBV-DNA using a highly sensitive qualitative PCR and analysed retrospectively. Results Overall, 7.28% of HIV positive patients showed presence of HBsAg as compared to 1.4% in the HIV negative control group. The prevalence of HBsAg was higher (8.55% in males than females (3.39%. The study revealed that occult HBV infection with detectable HBV-DNA was prevalent in 24.5% of patients positive for anti-HBc antibodies; being 45.5% in HBsAg negative patients. Most importantly the occult infection was

Screening of 110 cirrhotic patients for hepatitis B and C at Saidu Teaching Hospital, Saidu Sharif, Swat

International Nuclear Information System (INIS)

Khan, P.; Ahmad, A.; Ahmad, B.; Khan, T.M.

2009-01-01

Cirrhosis liver is amongst the commonest clinical conditions in Pakistan. Besides other causes, it is mostly related to previous viral infection, in this part of the world. The main objective of this study was to find the frequency of HBsAg and anti HCV in cirrhotic patients of Swat district. This Prospective Study was conducted in the Medical unit of Saidu Teaching Hospital, Saidu Sharif from January 2006 to December 2006. One hundred and ten Cirrhotic Patients, 62 Male and 48 Female aged from 14 to 75 years were included in this study. Sera were tested by third generation Elisa method. Fifty-nine out of 110 (53.6%) patients were positive for anti HCV antibodies. Twenty-four (21.81%) Patients were positive for HBsAg. Eleven (10%) patients were positive for both HBsAg and anti HCV anti bodies. Sixteen (14.54%) were negative for both sero maker of hepatitis B and C. It is evident from this study that Hepatitis C, is a leading cause of cirrhosis in District Swat followed by HBV. Both the viruses account for at least three fourths of the total Cirrhotic. (Author)

Construction of a hepatitis B virus neutralizing chimeric monoclonal antibody recognizing escape mutants of the viral surface antigen (HBsAg).

Science.gov (United States)

Golsaz-Shirazi, Forough; Amiri, Mohammad Mehdi; Farid, Samira; Bahadori, Motahareh; Bohne, Felix; Altstetter, Sebastian; Wolff, Lisa; Kazemi, Tohid; Khoshnoodi, Jalal; Hojjat-Farsangi, Mohammad; Chudy, Michael; Jeddi-Tehrani, Mahmood; Protzer, Ulrike; Shokri, Fazel

2017-08-01

Hepatitis B virus (HBV) infection is a global burden on the health-care system and is considered as the tenth leading cause of death in the world. Over 248 million patients are currently suffering from chronic HBV infection worldwide and annual mortality rate of this infection is 686000. The "a" determinant is a hydrophilic region present in all antigenic subtypes of hepatitis B surface antigen (HBsAg), and antibodies against this region can neutralize the virus and are protective against all subtypes. We have recently generated a murine anti-HBs monoclonal antibody (4G4), which can neutralize HBV infection in HepaRG cells and recognize most of the escape mutant forms of HBsAg. Here, we describe the production and characterization of the chimeric human-murine antibody 4G4 (c-4G4). Variable region genes of heavy and light chains of the m-4G4 were cloned and fused to constant regions of human kappa and IgG1 by splice overlap extension (SOE) PCR. The chimeric antibody was expressed in Chinese Hamster Ovary (CHO)-K1 cells and purified from culture supernatant. Competition ELISA proved that both antibodies bind the same epitope within HBsAg. Antigen-binding studies using ELISA and Western blot showed that c-4G4 has retained the affinity and specificity of the parental murine antibody, and displayed a similar pattern of reactivity to 13 escape mutant forms of HBsAg. Both, the parental and c-4G4 showed a comparably high HBV neutralization capacity in cell culture even at the lowest concentration (0.6μg/ml). Due to the ability of c-4G4 to recognize most of the sub-genotypes and escape mutants of HBsAg, this antibody either alone or in combination with other anti-HBs antibodies could be considered as a potent alternative for Hepatitis B immune globulin (HBIG) as an HBV infection prophylactic or for passive immunotherapy against HBV infection. Copyright © 2017 Elsevier B.V. All rights reserved.

Reactivation of hepatitis B in patients of chronic hepatitis C with hepatitis B virus infection treated with direct acting antivirals.

Science.gov (United States)

Yeh, Ming-Lun; Huang, Chung-Feng; Hsieh, Meng-Hsuan; Ko, Yu-Min; Chen, Kuan-Yu; Liu, Ta-Wei; Lin, Yi-Hung; Liang, Po-Cheng; Hsieh, Ming-Yen; Lin, Zu-Yau; Chen, Shinn-Cherng; Huang, Ching-I; Huang, Jee-Fu; Kuo, Po-Lin; Dai, Chia-Yen; Yu, Ming-Lung; Chuang, Wan-Long

2017-10-01

Hepatitis B virus (HBV) may reactivate when treating chronic hepatitis C (CHC) with direct acting antivirals (DAA). We aim to investigate the risk of HBV reactivation during DAA therapy. Chronic hepatitis C patients receiving pan-oral DAA therapy from December 2013 to August 2016 were evaluated. Fifty-seven patients that had a past HBV infection (negative hepatitis B surface antigen [HBsAg] and positive hepatitis B core antibody) and seven patients that had a current HBV infection (positive HBsAg) were enrolled. Serum HBV and hepatitis C virus (HCV) markers were regularly measured. The endpoints were the HCV sustained virological response (SVR) and the HBV virological/clinical reactivation. The overall SVR 12 rate was 96.9%, and two patients, one with positive HBsAg, had a relapse of HCV. No episodes of HBV virological reactivation were observed among the patients with a past HBV infection. For the seven patients with a current HBV infection, HBV virological reactivation was found in four (57.1%) of the seven patients. Clinical reactivation of HBV was observed in one patient with pretreatment detectable HBV DNA and recovered after entecavir administration. For the other three patients with HBV virological reactivation, the reappearance of low level HBV DNA without clinical reactivation was observed. HBsAg levels demonstrated only small fluctuations in all the patients. There was a minimal impact of hepatitis B core antibody seropositivity on HCV efficacy and safety. For CHC patients with current HBV infection, the risk of HBV reactivation was present, and monitoring the HBV DNA level during therapy is warranted. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Hepatitis B surface antigen (HBsAg) expression in plant cell culture: Kinetics of antigen accumulation in batch culture and its intracellular form.

Science.gov (United States)

Smith, Mark L; Mason, Hugh S; Shuler, Michael L

2002-12-30

The production of edible vaccines in transgenic plants and plant cell culture may be improved through a better understanding of antigen processing and assembly. The hepatitis B surface antigen (HBsAg) was chosen for study because it undergoes substantial and complex post-translational modifications, which are necessary for its immunogenicity. This antigen was expressed in soybean (Glycine max L. Merr. cv Williams 82) and tobacco NT1 (Nicotiana tabacum L.) cell suspension cultures, and HBsAg production in batch culture was characterized. The plant-derived antigen consisted predominantly of disulfide cross-linked HBsAg protein (p24(s)) dimers, which were all membrane associated. Similar to yeast, the plant-expressed HBsAg was retained intracellularly. The maximal HBsAg titers were obtained with soybean suspension cultures (20-22 mg/L) with titers in tobacco cultures being approximately 10-fold lower. For soybean cells, electron microscopy and immunolocalization demonstrated that all the HBsAg was localized to the endoplasmic reticulum (ER) and provoked dilation and proliferation of the ER network. Sucrose gradient analysis of crude extracts showed that HBsAg had a complex size distribution uncharacteristic of the antigen's normal structure of uniform 22-nm virus-like particles. The extent of authentic epitope formation was assessed by comparing total p24(s) synthesized to that reactive by polyclonal and monoclonal immunoassays. Depending on culture age, between 40% and 100% of total p24(s) was polyclonal antibody reactive whereas between 6% and 37% was recognized by a commercial monoclonal antibody assay. Possible strategies to increase HBsAg production and improve post-translational processing are discussed. Copyright 2002 Wiley Periodicals, Inc.

Human immunodeficiency virus (HIV) seropositivity and hepatitis B surface antigenemia (HBSAG) among blood donors in Benin city, Edo state, Nigeria.

Science.gov (United States)

Umolu, Patience Idia; Okoror, Lawrence Ehis; Orhue, Philip

2005-03-01

Human Immunodeficiency Virus and Hepatitis B virus are blood borne pathogens that can be transmitted through blood transfusion and could pose a huge problem in areas where mechanisms of ensuring blood safety are suspect. This study became necessary in a population where most of the blood for transfusion is from commercial blood donors. A total of 130 donors comprising 120 commercial donors and 10 voluntary donors were tested for antibodies to human immunodeficiency virus and hepatitis B surface antigen in Benin city using Immunocomb HIV - 1 and 2 Biospot kit and Quimica Clinica Aplicada direct latex agglutination method respectively. Thirteen (10%) samples were HIV seropositive and 7(5.8%) were HBsAg positive. The age bracket 18 - 25years had the highest numbers of donors and also had the highest number of HBsAg positive cases (7.8%) while the age group 29 - 38years had highest number of HIV seropositive cases. High prevalence of HIV antibodies and Hepatitis B surface antigen was found among commercial blood donors. Appropriate and compulsory screening of blood donors using sensitive methods, must be ensured to prevent post transfusion hepatitis and HIV.

Radioimmunologic determination of hepatitis B antigen (HBsAG) in selected groups of persons and in special blood preparations

Energy Technology Data Exchange (ETDEWEB)

Lipsic, T; Geso, L [Clinic of Haematology and Blood Transfusion, Bratislava (Czechoslovakia)

1978-06-30

Presence of HBsAg was investigated by the RIA method in groups: exposed patients, blood donors, medical staff and different plasma preparations, namely: antihaemophilic cryoprotein (AHCp), Fibrinogen, I. Cohn's fraction and PPSB. 1789 samples of serum or converted material (plasma and its fractions) were investigated. In 405 cases AUSRIA-I method was used, the remaining 1384 cases were investigated by AUSRIA-II. Data are tabulated.

Assessment of hepatitis B virus and hepatitis C virus infections and associated risk factors in HIV infected patients at Debretabor hospital, South Gondar, Northwest Ethiopia

Directory of Open Access Journals (Sweden)

Melashu Balew

2014-02-01

Full Text Available Objective: To assess hepatitis B and hepatitis C virus infections and associated risk factors among HIV infected patients at Debretabor hospital. Methods: A cross-sectional study was conducted among HIV/AIDS patients attending Debretabor hospital from February to April, 201 2. Venous blood samples were collected from study participants for HBsAg and anti HCV antibody tests. Bivariate and multivariate analyses were used to identify associated variables with HBsAg and anti HCV positivity. Variables having P<0.05 was taken as statistically significant association. Results: From a total of 395 HIV infected patients included in this study, 234 (59.2% were females and 161 (40.8% males with mean (依SD age of 36.31 (依9.91 years. The prevalence of HBsAg and anti HCV antibody was 6.1% and 1.3%, respectively. In multivariate analysis, multiple sexual partner (AOR=8.1, 95% CI=1.8-33.97 and history of opportunistic infections (AOR=3.17, 95% CI=1.3-7.7 were statistically associated with HBsAg positivity. History of blood transfusion (AOR=5.61, 95% CI= 1.03-36.59 was associated with presence of anti-HCV antibody. Conclusions: The prevalence of HBsAg and anti HCV antibodies in HIV coinfected patients was intermediate. However, it is relevant for HIV infected patients since viral hepatitis co-infections in HIV patients can cause multiple complications. Therefore, routine HBV and HCV screening with reliable diagnostic markers need to be carried out for close monitoring and better management in HIV patients.

Hepatitis B surface antigen (HBsAg) and core antigen (HBcAg) combine CpG oligodeoxynucletides as a novel therapeutic vaccine for chronic hepatitis B infection.

Science.gov (United States)

Li, Jianqiang; Ge, Jun; Ren, Sulin; Zhou, Tong; Sun, Ying; Sun, Honglin; Gu, Yue; Huang, Hongying; Xu, Zhenxing; Chen, Xiaoxiao; Xu, Xiaowei; Zhuang, Xiaoqian; Song, Cuiling; Jia, Fangmiao; Xu, Aiguo; Yin, Xiaojin; Du, Sean X

2015-08-20

Hepatitis B virus infection is a non-cytopathic hepatotropic virus which can lead to chronic liver disease and hepatocellular carcinoma. Traditional therapies fail to provide sustained control of viral replication and liver damage in most patients. As an alternative strategy, immunotherapeutic approaches have shown promising efficacy in the treatment of chronic hepatitis B patients. Here, we investigated the efficacy of a novel therapeutic vaccine formulation consisting of two HBV antigens, HBsAg and HBcAg, and CpG adjuvant. This vaccine formulation elicits forceful humoral responses directed against HBsAg/HBcAg, and promotes a Th1/Th2 balance response against HBsAg and a Th1-biased response against HBcAg in both C57BL/6 and HBV transgenic mice. Vigorous cellular immune response was also detected in HBV transgenic mice, for a significantly higher number of HBs/HBc-specific IFN-γ secreting CD4+ and CD8+ T cells was generated. Moreover, vaccinated mice elicited significantly intense in vivo CTL attack, reduced serum HBsAg level without causing liver damage in HBV transgenic mice. In summary, this study demonstrates a novel therapeutic vaccine with the potential to elicit vigorous humoral and cellular response, overcoming tolerance in HBV transgenic mice. Copyright © 2015 Elsevier Ltd. All rights reserved.

A meta-analysis of the antiviral activity of the HBV-specific immunotherapeutic TG1050 confirms its value over a wide range of HBsAg levels in a persistent HBV pre-clinical model.

Science.gov (United States)

Kratzer, Roland; Sansas, Benoît; Lélu, Karine; Evlachev, Alexei; Schmitt, Doris; Silvestre, Nathalie; Inchauspé, Geneviève; Martin, Perrine

2018-02-01

Pre-clinical models mimicking persistent hepatitis B virus (HBV) expression are seldom, do not capture all features of a human chronic infection and due to their complexity, are subject to variability. We report a meta-analysis of seven experiments performed with TG1050, an HBV-targeted immunotherapeutic, 1 in an HBV-persistent mouse model based on the transduction of mice by an adeno-associated virus coding for an infectious HBV genome (AAV-HBV). To mimic the clinical diversity seen in HBV chronically infected patients, AAV-HBV transduced mice displaying variable HBsAg levels were treated with TG1050. Overall mean percentages of responder mice, displaying decrease in important clinical parameters i.e. HBV-DNA (viremia) and HBsAg levels, were 52% and 51% in TG1050 treated mice, compared with 8% and 22%, respectively, in untreated mice. No significant impact of HBsAg level at baseline on response to TG1050 treatment was found. TG1050-treated mice displayed a significant shorter Time to Response (decline in viral parameters) with an Hazard Ratio (HR) of 8.3 for viremia and 2.6 for serum HBsAg. The mean predicted decrease for TG1050-treated mice was 0.5 log for viremia and 0.8 log for HBsAg, at the end of mice follow-up, compared to no decrease for viremia and 0.3 log HBsAg decrease for untreated mice. For mice receiving TG1050, a higher decline of circulating viremia and serum HBsAg level over time was detected by interaction term meta-analysis with a significant treatment effect (p = 0.002 and pHBV-persistent model mimicking clinical situations.

Analysis of hepatitis B virus intrahepatic covalently closed circular DNA and serum viral markers in treatment-naive patients with acute and chronic HBV infection.

Directory of Open Access Journals (Sweden)

Weijie Li

Full Text Available BACKGROUND: This study aimed to investigate the relationships of intrahepatic cccDNA with serum HBsAg and with HBV DNA in treatment-naive patients throughout acute and chronic HBV infection. METHODS: A total of 120 patients who had a liver biopsy were enrolled, including 19 with acute hepatitis B (AHB, and 101 patients with chronic HBV infection (CHB of whom were 10 in immune-tolerant (IT phase, 59 in immune-clearance (IC phase, 8 in low-replicative (LR phase, and 24 in HBeAg-negative hepatitis (ENH phase. Intrahepatic cccDNA, serum HBsAg and serum HBV DNA levels were comparatively analyzed. RESULTS: The median intrahepatic cccDNA levels were 0.18 4.80, 3.81, 0.22 and 0.97 copies/cell for patients with AHB, CHB-IT, CHB-IC, CHB-LR, and CHB-ENH, respectively. In AHB patients, intrahepatic cccDNA was positively correlated with serum HBsAg (r = 0.665, P = 0.003, as well as serum HBV DNA (r = 0.536, P = 0.022. In CHB patients, intrahepatic cccDNA was positively correlated with serum HBsAg in the IC phase (r = 0.392, P = 0.005, and with serum HBV DNA in the IC phase (r = 0.301, P = 0.036 and ENH phase (r = 0.588, P = 0.013. HBV replicative efficiency, defined as the ratio of serum HBV DNA to intrahepatic cccDNA, was obviously lower in AHB and CHB-LR patients than in CHB-IT, CHB-IC and CHB-ENH patients (0.70 and 0.53 vs. 1.12, 1.09 and 0.99, P<0.001, values were logarithmic transformed for analysis. In CHB-IC patients, HBV replicative efficiency was positively correlated with histological activity index of liver inflammation (r = 0.308, P = 0.009. CONCLUSION: Serum HBsAg and HBV DNA levels may reflect the amount of active intrahepatic cccDNA in treatment-naive AHB and CHB-IC patients. Reduced intrahepatic cccDNA and HBV replicative efficiency may imply effective immune control of HBV infection.

Prevalence of hepatitis B virus in patients with diabetes mellitus: a comparative cross sectional study at Woldiya General Hospital, Ethiopia.

Science.gov (United States)

Mekonnen, Daniel; Gebre-Selassie, Solomon; Fantaw, Surafel; Hunegnaw, Andualem; Mihret, Adane

2014-01-01

The overall prevalence of HBV in Ethiopia varies from 4.7-16.8% for Hepatitis B surface antigen (HBsAg) and 70-76.38% for at least one marker positive. Patients suffering from type I Diabetes Mellitus (DM) incur high risk of infection with hepatotropic viruses because of frequent hospitalization and blood tests. A comparative cross sectional study was conducted at Woldiya General Hospital using 108 consented study populations from Diabetes and 108 non diabetes control groups during the period November 2010 - January 2011. VISITECT HBsAg rapid test kit and Humastat 80 chemistry analyzer were used. Multivariate logistic regression was used to see the association of HBV with clinical history of participants and Sociodemographic variables. All tests were two-sided with α-level of 0.05 and 80% power. Prevalence of HBsAg was equal between diabetic and non diabetic individuals, 3.7% indicating that there was no difference between the two groups. Only history of invasive procedures and chronic liver disease showed association with HBsAg seropositivity. In this study a positive relation was not indicated between HBV and Diabetes and the prevalence of HBsAg was equal between diabetic and non diabetic individuals.

Hepatitis B and C Sero-prevalence in Patients with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome at a Tertiary Care Hospital in Izmir

Directory of Open Access Journals (Sweden)

Sabri ATALAY

2018-04-01

Full Text Available Objectives: Infections caused by human immunodeficiency virus (HIV, hepatitis B virus (HBV and hepatitis C virus (HCV represent a significant health problem. Co-infection with these viral agents is not uncommon as a result of the similar transmission routes. Our study was planned to investigate the prevalence of HBV and HCV infections in HIV/Acquired Immune Deficiency syndrome (AIDS patients followed up at our institution. Materials and Methods: In this study conducted in the Department of Infectious Diseases and Clinical Microbiology at Izmir Tepecik Training and Research Hospital, medical records of patients followed at the HIV/AIDS outpatient clinic between August 2002 and December 2014 were evaluated. Demographic data, main route of HIV transmission, hepatitis B surface antigen (HBsAg, anti-hepatitis B core (HBc immunoglobulin G (IgG, anti-HBs and anti-HCV results were evaluated. Results: A total of 157 treatment-naïve patients who were followed up at our HIV/AIDS outpatient clinic were included in this study. Four patients (2.6%, had HBsAg positivity. Anti-HBc IgG and anti-HBs positivity were detected in 34% and 28.4% of the patients, respectively. No patients had anti-HCV positivity. Conclusion: The prevalence of HBsAg in HIV-positive individuals was found to be similar to that in other population-based studies in our country. Absence of anti-HCV positivity suggests that hepatitis C infection is not a major health problem in this population.

Estudo da soroprevalência do AgHBs em gestantes da 15ª Regional de Saúde e da imunoprofilaxia para os recém-nascidos das gestantes AgHBs positivo = Study into the HBsAg seroprevalence in pregnant women from the 15th Health Regional and the immunoprophylaxia on the newborns of these HBsAg-positive women

Directory of Open Access Journals (Sweden)

Sonia Kaori Miyamoto

2008-01-01

Full Text Available Determinar a prevalência do AgHBs nas gestantes da 15ª Regional de Saúde (15ª R.S. atendidas no Laboratório de Ensino e Pesquisa em Análises Clínicas (Lepac, Universidade Estadual de Maringá, e verificar se foi solicitada a imunoprofilaxia para hepatite B aos recém-natos das gestantes AgHBs positivo, no período de janeiro de 1998 a dezembro de 2002. A pesquisa do AgHBs foi realizada pela técnica imunoenzimática IMxHBsAg e Axsym HBsAg (Laboratório Abbott. As solicitações de imunobiológicos especiais para a imunoprofilaxia da hepatite B ao CRIE foram obtidas na Seção de Epidemiologia da 15ª R.S. Foram analisadas 12.274 gestantes e a prevalência do AgHBs foide 1,0%. Dentre as 125 gestantes AgHBs positivo, foram solicitadas imunoprofilaxia para 32 (25,6% recém-nascidos. Ainda que a prevalência encontrada indique ser esta uma área de baixa endemicidade, os resultados reafirmam a importância da realização do diagnóstico da hepatite B no atendimento pré-natal, para adoção da imunoprofilaxia no recém-nascido.To determine HBsAg prevalence among pregnant women from the 15th Health Regional assisted in the Laboratório de Ensino e Pesquisa em Análises Clínicas (Lepac, Universidade Estadual de Maringá, and verify whether immunoprophylaxis with vaccine and immunoglobulin was requested for the newborns of HBsAg-positive women during the period from January 1998 to December 2002. The research about HBsAg was conducted using the immunoenzymatic IMxHBsAg (Abbot Lab and Axsym HBsAg (Abbot Lab techniques. The requests to the CRIE for specialimmunobiologic agents for Hepatitis B immunoprophylaxis were obtained in the Department of Epidemiology from the 15th Health Regional. The analysis includes 12,274 pregnant women, and the HBsAg prevalence was 1.0%. Among 125 HBsAg positive pregnant women, immunoprophylaxis was requested for 32 (25.6% newborns. Although the prevalence detected demonstrates this to be a low endemic area, the

Low prevalence of hepatitis B and C among tuberculosis patients in Duhok Province, Kurdistan: Are HBsAg and anti-HCV prerequisite screening parameters in tuberculosis control program?

Directory of Open Access Journals (Sweden)

Muayad A Merza

2016-01-01

Full Text Available Objective/background: Viral hepatitis, particularly hepatitis B virus (HBV and hepatitis C virus (HCV, infections and tuberculosis (TB are a global public health concern. Co-infection with HBV or HCV among TB patients may potentiate the risk of hepatotoxicity induced by anti-TB drugs. Hence, the aim of this study was to identify the prevalence of HBV and HCV among TB patients included in the Duhok National Tuberculosis Program (NTP. Methods: The Duhok NTP Center is a specialized institution in Duhok City, Iraq, concerned with management and follow-up of TB patients. A cross-sectional study was conducted at the center between June 2015 and May 2016. All documented TB patients were analyzed on the basis of socio-demographic and other characteristics. Thereafter, all patients underwent screening for hepatitis B surface antigen (HBsAg, anti-HCV, and anti-HIV using enzyme-linked immunosorbent assay (ELISA. The results obtained were analyzed by entering the data in binary format into a Microsoft Excel spreadsheet. A p value of <.05 was considered to be statistically significant. Results: Two-hundred fourteen documented TB patients were recruited in this study, with 127 (59.3% males and 87 (40.7% females. The mean age of the patients was 40.34 years (±20.29. Of the total number of patients, four cases (1.8% were HBsAg-positive and one case (0.9% was positive for anti-HCV. The variables significantly associated with HBV were history of surgical dental procedure [odds ratio (OR, 0.04; 95% confidence interval (CI, −0.01 to 0.04; p = .03], and nationality (OR, 13.67; 95% CI, 0.46–210.85; p = .007. Conclusion: The prevalence of HBV and HCV co-infection among TB patients in this study was low. This may be explained by the low rate of blood transfusion among the patients, the very low prevalence of HIV infections in Kurdistan, the negative history of injection drug use, and adherence to universal infection-control measures, including vaccination for HBV

Detection of HBsAg and Anti HBc on donors of a blood bank by IRMA and ELISA methods

International Nuclear Information System (INIS)

Freire Martinez, D.Y.

1985-10-01

Comparative evaluation of two methods, Immunoradiometric Assay (IRMA) and Enzyme Immunoassay (ELISA), for detecting HBsAg and Anti HBc was made for determining which is the most advantageous and reliable. The study was made on 300 donors of the Hospital San Juan de Dios Blood Bank. In comparison with the reference method (IRMA), ELISA shows 91.67% of sensitivity. The Anti HBc detection by IRMA is more reliable than the HBsAg detection by IRMA and ELISA for determining the carrier state

Frequency of hepatitis B and C in patients undergoing elective surgery

International Nuclear Information System (INIS)

Memon, M.R.; Arshad, S.; Shah, Q.A.; Soomro, A.A.

2010-01-01

Background: Viral Hepatitis (HBV and HCV) is a major health problem affecting approximately two billion population worldwide. It is one of the single most important cause of chronic liver disease and hepato-cellular carcinoma in Pakistan and worldwide and is now spreading beyond endemic dimensions. This study was carried out to assess the frequency of Hepatitis B and C infection in patients undergoing elective surgical operations, and to evaluate the associated risk factors. Methods: This was a descriptive study, conducted at Surgical Department of Ghulam Muhammad Mahar Medical College Hospital, Sukkur, from April 2009 to March 2010. All patients who were admitted in the Surgical Department for elective surgical operations were included in the study. The patients were screened for HBsAg and Anti-HCV using immunochromatography (ICT) method. Those who were weak positive by ICT were further confirmed by ELISA. Results: Total 913 patients were admitted in Surgical Department during study period for elective operations and were screened for HBsAg and Anti-HCV. Out of these, 572 (62.65%) were male and 341 (37.34%) were female. Mean age of these patients was 40 years. After screening, 33 (3.61%) patients were found HBsAg positive and 117 (12.8%) were Anti-HCV positive, while 9 (0.98%) were positive for both. Hepatitis-B was found in 21 (2.3%) males and 12 (1.3%) females, and Hepatitis-C was found in 68 (7.44%) males and 49 (5.36%) female patients. Parenteral injections by quacks, previous surgery, blood transfusion and shaving by barbers were found to be the risk factors. Conclusion: Our message is: 'Prevention is better than cure'. It is essential to prevent spread of Hepatitis B and C by screening every patient before surgery and counselling the patients. The doctors and paramedical staff must follow proper ethical practice ensuring use of sterile disposable where indicated and protecting patients and themselves from these viral infections. (author)

Infection with hepatitis B and hepatitis C virus as risk factors for hepatocarcinoma in Peru: Study of cases and control; Infeccion con virus de la hepatitis B y hepatitis C como factores de riesgo para hepatocarcinoma en el Peru: estudio de casos y controles

Energy Technology Data Exchange (ETDEWEB)

Ruiz, E; Celis, J; Pizarro, R; Montalbeti, J; Urbano, R [Instituto de Enfermedades Neoplasicas, Lima (Peru); Almonte, M [Centro de Investigacion en Cancer Maes Heller, Lima (Peru)

1998-09-01

To investigate whether past exposure to Hepatitis B virus (HBV) and Hepatitis C Virus (HCV) were risk factors for the development of Hepatocellular Carcinoma (HCC) in Peru, a case-control study of 136 patients with HCC and 136 age-matched and sex-matched control subjects was performed. Past exposure to HBV and HCV were assessed respectively by antibody to hepatitis B core antigen (Anti-HBc) and HbsAg and Anti-HCV. Of the HCC cases, 63,2% were positive for HbsAg and 0,73% for anti-HCV. Of the control patients, 4,4% were positive to HbsAg and 0,73% to anti-HCV. The mean age of patients with HCC negative for HbsAg was significantly greater than that of patients HCC positive for HbsAg (35,4 versus 29,4 years, p less than 0,001). The HbsAg patients are 36,26 times more prone to developing HCC than those with HbsAg negative (95% confidence interval: 15.31-90.7). Infection with HCV does not pose a risk for the development of HCC (RR 1, 95% confidence interval: 0.062-16.152). A causal relation between HBV infection in children HCC was observed. These results indicate that HbsAg carriage is a risk factor for HCC in Peru. The importance of vertical or perinatal transmission of HBV and the prophylactic role of passive immunization plus vaccination during childhood is emphasized as well as the selective vaccination of high risk groups. (authors)

Infection with hepatitis B and hepatitis C virus as risk factors for hepatocarcinoma in Peru: Study of cases and control

International Nuclear Information System (INIS)

Ruiz, E.; Celis, J.; Pizarro, R.; Montalbeti, J.; Urbano, R.; Almonte, M.

1998-01-01

To investigate whether past exposure to Hepatitis B virus (HBV) and Hepatitis C Virus (HCV) were risk factors for the development of Hepatocellular Carcinoma (HCC) in Peru, a case-control study of 136 patients with HCC and 136 age-matched and sex-matched control subjects was performed. Past exposure to HBV and HCV were assessed respectively by antibody to hepatitis B core antigen (Anti-HBc) and HbsAg and Anti-HCV. Of the HCC cases, 63,2% were positive for HbsAg and 0,73% for anti-HCV. Of the control patients, 4,4% were positive to HbsAg and 0,73% to anti-HCV. The mean age of patients with HCC negative for HbsAg was significantly greater than that of patients HCC positive for HbsAg (35,4 versus 29,4 years, p less than 0,001). The HbsAg patients are 36,26 times more prone to developing HCC than those with HbsAg negative (95% confidence interval: 15.31-90.7). Infection with HCV does not pose a risk for the development of HCC (RR 1, 95% confidence interval: 0.062-16.152). A causal relation between HBV infection in children HCC was observed. These results indicate that HbsAg carriage is a risk factor for HCC in Peru. The importance of vertical or perinatal transmission of HBV and the prophylactic role of passive immunization plus vaccination during childhood is emphasized as well as the selective vaccination of high risk groups. (authors)

The relationship between HBcrAg and HBV reinfection in HBV related post-liver transplantation patients.

Science.gov (United States)

Urabe, Ayako; Imamura, Michio; Tsuge, Masataka; Kan, Hiromi; Fujino, Hatsue; Fukuhara, Takayuki; Masaki, Keiichi; Kobayashi, Tomoki; Ono, Atsushi; Nakahara, Takashi; Kawaoka, Tomokazu; Hiramatsu, Akira; Kawakami, Yoshiiku; Aikata, Hiroshi; Hayes, Clair Nelson; Maki, Noboru; Ohdan, Hideaki; Chayama, Kazuaki

2017-03-01

Post-transplant hepatitis B virus (HBV) reinfection is one of the major problems facing patients who undergo HBV-related liver transplantation (LT). We analyzed the clinical impact of serum hepatitis B core-related antigen (HBcrAg) on HBV reinfection in post-LT patients with HBV-related liver diseases. Serum hepatitis B surface antigen (HBsAg), HBV DNA, and HBcrAg were measured over time in 32 post-LT patients. Twenty-one out of 32 patients had HCC at LT. The effects of HBcrAg, hepatocellular carcinoma (HCC) recurrence, and HBs gene mutation on HBV reinfection and withdrawal from hepatitis B immune globulin (HBIG) were analyzed. Sixteen out of 32 patients (50 %) were positive for HBcrAg even though only six patients were thought to have experienced HBV reinfection based on reappearance of either HBV DNA or HBsAg during a median follow-up time of 75 months. Three of these six patients who became re-infected with HBV experienced HCC recurrence after LT. The HBV DNA reappearance rate was significantly higher in patients with HCC recurrence after LT (p HBV re-infected patients without HCC recurrence had HBs gene mutations G145R and G145A, respectively. Anti-HBs antibody development rate by HB vaccination was similar between HBcrAg-positive and negative patients (p = 0.325). HBV reinfection is more common than is usually considered based on conventional measurement of HBsAg and HBV DNA. HCC recurrence and mutations in the HBV S gene were associated with HBV reinfection after LT.

Hepatitis B virus surface antigen and anti-hepatitis C virus rapid tests underestimate hepatitis prevalence among HIV-infected patients.

Science.gov (United States)

Hønge, Bl; Jespersen, S; Medina, C; Té, Ds; da Silva, Zj; Ostergaard, L; Laursen, Al; Wejse, C; Krarup, H; Erikstrup, C

2014-10-01

In the case of coinfection with HIV and hepatitis B virus (HBV) and/or hepatitis C virus (HCV), hepatic disease progression is often accelerated, with higher rates of liver cirrhosis and liver-related mortality. We aimed to evaluate the performance of the rapid tests used routinely to detect HBV surface antigen (HBsAg) and anti-HCV among HIV-infected patients in Guinea-Bissau. Blood samples from HIV-infected patients in Guinea-Bissau were stored after testing for HBsAg and anti-HCV with rapid tests. Samples were subsequently re-tested for HBsAg and anti-HCV in Denmark. Two rapid tests were used in Guinea-Bissau: HBsAg Strip Ref 2034 (VEDA.LAB, Alençon, France; sensitivity 62.3%; specificity 99.2%) and HEPA-SCAN (Bhat Bio-Tech, Bangalore, India; sensitivity 57.1%; specificity 99.7%). In the two tests the ability to obtain the correct outcome depended on the antigen and antibody concentrations, respectively. Sex, age, CD4 cell count and antiretroviral therapy status did not differ between false negative and true positive samples in either of the tests. The study is limited by a low number of anti-HCV positive samples. New diagnostic rapid tests should always be evaluated in the setting in which they will be used before implementation. © 2014 British HIV Association.

Long-term effect of interferon plus ribavirin on hepatitis B surface antigen seroclearance in patients dually infected with hepatitis B and C viruses.

Directory of Open Access Journals (Sweden)

Ming-Lun Yeh

Full Text Available BACKGROUND: Interferon-α/ribavirin combination therapy might promote hepatitis B surface antigen (HBsAg seroclearance in patients dually infected with hepatitis B and C viruses (HBV/HCV, but the long-term effect remains unclear. We aimed to investigate the rate of and the factors associated with HBsAg seroclearance during long-term follow-up after interferon-α/ribavirin combination therapy in HBV/HCV dually-infected patients. METHODOLOGY/PRINCIPAL FINDINGS: Eighty-one patients who received interferon-α/ribavirin combination therapy for 24 weeks with a follow-up period of >24 weeks were enrolled. HBV serological markers and HBV DNA were determined every 6 months. Early and late HBsAg seroclearance were defined as HBsAg loss in less or more than 6 months after end-of-treatment, respectively. Fifteen (18.5% patients had HBsAg seroclearance during a mean follow-up period of 3.4 (0.5-5.1 years. The 5-year cumulative incidence was 25.6%. Baseline cirrhosis and HBV DNA negativity 1 year after end-of-treatment were independently predictive of HBsAg seroclearance with an odds ratio (OR, 95% confidence intervals (CI of 16.6, 1.8-153 and 9.2, 1.4-62.1, respectively, by Cox regression hazard analysis. Four patients developed early and 11 developed late HBsAg seroclearance, respectively. Cox regression hazard analysis showed no factor was associated with early HBsAg seroclearance, whilst HBV DNA negativity 1 year after end-of-treatment was the only significant factor predicting late HBsAg loss (OR, 43.0; CI, 2.5-745. Five patients had HBsAg seroconversion with a 5-year cumulative incidence of 8.3%. HBV DNA negativity at baseline and one year after EOT had a trend for HBsAg seroconversion. HCV response did not correlate to HBsAg loss. CONCLUSIONS: We demonstrated that interferon-α/ribavirin had long-term effect on HBsAg seroclearance in dually HBV/HCV-infected patients. Baseline cirrhosis and seroclearance of HBV DNA 1 year after end-of-treatment were

A PILOT EXTERNAL QUALITY ASSURANCE STUDY OF TRANSFUSION SCREENING FOR HIV, HCV AND HBSAG IN TWELVE AFRICAN COUNTRIES

Science.gov (United States)

Bloch, Evan M; Shah, Avani; Kaidarova, Zhanna; Laperche, Syria; Lefrere, Jean-Jacques; van Hasselt, James; Zacharias, Peter; Murphy, Edward L

2014-01-01

Background and Objectives Serologic screening for the major transfusion transmissible viruses (TTV) is critical to blood safety and has been widely implemented. However, actual performance as measured by proficiency testing has not been well studied in Sub-Saharan Africa. Therefore, we conducted an external quality assessment of laboratories engaged in transfusion screening in the region. Materials and Methods Blinded test panels, each comprising 25 serum samples that were pedigreed for HIV, HBsAg, HCV and negative status, were sent to participating laboratories. The panels were tested using the laboratories’ routine donor screening methods and conditions. Sensitivity and specificity were calculated and multivariable analysis was used to compare performance against mode of testing, country and infrastructure. Results A total of 12 African countries and 44 laboratories participated in the study. The mean (range) sensitivities for HIV, HBsAg and HCV were 91.9% (14.3-100), 86.7% (42.9-100) and 90.1% (50-100), respectively. Mean specificities for HIV, HBsAg and HCV were 97.7%, 97% and 99.5% respectively. After adjusting for country and infrastructure, rapid tests had significantly lower sensitivity than enzyme immunoassays (EIA) for both HBsAg (p<0.0001) and HCV (p<0.05). Sensitivity also varied by country and selected infrastructure variables. Conclusion While specificity was high, sensitivity was more variable and deficient in a substantial number of testing laboratories. These findings underscore the importance of proficiency testing and quality control, particularly in Africa where TTV prevalence is high. PMID:25052195

Risk Factors for Hepatitis B virus Surface Antigen Positive Prevalence in the Most Migratory Province of Iran: A Matched Case- Control Study

Directory of Open Access Journals (Sweden)

Gh. Karimi

2015-02-01

Full Text Available Background and Objective: Hepatitis B Virus Infection is one of the most common infectious diseases and also among the world's top ten causes of this group diseases-related mortality, so that 500,000 to 1.2 million annually die due to the consequences of this infection such as chronic hepatitis, cirrhosis and hepatocellular carcinoma. This study was conducted to determine risk factors for HBsAg-positive prevalence in Alborz Province. Materials and Methods: A 1:1 matched case-control study, 213 of cases reported HBsAg positive to the Alborz University of Medical Sciences in 2013 as case group with 213 of family members of patients with hepatitis C who have serologic markers Anti- HCV negative and HBsAg negative as the control group, were compared in terms of demographic characteristics, History of high risk behaviors, Iatrogenic exposures, community exposures and history of liver disease. Statistical analysis using logistic regression was performed by SPSS software version 18. Results: Reported cases with a mean age of 37.6±15.5 years, was more relevant to marginalized, immigrants and male gender. Nationality, being married, low level of education, family history of HBsAg positive, history of non-intravenous drug abuse, alcohol consumption, history of prison, employment in high risk occupations, sharing of razor, injuries with contaminated sharp instruments and history of jaundice in mother were found to be independent risk factors for HBsAg positive prevalence (OR: 0.27, 3.61, 1.68, 18.04, 12.21, 2.9, 7.52, 2.47, 5.55, 21.48, 11.3, respectively. Conclusions: Unfavorable situation of the marginalized and the prisoners, imported illegal immigrants, especially Afghans can be extended to high-risk behaviors and the threat of a disease surveillance system. Screening and vaccination aforementioned groups, health promotion of the marginalized and raise public knowledge is necessary.

Evaluation of a semi-automatic radioimmunoassay for hepatitis B surface antigen (HBsAg)

International Nuclear Information System (INIS)

Vries, J. de; Kruining, J.; Heijtink, R.A.

1983-01-01

The recently developed semi-automatic Hepatube system was evaluated in comparison to another radioimmunoassay for the detection of hepatitis B surface antigen (HBsAg), the manual Ausria II-125 test. After incubation of serum in anti-HBs coated tubes, the Hepatube system uses a machine to wash the tubes and to add tracer. After a second incubation, tubes are washed again in the machine and are manually transferred to the #betta# counter. Two machines were used. Machine 1 had an undefined defect. Of 1490 samples tested, 69 (4.6%) gave false-positive results versus 11 (0.7%) in the Ausria II-125 test. Machine 2 had one false-positive result among 920 samples versus 5 in the Ausria II-125 test. The sensitivity was measured with reference panels from Wellcome and Abbott as well as in titration series. The Hepatube system was found to be a factor three less sensitive than the Ausria II-125 test. The Hepatube processor is easy to handle; radioactive material can be held at a distance during the whole procedure; waste material is limited and less voluminous than in the Ausria II-125 test. (Auth.)

Acute hepatitis B virus infection with simultaneous high HBsAg and high anti-HBs signals in a previously HBV vaccinated HIV-1 positive patient

NARCIS (Netherlands)

van Dommelen, Laura; Verbon, Annelies; van Doorn, H. Rogier; Goossens, Valère J.

2010-01-01

We present a case of a clinical manifest hepatitis B virus infection and a potentially misleading HBV serological profile in an HIV-1 positive patient despite previous HBV vaccination. The patient presented with an acute hepatitis B and there was no indication of chronic HBV infection or the

Ausab test - a radioimmunoassay in the solid phase for the detection of antibodies against HBsAg

Energy Technology Data Exchange (ETDEWEB)

Lange, W; Koehler, H; Apodaca, J [Bundesgesundheitsamt, Berlin (Germany, F.R.). Abt. fuer Virologie

1974-01-01

The suitability of a newly developed RIA (Ausab test, Abbott laboratories) for the detection of antibodies against the Hepatitis B (surface) antigen (HBsAg) has been tested on 1968 sera of blood donors. Reproducibility test and specificity test were included. During the examination the technique of the Ausab test was changed from the original one-step to the two-step procedure. With the one-step technique 431 of 1968 sera (21.9%) showed positive reactions. During the test problems concerning the differentiation between positive and negative results were encountered due to high unspecific binding of radioactivity. Positive sera were re-examined employing the two-step technique and only 77.4% of the previously positive reactions could be reproduced. 50 sera that were negative in the one-step test remained negative in the two-step test. Difficulties concerning nonspecific binding of radioactivity as observed with the one-step technique were not encountered with the two-step procedure. On 92 of the confirmed positive sera a specificity test was run and 90 (97.8%) proved to be specific. A calculated 16.5% of the blood donors in Berlin have to be considered as antibody carriers. Only 6 of the Ausab positive sera were found to give positive reactions in CEP. 3 sera that were initially positive in CEP could neither be confirmed in a repeated CEP nor in the Ausab test.

Treatment outcome in patients of hepatitis B with hepatitis D: of 4 years at a tertiary care centre in pakistan

International Nuclear Information System (INIS)

Zuberi, B.F.; Afsar, S.; Akhtar, N.; Kumar, A.; Dodani, S.K.; Quraishy, M.S.

2007-01-01

To determine HBV suppression in patients with dual HBV and HDV infection after 48 weeks with 10.0 MIU of interferon-a 2b. All HBsAg positive patients were screened for anti-HDV, all positives were included. Baseline investigations, liver chemistries and HBsAg; HBeAg; anti-HBcore IgM; HBV DNA quantitative PCR were done. Patients with hepatocellular carcinoma and decompensated cirrhosis were excluded. Patients were treated with Interferon- a 10.0 MIU sc t.i.w. for 48 weeks. HBeAg and quantitative HBV DNA was done at week 0, 24 and 48 while CBC and SGPT were done monthly. HBV suppression was defined as levels <400 copies/ml. Fifty-two patients were selected for intervention, including 34 males and 18 females. At the end of therapy after 48 weeks, HBV DNA suppression was achieved in 51.9% and HBeAg became undetectable in 53.8% of patients. Twenty -one patients with HBV suppression still had raised SGPT. HDV should be screened in all patients eligible for HBV treatment. (author)

Occult hepatitis B virus among the patients with abnormal alanine transaminase.

Science.gov (United States)

Makvandi, Manoochehr; Neisi, Niloofar; Khalafkhany, Davod; Makvandi, Kamyar; Hajiani, Eskandar; Shayesteh, Ali Akbar; Masjedi Zadeh, Abdolrahim; Sina, Amir Hosein; Hamidifard, Mojtaba; Rasti, Mojtaba; Aryan, Ehsan; Ahmadi, Kambiz; Yad Yad, Mohammad Jafar

2014-08-01

The occult hepatitis B infection (OBI) is defined as the presence of hepatitis B virus (HBV) DNA in the sera or in the liver biopsy and the absence of hepatitis B surface antigen (HBsAg) by serological test. The current study aimed to evaluate the occult HBV infection by polymerase chain reaction (PCR) and determine HBV genotyping among the patients with abnormal alanine transaminase (ALT) in Ahvaz city, Iran. The sera of 120 patients, 54 (45%) females and 66 (55%) males, with abnormal ALT 40-152 IU were collected. All the patients were negative for HBsAg for more than one year. The patients` sera were tested by PCR using primers specified for the S region of HBV. Then the positive PCR products were sequenced to determine HBV genotyping and phylogenic tree. Of these 120 subjects, 12 (10%) patients including 6 (5%) males and 6 (5%) females were found positive for HBV DNA by PCR, which indicated the presence of occult HBV infection among these patients. The sequencing results revealed that genotype D was predominant with sub-genotyping D1 among OBI patients. Occult hepatitis B infection is remarkably prevalent in Ahvaz, Iran, and should be considered as a potential risk factor for the transmission of Hepatitis B Virus throughout the community by the carriers.

Chronic hepatitis B virus infection in Asian countries.

Science.gov (United States)

Merican, I; Guan, R; Amarapuka, D; Alexander, M J; Chutaputti, A; Chien, R N; Hasnian, S S; Leung, N; Lesmana, L; Phiet, P H; Sjalfoellah Noer, H M; Sollano, J; Sun, H S; Xu, D Z

2000-12-01

Of the estimated 50 million new cases of hepatitis B virus (HBV) infection diagnosed annually, 5-10% of adults and up to 90% of infants will become chronically infected, 75% of these in Asia where hepatitis B is the leading cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC). In Indonesia, 4.6% of the population was positive for HBsAg in 1994 and of these, 21% were positive for HBeAg and 73% for anti-HBe; 44% and 45% of Indonesian patients with cirrhosis and HCC, respectively, were HBsAg positive. In the Philippines, there appear to be two types of age-specific HBsAg prevalence, suggesting different modes of transmission. In Thailand, 8-10% of males and 6-8% of females are HBsAg positive, with HBsAg also found in 30% of patients with cirrhosis and 50-75% of those with HCC. In Taiwan, 75-80% of patients with chronic liver disease are HBsAg positive, and HBsAg is found in 34% and 72% of patients with cirrhosis and HCC, respectively. In China, 73% of patients with chronic hepatitis and 78% and 71% of those with cirrhosis and HCC, respectively, are HBsAg positive. In Singapore, the prevalence of HBsAg has dropped since the introduction of HBV vaccination and the HBsAg seroprevalence of unvaccinated individuals over 5 years of age is 4.5%. In Malaysia, 5.24% of healthy volunteers, with a mean age of 34 years, were positive for HBsAg in 1997. In the highly endemic countries in Asia, the majority of infections are contracted postnatally or perinatally. Three phases of chronic HBV infection are recognized: phase 1 patients are HBeAg positive with high levels of virus in the serum and minimal hepatic inflammation; phase 2 patients have intermittent or continuous hepatitis of varying degrees of severity; phase 3 is the inactive phase during which viral concentrations are low and there is minimal inflammatory activity in the liver. In general, patients who clear HBeAg have a better prognosis than patients who remain HBeAg-positive for prolonged periods of

Posintro™-HBsAg, a modified ISCOM including HBsAg, induces strong cellular and humoral responses

DEFF Research Database (Denmark)

Schiött, Asa; Larsson, Kristina; Manniche, Søren

2011-01-01

HBsAg vaccine formulation, Posintro™-HBsAg, was compared to two commercial hepatitis B vaccines including aluminium or monophosphoryl lipid A (MPL) and the two adjuvant systems MF59 and QS21 in their efficiency to prime both cellular and humoral immune responses. The Posintro™-HBsAg induced...

Circulating Interferon-λ3, Responsiveness to HBV Vaccination, and HBV/HCV Infections in Haemodialysis Patients

Directory of Open Access Journals (Sweden)

Alicja E. Grzegorzewska

2017-01-01

Full Text Available The IFN-λ3 gene (IFNL3 plays a role in HCV clearance. We investigated circulating IFN-λ3 and IFNL3 SNPs in haemodialysis patients who differed in their response to HBV vaccination and their HBV/HCV infection status. In 201 patients, plasma IFN-λ3 was determined using ELISA. IFNL3 SNPs (rs12979860, rs8099917 were genotyped using HRM analysis. Differences in IFN-λ3 levels were shown between responders and nonresponders to HBV vaccination and between HBsAg-positive patients and those who developed anti-HBs after infection and became HBsAg negative. HBV vaccine responders without HCV resolution revealed lower IFN-λ3 than noninfected responders. HBsAg/HCV RNA-positive subjects showed lower IFN-λ3 than patients positive only for HCV RNA or subjects who resolved both infections. Circulating IFN-λ3 correlated positively with anti-HBs and negatively with positive HCV RNA testing in the adjusted regression analyses. HBV vaccine nonresponders, HBsAg-positive patients, and subjects with replicating HCV composed a group with unfavourable outcomes. Responders to HBV vaccination, subjects who became HBsAg negative, and those who cleared HCV were analysed as having favourable outcomes. The latter showed higher IFN-λ3 but did not differ in distribution of IFNL3 SNPs compared with subjects with unfavourable outcomes. Higher IFN-λ3 concentrations are associated with response to HBV vaccination, self-limited HBV infection, and HCV resolution.

The Ausab test - a radioimmunoassay in the solid phase for the detection of antibodies against HBsAg

International Nuclear Information System (INIS)

Lange, W.; Koehler, H.; Apodaca, J.

1974-01-01

The suitability of a newly developed RIA (Ausab test, Abbott laboratories) for the detection of antibodies against the Hepatitis B (surface) antigen (HBsAg) has been tested on 1968 sera of blood donors. Reproducibility test and specificity test were included. During the examination the technique of the Ausab test was changed from the original one-step to the two-step procedure. With the one-step technique 431 of 1968 sera (21.9%) showed positive reactions. During the test problems concerning the differentiation between positive and negative results were encountered due to high unspecific binding of radioactivity. Positive sera were re-examined employing the two-step technique and only 77.4% of the previously positive reactions could be reproduced. 50 sera that were negative in the one-step test remained negative in the two-step test. Difficulties concerning nonspecific binding of radioactivity as observed with the one-step technique were not encountered with the two-step procedure. On 92 of the confirmed positive sera a specificity test was run and 90 (97.8%) proved to be specific. A calculated 16.5% of the blood donors in Berlin have to be considered as antibody carriers. Only 6 of the Ausab positive sera were found to give positive reactions in CEP. 3 sera that were initially positive in CEP could neither be confirmed in a repeated CEP nor in the Ausab test. (orig.) [de

Prevalence and chemotherapy-induced reactivation of occult hepatitis B virus among hepatitis B surface antigen negative patients with diffuse large B-cell lymphoma: Significance of hepatitis B core antibodies screening

International Nuclear Information System (INIS)

Elbedewy, T.A.; Elashtokhy, H.A.; Rabee, E.S.; Kheder, G.E.

2015-01-01

Background: Occult hepatitis B infection (OBI) is characterized by negative hepatitis B surface antigen (HBsAg) and detectable hepatitis B virus (HBV)-DNA in the liver and/or serum, with or without hepatitis B core antibody (anti-HBc). Anti-HBc is the most sensitive marker of previous HBV. HBV reactivation in patients under immunosuppressive treatment is life-threatening, occurring in both overt and occult HBV especially in hematological malignancies. Aim of the work: To evaluate the prevalence and chemotherapy-induced reactivation of OBI among hepatitis B surface antigen negative patients with diffuse large B-cell lymphoma (DLBCL) patients and to determine the significance of anti-HBc screening among this group of patients before receiving chemotherapy. Patients and methods: This cross-sectional study included 72 DLBCL patients negative for HBsAg, HBsAb and hepatitis C virus antibodies (anti-HCV). Patients were subjected to investigations including anti-HBc. All patients underwent alanine transaminase (ALT) monitoring before each cycle of chemotherapy and monthly for 12 months after the end of chemotherapy. Patients with suspected OBI were tested for HBV-DNA using real-time polymerase chain reaction (PCR). Results: Anti-HBc was detected in 10 of 72 HBsAg negative sera (13.89%) (95% confidence interval 6.9-22.2%). Five of the 10 anti-HBc positive patients in this study had OBI reactivation. Conclusion: The study concluded that anti-HBc screening is mandatory before chemotherapy. HBsAg-negative/anti-HBc-positive patients should be closely observed for signs of HBV reactivation through the regular monitoring of ALT. Prophylaxis lamivudine is recommended for anti-HBc positive patients before chemotherapy.

Occult Hepatitis B Virus Among the Patients With Abnormal Alanine Transaminase

Science.gov (United States)

Makvandi, Manoochehr; Neisi, Niloofar; Khalafkhany, Davod; Makvandi, Kamyar; Hajiani, Eskandar; Shayesteh, Ali Akbar; Masjedi Zadeh, Abdolrahim; Sina, Amir Hosein; Hamidifard, Mojtaba; Rasti, Mojtaba; Aryan, Ehsan; Ahmadi, Kambiz; Yad Yad, Mohammad Jafar

2014-01-01

Background: The occult hepatitis B infection (OBI) is defined as the presence of hepatitis B virus (HBV) DNA in the sera or in the liver biopsy and the absence of hepatitis B surface antigen (HBsAg) by serological test. Objectives: The current study aimed to evaluate the occult HBV infection by polymerase chain reaction (PCR) and determine HBV genotyping among the patients with abnormal alanine transaminase (ALT) in Ahvaz city, Iran. Patients and Methods: The sera of 120 patients, 54 (45%) females and 66 (55%) males, with abnormal ALT 40-152 IU were collected. All the patients were negative for HBsAg for more than one year. The patients` sera were tested by PCR using primers specified for the S region of HBV. Then the positive PCR products were sequenced to determine HBV genotyping and phylogenic tree. Results: Of these 120 subjects, 12 (10%) patients including 6 (5%) males and 6 (5%) females were found positive for HBV DNA by PCR, which indicated the presence of occult HBV infection among these patients. The sequencing results revealed that genotype D was predominant with sub-genotyping D1 among OBI patients. Conclusions: Occult hepatitis B infection is remarkably prevalent in Ahvaz, Iran, and should be considered as a potential risk factor for the transmission of Hepatitis B Virus throughout the community by the carriers. PMID:25485052

HBV-DNA in hemodialysis patients infected by HCV

International Nuclear Information System (INIS)

Arababadi, Mohammad Kazemi; Hassanshahi, Gholamhossein; Yousefi, Hassan

2009-01-01

End-stage renal disease patients on chronic hemodialysis (HD) patients are at risk for both hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, and they may coexist. To determine the prevalence and clinical impact of HBV and HCV infection, we studied poly chain reaction (PCR) and reverse transcription (RT)-PCR on the blood samples of 90 HD patients in Kerman, Iran. ELISA test was used to detect anti-HBc, anti-HBs and HBs Ag. We found that 30 out of 90 (33.3%) patients were PCR-RT-PCR positive for HCV-RNA. No HBV-DNA (0%) was detected through the PCR study in both positive and negative HCV-RNA patient groups. Though none of the samples was HBsAg positive, 10 (33.3%) HCV-RNA positive patients were anti-HBc positive, and 12 (40.7%) were anti-HBs positive. We conclude that prevalence of hepatitis C infection is high in HD patients in our region, but not associated with active HBV infection. (author)

HBV reactivation in patients with HCV/HBV cirrhosis on treatment with direct-acting antivirals.

Science.gov (United States)

Calvaruso, V; Ferraro, D; Licata, A; Bavetta, M G; Petta, S; Bronte, F; Colomba, G; Craxì, A; Di Marco, V

2018-01-01

Anecdotal reports suggest that patients with chronic hepatitis C virus (HCV) hepatitis and overt or occult hepatitis B virus (HBV) coinfection may reactivate HBV when HCV is suppressed or cleared by direct-acting antivirals (DAAs). We assessed the prevalence of overt or previous HBV coinfection and the risk of HBV reactivation in patients with HCV cirrhosis treated with DAAs. This was a retrospective cohort of 104 consecutive patients with HCV cirrhosis treated with DAAs. Serum HCV-RNA and HBV-DNA were tested at weeks 4, 8 and 12 of DAAs therapy and at week 12 of follow-up. At the start of DAAs, eight patients (7.7%) were HBsAg positive/HBeAg negative with undetectable HBV-DNA and low levels of quantitative HBsAg (four on nucleos(t)ide analogues [NUCs] and four inactive carriers), 37 patients (35.6%) had markers of previous HBV infection (25 anti-HBc positive, 12 anti-HBc/anti-HBs positive) and 59 (56.7%) had no evidence of HBV infection. Sixty-seven patients (64.4%) were HCV-RNA negative at week 4 and 98 (94.2%) achieved sustained virological response. All four HBsAg-positive patients treated with NUCs remained HBV-DNA negative, but three of four untreated patients showed an increase in HBV-DNA of 2-3 log without a biochemical flare and achieved HBV-DNA suppression when given NUCs. During or after DAAs, by conventional assay, HBV-DNA remained not detectable in all 37 anti-HBc-positive patients but in three of them (8.1%) HBV-DNA became detectable with a highly sensitive PCR. HBV reactivation is likely to occur in untreated HBV/HCV-coinfected cirrhotic patients when they undergo HCV treatment with DAAs. Pre-emptive therapy with NUCs should be considered in this setting. Anti-HBc-positive patients rarely reactivate HBV without clinical or virological outcomes. © 2017 John Wiley & Sons Ltd.

Estudo da soroprevalência do AgHBs em gestantes da 15ª Regional de Saúde e da imunoprofilaxia para os recém-nascidos das gestantes AgHBs positivo - DOI: 10.4025/actascihealthsci.v30i1.4394 Study into the HBsAg seroprevalence in pregnant women from the 15th Health Regional and the immunoprophylaxia on the newborns of these HBsAg-positive women - DOI: 10.4025/actascihealthsci.v30i1.4394

Directory of Open Access Journals (Sweden)

Dennis Armando Bertolini

2008-07-01

Full Text Available Determinar a prevalência do AgHBs nas gestantes da 15ª Regional de Saúde (15ª R.S. atendidas no Laboratório de Ensino e Pesquisa em Análises Clínicas (Lepac, Universidade Estadual de Maringá, e verificar se foi solicitada a imunoprofilaxia para hepatite B aos recém-natos das gestantes AgHBs positivo, no período de janeiro de 1998 a dezembro de 2002. A pesquisa do AgHBs foi realizada pela técnica imunoenzimática IMxHBsAg e Axsym HBsAg (Laboratório Abbott. As solicitações de imunobiológicos especiais para a imunoprofilaxia da hepatite B ao CRIE foram obtidas na Seção de Epidemiologia da 15ª R.S. Foram analisadas 12.274 gestantes e a prevalência do AgHBs foi de 1,0%. Dentre as 125 gestantes AgHBs positivo, foram solicitadas imunoprofilaxia para 32 (25,6% recém-nascidos. Ainda que a prevalência encontrada indique ser esta uma área de baixa endemicidade, os resultados reafirmam a importância da realização do diagnóstico da hepatite B no atendimento pré-natal, para adoção da imunoprofilaxia no recém-nascido.To determine HBsAg prevalence among pregnant women from the 15th Health Regional assisted in the Laboratório de Ensino e Pesquisa em Análises Clínicas (Lepac, Universidade Estadual de Maringá, and verify whether immunoprophylaxis with vaccine and immunoglobulin was requested for the newborns of HBsAg-positive women during the period from January 1998 to December 2002. The research about HBsAg was conducted using the immunoenzymatic IMxHBsAg (Abbot Lab and Axsym HBsAg (Abbot Lab techniques. The requests to the CRIE for special immunobiologic agents for Hepatitis B immunoprophylaxis were obtained in the Department of Epidemiology from the 15th Health Regional. The analysis includes 12,274 pregnant women, and the HBsAg prevalence was 1.0%. Among 125 HBsAg positive pregnant women, immunoprophylaxis was requested for 32 (25.6% newborns. Although the prevalence detected demonstrates this to be a low endemic area, the

Hepatitis B and C seroprevalence in patients with diabetes mellitus and its relationship with microvascular complications

Directory of Open Access Journals (Sweden)

Kadir Gisi

2016-12-01

Full Text Available Introduction: Diabetic patients are susceptible to bacterial, viral and fungal infections because of various deficiencies in the immune system. Aim: To investigate a possible link between hepatitis B/C prevalence and microvascular complications as well as duration of diabetes. Material and methods: In total 1263 diabetic patients (1149 type 2, 114 type 1 were enrolled in the study. The control group consisted of 1482 healthy blood donors who were over 40 years old. All diabetic patients were tested for HBsAg, anti-HBs and anti-HCV beside routine laboratory tests. Diabetic patients were divided into three groups according to their diabetes duration, and all of the patients were scanned for microvascular complications. Demographic data of all patients were recorded. Results : HBsAg seropositivity was 3.7% in diabetic patients and 1.08% in the control group; this difference was statistically significant (p < 0.001. HBsAg positivity rates in type 1 and type 2 diabetics were 0.8% and 4%, respectively (p = 0.09. HCV seropositivity was 2.2% for diabetics and 0.5% for the control group; this difference was statistically significant (p 0.05. Also, no relationship was found between microvascular complications of diabetes and hepatitis B/C seropositivity. Conclusions : Hepatitis B and C seroprevalence was found to be increased in diabetes mellitus; however, there was no relationship between hepatitis seroprevalence and the duration or microvascular complications of diabetes.

Importance of radioimmunoassays (HBsAg, HBsAb and HBcAb) for reducing the risk of hepatitis B transfer by blood

International Nuclear Information System (INIS)

Novak, J.; Kselikova, M.

1979-01-01

The principles are reported of the radioimmunoanalytical assay of the hepatitis B surface antigen, antibodies against this antigen which constitute immunologically indirect evidence, and antibodies against the nucleus of Dane's particles, which is circumstantial immunological evidence. The results obtained by radioimmunoassay are compared with those obtained by enzyme immunoassay. The results are presented obtained during the investigations of a total of 79 individuals, blood donors, health workers, and haemodialytic patients. In the whole group the hepatitis B surface antigen was proved by radioimmunoassay in 54%, by enzyme immunoassay in 47%; the antibody against the hepatitis B surface antigen in 19%; the antibody against the nucleus of the hepatitis B virus showed the largest proportion 75%. In 6.3% radioimmunoassay showed symptoms all three of hepatitis B, i.e., the surface antigen, the antibody against it, and the antibody against the hepatitis B virus nucleus; the correlation of the three symptoms is shown. The presence of HBsAg, HBsAb, and HBcAb is believed to be a contraindication of blood taking for routine purposes; the disappearance of HBsAg for a longer time may justify the re-inclusion among blood donors; the presence of HBsAb and HBcAb does not preclude the preparation of the plasma from such blood for the production of a specific anti-HBs immunoglobulin. (author)

The Ausab test - a radioimmunoassay in the solid phase for the detection of antibodies against HBsAg

International Nuclear Information System (INIS)

Lange, W.; Koehler, H.; Apodaca, J.

1974-01-01

The suitability of a newly developed RIA (Ausab test, Abbott Laboratories) for the detection of antibodies against the Hepatitis B (surface) antigen (HBsAg) has been tested on 1,968 sera of blood donors. Reproducibility test and specificity test were included. During the examination the technique of the Ausab test was changed from the original one-step to the two-step procedure. With the one-step technique 431 of 1,968 sera (21.9%) showed positive reactions. During the test problems concerning the differentiation between positive and negative results were encountered due to high unspecific binding of radioactivity. Positive sera were reexamined employing the two-step technique and only 77.4% of the previously positive reactions could be reproduced. 50 sera that were negative in the one-step test remained negative in the two-step test. Difficulties concerning nonspecific binding of radioactivity as observed with the one-step technique were not ecountered with the two-step procedure. On 92 of the confirmed positive sera a specificity test was run and 90 (97.8%) proved to be specific. A calculated 16.5% of the blood donors in Berlin have to be considered as antibody carriers. Only 6 of the Ausab positive sera were found to give positive reactions in CEP. 3 sera that were initially positive in CEP could neither be confirmed in a repeated CEP nor in the Ausab test. (orig.) [de

Low prevalence of hepatitis B and C among tuberculosis patients in Duhok Province, Kurdistan: Are HBsAg and anti-HCV prerequisite screening parameters in tuberculosis control program?

Science.gov (United States)

Merza, Muayad A; Haji, Safer M; Alsharafani, Abid Mohialdeen Hasan; Muhammed, Shivan U

2016-09-01

Viral hepatitis, particularly hepatitis B virus (HBV) and hepatitis C virus (HCV), infections and tuberculosis (TB) are a global public health concern. Co-infection with HBV or HCV among TB patients may potentiate the risk of hepatotoxicity induced by anti-TB drugs. Hence, the aim of this study was to identify the prevalence of HBV and HCV among TB patients included in the Duhok National Tuberculosis Program (NTP). The Duhok NTP Center is a specialized institution in Duhok City, Iraq, concerned with management and follow-up of TB patients. A cross-sectional study was conducted at the center between June 2015 and May 2016. All documented TB patients were analyzed on the basis of socio-demographic and other characteristics. Thereafter, all patients underwent screening for hepatitis B surface antigen (HBsAg), anti-HCV, and anti-HIV using enzyme-linked immunosorbent assay (ELISA). The results obtained were analyzed by entering the data in binary format into a Microsoft Excel spreadsheet. A p value of Kurdistan, the negative history of injection drug use, and adherence to universal infection-control measures, including vaccination for HBV. Both history of dental intervention and belonging to a Syrian population were independent risk factors for HBV/TB co-infection. Copyright © 2016 Asian-African Society for Mycobacteriology. Published by Elsevier Ltd. All rights reserved.

Serum hepatitis B surface antigen and hepatitis B e antigen titers: disease phase influences correlation with viral load and intrahepatic hepatitis B virus markers.

Science.gov (United States)

Thompson, Alexander J V; Nguyen, Tin; Iser, David; Ayres, Anna; Jackson, Kathy; Littlejohn, Margaret; Slavin, John; Bowden, Scott; Gane, Edward J; Abbott, William; Lau, George K K; Lewin, Sharon R; Visvanathan, Kumar; Desmond, Paul V; Locarnini, Stephen A

2010-06-01

Although threshold levels for hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) titers have recently been proposed to guide therapy for chronic hepatitis B (CHB), their relationship to circulating hepatitis B virus (HBV) DNA and intrahepatic HBV replicative intermediates, and the significance of emerging viral variants, remains unclear. We therefore tested the hypothesis that HBsAg and HBeAg titers may vary independently of viral replication in vivo. In all, 149 treatment-naïve CHB patients were recruited (HBeAg-positive, n = 71; HBeAg-negative, n = 78). Quantification of HBeAg and HBsAg was performed by enzyme immunoassay. Virological characterization included serum HBV DNA load, HBV genotype, basal core promoter (BCP)/precore (PC) sequence, and, in a subset (n = 44), measurement of intrahepatic covalently closed circular DNA (cccDNA) and total HBV DNA, as well as quantitative immunohistochemical (IHC) staining for HBsAg. In HBeAg-positive CHB, HBsAg was positively correlated with serum HBV DNA and intrahepatic cccDNA and total HBV DNA (r = 0.69, 0.71, 0.76, P < 0.01). HBeAg correlated with serum HBV DNA (r = 0.60, P < 0.0001), although emerging BCP/PC variants reduced HBeAg titer independent of viral replication. In HBeAg-negative CHB, HBsAg correlated poorly with serum HBV DNA (r = 0.28, P = 0.01) and did not correlate with intrahepatic cccDNA nor total HBV DNA. Quantitative IHC for hepatocyte HBsAg confirmed a relationship with viral replication only in HBeAg-positive patients. The correlation between quantitative HBsAg titer and serum and intrahepatic markers of HBV replication differs between patients with HBeAg-positive and HBeAg-negative CHB. HBeAg titers may fall independent of viral replication as HBeAg-defective variants emerge prior to HBeAg seroconversion. These findings provide new insights into viral pathogenesis and have practical implications for the use of quantitative serology as a clinical biomarker.

Rational design and evaluation of HBsAg polymeric nanoparticles as antigen delivery carriers.

Science.gov (United States)

Dewangan, Hitesh Kumar; Pandey, Tarun; Maurya, Lakshmi; Singh, Sanjay

2018-05-01

The present work is focused on the development and evaluation of single dose sustained-release Hepatitis B surface antigen (HBsAg) loaded nanovaccine for Hepatitis B. The conventional treatment suffers from repeated administration and hence requires a booster dose. Therefore, polymeric nanovaccine of HBsAg was developed by double emulsion solvent evaporation technique, utilizing central composite design for formulation optimization. The effects of independent variables (like polymer amount, stabilizer concentration, aqueous/organic phase ratio and homogenizer speed) were also studied on critical quality attributes like particle size and entrapment efficiency. Nanovaccine was characterized in terms of physicochemical parameters, release, internalization and in vivo immunological evaluation in BALB/c mice after administration by different routes such as oral, sub-cutaneous, nasal and intramuscular. The designed nanovaccine demonstrated nanometric size with smooth surface, negative zeta potential, maximum entrapment, sustained release and better internalization in macrophage and MRC-5 cell line. The immune-stimulating activity of nanovaccine administered by different routes was evaluated by measuring anti-HBsAg titre like specific immunoglobulin IgG and IgA response and cytokine level (interleukin-2, interferon-Y) measurement. The results indicated that the nanovaccine administered by intramuscular route produced better humoral as well as cellular responses and potential carriers for antigen delivery at single dose administration via intramuscular route. Copyright © 2018 Elsevier B.V. All rights reserved.

High rates of hepatitis delta virus superinfection/coinfection in balochistan

International Nuclear Information System (INIS)

Rishi, Z.I.; Malik, K.; Mengal, M.A.; Yousif, M.

2007-01-01

Hepatitis B carrier rate is still very high in Pakistan, especially in Balochistan, where in some areas almost 16% of the population is positive for HBsAg. Delta virus, also known as hepatitis D virus, only affects those suffering from Hep B infection (HbsAg positive). A study was carried out to check for Hepatitis Delta virus infection in these patients. This study showed that 35% HbsAg reactive patients had either coinfection or superinfection with the Hepatitis delta virus. These rates are much higher than the other studies, and are alarming. Vaccination against Hepatitis B virus can also prevent this infection. Awareness and prevention at community level is required. (author)

Occult hepatitis B virus infection in immunocompromised patients

Directory of Open Access Journals (Sweden)

Ruth Nogueira Cordeiro Moraes Jardim

Full Text Available Occult hepatitis B infection is characterized by hepatitis B virus (HBV DNA in the serum in the absence of hepatitis B surface antigen (HBsAg. We assessed occult HBV infection prevalence in two groups of immunocompromised patients (maintenance hemodialysis patients and HIV-positive patients presenting HBsAg-negative and anti-HBc positive serological patterns, co-infected or not by HCV. Thirty-four hemodialysis anti-HIV negative patients, 159 HIV-positive patients and 150 blood donors who were anti-HBc positive (control group were selected. HBV-DNA was detected by nested-PCR. Occult hepatitis B infection was not observed in the hemodialysis patients group but was found in 5% of the HIV-patients and in 4% of the blood donors. Immunosuppression in HIV positive patients was not a determining factor for occult HBV infection. In addition, no significant relationship between HBV-DNA and HCV co-infection in the HIV-positive patient group was found. A lack of significant associations was also observed between positivity for HBV-DNA and CD4 count, viral load and previous lamivudine treatment in these HIV-positive patients.

Micropropagation of transgenic lettuce containing HBsAg as a method of mass-scale production of standardised plant material for biofarming purposes.

Science.gov (United States)

Pniewski, Tomasz; Czyż, Marcin; Wyrwa, Katarzyna; Bociąg, Piotr; Krajewski, Paweł; Kapusta, Józef

2017-01-01

Micropropagation protocol of transgenic lettuce bearing S-, M- and L-HBsAg was developed for increased production of uniformised material for oral vaccine preparation. Effective manufacturing of plant-based biopharmaceuticals, including oral vaccines, depends on sufficient content of a protein of interest in the initial material and its efficient conversion into an administrable formulation. However, stable production of plants with a uniformised antigen content is equally important for reproducible processing. This can be provided by micropropagation techniques. Here, we present a protocol for micropropagation of transgenic lettuce lines bearing HBV surface antigens: S-, M- and L-HBsAg. These were multiplied through axillary buds to avoid the risk of somaclonal variation. Micropropagation effectiveness reached 3.5-5.7 per passage, which implies potential production of up to 6600 plant clones within a maximum 5 months. Multiplication and rooting rates were statistically homogenous for most transgenic and control plants. For most lines, more than 90 % of clones obtained via in vitro micropropagation had HBsAg content as high as reference plants directly developed from seeds. Clones were also several times more uniform in HBsAg expression. Variation coefficients of HBsAg content did not exceed 10 % for approximately 40-85 % of clones, or reached a maximum 20 % for 90 % of all clones. Tissue culture did not affect total and leaf biomass yields. Seed production for clones was decreased insignificantly and did not impact progeny condition. Micropropagation facilitates a substantial increase in the production of lettuce plants with high and considerably equalised HBsAg contents. This, together with the previously reported optimisation of plant tissue processing and its long-term stability, constitutes a successive step in manufacturing of a standardised anti-HBV oral vaccine of reliable efficacy.

Acute hepatitis B virus infection with simultaneous high HBsAg and high anti-HBs signals in a previously HBV vaccinated HIV-1 positive patient.

Science.gov (United States)

van Dommelen, Laura; Verbon, Annelies; van Doorn, H Rogier; Goossens, Valère J

2010-03-01

We present a case of a clinical manifest hepatitis B virus infection and a potentially misleading HBV serological profile in an HIV-1 positive patient despite previous HBV vaccination. The patient presented with an acute hepatitis B and there was no indication of chronic HBV infection or the presence of a mutation in the 'a' determinant. Remarkably, simultaneously with high HBV surface antigen and HBV viral load, high anti-HBs antibodies were present. If, due to previous HBV vaccination only anti-HBs was tested in this patient, the result of the high anti-HBs antibodies could be very misleading and offering a false sense of security. Our findings contribute to the ongoing discussion on how to assess HBV specific immunological memory and determining the role of HBV booster vaccinations in immunocompromised individuals.

Occult HBV infection status among chronic hepatitis C and hemodialysis patients in Northeastern Egypt: regional and national overview.

Science.gov (United States)

Mandour, Mohamed; Nemr, Nader; Shehata, Atef; Kishk, Rania; Badran, Dahlia; Hawass, Nashaat

2015-01-01

Occult hepatitis B infection (OBI) is considered to be one of the major risks for patients suffering from end-stage renal disease (ESRD) on regular hemodialysis (HD) and patients with chronic hepatitis C virus (HCV) infection. This study compared the prevalence of OBI among these two high-risk groups in the Suez Canal region, Northeastern Egypt, to obtain a better national overview of the magnitude of OBI in this region. Serum samples were collected from 165 HD patients and 210 chronic HCV-infected patients. Anti-HCV antibody, hepatitis B surface antigen (HBsAg), total hepatitis B core (anti-HBc) antibody, and hepatitis B surface antibody (anti-HBs) were detected by enzyme-linked immunosorbent assay (ELISA). HCV RNA was detected using a quantitative real-time RT-PCR assay, and HBV was detected using a nested PCR. All patients were negative for HBsAg. A total of 49.1% and 25.2% of the patients in the HD and HCV groups, respectively, were anti-HBc-positive. In addition, more anti-HBs-positive patients were detected in the HD group compared to the HCV group (52.1% and 11.4%, respectively). Three cases were positive for HBV DNA in the HD group, while eighteen positive cases were detected in the HCV group. Both study groups showed significant differences in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level as well as anti-HBc, anti-HBs and HBV-DNA positivity. OBI was more prevalent among chronic HCV patients than HD patients in the Suez Canal region, Egypt, with rates of 8.5% and 1.8%, respectively. However, more precise assessment of this infection requires regular patient follow-up using HBV DNA detection methods.

Detection of HbsAg and hATIII genetically modified goats (Caprahircus) by loop-mediated isothermal amplification.

Science.gov (United States)

Tao, Chenyu; Zhang, Qingde; Zhai, Shanli; Liu, Bang

2013-11-01

In this study, sensitive and rapid detection systems were designed using a loop-mediated isothermal amplification (LAMP) method to detect the genetically modified goats. A set of 4 primers were designed for each exogenous nucleic acids HBsAg and hATIII. The DNA samples were first amplified with the outer and inner primers and released a single-stranded DNA,of which both ends were stem-loop structure. Then one inner primer hybridized with the loop, and initiated displacement synthesis in less than 1 h. The result could be visualized by both agarose gel electrophoresis and unaided eyes directly after adding SYBR GREEN 1. The detection limit of LAMP was ten copies of target molecules, indicating that LAMP was tenfold more sensitive than the classical PCR. Furthermore, all the samples of genetically modified goats were tested positively by LAMP, and the results demonstrated that the LAMP was a rapid and sensitive method for detecting the genetically modified organism.

Infección oculta por el virus de la hepatitis B en hijos de madres positivas al HBsAg

Directory of Open Access Journals (Sweden)

Marité Bello-Corredor

2016-04-01

Full Text Available La infección oculta por el virus de la hepatitis B (IOB, se caracteriza por la presencia en suero o plasma del genoma viral (ADN-VHB y anticuerpos contra la proteína de la cápside (anti-HBc en ausencia del antígeno de superficie (HBsAg, marcador que tradicionalmente se emplea para identificar la presencia del virus. Con el objetivo de caracterizar la presencia de IOB en hijos de madres positivas al HBsAg, se estudiaron 291 muestras séricas de niños con la condición de ser HBsAg (- y anticuerpos anti-HBsAg (anti-HBs menores de 50 UI/L, conservadas en la seroteca del Laboratorio de Referencia Nacional de Hepatitis Virales. Se realizaron ensayos para determinar la exposición al virus (anti-HBc, a los sueros anti-HBc (+ se les realizó Reacción en Cadena de la Polimerasa en Tiempo Real (RCP-TR para determinar y cuantificar el ADN-VHB. La prevalencia de exposición al VHB (anti-HBc fue 16,8% (49/291. El ADN viral se cuantificó en el 14% (6/43 de los casos anti-HBc (+, observándose cargas virales que oscilaban entre 2,15 x 101 hasta 3,42 x 101 UI/mL. La prevalencia de la IOB para el total de los pacientes analizados fue 2,1% (6/291, considerada relativamente baja. No se encontró asociación significativa entre las variables sociodemográficas analizadas tales como: edad, sexo y provincia de procedencia. La IOB está presente en hijos de madres positivas al HBsAg, a pesar de la profilaxis contra la hepatitis B. Por lo tanto, se requiere de pesquisajes adecuados para detectar dicha entidad. Las implicaciones clínicas y epidemiológicas de la misma, requieren de un estrecho monitoreo y atención de estos pacientes. Este estudio se realiza por primera vez en Cuba y aporta conocimientos útiles para el diagnóstico, prevención y control de esta enfermedad en niños.

Comparison of hepatitis E virus seroprevalence between HBsAg-positive population and healthy controls in Shandong province, China.

Science.gov (United States)

Zhang, Li; Jiang, Zechun; Lv, Jingjing; Liu, Jiaye; Yan, Bingyu; Feng, Yi; Li, Li; Zhang, Guomin; Wang, Fuzhen; Xu, Aiqiang

2018-02-12

Persons with chronic hepatitis B (CHB) infection were reported to suffer severe disease after hepatitis E virus (HEV) superinfection, but the studies regarding HEV seroprevalence in this population were limited. A recent study in Vietnam found higher HEV seroprevalence among CHB patients compared with healthy controls. A community-based case-control study was conducted in two counties of Shandong province, China, where hepatitis E incidence was at the highest (Rushan) and lowest (Zhangqiu) in the province based on data from routine public health surveillance. Four townships were selected randomly from each county and all residents in these townships were tested for hepatitis B surface antigen (HBsAg). Those tested positive for HBsAg (CHB group) and the 1:1 age and sex-matched HBsAg-negative residents (control group) were included. Anti-HEV IgM and IgG were tested and positive rates of IgG and IgM were compared between the CHB group and the control group. In total, 2048 CHB participants and 2054 controls were included in the study. In the CHB group, HEV IgG seroprevalence was 9.16% (95% CI: 7.47-11.09) in Zhangqiue and 38.06% (95% CI: 35.07-41.19) in Rushan (P < 0.001); the corresponding rates of IgM were 0.1% (95% CI: 0.002-0.54) and 1.57% (95% CI: 0.90-2.53), respectively (P < 0.001). HEV IgG seroprevalence was similar between CHB group and the control group in both counties (P = 0.21, P = 0.47, respectively) and the same results were found for the positive rate of IgM (P = 0.103, P = 0.262, respectively). Multivariable analysis showed the status of HBsAg was not independently associated with the status of anti-HEV IgG in either Zhangqiu or Rushan [P = 0.187, OR = 1.23(95% CI: 0.90, 1.68); P = 0.609, OR = 1.05 (95% CI: 0.87, 1.26)]. The seroprevalence of HEV varies greatly in different geographic areas, but the seroprevalence is similar between populations with and without CHB. CHB patients residing in high HEV endemic areas

Detection of hepatitis B surface antigen by solid phase radioimmunoassay and immunometric assay (using enhanced luminescence)

International Nuclear Information System (INIS)

Nicholson, S.; Efandis, T.; Gust, I.

1991-01-01

A study was performed to assess the sensitivity and specificity of the amerlite monoclonal immunoassay for detection of hepatitis B surface antigen (HBsAG) by comparison with the Abbott Ausria II radioimmunoassay (RI). Serial bleeds from 34 patients with acute or chronic hepatitis B were tested by both assays. The Abbott Ausria II assay detected HBsAG longer than the Amersham Amerlite assay on two occasions and earlier on one occasion. Twelve patients with low HBsAg positive results (confirmed by Ausria II) were tested by the Amerlite assay, four were repeatably positive, five repeatably negative and three gave borderline results (which on repeat testing were negative). A similar trend was seen when a panel of sera containing known concentrations of HBsAG was tested. Replicate testing of 10 specimens eight times showed very good reproducibility by the Amerlite assay. Overall, the specificity of both assays was comparable, however differences in sensitivity were observed. 3 tabs

Alpha-fetoprotein still is a valuable diagnostic and prognosis predicting biomarker in hepatitis B virus infection-related hepatocellular carcinoma.

Science.gov (United States)

Yao, Mingjie; Zhao, Jingmin; Lu, Fengmin

2016-01-26

Use of serum alpha-fetoprotein (AFP) in clinical practices has been challenged in recent years, due to the lack of specificity and sensitivity. Here we conducted a retrospective study to evaluate the diagnostic and prognostic value of serum AFP among hepatocellular carcinoma (HCC) patients with their pathogenic features taken into consideration. The cohort for this study comprised 318 cases of hepatitis and 731 cases of cirrhosis, as well as 796 HCC patients. Using 11.62ng/mL as a cut-off value, the positive rate of AFP test among serum hepatitis B surface antigen (HBsAg) positive HCC patients was significantly higher than that in those HBsAg negative HCC patients (79.55% vs 56.49%, P < 0.000). Similarly, the median serum AFP level in HCC patients with serum HBsAg positive was significantly higher than that in those HBsAg negative HCC patients (423.89ng/ml vs 40.82ng/ml, P < 0.000). In addition, Kaplan-Meier curve analysis revealed that lower preoperative AFP level implicated a much higher overall survival rate. Of note, such prognosis predicting value was only seen in those chronic HBV infection-related HCC patients, but not among the HCC patients etiologically irrelevant to HBV infection. We believe that serum AFP is of diagnosis and prognostic predicting value for HCC with chronic HBV infection, and strongly suggest use of serum AFP as a biomarker in China and other HBV infection endemic area like Southeast Asia.

Anti-idiotypic antibodies directed against anti-HBs among the patients with chronic hepatitis B.

Science.gov (United States)

Kobayashi, K; Suzuki, H; Ueno, Y; Nagatomi, R; Kanno, A; Otsuki, M; Toyota, T

1990-08-01

Anti-idiotypic antibodies (anti-Id) against anti-HBs were found in the sera of patients with chronic hepatitis type B. Anti-idiotypic antibodies were detected by an enzyme-linked immunosorbent assay using horseradish peroxidase conjugated mouse monoclonal anti-HBs. Ten of 72 HBsAg positive sera contained anti-Id (13.9%). The prevalence of anti-Id did not appear to correlate with HBeAg/anti-HBe system. However, HB virus specific DNA polymerase activity was significantly higher in anti-Id positive sera. In the sera obtained from the patients treated with predonisolone before, anti-Id positive rate was higher than that in the patients without a history of predonisolone therapy. These results suggest that anti-Id may be related to the immunoregulatory mechanism of HB virus replication.

Prevalence and risk factors for hepatitis B and C viruses in patients with leprosy.

Science.gov (United States)

Costa, J E F; Morais, V M S; Gonçales, J P; Silva, D M; Coêlho, M R C D

2017-08-01

It has been reported a higher seroprevalence of HBV and HCV in leprosy patients than in the general population, but the reasons for these findings are not yet clear. On the other hand, there is evidence that these viruses may influence the onset of leprosy reactional episodes, an important cause of neurological sequelae. This study aimed to determine seroprevalence and risk factors for HBV and HCV in leprosy patients and to investigate its association with leprosy reactions. Patients attended from 2015 to 2016 at a Reference Center in Leprosy in Northeastern region of Brazil, were interviewed, had their records reviewed to investigate biological, clinical, behavioral and socioeconomic factors, and underwent blood sample collection. Biological samples were tested for HBV (HBsAg, anti-HBs and anti-HBs) and HCV (anti-HCV) serological markers by ELISA and, in anti-HCV positive samples, HCV RNA was screened by real time PCR. SPSS program was used to analyze the data. A total of 403 leprosy patients were included. Although anti-HBc was positive in 14.1%, there was no detection of HBsAg, which contradicts the hypothesis that leprosy patients have immune deficit that make them more prone to chronic HBV infection. Multibacillary leprosy (0.057), health-related work (0.011) and lower educational level (0.035) were associated with anti-HBc positivity. Anti-HCV was positive in 0.5%, with no detection of HCV RNA. No association was identified between anti-HCV and the epidemiological analyzed factors. There was also no association of anti-HBc or anti-HCV with type 1 or type 2 leprosy reactions. Thus, the seroprevalence of HBV and HCV in leprosy patients was similar to that of the general population of Northeastern region of Brazil, and no association of HBV or HCV with leprosy reactions was observed. Copyright © 2017 Elsevier B.V. All rights reserved.

[HCV and HBV seropositivity in university students of the State of Nuevo Leòn, Mexico].

Science.gov (United States)

Flores-Castañeda, M S; García-Méndez, B L; Tijerina-Menchaca, R

1996-01-01

Viral hepatitis is a contagious disease. Patients infected with hepatitis B virus (HBV) or hepatitis C virus (HCV), may be either chronically symptomatic or asymptomatic, and suffer cirrhosis and high risk of hepatic carcinoma. Asymptomatic carriers of HBV surface antigen (HBs-Ag) or with anti-HCV antibodies are potentially infectious, and therefore a risk to public health. This work seeks to establish the frequency of seropositivity for HBs-Ag and anti-HCV antibodies in a population of 774 newly accepted students of the Medical School of the Autonomous University of Nuevo Leon, whose average age was 18 years. Second generation ELISA test were used to screen for HBs-Ag and anti-HCV antibodies. HBs-Ag was confirmed by a neutralization test and anti-HCV antibodies were confirmed by a RIBA test. Three sera were positive for HBs-Ag by ELISA and only one serum (0.13% of analyzed samples) was confirmed by the neutralization technique. On the other hand 12 sera were positive for anti-HCV antibodies by ELISA, and eight of these were confirmed by RIBA (1.03% of the analyzed samples). Intensive reactivity bands were found in two sera, and weak reactivity bands were found in six sera. ELISA screening for anti-HCV antibodies showed 0.5% of false positives. This study shows that the frequency of anti-HCV antibodies is 7.95% times higher than that found for HBs-Ag. All seropositive patients were asymptomatic and potentially infective. This demonstrates the need to routinely screen for HBs-Ag and anti-HCV antibodies to establish the prevalence of these diseases in our area.

Rituximab plus chemotherapy as first-line treatment in Chinese patients with diffuse large B-cell lymphoma in routine practice: a prospective, multicentre, non-interventional study

International Nuclear Information System (INIS)

Wu, Jianqiu; Song, Yongping; Su, Liping; Xu, Li; Chen, Tingchao

2016-01-01

The efficacy and safety of rituximab-based chemotherapy (R-chemo), the standard regimen for patients with diffuse large B-cell lymphoma (DLBCL), which is more common in Asia than in Western countries, are well confirmed in randomized controlled trials (RCTs). However, the safety and effectiveness of R-chemo in patients who are largely excluded from RCTs have not been well characterized. This real-world study investigated the safety and effectiveness of R-chemo as first-line treatment in Chinese patients with DLBCL. Treatment-naive DLBCL patients who were CD20 positive and eligible to receive R-chemo were enrolled with no specific exclusion criteria. Data collected at baseline included age, gender, disease stage, international prognostic index (IPI), B symptoms, extranodal involvement, performance status, and medical history. In the present study, data on safety, treatment effectiveness, and HBV infection management were collected 120 days after the last R-chemo administration. Overall, R-chemo was well tolerated. The safety profile of R-chemo in patients with a history of heart or liver disease was well described without any additional unexpected safety concerns. The overall response rate (ORR) in the Chinese patients from this study was 94.2 % (complete response [CR], 55.0 %; CR unconfirmed [CRu] 18.2 %; and partial response [PR], 20.9 %). Compared to patients with no history of disease, the CR and PR rates of patients with a history of heart or liver disease were lower and higher, respectively; this tendency could be in part explained by treatment interruptions in patients with heart or liver diseases. HBsAg positivity and a maximum tumor diameter of ≥7.5 cm negatively correlated with CR + CRu, whereas age and HBsAg positivity negatively correlated with CR. This study further validated the safety and effectiveness of R-chemo in Chinese patients with DLBCL. Patients with a history of heart or liver disease may further benefit from R-chemo if preventive measures

HIV, HCV, HBV and syphilis rate of positive donations among blood donations in Mali: lower rates among volunteer blood donors.

Science.gov (United States)

Diarra, A; Kouriba, B; Baby, M; Murphy, E; Lefrere, J-J

2009-01-01

Good data on background seroprevalence of major transfusion transmitted infections is lacking in Mali. We gathered data on the rate of positive donations of human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV) and syphilis among blood donations in Mali for calendar year 2007. Donations with repeatedly reactive results on screening enzyme immunoassay (EIA) were considered to be seropositive. Rate of positive donations per blood unit collected was 2.6% for HIV, 3.3% for HCV, 13.9% for hepatitis B surface antigen (HBsAg) and 0.3% for syphilis. For HIV, HBsAg and syphilis, rate of positive donations was significantly (pdonations from replacement donors than those from volunteer donors, while HCV rate of positive donations was similar in the two groups. Rate of positive donations was also significantly (p<0.0001) lower in blood units from regular than from first-time donors. These data reinforce WHO recommendations for increasing the number of regular, volunteer blood donors in Africa.

The HBsAg Prevalence Among Blood Donors From Eastern Mediterranean and Middle Eastern Countries: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Babanejad, Mehran; Izadi, Neda; Najafi, Farid; Alavian, Seyed Moayed

2016-03-01

The world health organization (WHO) recommends that all blood donations should be screened for evidence of infections, such as hepatitis B. The present study aimed to determine the prevalence of hepatitis B surface antigen (HBsAg) in blood donors at the eastern Mediterranean region office (EMRO) of the WHO and middle eastern countries. A meta-analysis was carried out based on the results of an electronic literature search of PubMed, Ovid, Scopus, and Google Scholar for articles published from January 1, 2000, to August 31, 2015. In accordance with a significant homogeneity test and a large value of I2, the random effects model was used to aggregate data from the studies and produce the pooled estimates using the "Metan" command. We included 66 eligible studies. The pooled prevalence of HBsAg in blood donors of both EMRO and middle eastern (E and M) countries was 2.03% (95% confidence interval [CI]: 1.79 - 2.26). In addition, the prevalence rates in the EMRO countries was 1.99% (95% CI: 1.84 - 2.14) and 1.62% in the Middle Eastern countries (95% CI: 1.36 - 1.88). The prevalence among blood donors with more than one study was 1.58% in Egypt, 0.58% in Iran, 0.67% in Iraq, 2.84% in Pakistan, 3.02% in Saudi Arabia, 1.68% in Turkey, and 5.05% in Yemen. Based on the WHO classification of hepatitis B virus (HBV) prevalence, the prevalence of HBsAg in blood donors from E and M countries reached an intermediate level. However, there were low prevalence levels in some E and M countries.

Epidemiological and clinical characteristics of hepatitis B virus in HIV-infected patients in Guangdong, China.

Science.gov (United States)

Huang, S M; Cai, W P; Hu, F Y; Lan, Y; Liao, B L; Chen, Y P; Tang, X P

2016-09-01

This study investigated the epidemiological and clinical characteristics of hepatitis B virus (HBV) in HIV-infected adults at the time of antiretroviral therapy (ART) initiation in Guangdong province, China. A total of 2793 HIV-infected adults were enrolled between January 2004 and September 2011. Demographic data and laboratory parameters were collected, HBV-DNA levels were measured, and HBV genotypes were identified before ART initiation. The prevalence of hepatitis B surface antigen (HBsAg) in HIV-infected patients was 13.2%. A total of 266 HIV/HBV co-infected patients and 1469 HIV mono-infected patients were recruited. The median alanine aminotransferase and aspartate aminotransferase levels of HIV/HBV co-infected patients were higher than HIV mono-infected patients (32 U/L vs. 22 U/L, p HIV/HBV co-infected patients was lower than HIV mono-infected patients (59 cells/mm(3) vs. 141 cells/mm(3), p study indicates a high prevalence of HBsAg in HIV-infected adults in Guangdong. The level of CD4 cell count in HIV/HBV co-infected patients was much lower than HIV mono-infected patients, especially in patients who were HBeAg-positive and had a high level of HBV-DNA. The predominant HBV genotype in HIV/HBV co-infected patients is genotype B. © The Author(s) 2015.

Optimisation of secretion of recombinant HBsAg virus-like particles: Impact on the development of HIV-1/HBV bivalent vaccines

NARCIS (Netherlands)

Michel, Marie; Lone, Yu-Chun; Centlivre, Mireille; Roux, Pascal; Wain-Hobson, Simon; Sala, Monica

2007-01-01

The hepatitis B surface antigen (HBsAg) assembles into virus-like particles (VLPs) that can be used as carrier of immunogenic peptides for the development of bivalent vaccine candidates. It is shown here that by respecting certain qualitative features of mammalian preS1 and preS2 protein domains

Efficacy of selective antenatal screening for hepatitis B among pregnant women in Denmark: is selective screening still an acceptable strategy in a low-endemicity country?

DEFF Research Database (Denmark)

Jensen, Lise; Heilmann, Carsten; Smith, Else

2003-01-01

The prevalence of hepatitis B virus (HBV) carriage in Denmark is unknown, but expected to be low (0.1%). This study aimed to evaluate the efficacy of selective antenatal screening for HBV infection and the epidemiology of HBV and hepatitis C virus (HCV) among pregnant women. 4098 women were...... included in the study. Blood tests were examined for hepatitis B surface antigen (HBsAg), anti-hepatitis B core antigen (HBc) and anti-HCV. Case records were studied to evaluate whether patients at risk for HBV infection had been tested. Among the 4098 women, 18 10.4%, 95% confidence interval (95% CI) 0.......3-0.71 were HBsAg positive. All had a risk factor for HBV infection. Only 13 (72%) were identified as HBsAg positive in the selective screening programme. 115 women (2.8%, 95% CI 2.3-3.4) were anti-HBc positive only. 95 (83%) were at risk for HBV. Only 72 of these (63%) were tested for HBsAg. The screening...

Frequency of hepatitis b, hepatitis c and hiv infections amongst employees of a united nations peace keeping mission

International Nuclear Information System (INIS)

Khan, I.; Arshad, A.R.; Ibrahim, A

2014-01-01

Objective: To determine the frequency of HBsAg, anti HCV antibodies and anti HIV antibodies amongst UNAMID employees attending our dental clinics. Study Design: Observational study. Place and Duration of Study: The study was carried out at Pakistan Field Hospital Level III, Nyala, Sudan from Oct 2011 to Dec 2011. Patients and methods: All patients who were to undergo some dental surgical procedure had their HBsAg, anti HCV antibodies and anti HIV antibodies status checked by immunochromatographic technique prior to the procedure. Results: Out of the 156 patients studied, HBsAg was detectable in 7.7% and anti HCV antibodies in 1.3% of the patients. None tested positive for anti HIV antibodies. Conclusion: Hepatitis B and C infections do occur in our patient population. However HIV infections are not seen. (author)

HBsAg RIA QUICK and Anti-HBs RIA QUICK. Information of a new technique of radioimmunoassay of hepatitis B virus surface antigen and the corresponding antibody using kits by IMMUNO Vienna

Energy Technology Data Exchange (ETDEWEB)

Kselikova, M; Urbankova, J

1985-11-01

With regard to the high sensitivity of HBsAg and anti-HBs detection using kits HBsAg RIA QUICK and Anti-HBs RIA QUICK, and with regard to the excellent technical set-up which substantially reduces demands on manual work and eliminates the need to equip the department with a rinser, and also with regard to the lower price as compared with similar kits by Abbott Co., the above mentioned two kits will be imported to Czechoslovakia.

Safety and Efficacy of Nucleic Acid Polymers in Monotherapy and Combined with Immunotherapy in Treatment-Naive Bangladeshi Patients with HBeAg+ Chronic Hepatitis B Infection.

Directory of Open Access Journals (Sweden)

Mamun Al-Mahtab

Full Text Available Previous in vivo studies have suggested that nucleic acid polymers (NAPs may reduce circulating levels of HBsAg in the blood by blocking its release from infected hepatocytes and that this effect may have clinical benefit. NAP treatment, was evaluated in two clinical studies in patients with HBeAg positive chronic HBV infection. The REP 101 study examined REP 2055 monotherapy in 8 patients and the REP 102 study examined REP 2139-Ca, in monotherapy in 12 patients, 9 of which transitioned to short term combined treatment with pegylated interferon alpha 2a or thymosin alpha 1. In both studies NAP monotherapy was accompanied by 2-7 log reductions of serum HBsAg, 3-9 log reductions in serum HBV DNA and the appearance of serum anti-HBsAg antibodies (10-1712 mIU / ml. Eight of the 9 patients transitioning to combined treatment with immunotherapy (pegylated interferon or thymosin alpha 1 in the REP 102 study experienced HBsAg loss and all 9 patients experienced substantial increases in serum anti-HBsAg antibody titers before withdrawal of therapy. For 52 weeks after removal of REP 2055 therapy, rebound of serum viremia (HBV DNA > 1000 copies / ml, HBsAg > 1IU / ml was not observed in 3 / 8 patients. Suppression of serum virema was further maintained for 290 and 231 weeks in 2 of these patients. After withdrawal of all therapy in the 9 patients that transitioned to combination therapy in the REP 102 study, 8 patients achieved HBV DNA < 116 copies / ml after treatment withdrawal. Viral rebound occurred over a period of 12 to 123 weeks in 7 patients but was still absent in two patients at 135 and 137 weeks of follow-up. Administration tolerability issues observed with REP 2055 were rare with REP 2139-Ca but REP 2139-Ca therapy was accompanied by hair loss, dysphagia and dysgeusia which were considered related to heavy metal exposure endemic at the trial site. These preliminary studies suggest that NAP can elicit important antiviral responses during

Safety and Efficacy of Nucleic Acid Polymers in Monotherapy and Combined with Immunotherapy in Treatment-Naive Bangladeshi Patients with HBeAg+ Chronic Hepatitis B Infection.

Science.gov (United States)

Al-Mahtab, Mamun; Bazinet, Michel; Vaillant, Andrew

2016-01-01

Previous in vivo studies have suggested that nucleic acid polymers (NAPs) may reduce circulating levels of HBsAg in the blood by blocking its release from infected hepatocytes and that this effect may have clinical benefit. NAP treatment, was evaluated in two clinical studies in patients with HBeAg positive chronic HBV infection. The REP 101 study examined REP 2055 monotherapy in 8 patients and the REP 102 study examined REP 2139-Ca, in monotherapy in 12 patients, 9 of which transitioned to short term combined treatment with pegylated interferon alpha 2a or thymosin alpha 1. In both studies NAP monotherapy was accompanied by 2-7 log reductions of serum HBsAg, 3-9 log reductions in serum HBV DNA and the appearance of serum anti-HBsAg antibodies (10-1712 mIU / ml). Eight of the 9 patients transitioning to combined treatment with immunotherapy (pegylated interferon or thymosin alpha 1) in the REP 102 study experienced HBsAg loss and all 9 patients experienced substantial increases in serum anti-HBsAg antibody titers before withdrawal of therapy. For 52 weeks after removal of REP 2055 therapy, rebound of serum viremia (HBV DNA > 1000 copies / ml, HBsAg > 1IU / ml) was not observed in 3 / 8 patients. Suppression of serum virema was further maintained for 290 and 231 weeks in 2 of these patients. After withdrawal of all therapy in the 9 patients that transitioned to combination therapy in the REP 102 study, 8 patients achieved HBV DNA < 116 copies / ml after treatment withdrawal. Viral rebound occurred over a period of 12 to 123 weeks in 7 patients but was still absent in two patients at 135 and 137 weeks of follow-up. Administration tolerability issues observed with REP 2055 were rare with REP 2139-Ca but REP 2139-Ca therapy was accompanied by hair loss, dysphagia and dysgeusia which were considered related to heavy metal exposure endemic at the trial site. These preliminary studies suggest that NAP can elicit important antiviral responses during treatment which may

Extrahepatic Manifestations of Hepatitis B Virus Infection: Addison’s Disease and Myelofibrosis in a Patient with Persistent Hepatitis B Surface Antigenemia

Directory of Open Access Journals (Sweden)

François Somlo

1993-01-01

Full Text Available A 60-year-old white male patient was admitted to the hospital with acute abdominal pain, seemingly a self-limited ileus. He was found to be hepatitis B surface antigen (HBsAg-positive. Previous dental treatment was suspected to be the initial source of the infection with hepatitis B virus. Five months later he was re-admitted with a diagnosis of adrenal insufficiency (Addison’s disease which responded well to steroids. Four years later he developed fever and leucocytosis. A bone marrow biopsy revealed myelofibrosis. He had several episodes of pyrexia during his lifetime. After a 12-year period the patient suffered a fatal myocardial infarction. At autopsy the adrenal glands were reduced to scarred remnants and HBsAg was found to be present in the residual adrenocortical cells by immunoflouresence methods. Bone marrow at autopsy revealed myelosclerosis as well HBsAg (via immunofluoresence. Hepatitis B virus was therefore closely correlated with the development of Addison’s disease and myelofibrosis in this case.

Lack of immune potentiation by complexing HBsAg in a heat-inactivated hepatitis B vaccine with antibody in hepatitis B immunoglobulin

NARCIS (Netherlands)

Lelie, P. N.; van Amelsfoort, P. J.; Martine de Groot, C. S.; Bakker, E.; Schaasberg, W.; Niessen, J. C.; Reesink, H. W.

1989-01-01

In a randomized, dose-response study among 305 health care workers, we examined whether the immunogenicity of a heat-inactivated hepatitis B vaccine could be enhanced when HBsAg was complexed by anti-HBs contained in hepatitis B immunoglobulin either at equivalent proportions or at 10-fold antigen

Potential risk of HBV reactivation in patients with resolved HBV infection undergoing direct-acting antiviral treatment for HCV.

Science.gov (United States)

Ogawa, Eiichi; Furusyo, Norihiro; Murata, Masayuki; Toyoda, Kazuhiro; Hayashi, Takeo; Ura, Kazuya

2018-01-01

Despite a known risk of hepatitis B virus (HBV) reactivation during direct-acting antiviral (DAA) treatment for patients with hepatitis C virus (HCV)-HBV coinfection, it remains unclear whether patients with past HBV infection are at risk for reactivation. This study evaluated the risk of HBV reactivation during treatment with sofosbuvir (SOF)-based regimens, focusing on patients with resolved HBV infection. This study analyzes the data of 183 consecutive patients treated with SOF-based regimens. From these patients, 63 with resolved HBV infection (negative for hepatitis B surface antigen [HBsAg] and undetectable HBV DNA but positive for hepatitis B core antibody) were eligible for this study. HBV reactivation was defined as a quantifiable HBV DNA level >20 IU/mL. Among the patients antibody to HBsAg (anti-HBs) positive (10-500 mIU/mL) (n = 30), the titre of anti-HBs was significantly decreased with time, as shown by the results of repeated-measures analysis of variance (P = .0029). Overall, four patients (6.3%) with resolved HBV infection came to have detectable HBV DNA during treatment, including one who had HBV reactivation at week 4 (HBV DNA 80 IU/mL). However, none developed hepatic failure. Among four patients who had detectable HBV DNA during treatment, all were negative or had very low-titre (HBV infection and negative or very low-titre anti-HBs at baseline are at risk for having detectable HBV DNA transiently during treatment. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Hepatitis B infection transmission by anti-HBc-positive grafts].

Science.gov (United States)

Bárcena, Rafael

2014-07-01

In Spain, the rate of anti-HBc positive, HBsAg-negative carriers is approximately 10% of adults between the ages of 26 and 65 years. It is therefore impossible to exclude these donors without increasing the mortality of recipients on waiting lists. The incidence of de novo hepatitis B infection in HBsAg-negative recipients of anti-HBc-positive donors is high without prophylaxis and is related to the serological state of the recipient against HBV. Anti-HBc and anti-HBs-positive recipients have low risk, with or without prophylaxis. This patient group therefore does not require prophylaxis but rather periodic posttransplantation checkups. For the other recipient groups (naïve, anti-Hbc and anti-HBs isolates), prophylaxis with IgG HB, lamivudine or combined therapy decreases the incidence of infection. These patients should be treated with prophylaxis immediately after transplantation. Depending on the risk, cost and benefit, patients should currently be treated with lamivudine 100mg/d indefinitely or for longer periods (>10 years). Periodic checkups of HBsAg should be conducted, and if there is graft dysfunction then HBV DNA should be checked. IF HBV DNA is discovered in the donor and found to be positive in serum or in the biopsy, the prophylaxis should be an analogue with a high barrier to resistance from the start. Grafts from anti-HBc-positive donors are not considered at-risk grafts and are used according to donor severity, without being determined by the recipient's serological profile. Copyright © 2014 Elsevier España, S.L. All rights reserved.

Hepatitis B and Hepatitis C virus in women with first pregnancy

International Nuclear Information System (INIS)

Jadoon, S.M.; Adeel, M.

2017-01-01

Hepatitis B and Hepatitis C are amongst the leading causes of morbidity and mortality in pregnant women throughout the globe. This study is aimed at determining the frequency of these infections among primigravid females and the common factors that make them prone to these infections. Methods: This cross-sectional study was conducted at Ayub Teaching Hospital, Abbottabad from December 2015 to May 2016. A total of 174 jaundiced primigravida patients were included in the study through non-probability consecutive sampling. Blood samples were sent for HBsAg and anti-HCV ELISA. Samples were analysed by the pathologist with more than 5 years clinical experience. All data will be analysed using SPSS-16. Results: The mean age of the subjects was 24±5.7 years. Six (3.4%) patients were HBsAg positive and 13 (7.5%) were anti-HCV positive. About 9% of patients had undergone surgery in their life and 1.7% reported having received blood transfusion during their life. Thirty-two of them had history of intravenous or intramuscular injections. History of piercing of body part mostly ear-piercing for ornaments was present in 170 (97.7%) respondents. However, the frequency of blood transfusion, surgery and body piercing was not statistically significantly between HBsAg positive, HBsAg negative, and anti-HCV positive and negative patients (p>0.05). Conclusion: The incidence of these viral infections in our community is on the rise. It emphasizes the need of routine antenatal screening in pregnant ladies for these viruses and to educate the public about preventive measures against these infections. (author)

[Current seroprevalence, vaccination and predictive value of liver enzymes for hepatitis B among refugees in Germany].

Science.gov (United States)

Hampel, Annika; Solbach, Philipp; Cornberg, Markus; Schmidt, Reinhold E; Behrens, Georg M N; Jablonka, Alexandra

2016-05-01

Currently only vague estimates exist for the seroprevalence and vaccination status for viral hepatitis B (HBV) in refugees arriving in Germany during the current refugee crisis. To assess the prevalence of hepatitis B in refugees arriving in northern Germany in 2015. In a cross-sectional study in 793 patients from all age groups tests for serological markers of hepatitis B virus infection (HBsAg, anti-HBc) and liver enzymes (ALT, AST, bilirubin, γGT, alkaline phosphatase) were performed in August 2015 at six reception centers in northern Germany. In 258 patients anti-HBs antibodies were assessed additionally. Of the tested refugees, 76.7 % were male, the median age was 28.8 ± 11.4 years, and 7.8 % were children under the age of 18. The overall prevalence of HBsAg and total anti-HBc was 2.3 % and 14.0 % respectively (2.5 % and 14.5 % in men; 1.2 % and 13.5 % in women). Prevalence was highest in 35 to 49-year-old patients for HBsAg (3.1 %) and for refugees over 50 years for anti-HBc (38 %). No immunity to Hepatitis B was found in 62 %, 18.6 % had been vaccinated against Hepatitis B, while 50 % of children aged up to 15 years (n = 12) had been vaccinated. Positive predictive values of elevated AST and ALT for detection of HBsAg was 0 and 0.016, respectively. Only two patients with a positive HBsAg had elevated transaminases. This study showed a high prevalence of HBsAg in a German refugee sample in comparison to the general German population. Liver enzymes are not an appropriate tool for screening for hepatitis B virus infection.

Positioning devices for patients

International Nuclear Information System (INIS)

Heavens, M.

1981-01-01

It has been suggested that it is very important to position patients reproducibly at different stages of radiotherapy treatment planning and treatment, or similar procedures. Devices have been described for positioning a patient's upper and lower thorax. This invention provides reproducible positioning for a female patient's breasts, for example in planning treatment of and treating breast tumours. The patient is placed prone, using for example an upper thorax device. A support device is placed central to and beneath her breasts to partially displace them outwards. The device may be triangular in section with one apex contacting the chest wall at the sternum. Restraining straps may be provided to hold the breasts against the support device. Means may be provided to take a healthy breast from the path of radiation through the tumour. (author)

Seroprevalence of hepatitis B e antigen (HBe antigen and B core antibodies (IgG anti-HBcore and IgM anti-HBcore among hepatitis B surface antigen positive blood donors at a Tertiary Centre in Nigeria

Directory of Open Access Journals (Sweden)

Akinbami Akinsegun A

2012-03-01

Full Text Available Abstract Background Hepatitis B virus (HBV is a common cause of liver disease throughout the world. HBV is transmitted through blood and other body fluids, including semen and saliva. Chronic replication of HBV virons is characterized by persistence circulation of HBsAg, HBeAg and HBV DNA; usually with anti-HBc and occasionally with anti-HBs. Aim: To determine the prevalence of HBeAg, IgG anti-HBcore and IgM anti-HBcore amongst HBsAg positive blood donors. These parameters are reflective of transmissibility and active hepatitis B infection. A cross sectional study was carried out at the blood donor clinics of Lagos State University Teaching Hospital Ikeja and Lagos University Teaching Hospital Idiaraba. A total of 267 donors were recruited to determine HBe antigen, IgG and IgM anti-HBcore antibodies amongst hepatitis BsAg positive donors. Five milliliters of blood was collected from those who tested positive to HBsAg screen during donation. The sera were subjected to enzyme linked immunosorbent assay (ELISA. Pearson chi-squared test was used for the analytical assessment. Findings A total number of 267 HBsAg positive blood donors were studied. A seroprevalence of 8.2% (22 of 267 HBeAg was obtained, 4 of 267 (1.5% were indeterminate while 241 (90.3% tested negative. Only 27 out of 267 donors (10.1% tested positive to IgM anti-HBcore, 234(87.6% tested negative, while 6(2.2% were indeterminate. A higher percentage of 60.7% (162 of 267 tested positive to IgG anti-HBcore, while 39.3% (105 of 267 tested negative. Conclusion There is a low seroprevalence rate of HBeAg-positive chronic hepatitis and relatively high IgG anti-HBcore and IgM anti-HBcore rates in South West Nigeria.

Impact of occult hepatitis B virus infection on antiviral therapy in ...

African Journals Online (AJOL)

Gamal El Din Ahmed Elsawaf

2015-01-07

Jan 7, 2015 ... in the serum of patients who are negative for HBsAg. The presence ... positive. The frequency of HBV-DNA positive HCV patients has a statistically significant associa- ..... not affect the outcome of therapy at weeks 12 and 24.

Safety and Efficacy of Nucleic Acid Polymers in Monotherapy and Combined with Immunotherapy in Treatment-Naive Bangladeshi Patients with HBeAg+ Chronic Hepatitis B Infection

OpenAIRE

Al-Mahtab, Mamun; Bazinet, Michel; Vaillant, Andrew

2016-01-01

Previous in vivo studies have suggested that nucleic acid polymers (NAPs) may reduce circulating levels of HBsAg in the blood by blocking its release from infected hepatocytes and that this effect may have clinical benefit. NAP treatment, was evaluated in two clinical studies in patients with HBeAg positive chronic HBV infection. The REP 101 study examined REP 2055 monotherapy in 8 patients and the REP 102 study examined REP 2139-Ca, in monotherapy in 12 patients, 9 of which transitioned to s...

Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis B

Directory of Open Access Journals (Sweden)

Han Ah Lee

2016-09-01

Full Text Available Background/Aims Clear indicators for stopping antiviral therapy in chronic hepatitis B (CHB patients are not yet available. Since the level of hepatitis B surface antigen (HBsAg is correlated with covalently closed circular DNA, the HBsAg titer might be a good indicator of the off-treatment response. This study aimed to determine the relationship between the HBsAg titer and the entecavir (ETV off-treatment response. Methods This study analyzed 44 consecutive CHB patients (age, 44.6±11.4 years, mean±SD; men, 63.6%; positive hepatitis B envelope antigen (HBeAg at baseline, 56.8%; HBV DNA level, 6.8±1.3 log10 IU/mL treated with ETV for a sufficient duration and in whom treatment was discontinued after HBsAg levels were measured. A virological relapse was defined as an increase in serum HBV DNA level of >2000 IU/mL, and a clinical relapse was defined as a virological relapse with a biochemical flare, defined as an increase in the serum alanine aminotransferase level of >2 × upper limit of normal. Results After stopping ETV, virological relapse and clinical relapse were observed in 32 and 24 patients, respectively, during 20.8±19.9 months of follow-up. The cumulative incidence rates of virological relapse were 36.2% and 66.2%, respectively, at 6 and 12 months, and those of clinical relapse were 14.3% and 42.3%. The off-treatment HBsAg level was an independent factor associated with clinical relapse (hazard ratio, 2.251; 95% confidence interval, 1.076–4.706; P=0.031. When patients were grouped according to off-treatment HBsAg levels, clinical relapse did not occur in patients with an off-treatment HBsAg level of ≤2 log10 IU/mL (n=5, while the incidence rates of clinical relapse at 12 months after off-treatment were 28.4% and 55.7% in patients with off-treatment HBsAg levels of >2 and ≤3 log10 IU/mL (n=11 and >3 log10 IU/mL (n=28, respectively. Conclusion The off-treatment HBsAg level is closely related to clinical relapse after treatment

Hepatitis B and Delta Virus Are Prevalent but Often Subclinical Co-Infections among HIV Infected Patients in Guinea-Bissau, West Africa

DEFF Research Database (Denmark)

Hønge, Bo Langhoff; Jespersen, Sanne; Medina, Candida

2014-01-01

BACKGROUND: Co-infection with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) may lead to accelerated hepatic disease progression with higher rates of liver cirrhosis and liver-related mortality compared with HBV mono-infection. Co or super-infection with hepatitis Delta virus (HDV...... not performed for eight patients. HBV DNA was detected in 42 of 86 samples (48.8%) positive for HBsAg and genotyping was performed in 26 patients; 25 of whom had genotype E and one genotype D. Among 9 patients on antiretroviral treatment (ART), one patient had the [L180M, M204V] mutation associated...

Frequency of hepatitis B in asymptomatic patients of district Headquarter hospital Kotli, Azad Kashmir

International Nuclear Information System (INIS)

Sarwar, J.; Ahmad, W.; Saleem, M.; Jamshed, F.; Gul, N.; Idrees, M.

2010-01-01

Background: Hepatitis B is prevalent throughout the world including Pakistan. A large proportion of patients suffering from Hepatitis B may be asymptomatic and can transmit the disease to healthy population. Objectives of this study were to estimate the frequency of Hepatitis B in asymptomatic adult population coming to District Headquarter Hospital Kotli, Azad Kashmir and to determine the risk factors associated with its transmission. Methods: This was a cross-sectional study extending from January to December 2008. Subjects were randomly selected from those who attended the medial OPD of DHQ Hospital Kotli, Azad Kashmir for non-Hepatitis related problems. Both males and females between the ages of 15-80 years were included in the study. Blood samples taken from selected subjects were analysed for Hepatitis B surface antigen (HBsAg) by Immuno chromatographic kit methods (ICT). Hepatitis B positive samples were further confirmed by third generation ELIZA. The patients thus confirmed were interrogated for different risk factors associated with transmission of Hepatitis B. Results: A total of 9,564 patients were analysed. Out of them 4230 (44.22%) were males and 5334 (55.77%) were females. Overall 141 (1.47%) patients were positive for HBSAg, 71 (1.68%) males and 70 (1.31%) females. Patients between 21-30 years of age were most commonly effected (35.46%, n=50). Blood transfusion was the most common risk factor (24.82%, n=35) associated with Hepatitis B transmission followed by dental procedures (14.18%, n=20). Conclusion: Frequency of Hepatitis B in asymptomatic people in this study was quite high. Blood transfusions and dental procedures were the most common risk factors associated with the transmission of Hepatitis B. (author)

Targeted case finding for hepatitis B using dry blood spot testing in the British-Chinese and South Asian populations of the North-East of England.

Science.gov (United States)

McPherson, S; Valappil, M; Moses, S E; Eltringham, G; Miller, C; Baxter, K; Chan, A; Shafiq, K; Saeed, A; Qureshi, R; Hudson, M; Bassendine, M F

2013-09-01

Chronic infection with the hepatitis B virus (HBV) is a frequent cause of cirrhosis and liver cancer. Targeted HBV screening is recommended by the Centre for Disease Control (CDC) and Prevention for subjects born in countries with >2% HBV prevalence. However, there are no UK guidelines. Here, we applied the (CDC) recommendations to the British-Chinese and British-South Asian community of North-East (NE) England. British-Chinese and South Asian subjects were invited to attend for HBV education and screening sessions held in community centres. Hepatitis B surface antigen (HBsAg) and hepatitis B core total antibody (HBcAb) were tested with dry blood spot tests. South Asians were also tested for hepatitis C antibody (HCVAb). A total of 1126 subjects (606 Chinese and 520 South Asian) were screened. Sixty-two (5.5%) were HBsAg positive. Ten of these reported a previous diagnosis of HBV. The prevalence of HBsAg positivity was 4.6% when previously diagnosed individuals were excluded. The HBsAg prevalence was significantly higher in the Chinese subjects compared with South Asians (8.7% VS. 1.7% P < 0.001). In Chinese subjects, HBsAg positivity was highest in subjects born in Vietnam (17.4%), followed by China (11%), Hong Kong (7.8%) and the UK (6.7%). Subjects from Pakistan had the highest HBsAg and HCV Ab prevalence in the South Asians (3.1% and 1.8%, respectively). Ten percentage of HBsAg positive patients who had follow-up assessment had active disease requiring antiviral treatment. Undiagnosed HBV infection was above the 2% threshold for screening suggested by the CDC in the British-Chinese and Pakistani community of NE England, which provides evidence for a UK HBV-targeted screening programme. © 2013 John Wiley & Sons Ltd.

Patient positioning and ventilator-associated pneumonia.

Science.gov (United States)

Hess, Dean R

2005-07-01

Rotational beds, prone position, and semi-recumbent position have been proposed as procedures to prevent ventilator-associated pneumonia (VAP). Rotational therapy uses a special bed designed to turn continuously, or nearly continuously, the patient from side to side; specific designs include kinetic therapy and continuous lateral rotation therapy. A meta-analysis of studies evaluating the effect of rotational bed therapy shows a decrease in the risk of pneumonia but no effect on mortality. Two studies reported a lower risk of VAP in patients placed in a prone position, with no effect on mortality. Studies using radiolabeled enteral feeding solutions in mechanically ventilated patients have reported that aspiration of gastric contents occurs to a greater degree when patients are in the supine position, compared with the semirecumbent position. One study reported a lower rate of VAP in patients randomized to semi-recumbent compared to supine position. Although each of the techniques discussed in this paper has been shown to reduce the risk of VAP, none has been shown to affect mortality. The available evidence suggests that semi-recumbent position should be used routinely, rotational therapy should be considered in selected patients, and prone position should not be used as a technique to reduce the risk of VAP.

Clinical evaluation of 413 Thalassemic patients

Directory of Open Access Journals (Sweden)

Korosdari Gh.H

2000-08-01

Full Text Available Thalassemia is the most prevalent genetic disorder in Iran and around the world and these patients need regular careful care. The present study reports results of routine examination of patients visited Thalassemia clinic of Tehran. Data about clinical and laboratory examinations of 413 Thalassemic were extracted and analyzed. The prevalence of heart complications, diabetes, growth retardation, delayed puberty and primary and secondary amenorrhea was 9%, 8%, 21.3%, 3.1% and 6.3%, respectively. 44% didn't have secondary sex characteristics. Splenectomy had been done for 67.2% of cases. HBsAg, HBsAb and HBcAb were positive in 1.9%, 57.4% and 43%, respectively. We concluded that blood transfusion standards in this clinic was acceptable, whereas because of poor knowledge, iron chelating is unfavorable.

Peg-interferon plus nucleotide analogue treatment versus no treatment in patients with chronic hepatitis B with a low viral load: a randomised controlled, open-label trial.

Science.gov (United States)

de Niet, Annikki; Jansen, Louis; Stelma, Femke; Willemse, Sophie B; Kuiken, Sjoerd D; Weijer, Sebastiaan; van Nieuwkerk, Carin M J; Zaaijer, Hans L; Molenkamp, Richard; Takkenberg, R Bart; Koot, Maarten; Verheij, Joanne; Beuers, Ulrich; Reesink, Hendrik W

2017-08-01

Antiviral treatment is currently not recommended for patients with chronic hepatitis B with a low viral load. However, they might benefit from acquiring a functional cure (hepatitis B surface antigen [HBsAg] loss with or without formation of antibodies against hepatitis B surface antigen [anti-HBs]). We assessed HBsAg loss during peg-interferon-alfa-2a (peg-IFN) and nucleotide analogue combination therapy in patients with chronic hepatitis B with a low viral load. In this randomised controlled, open-label trial, patients were enrolled from the Academic Medical Center (AMC), Amsterdam, Netherlands. Eligible patients were HBsAg positive and hepatitis B e antigen (HBeAg) negative for more than 6 months, could be treatment naive or treatment experienced, and had alanine aminotransferase (ALT) concentrations less than 5 × upper limit of normal (ULN). Participants were randomly assigned (1:1:1) by a computerised randomisation programme (ALEA Randomisation Service) to receive peg-IFN 180 μg/week plus adefovir 10 mg/day, peg-IFN 180 μg/week plus tenofovir disoproxil fumarate 245 mg/day, or no treatment for 48 weeks. The primary endpoint was the proportion of patients with serum HBsAg loss among those who received at least one dose of study drug or had at least one study visit (modified intention-to-treat population [mITT]). All patients have finished the initial study of 72 weeks and will be observed for up to 5 years of follow-up. This study is registered with ClinicalTrials.gov, number NCT00973219. Between Aug 4, 2009, and Oct 17, 2013, 167 patients were screened for enrolment, of whom 151 were randomly assigned (52 to peg-IFN plus adefovir, 51 to peg-IFN plus tenofovir, and 48 to no treatment). 46 participants in the peg-IFN plus adefovir group, 45 in the peg-IFN plus tenofovir group, and 43 in the no treatment group began treatment or observation and were included in the mITT population. At week 72, two (4%) patients in the peg-IFN plus adefovir group and two (4

Antenatal screening of women for hepatitis B and C in an out-patient department

International Nuclear Information System (INIS)

Batool, A.; Bano, K.A.; Khan, M.U.I.; Hussain, R.

2008-01-01

To determine frequency of hepatitis B virus (HBV) and hepatitis C virus (HCV) and its clinical manifestation in pregnant women. Pregnant women visiting the Gynaecology and Obstetrics out patient's department of Sir Ganga Ram Hospital Lahore for antenatal check-ups from October 2006 to March 2007 were screened for hepatitis B and C. Immune- chromatography was used for initial screening and diagnosis was confirmed by ELISA technique. Data collection included maternal age, parity, symptoms or past history of jaundice, fatigue, tiredness, insomnia, depression, dyspepsia, fever, anorexia and pale stool. Risk factors investigated include past history of some surgical procedures, the dental visit, blood transfusion, tattooing, hospitalization and history of injection. Among the screened population, 7.3% out of 2439 ladies were positive for anti HCV and 2.2% for HBsAg while dual infection with HBV and HCV was observed in 0.08 % . Symptoms observed in hepatitis B patients were fatigue (90%), depression and pale stool (70%), anorexia (60%), jaundice (57.2%), fever (56.4%) and dyspepsia (51.2%). In hepatitis C antibody positive patients fatigue was the main symptom (95.7%) followed by pale stool (84.5%) and depression (80.2%); 63.3% had insomnia, 59.1% had anorexia, 50.7% had fever, 50.7% had jaundice and 43.6% had dyspepsia. Past history of blood transfusion was reported by 32.3% patients, surgery by 42.2% and tattooing was observed in 0.70%. One or more tooth extraction was reported by 50.2% subjects, and 49.25% had history of repeated injections. The frequency of sero-positivity for HBsAg and HCV among pregnant women is alarming. These sero-positive mothers are not only predisposed to chronic consequences of hepatitis, but also are a continuous threat to their offsprings and care providers. Hence, there is a direct need for further epidemiological studies and to take measures for prevention and control of the disease. (author)

21 CFR 868.6820 - Patient position support.

Science.gov (United States)

2010-04-01

...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Miscellaneous § 868.6820 Patient position support. (a) Identification. A patient position support is a device intended to maintain the position of an anesthetized... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Patient position support. 868.6820 Section 868...

High rates of chronic HBV genotype E infection in a group of migrants in Italy from West Africa: Virological characteristics associated with poor immune clearance.

Science.gov (United States)

Malagnino, Vincenzo; Salpini, Romina; Maffongelli, Gaetano; Battisti, Arianna; Fabeni, Lavinia; Piermatteo, Lorenzo; Colagrossi, Luna; Fini, Vanessa; Ricciardi, Alessandra; Sarrecchia, Cesare; Perno, Carlo Federico; Andreoni, Massimo; Svicher, Valentina; Sarmati, Loredana

2018-01-01

Hepatitis B virus (HBV) genotype E almost exclusively occurs in African people, and its presence is more commonly associated with the development of chronic HBV (CHB) infection. Moreover, an epidemiological link has been found between the distribution of HBV genotype E infection and African countries with high incidences of hepatocellular carcinoma. As part of a programme for the health assessment of migrants, we evaluated 358 young African subjects for HBV infection; 58.1% (208/358) were positive for an HBV marker, and 54 (25.5%) had CHB. Eighty-one percent of the CHB subjects were infected with HBV genotype E, with a median serum HBV-DNA of 3.2 (IQR: 2.7-3.6) logIU/ml. All patients had high serum HBsAg titres (10,899 [range 5,359-20,272] IU/ml), and no correlation was found between HBsAg titres and HBV-DNA plasma levels. RT sequence analysis showed the presence of a number of immune escape mutations: strains from all of the patients had a serine at HBsAg position 140; 3 also had T116N, Y100C, and P142L+S143L substitutions; and 1 had a G112R substitution. Six (18%) patients had stop-codons at position 216. In 5 of the 9 (26.5%) CHB patients, ultrasound liver biopsy, quantification of total intrahepatic HBV-DNA and cccDNA, and RT/HBsAg sequencing were performed. The median (IQR) total intrahepatic HBV-DNA was 766 (753-1139) copies/1000 cells, and the median (IQR) cccDNA was 17 (10-27) copies/1000 cells. Correlations were observed for both total intrahepatic HBV-DNA and cccDNA with serum HBV-DNA, while no correlation was found for the HBsAg titres. A difference of 2.5/1,000 nucleotides was found in the HBsAg sequences obtained from plasma and from liver tissue, with 3 cases of possible viral anatomical compartmentalization. In conclusion, a high rate of CHB infection due to the E genotype was demonstrated in a group of immigrants from Western Africa. An analysis of the viral strains obtained showed the virological characteristics of immune escape, which may be the

Prevalence of hepatitis B and C infection in patients admitted at tertiary eye care centre: a hospital based study

International Nuclear Information System (INIS)

Junejo, S.A.; Khan, N.A.; Lodhi, A.A.

2009-01-01

Objective: To determine the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections and the risk factors in patients admitted for ocular treatment at a tertiary eye care centre in Sindh Pakistan. Methodology: Nine hundred thirty one patients admitted at Liaquat University Eye Hospital Hyderabad for ocular treatment, were screened for HBV and HCV. Patients of either sex, with more than thirty years of age were included. Screening for HBV surface antigen (HBsAg) and antibodies against HCV (anti-HCV) was performed through chromatography method. Samples repeatedly reactive for HBsAg or anti-HCV were considered positive. Results: Out of 931 registered patients, 497 (53.3%) were male and 434 (46.7%) female. Hepatitis B and C was detected in 167 (17.9%) subjects. The overall seroprevalence of HBV infection within the study period was 4.6%, HCV 13.3%, and for HBV and HCV both was 3.9%. Regarding the predisposing factors, past history of blood transfusion was present in 08.3% subjects, needle injection 89.2%, barber shaving 52.6%, and 46 (27.5%) patients presented with past history of surgery. Conclusion: For the prevention of transmission of HBV and HCV infection, the community awareness regarding vaccination against Hepatitis B and risk factors for spread of HBV and HCV, implementation of population based screening and vaccination for HBV on large scale should be ensured. (author)

Precise positioning of patients for radiation therapy

International Nuclear Information System (INIS)

Verhey, L.J.; Goitein, M.; McNulty, P.; Munzenrider, J.E.; Suit, H.D.

1982-01-01

A number of immobilization schemes which permit precise daily positioning of patients for radiation therapy are discussed. Pretreatment and post-treatment radiographs have been taken with the patient in the treatment position and analyzed to determine the amount of intratreatment movement. Studies of patients in the supine, seated and decubitus positions indicate mean movements of less than 1 mm with a standard deviation of less than 1 mm. Patients immobilized in the seated position with a bite block and a mask have a mean movement of about 0.5 mm +/- 0.3 mm (s.d.), and patients immobilized in the supine position with their necks hyperextended for submental therapy evidence a mean movement of about 1.4 mm +/- 0.9 mm (s.d.). With the exception of those used for the decubitus position, the immobilization devices are simply fabricated out of thermoplastic casting materials readily available from orthopedic supply houses. A study of day-to-day reproducibility of patient position using laser alignment and pretreatment radiographs for final verification of position indicates that the initial laser alignment can be used to position a patient within 2.2 mm +/- 1.4 mm (s.d.) of the intended position. These results indicate that rigid immobilization devices can improve the precision of radiotherapy, which would be advantageous with respect to both tumor and normal tissue coverage in certain situations

Seroprevalence of hepatitis and human immuno-deficiency virus in multitransfused patients from a pediatric hematology clinic

Directory of Open Access Journals (Sweden)

Suar Çakı Kılıç

2008-12-01

Full Text Available OBJECTIVE: Transfusion transmitted hepatitis has been a severe problem in Turkey in pediatric cancer patients and in chronic congenital anemia. The aim of the present study was to investigate the prevalence of hepatitis B, hepatitis C and human immunodeficiency virus infections in these patients in a University Hospital. METHODS: Multi-transfused 66 children (59 acute leukemia, 6 thalassemia major, 1 severe hereditary spherocytosis diagnosed and followed-up between May, 2000 and December, 2006 were evaluated. Screening of all the patients for HbsAg, anti-HBs, anti-HBc, anti-HCV and anti-HIV was performed at presentation and during the last follow-up. Serologic studies of leukemic patients were also repeated at the end of the chemotherapy. Hepatitis B vaccination was administered to unvaccinated patients with anemia. All blood products were provided by Blood Bank of the Center. RESULTS: No patient was found HBsAg, anti-HCV or anti-HIV positive at diagnosis and at the end of the therapy. There was history of hepatitis B vaccination in only 42% of the patients at diagnosis due to administration of this vaccine to newborns since 1998. At the beginning of the study, 45 % (n=27 of the leukemic patients were immune for hepatitis B, but after completion of the intensive chemotherapy seropositivity persisted in only 28.8 % (n=17. CONCLUSION: Transmission of these viruses is no longer a real problem even in multitransfused immunosuppressed children in Pediatric Hematology Units as a result of the improvements in screening of voluntary blood donors, administration of disposable material in clinics and vaccination by hepatitis B.

Quantification of serum markers of hepatitis B (HBV) and Delta virus (HDV) infections in patients with chronic HDV infection.

Science.gov (United States)

Ricco, Gabriele; Popa, Delia Codruta; Cavallone, Daniela; Iacob, Speranta; Salvati, Antonio; Tabacelia, Daniela; Oliveri, Filippo; Mascolo, Giovanni; Bonino, Ferruccio; Yuan, Quan; Xia, Ning-Shao; Gheorghe, Liana; Brunetto, Maurizia Rossana

2018-03-25

The interplay between hepatitis B (HBV) and Delta (HDV) viruses is complex and not always characterized during chronic HDV infection. We assessed the clinical usefulness of new quantitative assays for HBV and HDV serum markers in a retrospective cross-sectional study. Sera obtained from 122 HDV-genotype-1 and HBV-genotype-D co-infected, anti-HIV-negative patients [71 males; median age 49.8 (21.7-66.9) years], recruited consecutively in two geographic areas (Italy 69 patients, Romania 53) with different HBV and HDV epidemiology, were tested for HBsAg, HBV-DNA, HBcrAg, total anti-HBc, HDV-RNA, IgM and total anti-HDV using quantitative assays. Cirrhosis, that showed comparable prevalence in the two cohorts, was diagnosed in 97 of 122 (79.5%) patients. At multivariate analysis, cirrhosis was associated with lower total anti-HBc/IgM-anti-HDV ratio (OR 0.990, 95%CI 0.981-0.999, P=0.038), whereas disease activity was associated with higher total anti-HDV (OR 10.105, 95% CI 1.671-61.107, P=0.012) and HDV-RNA levels (OR 2.366, 95% CI 1.456-3.844, P=0.001). HDV-RNA serum levels showed a positive correlation with HBV-DNA (ρ=0.276, P=0.005), HBsAg (ρ=0.404, PHBV and HDV serum markers identifies specific patterns associated with activity and stage of chronic hepatitis D (CHD). HDV pathogenicity depends on the underlying active HBV infection in spite of the inhibition of its replication. HDV-RNA, IgM anti-HDV, total anti-HDV, total anti-HBc, HBsAg and HBcrAg serum levels qualify for prospective studies to predict progressive CHD and identify candidates to antiviral therapy. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Hepatitis B co-infection in HIV-infected patients receiving ...

African Journals Online (AJOL)

2016-05-20

May 20, 2016 ... smart phone or .... 'data mining' to establish an estimate for the local positivity ... The relevant data (gender, age, CD4 counts and HBsAg) for .... cards. This might either be the case in HIV treatment failure with the first-line ...

[IgM class antibodies against hepatitis A viruses in the differentiation of viral hepatitis].

Science.gov (United States)

Zivanović-Marinković, V; Stanković, D; Parabucki, S; Lazarov, A; Marinković, V; Krstić, L; Letica, Z

1982-01-01

The sera of 64 patients with acute viral hepatitis which were previously HbsAG negative by rPHA were tested by RIA methods for the presence of HBsAG and anti-HBc, by EIA method for HBc and anti-HBc and also by RIA method for the presence of IgM antibodies against hepatitis A virus. The pairs of sera were tested also for the presence of antibodies against cytomegalovirus and EB viruses. Of the total of 64 patients, markers of fresh HB viral infection were proved in 5 patients, sera positive to IgM antibodies to hepatitis A virus were found in 51 and no positive tests to any of the tested viruses were found in 8. The authors consider that they belonged to "non-A, non-B" viral hepatitis.

Evaluation of Hepatitis B Infection Prevalence in Institutionalized Intellectually Disabled Children

Directory of Open Access Journals (Sweden)

Foad Davoodbeglou

2016-04-01

Full Text Available Background: Hepatitis B virus (HBV infection causes chronic infection in human population, with high mortality. One of the high risk communities is mentally retarded children, who are institutionalized. Special conditions in these centers predispose children for HBV infection and transmission to healthy people. In this study our objective was to determine the prevalence of HBV infection among institutionalized mentally retarded children and study its associated risk factors.Materials and Methods: In this study, 250 mentally retarded children (younger than 14 years old were included. They were living in 5 nursing institutions, located in different parts of Tehran. Hepatitis B surface antigen (HBsAg was measured in the sera of these patients by ELISA method.Results: Among 250 children, 20 children (8% were HBsAg positive. HBV infection in girls was more than boys (11% to 5.6%. Among the types of mental retardation, children with cerebral palsy had the highest positive result for HBsAg. The most HBV infection (28.5% was seen in children with longest duration of being institutionalized (10 to 11 years. Vaccinated children were more HBsAg positive (8.7% than non-vaccinated children (5.3%. However, no significant relationship was observed between any of these factors and HBsAg positivity.Conclusion: Despite improvement of people’s health condition and implementation of HBV vaccination, the prevalence of HBV infection is increased in institutionalized mentally retarded children, which highlights the need for active measures to reduce this infection among this high risk population

Resolution of HBV infection occurs sooner than recovery of renal disease in adult serum HBsAg-negative HBV-associated glomerulonephritis.

Science.gov (United States)

Xu, Fang; Wang, Chong; Shi, Xiaoju; Hou, Jie; Guo, Xiaolin; Gao, Pujun

2018-05-02

Most cases of hepatitis B virus-associated glomerulonephritis (HBV-GN) occur in children and present with serum HBsAg positivity. Few studies have investigated adult HBV-GN patients who are serum HBsAg-negative. This study aimed to determine the clinical and pathological features of serum HBsAg-negative adult HBV-GN patients. Clinical, pathologic and laboratory findings were collected and analyzed in a cohort of 27 adult HBV-GN patients who were serum HBsAg negative upon diagnosis. The study population included mostly men of middle age (40-59 years). Clinically, patients presented with nephrotic syndrome. Serum IgG levels were low, while serum IgM, IgA, C3, and C4 levels as well as liver and renal function tests were normal in most or all patients. Among the 27 patients, 21 tested positively for HBV antibodies. MN was the dominant pathological form on kidney biopsy. In addition, only a few patients showed a "full house" staining pattern and renal immune deposit of C1q. Serum HBsAg negative HBV-GN may represent a late stage of HBV infection. We recommend routine testing for HBV markers on renal biopsy in regions where HBV is prevalent, even when tests for serum HBV markers are negative. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Cloning analysis of HBV-specific CD8 T cell receptor gene in patients with acute hepatitis B

Directory of Open Access Journals (Sweden)

Ning DING

2011-05-01

Full Text Available Objective To investigate the molecular mechanism of T cell receptor(TCR in CD8 T cell-mediated immune response to HBV in patients with acute hepatitis B(AHB.Methods Peripheral blood mononuclear cells(PBMCs were collected from HLA-A2-positive AHB patients.To determine HBsAg183-191 and HBsAg335-343-specific CD8 T cell frequencies,the PBMCs were stained by fluorescence-labeled anti-CD3,anti-CD8 and pentamers,and analyzed by flow cytometry.PBMCs from 6 patients were stimulated with epitopic peptide HBsAg335-343 in vitro for 3 to 4 weeks.HBV-specific CD8 T cells were isolated by magnetic activated cell sorting followed by flow florescence activated cell sorting.The mRNA of sorted cells was extracted after expanding by IL-2,anti-CD3 and anti-CD8.The full-length gene fragments of variable region of TCR α and β chains were gained by 5’-RACE,and then cloned and sequenced(≥50 clones for single chain of each sample.The gene families of TCR α and β chains were identified and the sequence characters of CDR3 were compared.Results Analysis of more than 600 cloned gene sequences of TCR α and β chains showed that the proliferated HBV-specific CD8 T cells from 6 AHB patients presented a predominant expression in TCR α and chains,with 2-4 α chain families and 1-4 chain families in each case.The α2,α14,α15,β3,β13 and 23 families were detected in more than one case.The chain genes were all 13 for all tested clones in one case.For the same α chain or-chain family,CDR3 sequences tended to be identical in one case but different among cases.Conclusions HBV-specific CD8 T cells with antigenic peptide-induced proliferation present predominance in the usage of TCR α and β chains.This property might be one of the important molecular factors influencing anti-HBV immunity.

Evaluation of the highly sensitive chemiluminescent enzyme immunoassay "Lumipulse HBsAg-HQ" for hepatitis B virus screening.

Science.gov (United States)

Deguchi, Matsuo; Kagita, Masanori; Yoshioka, Nori; Tsukamoto, Hiroko; Takao, Miyuki; Tahara, Kazuko; Maeda, Ikuhiro; Hidaka, Yoh; Yamauchi, Satoshi; Kaneko, Atsushi; Miyakoshi, Hideo; Isomura, Mitsuo

2017-10-06

Ongoing efforts in the development of HBsAg detection kits are focused on improving sensitivity and specificity. The purpose of this study was to evaluate an improved, highly sensitive quantitative assay, "Lumipulse HBsAg-HQ", a chemiluminescent enzyme immunoassay designed for a fully automated instrument, the "Lumipulse G1200". Serum samples for reproducibility, dilution, correlation, sensitivity, and specificity studies were obtained from patients at the Osaka University Hospital. Seroconversion and sensitivity panels were purchased from a commercial vender. Subtype, sensitivity panels, and HBsAg recombinant proteins with one or two amino acid substitutions were prepared in-house. The coefficients of variation for the low, medium, and high concentration samples ranged from 1.93 to 2.55%. The HBsAg-HQ reagent for dilution testing showed good linearity in the 0.005-150 HBsAg IU/mL range and no prozone phenomenon. All 102 HBV carrier samples were positive by HBsAg-HQ, while other commercial reagents showed one or more to be negative. In the seroconversion panel, the 14-day blood sample was positive. The sensitivity against HBsAg-HQ "ad" and "ay" subtypes was 0.025 ng/mL. Comparisons among the HBsAg-HQ, HISCL, and Architect HBsAg reagents were performed using the Bland-Altman plot. Specificity for 1000 seronegative individuals was 99.7%. HBsAg-HQ detected 29 positive serum among 12 231 routinely obtained serum samples, which showed concentrations of 0.005-0.05 HBsAg IU/mL. According to these results, the Lumipulse HBsAg-HQ assay, with a highly sensitive limit of detection of 0.005 IU/mL, may facilitate the development of a better management strategy for a considerable proportion of infected patients. © 2017 Wiley Periodicals, Inc.

Liver biopsy performance and histological findings among patients with chronic viral hepatitis

DEFF Research Database (Denmark)

Christensen, Peer Brehm; Krarup, Henrik Bygum; Møller, Axel

2007-01-01

We investigated the variance of liver biopsy frequency and histological findings among patients with chronic viral hepatitis attending 10 medical centres in Denmark. Patients who tested positive for HBsAg or HCV- RNA were retrieved from a national clinical database (DANHEP) and demographic data...... had developed in 23% after 20 y of infection. Age above 40 y was a better predictor of cirrhosis than elevated ALT. National database comparison may identify factors of importance for improved management of patients with chronic viral hepatitis......., laboratory analyses and liver biopsy results were collected. A total of 1586 patients were identified of whom 69.7% had hepatitis C, 28.9% hepatitis B, and 1.5% were coinfected. In total, 771 (48.6%) had a biopsy performed (range 33.3-78.7%). According to the Metavir classification, 29.3% had septal fibrosis...

Investigation and analysis of eight indicators about hepatitis B in 360 pairs of mother and baby

International Nuclear Information System (INIS)

Feng Nian

2004-01-01

To explore the infectivity of predelivery women with different modes of hepatitis B virus infections to their fetuses, eight indicators (HBsAg, anti-HBs, HBcAg, anti-HBc, HBeAg, anti-HBe, PHSA-R and anti-HBc-IgM) in serum of mother and umbilical cord blood of baby were detected. By matched pairs the result s showed that there were 170 mothers whose serum was positive for more than one indicator. The positive rate was 47.2% altogether. 15 infections modes appeared. There were 18 mothers whose serum was positive for HBsAg. Of their baby, there were 16 whose umbilical card blood was positive for HBsAg. From mother to baby, the infection rate was 88.8%(16/18). There were two babies whose umbilical cord blood was positive for HBsAg, but the serum of their mother was only positive for anti-HBc. There was one case, the umbilical cord blood of baby was positive for HBsAg, but the serum of his mother was all negative for these eight indicators. (author)

Molecular epidemiology of co-infection with hepatitis B virus and human immunodeficiency virus (HIV) among adult patients in Harare, Zimbabwe.

Science.gov (United States)

Baudi, Ian; Iijima, Sayuki; Chin'ombe, Nyasha; Mtapuri-Zinyowera, Sekesai; Murakami, Shuko; Isogawa, Masanori; Hachiya, Atsuko; Iwatani, Yasumasa; Tanaka, Yasuhito

2017-02-01

The objective of this study was to determine the prevalence of co-infection with hepatitis B virus (HBV) and human immunodeficiency virus (HIV) and the genetic characteristics of both viruses among pre-HIV-treatment patients in Harare, Zimbabwe. This cross-sectional survey involved 176 remnant plasma samples collected from consenting HIV patients (median age 35 [18-74]) between June and September 2014. HBV seromarkers were determined by high-sensitivity chemiluminescence assays. Molecular evolutionary analyses were conducted on the basal core promoter/precore (BCP/PC) and S regions of HBV, as well as part of the HIV pol region. Of the 176 participants (65.7% female), 19 (10.8%) were positive for HBsAg (median 0.033 IU/ml (IQR 0.01-415). The HBsAg incidence was higher in men than women (P = 0.009). HBsAg-positive subjects had lower median CD4 counts (P = 0.016). HBV DNA was detectable in 12 HBsAg-positive samples (median 3.36 log cp/ml (2.86-4.51), seven being amplified and sequenced. All isolates were subgenotype A1 without HBV drug resistance mutations but each had at least one BCP/PC mutation. PreS deletion mutants and small S antigen variants M133I/T and D144G were identified. Of the 164 HIV isolates successfully genotyped, 163 (99.4%) were HIV-1 subtype C and only one was HIV-1 subtype F1. Sixteen (9.8%) had at least one drug resistance mutation, predominantly non-nucleoside reverse transcriptase inhibitor-related mutations, observed mostly among female participants. This study shows that co-infection with HBV is present among HIV patients enrolling into HIV care in Zimbabwe, suggesting that HBV screening and monitoring programmes be strengthened in this context. J. Med. Virol. 89:257-266, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Prevalence of positive autoimmune biomarkers in the brucellosis patients.

Science.gov (United States)

Ahmadinejad, Zahra; Abdollahi, Alireza; Ziaee, Vahid; Domiraei, Zeinab; Najafizadeh, Seyed-Reza; Jafari, Sirus; Ahmadinejad, Mahdi

2016-10-01

Brucellosis is a chronic infectious disease with articular involvement. Discrimination between brucellosis and rheumatologic disorders is difficult in regions endemic for brucellosis. There are few studies about the rate of positive autoantibodies as rheumatologic biomarkers in brucellosis, and the prevalence is variable. In this study, the rheumatologic tests were studied in brucellosis patients. This cross sectional study was performed in two teaching hospitals in Tehran, Iran. Forty-nine patients with brucella infection and 42 healthy participants were enrolled in this study. Brucellosis was diagnosed on the basis of the clinical symptoms and positive serology for brucellosis. Rheumatic factor (RF) and antinuclear antibodies (ANA) were evaluated in all patients. Cyclic citrullinated peptides antibody (ACPA) and anti-double strand DNA (anti-dsDNA) were checked in all patients and control groups. Out of 49 patients, 15 (30.6 %) were RF positive and 4 (8.2 %) were ANA positive. Anti-dsDNA was concurrently positive with ANA in 1 patient (2 %) but ACPA titer was positive in 8 patients (16.3 %). None of the patients with positive autoantibody biomarkers fulfilled the criteria for rheumatologic disorders. The rate of positive RF in healthy people was significantly lower than patient group (2.4 vs. 30.6 %), but the positiveness rate of other biomarkers did not have significant difference in two groups. Sixty percent of the patients with positive RF and 75 % with positive ACPA had skeletal involvement (P brucellosis. Rheumatologists should be aware of brucellosis in patients with musculoskeletal involvement and positive autoantibody biomarkers in endemic regions.

Uptake of tenofovir-based antiretroviral therapy among HIV-HBV-coinfected patients in the EuroSIDA study

DEFF Research Database (Denmark)

Peters, Lars; Mocroft, Amanda; Grint, Daniel

2018-01-01

BACKGROUND: According to guidelines all HIV/HBV co-infected patients should receive tenofovir-based combination antiretroviral therapy (cART). We aimed to investigate uptake and outcomes of tenofovir-based cART among HIV/HBV patients in the EuroSIDA study. METHODS: All HBsAg+ patients followed up...

The seroprevalence of hepatitis B and C in hospitalized Danish patients

DEFF Research Database (Denmark)

Nelsing, S; Wantzin, P; Skøt, J

1995-01-01

Health care workers are at risk of acquiring blood-borne infections. To assess the risk of exposure to hepatitis B or C in the case of occupational blood exposure, we determined the seroprevalence of these infections in 466 patients admitted to a Copenhagen university hospital. Serological markers...... for hepatitis B or C were detected in 56 patients (12.0%). The seroprevalence of HBsAg and anti-HCV was 0.9% and 1.5% respectively. HCV RNA, indicating ongoing hepatitis C, was found in five of seven anti-HCV-positive patients by polymerase chain reaction. The serological findings had not previously been...... diagnosed in 4 of 10 potentially infectious patients and only 6 of 10 patients belonged to high-risk groups. In conclusion, health care workers should be aware of the potential the occupational risk of hepatitis B and C even in a low-prevalence country like Denmark. Management of health care workers after...

Type B Hepatitis in Iran

Directory of Open Access Journals (Sweden)

M. Tabarestani

1977-01-01

Full Text Available Hepatitis B surface antigen CHBsAg was found in 1% of controls, 2.1% of professional blood donors, 2.0% of leprosy patients and 76.1% of acute hepatitis in Tehran and Mashhad, Iran. All HBsAg positive samples also possessed antibody to the hepatitis B core antigen and all were subtype ayw. Type B hepatitis and the HBsAg state aloe frequent in Iran, but most must be accounted for by u nonparenter- al" or "rnapparent'' parenteral exposure.

Lateral positioning for critically ill adult patients.

Science.gov (United States)

Hewitt, Nicky; Bucknall, Tracey; Faraone, Nardene M

2016-05-12

Critically ill patients require regular body position changes to minimize the adverse effects of bed rest, inactivity and immobilization. However, uncertainty surrounds the effectiveness of lateral positioning for improving pulmonary gas exchange, aiding drainage of tracheobronchial secretions and preventing morbidity. In addition, it is unclear whether the perceived risk levied by respiratory and haemodynamic instability upon turning critically ill patients outweighs the respiratory benefits of side-to-side rotation. Thus, lack of certainty may contribute to variation in positioning practice and equivocal patient outcomes. To evaluate effects of the lateral position compared with other body positions on patient outcomes (mortality, morbidity and clinical adverse events) in critically ill adult patients. (Clinical adverse events include hypoxaemia, hypotension, low oxygen delivery and global indicators of impaired tissue oxygenation.) We examined single use of the lateral position (i.e. on the right or left side) and repeat use of the lateral position (i.e. lateral positioning) within a positioning schedule. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 5), MEDLINE (1950 to 23 May 2015), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1937 to 23 May 2015), the Allied and Complementary Medicine Database (AMED) (1984 to 23 May 2015), Latin American Caribbean Health Sciences Literature (LILACS) (1901 to 23 May 2015), Web of Science (1945 to 23 May 2015), Index to Theses in Great Britain and Ireland (1950 to 23 May 2015), Trove (2009 to 23 May 2015; previously Australasian Digital Theses Program (1997 to December 2008)) and Proquest Dissertations and Theses (2009 to 23 May 2015; previously Proquest Digital Dissertations (1980 to 23 May 2015)). We handsearched the reference lists of potentially relevant reports and two nursing journals. We included randomized and quasi-randomized trials examining effects of

Prevalence of HBV in pregnant women from areas of different endemicity in Peru

International Nuclear Information System (INIS)

Vasquez, S.; Garcia, B.; Torres, R.; Larrabure, G.; Lucen, A.; Pernaz, G.; Gonzales, L.; Miranda, G.; Davalos, E.; Galarza, C.; Camasca, N.; Jara, R.

1999-01-01

The present study was performed to estimate the prevalence of HBV in pregnant women (mean age among groups 25,0 ± 6,9) who live in areas of different endemicity, and located in the Department of Lima, Junin, Apurimac, and Ayacucho in Peru. All studies were carried out using radioimmunological techniques. In the Instituto Materno Perinatal in Lima, located in a low endemic area, 2086 pregnant women whose ages ranged between 14 and 44 years old were evaluated (for laboratory tests) at their first prenatal examination. A prevalence of 0,38% (HBsAg+), 0,38% (Ratio), and 3,18% (HBsAg+, anti-HBsAg+) was found, corresponding to 107 HBsAg+ pregnant women whose treated newborn would prevent the HBV chronic infection of approximate 21 newborn each year. 63% HBsAg+ pregnant women were born in Departments other than Lima. In the Hospital de Apoyo La Merced, located in Chanchamayo, Junin, which is a medium endemic area, 217 pregnant women whose ages ranged between 14 and 48 years old were evaluated. T he prevalence found in this hospital was of 1,38% (HBsAg+), 1,2% (Ratio), and 17,*% (HBsAg+, anti-HBs+). All positive HBsAg were negative for HBeAg. The projection of results corresponded to a total of 9 HbsAg+ pregnant women and 2 newborn preventive of chronic disease per year. In the Guillermo Diaz de la Vega Hospital in Abancay, Apurimac, located in a medium to high endemic area, 221 pregnant women whose ages ranged between 15 and 46 years old were evaluated. A prevalence of 1,36% (HBsAg+), 1,0% (Ratio), and 36.16% (HBsAg+, anti-HBs+) was found. All positive HBsAg were negative for HBeAg. Projected results corresponded to a total of 37 HBsAg+ pregnant carriers and 7 newborn preventive of chronic disease per year. The Hospital General de Huanta, in Ayacucho, located in a high endemicity area, presented a prevalence of 3,2% (HBsAg+), 1,9% (Ratio), and 76, 2% (HBsAg+, anti-HBs+) from 126 pregnant women evaluated with ages between 15 and 48 years old. These results gave a total

[HIVAb, HCVAb and HBsAg seroprevalence among inmates of the prison of Bologna and the effect of counselling on the compliance of proposed tests].

Science.gov (United States)

Sabbatani, Sergio; Giuliani, Ruggero; Fulgaro, Ciro; Paolillo, Pasquale; Baldi, Elena; Chiodo, Francesco

2004-01-01

The aims of the study were to evaluate the HIVAb, HCVAb and HBsAg seroprevalence among Italian and foreign inmates of the prison of Bologna, to evaluate if the extensive counselling of "new" inmates has significantly enhanced adherence to laboratory tests. The serological status was determined by a blood withdraw following the informed consent. Before asking their consent, patients were informed by cultural mediators who had been instructed about the aims of the study/exam during introductory meetings. The initial step managed by mediators was followed by further individual counselling interventions, carried out by hospital infective disease unit, prison and prison drug abuse service physicians. The laboratory tests were performed in an external structure. Prison of Bologna. The study was conducted on 433 subjects among a whole population of 900 inmates in the local prison: 390 subjects were males (90.1%) and 43 were females (9.9%). The median age of the whole population was 34.86 years (+/- 9.9). The studied population counted 147 (33.9%) intravenous drug users (IDU) and 286 not addicts (66.1%). As regards nationality, 212 subjects were Italian (48.9%) and 221 (51.1%) foreigners. Among the total 433 inmates considered, 78 (18%) were known as previous IDU with conviction history or condemned to long term sentences, while 59 (13.6%) were inmates recently convicted active IDU assisted by the internal drug abusers service. The third group was composed by 296 inmates imprisoned during the summer (103 Italians and 193 foreigners) self declared not IDU. A. 12.5% of inmates were HIV positive, 8.1% HBV positive and 31.1% HCV positive. 25 subjects were found positive both to HIV and HCV; 1 both to HIV and HBV and 5 to HIV, HBV and HCV. HIV positivity is more common among Italian vs. foreigners inmates, among IDU vs. not IDU. HCV positivity is more common among Italian vs. foreigners inmates, and among IDU vs. not IDU. The distribution of HBV seropositivity among the

Liver biopsy performance and histological findings among patients with chronic viral hepatitis: a Danish database study

DEFF Research Database (Denmark)

Christensen, Peer Brehm; Krarup, Henrik Bygum; Møller, Axel

2007-01-01

We investigated the variance of liver biopsy frequency and histological findings among patients with chronic viral hepatitis attending 10 medical centres in Denmark. Patients who tested positive for HBsAg or HCV- RNA were retrieved from a national clinical database (DANHEP) and demographic data...... had developed in 23% after 20 y of infection. Age above 40 y was a better predictor of cirrhosis than elevated ALT. National database comparison may identify factors of importance for improved management of patients with chronic viral hepatitis. Udgivelsesdato: 2007-null......, laboratory analyses and liver biopsy results were collected. A total of 1586 patients were identified of whom 69.7% had hepatitis C, 28.9% hepatitis B, and 1.5% were coinfected. In total, 771 (48.6%) had a biopsy performed (range 33.3-78.7%). According to the Metavir classification, 29.3% had septal fibrosis...

Immunological disorders in chronic hepatitis C Egyptian patients.

Science.gov (United States)

Shaker, M K; Fahmy, H M

1997-01-01

It is known that hepatitis C virus (HCV) related to chronic liver disease may be associated with various immunological disorders, among these disorders are mixed cryoglobulinemia, serum antinuclear antibodies, antismooth muscle antibodies and liver/kidney microsomal antibody type 1 (LKM1). However, the actual prevalence and pathogenic role of these disorders in patients with chronic hepatitis C are unclear. It was our aim to estimate the prevalence of different autoimmune antibodies in cases of hepatitis C chronic liver disease and to assess if such changes have any clinical significance. A total of 30 chronic hepatitis C patients (22 males and 8 females) with a mean age of 43.5 +/- 6.7 years, all patients were ELISA II positive, HCV RNA PCR positive and HbsAg negative, with elevated ALT more than 2 folds of the normal, in addition to 20 healthy controls of matched age and sex were tested for rheumatoid factor, cryoglobulin, antinuclear antibody, antismooth muscle antibody, antimitochondrial antibody and LKM1. The rheumatoid factor was present in 18 (60%) of the HCV Ab +ve patients and in 1 (5%) of the controls (p 0.24), antinuclear antibody was positive in 4 (13.3%) of the patients and in 1 (5%) of the controls (p > 0.6), antismooth muscle antibody was positive in 1 (3.3%) of the patients and not detected in any of the controls, the antimitochondrial antibody and LKM1 were not detected in both the patients and the controls. In conclusion, we can see that chronic hepatitis C patients show prevalence of some autoimmune antibodies and their presence is not associated with any implication on the clinical presentation.

Detection of Hepatitis B Virus (HBV) in Blood Serum By Means of PCR (Polymerase Chain Reaction) Technique

International Nuclear Information System (INIS)

Lina, M.; Dadang, S.; Suhadi, F.

2002-01-01

Research for detecting the presence of HBV DNA in serum with PCR technique by using two pairs of oligonucleotide primers, has been carried out. Ten serum consisted of 5 HBsAg positive serum, I HBsAg weak positive serum, 3 HBsAg negative serum, and I sampel with negative HBV DNA as a previous PCR product trom another laboratory, were used to purify and to extract the DNA of virus, the sample pretreatment was done with Boom method. The two pairs of primers used for the- PCR process, were PC1 and PC2 and P1 and P2. The amplification process by means of PC1 and PC2 primer was carried out with two treatments, l.a. and l.b treatments of 5 HBsAg positive serum samples, 3 were positive for HBV DNA by PCR test with l.a. treatment. The PCR test by means of either the same primer but different treaunent (l.b treatment) or different pair of primer (pI and P2 pimer), revealed the presence of HBV DNA in all of HBsAg serum mentioned above of HBsAg negative Seruln, I serum was positive for HBV DNA and it was an amplification product of PCR test by using PI and P2 primer. The amplification products of PCR processwith either l.b treatment or PI and P2 primer, showed the positive results for I HBV positive serum as a previous PCR product trom another laboratory. All of the PCR test in this research provided the negative HBV DNA result in the HBsAg weak positive serum. The DNA amplification process by means of PI and P2 primer was more sensitive compared with PC I and PC2 primer

Mucocutaneous disorders in Hiv positive patients

Directory of Open Access Journals (Sweden)

Kar H

1996-01-01

Full Text Available Twenty eight HIV positive patients were included in this study. They were evaluated for their mucocutaneous disorders, sexually transmitted diseases and other systemic disorders between 1994-95 in the department of Dermatology and STD Dr R M L Hospital of New Delhi. The heterosexual contact with commercial sex workers (CSWs was the most common route of HIV transmission. Chancroid, syphilis and genital warts were common STDs found in HIV positive patients. Oral thrush (67.9% was the commonest mucocutaneous disorder found in these patients followed by herpes zoster (25% and seborrhoeic dermatitis (21.4%. There was no unusual clinical presentation seen in mucocutaneous disorders and STDs.

The Clinical Significance of Serum Beta{sub 2}-microglobulin Levels in Patients with Various Liver Diseases

Energy Technology Data Exchange (ETDEWEB)

Chang, Suk Won; Cho, Tae Bong; Choe, Jung Ho; Kim, So Yon; Cho, Min Koo; Lee, Gwon Jun [National Police Hospital, Seoul (Korea, Republic of)

1985-09-15

To evaluate the significance of serum beta{sub 2}-microglobulin in patients with various liver diseases, serum {sub 2} m levels were measured in 44 cases of normal controls, 32 cases of asymptomatic HBsAg carriers and 134 patients with various liver diseases, by radioimmunoassay using Phadebas Beta{sub 2}-micro test kits. The following results were obtained: I) The mean level of serum beta{sub 2} m was 1 39+-0.25 mg/l(Mean+-S.D.) in normal controls (1.39+-0.23 mg/l in 24 males, 1.38+-0,27 mg/l in 20 females). 2) The serum levels of beta{sub 2} in patients with various liver diseases and asymptomatic HBsAg carriers were as follows; 1.40+-0.27 mg/l in asymptomatic HBsAg carriers, 2.42+-0.377 mg/l in 45 patients with acute viral hepatitis, 2.10+-0.26 mg/l in 46 patients with chronic persistent hepatitis, 2.60+-0.34 mg/l in 23 patients with chronic active hepatitis, and 2.60+-0.49 mg/l in 20 patients with liver cirrhosis. Serum beta{sub 2}m levels of each disease group were significantly higher than that of normal controls(p<0.001). 3) There was significant correlation between the levels of serum beta{sub 2}m and the degrees of lymphocytic infiltration in patients with chronic active hepatitis(p<0.001). 4) Significant correlations were observed between the levels of serum beta{sub 2}-microglobulin and serum alanine aminotransferase(r=0.68, p<0.05) and bilirubin(r=0.63, p<0.05) in 15 patients with acute viral hepatitis. In conclusion, the serum beta{sub 2}-microglobulin levels were increased in patients with various liver diseases, and it may serve as a new index of liver disease activity.

Croatian Recommendations for Dialysis of HIV-Positive Patients

Directory of Open Access Journals (Sweden)

Gulin Marijana

2016-06-01

Full Text Available Human immunodeficiency virus (HIV infection may be associated with renal impairment since about 0.4% of all HIV-positive patients develop end-stage renal disease. The share of patients with HIV infection in hemodialysis centers throughout the world ranges from 0.3% to as high as 38%. In Croatia, renal replacement therapy was needed by 1% of all the HIV-positive patients from 1985 until the end of 2014. Healthcare professionals (HP should be aware of the risks of occupational exposure to blood-borne infections in their daily work. Performing dialysis in HIV-positive patients increases the risk of exposure to HIV during the extracorporeal circulation of the infected blood. However, post-exposure prophylaxis (PEP with effective antiretroviral drugs significantly reduces the risk of infection after occupational exposure. On behalf of the Croatian Society of Nephrology, Dialysis and Transplantation, the authors of this paper have proposed recommendations for the management of HIVpositive patients on dialysis, which aim to prevent the transmission of HIV among patients and HPs. The important recommendations include the following: 1. when the need arises, it is necessary to provide HIV-positive patients with dialysis in the vicinity of their place of residence. 2. HIV-positive patients should be dialyzed with a separate hemodialysis machine in an isolated area. Alternatively, they can be dialyzed in an area for the hemodialysis of HCV-positive and/or HBVpositive patients. 3. Specialized and trained personnel should be provided during the hemodialysis procedure, together with strict compliance with the standard precautions for the prevention of blood-borne infections. 4. There should be a good and prompt cooperation with the National Referral Center for HIV infection.

Impact of HBV DNA detection methods on evaluating the clinical effect of PEG-IFNɑ-2b in treatment of HBeAg-positive chronic hepatitis B: a comparative analysis

Directory of Open Access Journals (Sweden)

GUO Chunxia

2017-04-01

Full Text Available ObjectiveTo investigate the impact of different HBV DNA detection methods on evaluating the clinical effect of PEG-IFNɑ-2b in the treatment of HBeAg-positive chronic hepatitis B (CHB. MethodsA total of 83 CHB patients who were admitted to Tianjin Second People′s Hospital from September 2014 to January 2016 and treated with PEG-IFNɑ-2b for less than 24 weeks with clearance for the first time detected by HBV DNA low-sensitivity method (the lower limit of detection was 500 IU/ml and negative results within 36 weeks obtained by low-sensitivity detection. Among these patients, 33 patients with negative results within 36 weeks obtained by high-sensitivity detection (the lower limit of detection was 20 IU/ml were enrolled in negative group, and 50 with positive results were enrolled in positive group. The reductions in HBeAg and HBsAg and HBeAg seroconversion rate at 12, 24, and 36 weeks were compared between the two groups. The independent-samples t test was used for comparison of normally distributed continuous data between groups, the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsAt 12, 24, and 36 weeks after negative results were obtained by HBV DNA low-sensitivity detection, the negative group had a significant reduction in HBeAg than the positive group ［12 weeks: 0.32 (0.16-0.92 log10 COI vs 014 (0.01-0.30 log10 COI, Z=-3.061, P=0.002; 24 weeks: 0.44 (0.19-1.15 log10 COI vs 0.16 (0.04-0.35 log10 COI, Z=-3.043, P=0.002; 36 weeks: 0.51 (0.36-1.21 log10 COI vs 0.24 (0.10-0.46 log10 COI, Z=-3.880, P＜0.001］. At 12 weeks after negative results were obtained by HBV DNA low-sensitivity detection, there was no significant difference in the reduction in HBsAg (P=0.067, while at 24 and 36 weeks, the negative group had a significant reduction in HBsAg than the positive group ［24 weeks: 0

JS-K, a nitric oxide prodrug, induces DNA damage and apoptosis in HBV-positive hepatocellular carcinoma HepG2.2.15 cell.

Science.gov (United States)

Liu, Zhengyun; Li, Guangmin; Gou, Ying; Xiao, Dongyan; Luo, Guo; Saavedra, Joseph E; Liu, Jie; Wang, Huan

2017-08-01

Hepatocellular carcinoma (HCC) is the most important cause of cancer-related death, and 85% of HCC is caused by chronic HBV infection, the prognosis of patients and the reduction of HBV DNA levels remain unsatisfactory. JS-K, a nitric oxide-releasing diazeniumdiolates, is effective against various tumors, but little is known on its effects on HBV positive HCC. We found that JS-K reduced the expression of HBsAg and HBeAg in HBV-positive HepG2.2.15 cells. This study aimed to further examine anti-tumor effects of JS-K on HepG2.2.15 cells. The MTT assay and colony forming assay were used to study the cell growth inhibition of JS-K; scratch assay and transwell assay were performed to detect cell migration. The cell cycle was detected by flow cytometry. The immunofluorescence, flow cytometry analysis, and western blot were used to study DNA damage and cell apoptosis. JS-K inhibited HepG2.2.15 cell growth in a dose-dependent manner, suppressed cell colony formation and migration, arrested cells gather in the G2 phase. JS-K (1-20μM) increased the expression of DNA damage-associated protein phosphorylation H 2 AX (γH 2 AX), phosphorylation of checkpoint kinase 1 (p-Chk1), phosphorylation of checkpoint kinase 2 (p-Chk2), ataxia-telangiectasia mutated (ATM), phosphorylation of ataxia-telangiectasia mutated rad3-related (p-ATR) and apoptotic-associated proteins cleaved caspase-3, cleaved caspase-7, cleaved poly ADP-ribose polymerase (cleaved PARP). The study demonstrated JS-K is effective against HBV-positive HepG2.2.15 cells, the mechanisms are not only related to inhibition of HBsAg and HBeAg secretion, but also related with induction of DNA damage and apoptosis. JS-K is a promising anti-cancer candidate against HBV-positive HCC. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

[Hepatitis B and C virus infection and the hepatocellular carcinoma in the East Amazon, Brazil].

Science.gov (United States)

Miranda, Esther Castello Branco Mello; Moia, Lizomar de Jesus Pereira; Amaral, Ivanete do Socorro Abraçado; Barbosa, Maria Silvia de Brito; Conde, Simone Regina Souza da Silva; de Araújo, Marialva Tereza Ferreira; da Cruz, Ermelinda do Rosário Moutinho; Demachki, Samia; Bensabath, Gilberta; Soares, Manoel do Carmo Pereira

2004-01-01

In order to contribute to a better understanding of the possible role of hepatits B and C in the etiopathogenis of HCC in the East Amazon, there were studied 36 patients in Belém/PA. Serological hepatitis markers were evaluated and polymerase chain reaction assays were used to detect HBV-DNA and HCV-RNA. Alcohol abuse was observed in 33.3% and cirrhosis in 83.3%. In 88.9% of the sample, one or more hepatitis B markers were positive. Also, 8.3% those patients had anti-HCV simultaneously positive. The HBsAg serological test was positive in 58.3%; anti-HBc in 86%; anti-HBe in 85.7%; anti-HBe in 9.5%; IgM anti-HBc in 57.1%. The HBV DNA was found in 37.7% and in 65% of the HBsAg positive. The HCV RNA was detected in 8.5% and in 100% of the patients positive to anti-HCV. The AFP was above the normal value in 88.9% of patients, with levels up to 400ng/ml in 75% of them. In conclusion, hepatitis B virus infection seems to be important in the etiology of HCC and improving measures such immunization and screening in the risk population should be emphasyzed.

Clinical Significance on the Serologic Profiles of HBV Markers in Various Liver Diseases

Energy Technology Data Exchange (ETDEWEB)

Yu, Byung Hee; Lee, Choong Kyu; Kim, Jong Hwa; Kim, Kwang Ill; Lee, Chong Suk [National Medical Canter, Seoul (Korea, Republic of)

1983-09-15

By radioimmunoassay, serologic markers of Hepatitis B Virus were studied in 44 patients with acute viral hepatitis, 10 patients with chronic persistent hepatitis, 10 patients with chronic active hepatitis, 44 patients with liver cirrhosis and 25 patients with primary hepatocellular carcinoma. The results were follows: 1) HBsAg was present in 77.2% of AVH, 40% of CPH, 80% of CAH, 55.1% of LC and 68% of PHC. In this HBsAg positive groups, all but one in liver cirrhosis had Anti-HBc. 2) Anti-HBs was most commonly detected in CPH and accompanied by Anti-HBc except one case in AVH. 3) Anti-HBc was the only marker detected in 11.4% of AVH, 20% of CPH, 20% of CAH, 16.3% of LC and 8% of PHC. 4) HBeAg was most commonly found in HBsAg-positive CPH but Anti-HBe was most frequently detected in PHC. 5) The absence of HBV markers was noted in 2.3% of AVH, 10% of CPH, 8% of PHC except CAH and LC.

Clinical significance of detection of serum markers of several viral infections in hospitalized patients before blood exposure

International Nuclear Information System (INIS)

Hong Kai; Chen Linxing; Chen Yichang; Ding Yingshu

2005-01-01

Objective: To explore the desirability of setting a routine of test for detection of the serum markers of several viral infections hospitalized patients before anticipated blood exposure. Methods: Serum levels of five HBV markers, anti-HCV, anti-HIV (with ELISA) and ALT were determined in 214 hospitalized patients before forthcoming blood exposure as well as in 2468 controls. Results: The positive rate of each of the above-mentioned markers in the patients was: HBsAg 15.2% (397/2614), HBcAb- IgG 72.5% (1895/2614), anti-HCV 3.91% (102/2614), anti- HIV 0.08% (2/2614) and ALT level was above 40 u in 8.7% of the patients (227/2614). Each of the positive rate was significantly higher than that in the controls. Conclusion: There is a substantial portion of subjects harboring viral infections in the hospitalized patients. It is imperative to have these patients identified before blood exposure so that proper cautions can be taken and preventive measures implemented to minimize possible nosocomial as well as patients-to-staff infections. Moreover, any potential legal problems can also be appropriately dealt with. (authors)

PREVALENCE OF HEPATITIS B AND HEPATITIS C MARKERS IN ALCOHOLICS WITH AND WITHOUT CLINICALLY EVIDENT HEPATIC CIRRHOSIS

Directory of Open Access Journals (Sweden)

OLIVEIRA Luiz Carlos Marques de

1999-01-01

Full Text Available We assessed the frequency of serological markers of hepatitis B virus (HBV and hepatitis C virus (HCV infections in 365 alcoholics by determining, by ELISA, the presence of HBsAg, anti-HBc, anti-HBs and anti-HCV. Fifty patients were cirrhotics and 315 had no evidence of hepatic cirrhosis; of the latter HBsAg was assessed in all, anti-HBc and anti-HBs in 130, and anti-HCV in 210. Among the alcoholics the frequencies of HBsAg (1.9%, anti-HBc (28.3% and anti-HCV (3.8% were higher (p<0.001 than among the controls (N=17,059, 0.4%, 4.0% and 0.4% respectively. The frequency of positive HBsAg was higher (p<0.001 in the cirrhotic patients (8.0% than in alcoholics without cirrhosis (0.95% and in controls (0.4%, and similar between the latter; of anti-HBc in alcoholics without cirrhosis (28.5% was similar in cirrhotics patients (28.0% and higher (p<0.001 than in the controls (4.0%; of anti-HBs in alcoholics without cirrhosis (20.8% was similar to that of the cirrhotic patients (10.0%, and the anti-HCV was similar between alcoholics with (6.0% and without cirrhosis (3.3% and higher (p<0.001 than in controls (0.4%. We concluded that: a alcoholics with or without cirrhosis have similar frequencies of infection with HBV and HCV between them, and higher than in nonalcoholics; b alcoholics without cirrhosis had a frequency of HBV active infection (HBsAg+ which was similar to the controls, whereas among those who progressed to cirrhosis this frequency was significantly higher, what suggests that HBV may be implicated in the pathogenesis of cirrhosis in a few alcoholic individuals.

Use of radioimmune assay in investigating reagents to be used in the immunocytochemical localization of hepatitis B surface antigen in immune complexes in the kidney of patients with membranous nephropathy and Australia antigenaemia

Energy Technology Data Exchange (ETDEWEB)

Wolfe-Coote, S [South African Medical Research Council, Tygerberg (South Africa). Inst. for Electron Microscopy

1983-09-01

Radioimmune assay (RIA) was used to investigate the effect of fixatives on antigenicity of the hepatitis B surface antigen (HBsAg) and the effect of pronase on the elution of antibody (Ab) from the HBsAg-Ab complex. The effect of pronase on Ab elution was also tested on sections of kidney from a patient with the immune complex disease systemic lupus erythematosus (SLE). Immunoglobulin G (IgG) was located in pronase treated and untreated sections using the indirect immunoperoxidase technique. Glutareldehyde was shown to be the fixative of choice for studies involving HBsAg. All fixatives were shown to have less effect on antigenicity at 4/sup 0/C than at room temperature. Osmium tetroxide reduced antigenicity to one-third, even at 4/sup 0/C. RIA and SLE kidney section studies showed that Ab was eluted from immune complexes by pronase. Pre-fixation of the antigen (Ag) by glutaraldehyde appears to have no effect on the final elution, although fixation after pronase treatment seemed to enhance the elution effects. The availability of an RIA kit with HBsAg- and Ab-coated beads was of great assistance in evaluating reagents to be used in immunoperoxidase studies of HBsAg in immune complexes of patients with membranous nephropathy and Australia antigenaemia.

Frequency of hepatitis B surface antigen and anti-hepatitis c antibodies in apparently healthy blood donors in northern areas

International Nuclear Information System (INIS)

Alam, M.; Naeem, M.A.

2007-01-01

To determine the frequency of HBsAg and anti HCV among the potential blood donors belonging to Northern areas.A total of 8949 apparently healthy blood donors, belonging to Northern areas were screened for HBsAg and anti-HCV by rapid method.Overall sero-positivity of HBsAg was 3.66% and anti-HCV 1.35%. The result indicates that frequency of HBsAg is more than anti-HCV in Northern areas. (author)

Download this PDF file

African Journals Online (AJOL)

Methodology: 200 hepatitis B surface antigen (HBsAg) positive patients attending the Jos University. Teaching Hospital were enrolled in a cross-sectional study from June to November, 2010. A structured interviewer-administered questionnaire was used to obtain information from the participants regarding.

Prevalence of occult hepatitis B virus infection in haemodialysis patients from central Greece

Science.gov (United States)

Mina, Paraskevi; Georgiadou, Sarah P; Rizos, Christos; Dalekos, George N; Rigopoulou, Eirini I

2010-01-01

AIM: To assess the hepatitis B virus (HBV)-DNA and the prevalence of occult HBV infection in end-stage renal failure (ESRF) patients from Central Greece. METHODS: Sera from 366 ESRF patients attending five out of six dialysis units from Central Greece were investigated for HBV-DNA by real-time polymerase chain reaction. Only serum samples with repeatedly detectable HBV-DNA were considered positive. IgG antibodies to hepatitis C virus (anti-HCV) were tested by a third generation enzyme linked immunosorbent assay (ELISA), while IgG antibodies to hepatitis E virus (anti-HEV) were tested by two commercially available ELISAs. RESULTS: HBV-DNA was detected in 15/366 patients (4.1%) and HBsAg in 20/366 (5.5%). The prevalence of occult HBV infection was 0.9% (3/346 HBsAg-negative patients). Occult HBV was not associated with a specific marker of HBV infection or anti-HCV or anti-HEV reactivity. There was no significant difference in HBV-DNA titres, demographic and biochemical features, between patients with occult HBV infection and those with HBsAg-positive chronic HBV infection. CONCLUSION: In central Greece, 4% of ESRF patients had detectable HBV-DNA, though in this setting, the prevalence of occult HBV seems to be very low (0.9%). PMID:20066742

Verification of the Patient Positioning in the Bellyboard Pelvic Radiotherapy

International Nuclear Information System (INIS)

Kasabasic, M.; Faj, D.; Smilovic Radojcic, D.; Svabic, M.; Ivkovic, A.; Jurkovic, S.

2008-01-01

The size and shape of the treatment fields applied in radiotherapy account for uncertainties in the daily set-up of the patients during the treatment. We investigated the accuracy of daily patient positioning in the bellyboard pelvic radiotherapy in order to find out the magnitude of the patients movement during the treatment. Translational as well as rotational movements of the patients are explored. Film portal imaging is used in order to find patient positioning error during the treatment of the pelvic region. Patients are treated in the prone position using the bellyboard positioning device. Thirty six patients are included in the study; 15 patients were followed during the whole treatment and 21 during the first 5 consecutive treatment days. The image acquisition was completed in 85 percent and systematic and random positioning errors in 453 images are analyzed. (author)

Variability of centric relation position in TMD patients.

NARCIS (Netherlands)

Zonnenberg, A.J.J.; Mulder, J.

2006-01-01

Reproducibility of the centric relation position for patients with temporomandibular disorders (TMD) is not documented in the current literature. It was the objective of this study to assess clinical variability of the centric relation position for TMD patients with a muscle-determined technique by

The patient position for PNL: does it matter?

Science.gov (United States)

Cracco, Cecilia Maria; Scoffone, Cesare Marco; Poggio, Massimiliano; Scarpa, Roberto Mario

2010-03-01

Currently, PNL is the treatment of choice for large and/or otherwise complex urolithiasis. PNL was initially performed with the patient in a supine-oblique position, but later on the prone position became the conventional one for habit and handiness. The prone position provides a larger area for percutaneous renal access, a wider space for instrument manipulation, and a claimed lower risk of splanchnic injury. Nonetheless, it implies important anaesthesiological risks, including circulatory, haemodynamic, and ventilatory difficulties; need of several nurses to be present for intraoperative changes of the decubitus in case of simultaneous retrograde instrumentation of the ureter, implying evident risks related to pressure points; an increased radiological hazard to the urologist's hands; patient discomfort. To overcome these drawbacks, various safe and effective changes in patient positioning for PNL have been proposed over the years, including the reverse lithotomy position, the prone split-leg position, the lateral decubitus, the supine position, and the Galdakao-modified supine Valdivia (GMSV) position. Among these, the GMSV position is safe and effective, and seems profitable and ergonomic. It allows optimal cardiopulmonary control during general anaesthesia; an easy puncture of the kidney; a reduced risk of colonic injury; simultaneous antero-retrograde approach to the renal cavities (PNL and retrograde ureteroscopy = ECIRS, Endoscopic Combined IntraRenal Surgery), with no need of intraoperative repositioning of the anaesthetized patient, less need for nurses in the operating room, less occupational risk due to shifting of heavy loads, less risk of pressure injuries related to inaccurate repositioning, and reduced duration of the procedure; facilitated spontaneous evacuation of stone fragments; a comfortable sitting position and a restrained X-ray exposure of the hands for the urologist. But, first of all, GMSV position fully supports a new comprehensive

Liver Function In Patients With Homozygous Sickle Cell Disease ...

African Journals Online (AJOL)

Using the sensitive ELISA technique, 213 patients with sickle cell anemia (112 males and 101 females) aged 6 months to 18 years were screened for Hepatitis B infection using Hepatitis B surface antigen (HBsAg) and antibody to Hepatitis B core antigen. A biochemical evaluation of liver function was carried out on all ...

Patient position matching between SPECT and CT

International Nuclear Information System (INIS)

Eubig, C.; Lodhi, L.M.; Trueblood, J.H.; Kingsbury, T.; Burke, G.; Flickenger, F.

1990-01-01

Since the authors had previously developed an ability for accurate repositioning of patients by means of video imaging of their external features, it was their purpose to determine if separate video systems placed in SPECT and CT rooms could be positioned and a calibration procedure for each modality developed to assure easy identification and acquisition of corresponding congruent axial image sections through the patient. A video frame grabber is used to acquire an image of the patient in one room and superimpose it on a similar image of the patient in the other room. A radioactive ruler visible at CT images obtained with a gamma camera computer, and a CT scout image are used to adjust the initial relative position of the video cameras and calibrate the acquisition parameters of both systems. The success of this alignment procedure was tested with a body phantom. The body phantom studies indicate that this method of positioning the patient and acquiring corresponding aligned CT and SPECT axial sections can be successful where internal organ shift between the acquisitions is minimal. This should lead to a reduction of the time and computer resources necessary to fuse or superimpose images of corresponding patient sections acquired with different modalities

Hepatitis B and C virus markers among patients with hepatosplenic mansonic schistosomiasis

Directory of Open Access Journals (Sweden)

AQUINO Renata Telles Rudge de

2000-01-01

Full Text Available PURPOSE: To evaluate the frequency and the consequences of the co-infection of hepatitis B and C viruses in patients with hepatosplenic schistosomiasis (HSS. METHODS: B and C serologic markers, exposure to risk factors, biochemical assays, upper gastrointestinal endoscopies, and abdominal ultrasonograms were evaluated in 101 patients with HSS from 1994 to 1997. Whenever possible, PCR was tested and histopathological studies were reviewed. RESULTS: At least one HBV virus marker was found in 15.8%, and anti-HCV was detected in 12.9% of the subjects. The seropositive subjects tended to be older than the seronegative ones. A history of blood transfusion was significantly related to the presence of anti-HCV. Three (18.75% out of 16 subjects exposed to B virus were HBsAg positive. Eleven (84.6% out of thirteen patients who were anti-HCV positive demonstrated viral activity. Patients with ongoing viral infection presented a higher average level of liver aminotransferases, a higher frequency of cell decompensation and a higher rate of chronic hepatitis. Portal hypertension parameters were not influenced by viral exposure. CONCLUSIONS: The rate of hepatitis B and C viruses serologic markers observed in the patients with HSS was higher than the control group. The co-infection was responsible for a higher frequency of cell decompensation.

Markers of viral hepatitis in hemophiliacs

International Nuclear Information System (INIS)

Malik, N.; Hussain, Z.

2006-01-01

Sero prevalence of Hepatitis B surface antigen (HbsAg) and anti-HCV IgG was determined in 100 persons with Hemophilia (PWH), registered with Hemophilia Patient Welfare Society (HPWS), Lahore Zone, Pakistan. The study shows that 4% were positive for HBsAg. However, there was a high level of anti-HCV sero positivity (56%) in our PWH, including many patients in younger age groups. When compared with figures from PWH in other regions of Asia like 23% in Western India, 33% in Sri Lanka and 15% of those in Iran, this figure is one of the highest. This rate is a reflection of the same rising trend in our population that is now exceeding 10%. The practice of unscreened blood/blood-products transfusions in the backdrop of high prevalence of HCV in our population is responsible for high figures seen in PWH. The need is to increase awareness amongst the patients, health care workers and policy makers about the transfusion associated viral infections in a group of patients who already had a hereditary disorder of severe nature. (author)

Prevalence and clinical outcomes of hepatitis B virus infection in patients with aplastic anemia.

Science.gov (United States)

Zhao, Pan; Gao, Qing; He, Qiulian; Tan, Jing

2017-10-01

The association of HBV infection with other hematopoietic diseases has been discussed previously. However, the clinical significance and clinical outcomes of HBV infection in AA patients have not been clarified. In this study, we sought to investigate the prevalence and related events of HBV in patients with AA who received immunosuppressive therapy. We retrospectively analyzed 245 patients with acquired AA. The HBsAg positivity rate was 14.69% in this group of AA patients. No significant difference was observed in the severity of AA patients with HBV infection and in those without (P = 0.6358). HBV reactivation occurred in 4.76% of HBsAg-positive patients who received ATG/ALG + CsA treatment without anti-viral prophylaxis. HBV-infected patients who received CsA alone did not develop reactivation. Patients with HBV reactivation showed favorable clinical outcomes, with no HBV-related deaths. There was no significant difference in overall probability of survival in patients with different HBV infection status (P = 0.8617). Given the low rate of reactivation and favorable outcomes after reactivation in AA patients, close monitoring of HBV DNA, hepatic function and patient immune status may be a more effective approach than routine prophylaxis for AA patients with HBV infection undergoing ATG/ALG + CsA treatment. Further studies are warranted to clarify the optimal time to initiate anti-viral treatment.

Hepatitis B Infection among high risk population: a seroepidemiological survey in Southwest of Iran

Directory of Open Access Journals (Sweden)

Khosravani Abdolmajid

2012-12-01

Full Text Available Abstract Background Hepatitis B virus (HBV infection remains a major global health problem. This study aimed to assess the prevalence and risk behaviors for HBV infection among high risk groups in Kohgiloyeh and Boyerahmad province, in Southwest of Iran. Methods Blood samples were collected from 2009 subjects, between 2009 and 2010 in Kohgiloyeh and Boyerahmad province, in southwest of Iran. Recruited subjects were the high risk groups for HBV infection, including inmates, injecting drug users, health care workers, patients on maintenance haemodialysis, hemophilic patients and patients with a history of blood transfusion. Their serum samples were tested for the presence of antibodies to hepatitis B core antigen (HBc IgM, IgG by enzyme-linked immunosorbent assay (ELISA. Seropositive specimens were tested for HBsAg. Demographic features of participants were recorded during sample collecting. Results HBsAg was detected in 24 of the 2009 subjects, giving an overall prevalence of 1.2%. All HBsAg positive cases were males. The prevalence of HBsAg among injection drug users was 3.2%. Significant correlation was found between HBV infection and drug abuse, level of education and place of residence (p Conclusion Based on the findings of this study, incarceration and drug abuse are the most important risk factors for acquiring HBV infection in this region. Modifying behavior, improving the individual education and expanding the HBV vaccination coverage may reduce the rate of infection in the region.

Seroprevalence of anti-HCV and hepatitis B surface antigen in HIV infected patients

Directory of Open Access Journals (Sweden)

Tankhiwale S

2003-01-01

Full Text Available Human immunodeficiency virus (HIV is known to influence the natural history of infections with certain hepatitis viruses and interactions between HIV and hepatitis viruses may potentiate HIV replication. There is high degree of epidemiological similarity between hepatitis B virus and HIV as regard to high-risk group and route of transmission. Transmission of hepatitis C virus (HCV through blood transfusion and intravenous drug abuse is well documented. Present study deals with the study of concurrent infection of HBV and HCV with HIV infection. In the study of 110 HIV seropositive patients, 34(30.4% were positive for HBV and 8(7.27% for HCV. The difference of concomitant infection was highly significant compared to controls. (p value < 0.0001. Heterosexual high risk behaviour was observed in 89(80.91% of 110 HIV positive patients, out of which 23(25.8% and 5(5.62% were HBsAg and anti-HCV positive respectively. History of transmission was unclear in remaining patients. Concomitant infection of HIV and HBV was found to be significantly more in the symptomatic group (40.68% compared to asymptomatic group (19.6%. As HIV infection is known to affect the natural history of both HBV and HCV infection, screening of their concurrent association is necessary.

Safety and efficacy of REP 2139 and pegylated interferon alfa-2a for treatment-naive patients with chronic hepatitis B virus and hepatitis D virus co-infection (REP 301 and REP 301-LTF): a non-randomised, open-label, phase 2 trial.

Science.gov (United States)

Bazinet, Michel; Pântea, Victor; Cebotarescu, Valentin; Cojuhari, Lilia; Jimbei, Pavlina; Albrecht, Jeffrey; Schmid, Peter; Le Gal, Frédéric; Gordien, Emmanuel; Krawczyk, Adalbert; Mijočević, Hrvoje; Karimzadeh, Hadi; Roggendorf, Michael; Vaillant, Andrew

2017-12-01

REP 2139 clears circulating hepatitis B virus (HBV) surface antigen (HBsAg), enhancing the restoration of functional control of HBV infection by immunotherapy. We assessed the safety and efficacy of REP 2139 and pegylated interferon alfa-2a in patients with chronic HBV and hepatitis D virus (HDV) co-infection. In this open-label, non-randomised, phase 2 trial, patients aged 18-55 years, who were treatment naive, hepatitis B e antigen [HBeAg] negative, anti-hepatitis D antigen [HDAg] positive, and HDV RNA positive, with serum HBsAg concentrations of more than 1000 IU/mL, and a history of HDV infection for 6 months or more before treatment, were recruited at Toma Ciorbă Hospital of Infectious Diseases in Chișinău, Moldova. Patients were excluded if they had HDV superinfection, liver infections other than HBV and HDV, or liver cirrhosis. Patients received 500 mg intravenous REP 2139 once per week for 15 weeks, followed by combined therapy with 250 mg intravenous REP 2139 and 180 μg subcutaneous pegylated interferon alfa-2a once per week for 15 weeks, then monotherapy with 180 μg pegylated interferon alfa-2a once per week for 33 weeks. The primary endpoints assessed at the end of treatment were the safety and tolerability of the treatment regimen, analysed in the intention-to-treat population. Secondary outcomes included the proportion of patients with serum HBsAg less than 50 IU/mL, the proportion of patients with suppressed HBV DNA, and the proportion of patients who maintained these responses through follow-up. The REP 301 trial is registered with ClinicalTrials.gov, number NCT02233075. We also did an additional follow-up at 1 year after the end of treatment, as an interim analysis of the REP 301-LTF trial (planned duration 3 years), registered with ClinicalTrials.gov, number NCT02876419, which is ongoing but not recruiting patients. Between Sept 8, 2014, and Jan 27, 2015, we enrolled 12 patients into the REP 301 study. All 12 patients experienced at least one

Immunomodulation therapy in children with chronic hepatitis B.

Science.gov (United States)

Karaoglan, Murat; Demirci, Fikret; Coskun, Yavuz; Karaoglan, Ilkay; Bayraktaroglu, Ziya; Okan, Vahap; Karsligil, Tekin

2006-01-01

PURPOSE: The aim of this study is to investigate the effects of HBsAg vaccine and levamisole on virological indicators in naive patients suffering from chronic hepatitis B (CHB) and in healthy carriers of hepatitis B. METHOD: Vaccination and treatment with levamisole were applied to 93 minor patients in total, 43 of them inactive CHB carriers and 50 patients suffering from CHB. RESULTS: 15 (30%) of 50 patients who had high ALT values in the beginning of the study had normal values after treatment. In nine (12%) patients, posttreatment ALT values were higher than pretreatment values, and six (10%) patients showed HBV-DNA loss. In spite of the presence of 50 (54%) HBeAg-positive patients before treatment, 17 (34%) patients proved to be HBeAg-negative after treatment. HBeAg sero-conversion was seen in 10 (20%) cases. In two (2%) patients, HBsAg sero-conversion occurred. CONCLUSION: It was found that treatment with levamisole and vaccine had positive effects on CHB patients and healthy carriers with respect to HBV DNA loss, HBeAg sero-conversion and ALT normalization. The viral load increases and ALT increases that occurred in certain cases were thought to be related to the early immune response. It was determined that combined levamisole and vaccine therapy had no additional positive effect. PMID:16708498

Erectile dysfunction in haemodialysis patients

International Nuclear Information System (INIS)

Mumtaz, A.; Hussain, S.; Nazir, M.

2009-01-01

There is a very high prevalence of Erectile Dysfunction (ED) in dialysis patients. There is no as such available data on ED and factors affecting it in our patients. Analytical, cross-sectional, hospital based study conducted from January to March 2008, Haemodialysis unit of Shalimar and Mayo Hospital, Lahore. All male patients of end stage renal disease (ESRD) on maintenance haemodialysis therapy, whose spouses are alive and able to perform intercourse, were included in the study. Patient with cognitive and communication deficits were excluded from study. International index of erectile function-5 (IIEF-5), adopted in Urdu was used for the determination of prevalence of erectile function. Categorization of erectile dysfunction was done as mild, moderate and severe. Demographic data were collected and certain laboratory parameters (haemoglobin, haematocrit, urea, HBsAg and Anti HCV) were sent. Total numbers of patient were fifty. Major cause of ESRD was diabetes mellitus 28 (56%). Most of the patients 33 (66%) have passed 10th grade or they were under 10th grade. Prevalence of ED was 86% with mean IIEF-5 score of 10.36+-7.13. Majority of patients 33 (64.7%) were suffering from severe degree of ED. Factors responsible for ED are diabetes mellitus, age more than 50 year, high pre dialysis urea and Anti HCV positive patients. In this study, smoking, duration of dialysis and monthly spending is not related with ED. Majority of the patients suffering from ESRD, on maintenance haemodialysis are having ED. None of the patients suffering from ED were taking any treatment for it. Haemodialysis does not improve sexual dysfunction. Major factors responsible for ED are diabetes mellitus, age more than 50 years, high pre dialysis urea and Anti HCV positive patients. (author)

Spontaneous viral clearance, viral load, and genotype distribution of hepatitis C virus (HCV) in HIV-infected patients with anti-HCV antibodies in Europe

DEFF Research Database (Denmark)

Soriano, Vincent; Mocroft, Amanda; Rockstroh, Juergen

2008-01-01

BACKGROUND: Variables influencing serum hepatitis C virus (HCV) RNA levels and genotype distribution in individuals with human immunodeficiency virus (HIV) infection are not well known, nor are factors determining spontaneous clearance after exposure to HCV in this population. METHODS: All HCV...... for hepatitis B surface antigen (HBsAg) were more likely to have spontaneously cleared HCV than were those negative for HBsAg (43% vs. 21%; aOR, 2.91 [95% CI, 1.94-4.38]). Of patients with HCV viremia, 786 (53%) carried HCV genotype 1, and 53 (4%), 440 (29%), and 217 (15%) carried HCV genotype 2, 3, and 4...

Recognition of Core- and Polymerase-derived immunogenic peptides included in novel therapeutic vaccine by T cells from Chinese chronic hepatitis B patients.

Science.gov (United States)

Huang, D; Sansas, B; Jiang, J H; Gong, Q M; Jin, G D; Calais, V; Yu, D M; Zhu, M Y; Wei, D; Zhang, D H; Inchauspé, G; Zhang, X X; Zhu, R

2017-11-01

Chronic hepatitis B (CHB) is one of the major public health challenges in the world. Due to a strong interplay between specific T-cell immunity and elimination of hepatitis B virus (HBV), efforts to develop novel immunotherapeutics are gaining attention. TG1050, a novel immunotherapy, has shown efficacy in an animal study. To support the clinical development of TG1050 in China, specific immunity to the fusion antigens of TG1050 was assessed in Chinese patients. One hundred and thirty subjects were divided into three groups as CHB patients, HBV spontaneous resolvers, and CHB patients with HBsAg loss after antiviral treatment. HBV-specific T-cell responses to pools of HBV Core or Polymerase genotype D peptides included in TG1050 were evaluated. HBV Core- or Polymerase-specific cells were detected in peripheral blood mononuclear cells (PBMCs) from the different cohorts. The frequencies and intensities of HBV Core-specific immune responses were significantly lower in CHB patients than in HBsAg loss subjects. In CHB patients, a dominant pool derived from Polymerase (Pol1) was the most immunogenic. CHB patients with low viral loads (Core peptide pool. Overall, genotype D-derived peptides included in TG1050 could raise broad and functional T-cell responses in PBMCs from Chinese CHB patients infected with genotype B/C isolates. Core-specific immunogenic domains appeared as "hot spots" with the capacity to differentiate between CHB vs HBsAg loss subjects. These observations support the extended application and associated immune monitoring of TG1050 in China. © 2017 The Authors. Journal of Viral Hepatitis Published by John Wiley & Sons Ltd.

[Prevalence of positive markers for hepatitis B (HBV Ags) and hepatitis C (Anti-HCV) in health personnel at the Social Security Institute of Mexico State and Municipalities].

Science.gov (United States)

González-Huezo, M S; Sánchez-Hernández, E; Camacho, M C; Mejia-López, M D; Rebollo-Vargas, J

2010-01-01

The prevalence of serum markers of viral hepatitis in health-care workers seems to be similar to that described in the general population, even though this group would appear at increased risk because exposure to potentially infectious material. There is scarce information available in Mexico in this regard. To define the prevalence of serum markers for hepatitis C (anti-HCV antibodies) and hepatitis B (hepatitis B surface antigen, HBsAg) in health-care workers at the Instituto de Seguridad Social del Estado de Mexico y Municipios (ISSEMYM) and to establish the presence of viremia in subjects with positive serum markers. Health-care workers from ISSEMyM with unknown hepatitis serologic status participated voluntarily in this trial. They completed a written questionnaire detailing potential risk factors for viral hepatitis and provided a blood sample. A total of 374 health-care workers were included. Seven subjects (1.8%) were positive, 5 for anti-HCV antibodies (1.3%) and 2 for HBsAg (0.5%). None of these subjects had detectable serum HCV RNA or HBV DNA on further testing. The frequency of positive serum markers for viral hepatitis in this group of healthcare workers is similar to the estimated prevalence among the general population in Mexico. No case of active infection defined by positive viremia was encountered in this group of subjects.

Hepatitis B virus infection among first-time blood donors in Italy: prevalence and correlates between serological patterns and occult infection.

Science.gov (United States)

Romanò, Luisa; Velati, Claudio; Cambiè, Giuseppe; Fomiatti, Laura; Galli, Claudio; Zanetti, Alessandro Remo

2013-04-01

A prospective, 1-year study was performed among Italian first-time, volunteer blood donors, who account for 12% of all donations, in order to assess the frequency and serological patterns of hepatitis B virus infection and the presence of occult infection. Consecutive donors (n=31,190) from 21 blood transfusion centres, from age classes not subjected to universal HBV vaccination, were tested for HBsAg and anti-HBc by commercial immunoassays. Other HBV serological markers were searched for and qualitative and quantitative assessments of HBV-DNA were made in HBsAg and/or anti-HBc-positive individuals. Of the 31,190 donors studied, 100 (0.32%) were positive for both HBsAg and anti-HBc, 2 for HBsAg (0.01%) alone, and 2,593 (8.3%) for anti-HBc. Of these last, 86.7% were also positive for anti-HBs (with or without anti-HBe), 2.9% were positive for anti-HBe without anti-HBs and 10.4% had no other HBV markers (anti-HBc alone). A general north-south increasing gradient of HBV prevalence was observed. Circulating HBV-DNA was found in 96.8% of HBsAg-positive subjects as compared to 0.55% (12/2,186) of anti-HBc-positive/HBsAg-negative subjects, with higher frequencies among anti-HBs-negative than among anti-HBs-positive ones (1.68% vs. 0.37%; p blood donors is much lower than in the past. The presence of occult infections in this group was confirmed (frequency: 1 in 2,599), supporting the hypothesis of long-term persistence of HBV infection after clearance of HBsAg. HBsAg and nucleic acid amplification testing for blood screening and vaccination against HBV are crucial in order to further reduce the risk of transfusion-transmitted HBV towards zero.

Prostate immobilization can be achieved with patient positioning

International Nuclear Information System (INIS)

Huang, David T.; Silverman, Larry N.; Tercilla, Oscar F.; Lutz, Stephen T.

1995-01-01

Purpose/Objective: With advances in 3D conformal therapy, daily variation in the position of the prostate poses increasing problems for radiation oncologists. In this study we attempt to define the optimal treatment position for patients with prostate cancer by measuring the range of movement of the prostate. Materials and Methods: Ten patients with biopsy proven adenocarcinoma of the prostate underwent prone and supine CT scans with IV and oral contrast. Foley catheters (FC) were placed in the urinary bladder, and renograffin was used to make the balloon radiopaque. AP/PA and lateral radiographs were taken for patients in the supine and prone position with either empty bladder (EB) or partially filled bladder (PFB, containing 60 cc of contrast medium). Measurements were taken from the Foley catheter (represents prostatic urethra), to the anterior rectal wall and pubic symphysis (PS). The rectal gas pattern was analyzed to evaluate the rectum-sparing effect. The false table top was not used. Results: For radiographs taken in the supine position, the FC was located 1.4 ± 0.5 cm from the PS in the case of PFB versus EB. In the prone position the variation was significantly less, with an increase in FC to PS distance of only 0.5 ± 0.3 cm for a PFB versus EB. The rectal gas pattern was also noted to vary, with a more expanded and rounded shape in the prone position. Conclusion: Most institutions treat patients with prostate cancer in the supine position. The previous rationale for treatment in the prone position has been small bowel sparing. Here, however, we show that prone treatment also minimizes the motion of the prostate. With less posterior margin required, 3D conformal treatment could be delivered with an additional 30-50% rectal sparing

Liver transplantation in HIV-positive patients: the position of the Brazilian groups.

Science.gov (United States)

Brandão, Ajacio Bandeira de Mello; Mariante-Neto, Guilherme

2005-01-01

Patients infected with the human immunodeficiency virus (HIV) have generally been excluded from consideration for liver transplantation. Recent advances in the management and prognosis of these patients suggest that this policy must be reevaluated. To identify the current position of Brazilian transplant centers concerning liver transplantation in asymptomatic HIV-infected patients with end-stage liver disease. A structured questionnaire was submitted by e-mail to Brazilian groups who perform liver transplantation and were active in late 2003, according to the Brazilian Association of Organ Transplantation. Of the 53 active groups, 30 e-mail addresses have been found of professionals working in 41 of these groups. Twenty-one responses (70%) were obtained. Most of the professionals (62%) reported that they do not include HIV-infected patients in waiting lists for transplants, primarily on account of the limited world experience. They also reported, however, that this issue will soon be discussed by the group. Those who accept these patients usually follow the guidelines provided by the literature: patients must fulfill the same inclusion criteria as the other patients with end-stage liver diseases, present low or undetectable HIV viral load, and a CD4 count above 250/mm3. They reported that there are 10 HIV-infected patients in waiting list and that only one patient has received a liver transplant in the country. Most centers do not accept in waiting lists for liver transplantation patients with HIV infection, even asymptomatic ones. However, advances in the management of HIV-infected patients suggest that this policy must be reevaluated. In Brazil, there is practically no experience in liver transplantation in HIV-positive patients.

Frequency and risk factors of hepatitis b and c in afghan patients presenting to tertiary care hospital in peshawar

International Nuclear Information System (INIS)

Khan, Z.A.

2015-01-01

Objective: To document the frequency and risk factors of Hepatits B and C in Afghan patients presenting to a tertiary care hospital in Peshawar. Study Design: Descriptive study. Place and Duration of Study: Rehman Medical Institute (RMI), Peshawar from 1st January, 2012 to 31st December, 2012. Patients and Methods: A total of 2166 Afghan national were included in the study who underwent surgery in RMI through consecutive, non-probability sampling. Hepatits B surface antigen (HBsAg) and anti-HCV antibody tests were performed by ELISA method. All patients who were positive for either of the two or both were investigated by a researcher-administered questionnaire to find the risk factors for seropositivity of hepatitis. Results: Out of a total of 2166 patients, 104 patients (4.8%) were found to be positive. Seventy-eight patients (75%) were HepBsAg positive while 24 patients (23%) were anti-HCV antibodies positive while 2 patients were positive for both viruses. Re-use of unsterilized syringes (23%) and history of previous surgery (19.2%) were the most common risk factors whereas no risk factor could be identified in 15 patients (14%). Seventy nine patients (76%) were newly diagnosed at time of test while 25 patients (24%) were known cases of either HBV or HCV. Only one patient had clinical/laboratory features of chronic liver disease while no patient had underwent Hep B vaccination or had hepatocellular carcinoma. Conclusion: A high seroprevalance of HBV and HCV was found in this study. Reuse of unsterilized syringes, history of previous surgery and tattoos piercing were found to be the most common risk factors. (author)

Effect of patient position on the lordosis and scoliosis of patients with degenerative lumbar scoliosis.

Science.gov (United States)

Fei, Han; Li, Wei-Shi; Sun, Zhuo-Ran; Jiang, Shuai; Chen, Zhong-Qiang

2017-08-01

This study aimed to analyze the effect of patient positions on the lordosis and scoliosis of patients with degenerative lumbar scoliosis (DLS).Seventy-seven patients with DLS were retrospectively analyzed. We measured lordosis and Cobb's angle on preoperative upright x-rays and magnetic resonance imagings in supine position. The lordosis and scoliosis of surgical segments in intraoperative prone position were measured on intraoperative radiographs of 20 patients to compare with that in standing position. Paired t tests were performed to investigate the parameters of the sample.From standing to supine position the whole lordosis increased (29.2 ± 15.7 degree vs. 34.9 ± 11.2 degree), and the whole scoliosis decreased (24.3 ± 11.8 degree vs. 19.0 ± 10.5 degree); 53 of 77 (68.8%) cases had increased lordosis, and 67 of 77 (87%) cases had decreased scoliosis. The lordosis of surgical segments in standing position had no difference with that in intraoprerative prone position. But in changing from supine/standing position to intraoprerative prone position, the scoliosis of surgical segments decreased (14.7 ± 9.4 degree vs. 11.4 ± 7.0 degree; 19.0 ± 11.8 degree vs. 11.4 ± 7.0 degree, respectively), and 18 of 20 (90%) cases had decreased scoliosis in intraoperative prone position than that in standing position.Compared with standing position in DLS patients, supine position increased lordosis and reduced scoliosis, and intraoperative prone position reduced scoliosis significantly. When evaluating the severity of DLS and making preoperative surgical plans, lumbar lordosis in supine position should also be evaluated in addition to upright x-ray, and the effects of different positions should be taken into consideration to reduce deviation.

Triple hapatitis: frequency and treatment outcome of co/super-infection of hepatitis C and D among patients of hapatitis B

International Nuclear Information System (INIS)

Zuberi, B.F.; Quraishy, M.S.

2008-01-01

To determine the frequency of hepatitis C and D in patients of chronic hepatitis B and the treatment response of hepatitis B in such patients. All patients of hepatitis B presenting during the study period were screened for triple infection by carrying out anti-HBc (IgG), anti-HCV and anti-HDV. Patients who were positive to all three were included in the study. Complete Blood Count (CBC); HBsAg; HBeAg; anti-HBc IgM; anti-HDV; anti-HCV; HBV DNA PCR; HCV RNA PCR; serum albumin; SGPT; serum bilirubin and ultrasound abdomen were acquired in all patients. All patients received pegylated interferon-a 2a 180 mcg sc weekly x 48 weeks. Patients who were also positive for HCV RNA also received ribavirin 1000- 1200 mg/d po x 24 weeks for genotype 3 and 48 weeks for genotype 1. Descriptive statistics were used for describing the data. Out of the 246 patients of HBV, 29 (11.8%) patients were also positive for anti-HBc IgG, anti-HDV and anti-HCV. After 48 weeks of therapy, the respective viral undetection by PCR was 4 (13.8%) in patients having only HBV DNA, 3 (10.3%) in patients with only HCV RNA and in patients who had both HBV DNA and HCV RNA positive, simultaneously HCV was cleared in 2 (6.9%) while HBV was not cleared in any case. In patients coming with one hepatic infection, other infections should be sought as they share a common mode of spread and may affect the overall response to treatment. (author)

Patient positioning and supporting arrangement

International Nuclear Information System (INIS)

Heavens, M.; James, R.C.; Slinn, D.S.

1980-01-01

This patent specification describes an E.M.I. claim relating to a patient positioning and support arrangement for a computerised axial tomography system, the arrangement comprising a curved platter upon which the patient can be disposed, a table having a curved groove to accommodate the platter, and means for driving the platter slidably along the groove; the platter being formed of a substantially rigid platform shaped to conform to the groove, and a shroud, secured to the platter and disposed between the platter and the surface of the groove, so as to permit the platter to slide smoothly. (U.K.)

Cerebral perfusion imaging in HIV positive patients

International Nuclear Information System (INIS)

Kundley, Kshama; Chowdhury, D.; Lele, V.R.; Lele, R.D.

1998-01-01

Full text: Twelve human immunodeficiency virus (HIV) positive patients were studied by SPECT cerebral perfusion imaging 1 hour post injection of 15 mCi of 99m Tc-ECD under ideal conditions with a triple head gamma camera (Prism 3000 X P LEUHR), fanbeam collimators followed by Folstein Mini Mental Status Examination (FMMSE) and AIDS dementia complex (ADC) staging on the same day. All 12 patients were male, in the age range of 23-45 y (mean 31 y). The infected status was diagnosed by ELISA (10 patients) or Western blot (5 patients). The interval between diagnosis and imaging ranged from 1 month - 35 months (mean 15.3 months). Two patients were alcoholic and 2 were smokers. None of them had CNS disorder clinically. ADC staging and FMMSE could be performed in 4 patients. Two patients were normal (stage 0) and 2 were subclinical (stage 0.5) on ADC staging. FMMSE revealed normal or near normal status (mean score 35; maximum score 36). Cerebral perfusion images were interpreted simultaneously by 3 observers blind towards history and examination using semi-quantitative and quantitative methods by consensus. It revealed multiple areas of hypoperfusion, viz. temporal (11 patients (91 %), parietal 10 patients (83%), frontal 9 patients (75%, pre and post central gyrus 7 patients (58%), occipital 6 patients (50%) cingulate gyrus and cerebellum 5 patients (41%) and thalamic in 2 patients (16%). Hyper perfusion in caudate nuclei was noted in 10 patients (83%). The study reveals presence of multiple perfusion abnormalities on cerebral perfusion imaging in HIV positive patients who have normal/near normal mental status suggesting precedence of perfusion abnormality over clinically apparent mental deficit

Diagnostic incidence of the presence of positive HBsAg: epidemiologic, clinical, and virological characteristics Incidencia diagnóstica de AgHBs positivo: Características epidemiológicas, clínicas y virológicas

Directory of Open Access Journals (Sweden)

Elvira Poves Martínez

2012-01-01

Full Text Available Objective: to analyze the epidemiological, clinical, and virological characteristics of patients newly diagnosed with active hepatitis B virus (HBV infection based on the presence of positive hepatitis B surface antigen (HBsAg in the digestive diseases department of a district hospital. Patients and methods: we performed a 3-year prospective study in patients newly diagnosed with HBV infection. We analyzed epidemiological, clinical, and virological characteristics, complete HBV markers, quantification of HBV DNA, and infection by hepatitis delta virus. We performed genotyping and resistance testing in patients with a high viral load. Results were obtained for patients who required liver biopsy. Results: we diagnosed 213 patients (18.8/10,000 inhabitants/year. Men accounted for 61%, and 59% were aged 20 to 40 years. Immigrants accounted for 53% of the population: 46% were from Rumania and 37% from Sub-Saharan African countries. At diagnosis, 2.3% had acute hepatitis (all with jaundice and 3.3% had cirrhosis with portal hypertension. With the exception of cases of acute hepatitis, positive HBeAg was observed in 9%. Serum transaminase levels were normal in 62.2% of patients, HBV DNA was > 2,000 IU/mL in 33.8%, and delta virus was present in 3.3%. Genotyping and resistance testing were performed in 70 patients: the most common genotype was D, followed by A. Resistance was detected at baseline in only 2 cases: to adefovir in one case and to entecavir in another. Among the 36 biopsies performed, 32.4% showed inflammatory activity ≥ 2, and 23.5% had fibrosis ≥ 2 according to the METAVIR scoring system. According to clinical practice, specific treatment for HBV infection was necessary (any reason in 17.4% of those diagnosed (3 patients per 100,000 inhabitants/year. Conclusions: despite prevention and vaccination, HBV infection is a health problem that most commonly affects the immigrant population and men. Serum transaminase levels are normal in 62

Changes of TSH-Stimulation Blocking Antibody (TSBAb and Thyroid Stimulating Antibody (TSAb Over 10 Years in 34 TSBAb-Positive Patients with Hypothyroidism and in 98 TSAb-Positive Graves’ Patients with Hyperthyroidism: Reevaluation of TSBAb and TSAb in TSH-Receptor-Antibody (TRAb-Positive Patients

Directory of Open Access Journals (Sweden)

Nobuyuki Takasu

2012-01-01

Full Text Available Two TRAbs: TSBAb and TSAb. TSBAb causes hypothyroidism. TSAb causes Graves’ hyperthyroidism. TSBAb and TSAb block TSH-binding to cells as TRAb, measured as TSH-binding inhibitory immunoglobulin (TBII. We reevaluate TSBAb and TSAb. We studied TSBAb, TSAb, and TBII over 10 years in 34 TSBAb-positives with hypothyroidism and in 98 TSAb-positives with hyperthyroidism. Half of the 34 TSBAb-positives with hypothyroidism continued to have persistently positive TSBAb, continued to have hypothyroidism, and did not recover from hypothyroidism. Ten of the 98 TSAb-positives with hyperthyroidism continued to have positive TSAb and continued to have hyperthyroidism. TSBAb had disappeared in 15 of the 34 TSBAb-positives with hypothyroidism. With the disappearance of TSBAb, recovery from hypothyroidism was noted in 13 (87% of the 15 patients. TSAb had disappeared in 73 of the 98 TSAb-positives with hyperthyroidism. With the disappearance of TSAb, remissions of hyperthyroidism were noted in 60 (82% of the 73. Two of the 34 TSBAb-positives with hypothyroidism developed TSAb-positive Graves’ hyperthyroidism. Two of the 98 TSAb-positive Graves’ patients with hyperthyroidism developed TSBAb-positive hypothyroidism. TSBAb and TSAb are TRAbs. TSBAb-hypothyroidism and TSAb-hyperthyroidism may be two aspects of one disease (TRAb disease. Two forms of autoimmune thyroiditis: atrophic and goitrous. We followed 34 TSBAb-positive patients with hypothyroidism (24 atrophic and 10 goitrous over 10 years. All of the 10 TSBAb-positive goitrous patients recovered from hypothyroidism and 19 (79% of the 24 TSBAb-positive atrophic patients continued to have hypothyroidism.

Changes of TSH-Stimulation Blocking Antibody (TSBAb) and Thyroid Stimulating Antibody (TSAb) Over 10 Years in 34 TSBAb-Positive Patients with Hypothyroidism and in 98 TSAb-Positive Graves' Patients with Hyperthyroidism: Reevaluation of TSBAb and TSAb in TSH-Receptor-Antibody (TRAb)-Positive Patients

Science.gov (United States)

Takasu, Nobuyuki; Matsushita, Mina

2012-01-01

Two TRAbs: TSBAb and TSAb. TSBAb causes hypothyroidism. TSAb causes Graves' hyperthyroidism. TSBAb and TSAb block TSH-binding to cells as TRAb, measured as TSH-binding inhibitory immunoglobulin (TBII). We reevaluate TSBAb and TSAb. We studied TSBAb, TSAb, and TBII over 10 years in 34 TSBAb-positives with hypothyroidism and in 98 TSAb-positives with hyperthyroidism. Half of the 34 TSBAb-positives with hypothyroidism continued to have persistently positive TSBAb, continued to have hypothyroidism, and did not recover from hypothyroidism. Ten of the 98 TSAb-positives with hyperthyroidism continued to have positive TSAb and continued to have hyperthyroidism. TSBAb had disappeared in 15 of the 34 TSBAb-positives with hypothyroidism. With the disappearance of TSBAb, recovery from hypothyroidism was noted in 13 (87%) of the 15 patients. TSAb had disappeared in 73 of the 98 TSAb-positives with hyperthyroidism. With the disappearance of TSAb, remissions of hyperthyroidism were noted in 60 (82%) of the 73. Two of the 34 TSBAb-positives with hypothyroidism developed TSAb-positive Graves' hyperthyroidism. Two of the 98 TSAb-positive Graves' patients with hyperthyroidism developed TSBAb-positive hypothyroidism. TSBAb and TSAb are TRAbs. TSBAb-hypothyroidism and TSAb-hyperthyroidism may be two aspects of one disease (TRAb disease). Two forms of autoimmune thyroiditis: atrophic and goitrous. We followed 34 TSBAb-positive patients with hypothyroidism (24 atrophic and 10 goitrous) over 10 years. All of the 10 TSBAb-positive goitrous patients recovered from hypothyroidism and 19 (79%) of the 24 TSBAb-positive atrophic patients continued to have hypothyroidism. PMID:22655217

The Use of Industrial Robot Arms for High Precision Patient Positioning

International Nuclear Information System (INIS)

Katuin, J.E.; Schreuder, A.N.; Starks, W.M.; Doskow, J.

2003-01-01

The Indiana University Cyclotron Facility (IUCF) is in the process of designing and building the Midwest Proton Radiation Institute (MPRI) [1]. The design process includes the development of several patient treatment systems. This paper discusses the use of two such systems that provide for the high precision positioning of a patient. They are the Patient Positioner System and the X-ray system. The Patient Positioner System positions an immobilized patient on a support device to a treatment position based on a prescribed Treatment Plan. The X-ray system uses an industrial robot arm to position a Digital Radiography Panel to acquire an X-ray image to verify the location of the prescribed treatment volume in a patient by comparing the acquired images with reference images obtained from the patient's Treatment plan

Investigations on uncertainties in patient positioning for prostate treatment with EPID

International Nuclear Information System (INIS)

Bakai, A.; Nuesslin, F.; Paulsen, F.; Plasswilm, L.; Bamberg, M.

2002-01-01

Background: Conformal radiotherapy techniques as used in prostate treatment allow to spare normal tissue by conforming the radiation fields to the shape of the planning target volume (PTV). To be able to fully utilize the advantages of these techniques correct patient positioning is an important prerequisite. This study employing an electronic portal imaging device (EPID) investigated the positioning uncertainties that occur in the pelvic region for different patient positioning devices. Patients and Methods: 15 patients with prostate cancer were irradiated with or without rectal balloon/pelvic mask at a linear accelerator with multileaf collimator (MLC). For each patient multiple portal images were taken from different directions and compared to the digitally reconstructed radiographs (DRRs) of the treatment planning system and to simulation films (Table 1, Figure 1). Results: In spite of different positioning devices, all patients showed comparable total positioning uncertainties of 4.0 mm (lateral), 4.5 mm (cranio-caudal) and 1.7 mm (dorso-ventral). The lateral positioning error was reduced for the pelvic mask patients while the cranio-caudal error increased (Table 2, Figure 2). A systematic and a random component sum up to the total positioning error, and a good estimate of the magnitudes of the two is possible from six to eight portal images (Figure 3). Conclusions: With a small number of portal images it is possible to find out the systematic and random positioning error of a patient. Knowledge of the random error can be used to resize the treatment margin which is clinically relevant since this error differs greatly for different patients (Figure 4). Image analysis with EPID is convenient, yet has some problems. For example, one only gets indirect information on the movement of the ventral rectum wall. The successful operation of positioning devices, although, needs further improvement - especially if one focuses on IMRT. (orig.) [de

Novel Electron Spin Resonance-Enzyme Immunosorbent Assay for Detecting Occult Hepatitis B Infection in HCV Chronic Liver Disease

Directory of Open Access Journals (Sweden)

Hala Badawi

2017-11-01

Full Text Available Background: Hepatitis B virus infection in patients who lack detectable hepatitis B surface antigen (HBsAg is called occult hepatitis B infection (OHB. The very low level of HBV genome may hamper its detection by molecular techniques. Recently, a highly sensitive EIA utilizing a novel modified electron spin resonance (ESR technique (modified ESR-EIA was developed to detect HBsAg by measuring stabilized nitroxide radicals. Aim: to detect occult HBV infection, using ESR-EIA among HCV-related chronic liver disease (CLD Egyptian patients who were seronegative for HBsAg by standard EIA. Methods: The study was conducted on two periods of time; in 1st period, 72 inpatients in Tropical Medicine Department of TBRI, were enrolled in the study. They were divided into two groups; 44 seropositive anti-HCV patients (Group I, 28 seronegative anti-HCV patients (Group II. Sera were subjected to virological assays for HBsAg, HBeAg, anti-HBc IgM, anti-HBc IgG, anti-HBs, anti-HCV and HCV RNA. We also examined serum HBV DNA by polymerase chain reaction (PCR technique and real-time detection polymerase chain reaction (RTD-PCR. In the 2nd period; modified ESR-EIA was applied on 32 TBRI inpatients, 23 in Tropical Medicine Department (Group I and 9 from hemodialysis unit (Group II with HCV-related CLD. Results: OHB was detected in 18.1% and 86.9% of our patients in 2002 and 2006 respectively. In phase 1, there was a higher detection rate among HCV patients in Group I (25% than Group II (7%, with higher prevalence (52.4% in patients with positive HCV RNA in Group I versus those with negative HCV viremia (8% in Group II. HBV DNA by either PCR or RTD-PCR was negative in all patients of both groups as the HBV viral load of the samples were below detectable level of the methods used; less than 100 copies/ml. None of 9 hemodialysis patients were positive for OHB. Conclusion: The newly developed quantitative ESR-EIA technique represents a great evolution for screening and

Cancer patients and positive sensory impressions in the hospital environment

DEFF Research Database (Denmark)

Timmermann, Connie; Uhrenfeldt, Lisbeth; Birkelund, Regner

2013-01-01

This study explores how cancer patients experience the meaning of positive sensory impressions in the hospital environment such as architecture, decoration and the interior. Data were obtained at a general hospital in Denmark by interviewing six cancer patients at two different wards. The analysis...... process was guided by the hermeneutical–phenomenological theory of interpretation as presented by the French philosopher Paul Ricoeur. Two main themes were identified: to preserve identity and positive thoughts and feelings. The participants experienced that positive sensory impressions in the hospital...... to recall some of their feelings of identity. This paper adds knowledge about how cancer patients experience sensory impressions in the hospital environment. An environment that provides homeliness and offers a view to nature seems to help some patients to preserve their identity. Furthermore, positive...

Frequency and characteristics of hepatitis B infection in children with malignant diseases

Directory of Open Access Journals (Sweden)

Jovanović Nada

2005-01-01

Full Text Available Introduction. Hepatitis B, a complication of blood transfusion or other means of transmission, occurs with variable frequency in children with malignant diseases. Objective. The objective of this study was to determine the frequency of hepatitis B virus infection in children with malignant diseases, to investigate the clinical course of the illness, and to analyze the influence of hepatitis on cytotoxic treatment. Method. The study included children diagnosed and treated for malignant diseases at the University Children's Hospital in Belgrade from 1997 to 2003. HBs Ag was analyzed in all patients who had elevated transarninases of twice normal value, in children who had icterus, and in one group of patients treated routinely after 2001 before, during, and after therapy. Results. A total of 137 male and 107 female children who had malignancies were treated. From 113 children who were evaluated for the presence of HBs Ag at the beginning of treatment, 2(1.7%] were HBsAg+. In this group of patients HBsAg was tested in 58 (51% children during and after chemotherapy, and HBsAg was discovered in 17 (29% of them. Of 123 children, in whom HBsAg was not tested at the beginning of their illness, 36 (55% out of 66 (51% tested patients were HBsAg+. No statistical difference between those two groups of patients was ascertained (X2=3.27, p>0.05. In summary, the presence of HBsAg was discovered in 53 patients, 22% out of 244 patients and 43% of tested patients. Nine patients had the icteric form of illness, with one case proving fatal due to fulminating hepatitis. Conclusion. Taking into consideration the uncertain long-term prognoses of these patients, follow-up and treatment is essential.

Serum iron parameters in liver cirrhosis

Science.gov (United States)

Siregar, G. A.; Maail, W.

2018-03-01

The liver plays a fundamental role in iron homeostasis. Iron parameters change, especially ferritin, need to be evaluated in patients with liver cirrhosis. Serum ferritin could predict the prognosis of patients with decompensated cirrhosis since it reflects immunemediated and infectious stimuli. Ferritin could express the severity of liver disease and possible subsequent complications. Finally, it might reflect an iron overload condition resulting in significant morbidity and early mortality. 70 patients with decompensated liver cirrhosis divided into three Child-Pugh subgroups. Serum iron parameters include serum iron (SI), total iron binding capacity (TIBC) and ferritin was measured in these groups. From these 70 patients, 30 (42.9%) with HbsAg positive, 26 (37.1%) with anti-HCV positive and 14 (20%) with both HbsAg and anti-HCV positive. Of the 70 patients, 14 (20%) had CTP Class A cirrhosis, 17 (24.3%) had CTP Class B cirrhosis, and 39 (55.7%) had CTP C cirrhosis. The median (range) value of serum iron was 36 (10-345) μg/dl, TIBC was 160 (59-520) μg/dl, Ferritin was 253.5 (8-6078) ng/ml and the transferrin saturation was 22.9 (3.65-216.98) %.We found a significant difference in serum ferritin level with CTP score. Ferritin levels increased as Child-Pugh class progressed (p<0.001).

Hepatitis B Viral Markers in Surface Antigen Negative Blood Donors ...

African Journals Online (AJOL)

Of the 20 who were anti-HBc positive, seven had tattoo/traditional marks on their body and one had previous history of blood transfusion. Conclusion: This study has shown that some potential blood units containing HBV are being transfused to patients unknowingly by screening for HBsAg only. Screening for other markers ...

Hepatitis B virus, hepatitis C virus and human immunodeficiency virus infection in undocumented migrants and refugees in southern Italy, January 2012 to June 2013.

Science.gov (United States)

Coppola, Nicola; Alessio, Loredana; Gualdieri, Luciano; Pisaturo, Mariantonietta; Sagnelli, Caterina; Caprio, Nunzio; Maffei, Rita; Starace, Mario; Angelillo, Italo Francesco; Pasquale, Giuseppe; Sagnelli, Evangelista

2015-01-01

Screening of undocumented migrants or refugees for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections has been offered free of charge and free from bureaucratic procedures since 2012 at four primary-level clinical centres in Naples and Caserta, Italy. Of 926 undocumented migrants and refugees visiting one of the primary-level clinical centres from January 2012 to June 2013, 882 (95%) were screened for hepatitis B surface antigen (HBsAg), total hepatitis B core antibody (anti-HBc) and antibodies against HCV and HIV. Of the 882 individuals enrolled, 78 (9%) were HBsAg positive, 35 (4%) anti-HCV positive and 11 (1%) anti-HIV positive (single infections); seven (1%) had more than one infection (three were HBsAg positive). Of the 801 HBsAg-negative patients, 373 (47%) were anti-HBc positive. The HBsAg-positivity rate was high (14%; 62/444) in individuals from sub-Saharan Africa and intermediate in those from eastern Europe (6%; 12/198), northern Africa (2%; 2/80) and Bangladesh, India, Pakistan and Sri Lanka (the 'India-Pakistan area') (3%; 4/126). Anti-HCV was detected in 9/126 (7%) individuals originating from the India-Pakistan area, in 12/198 (6%) from eastern Europe, in 17/444 (4%) from sub-Saharan and in 2/80 (2%) from northern Africa. The HBV, HCV and HIV infections in the undocumented migrants and refugees screened serve as a reminder to the Italian healthcare authorities to carry out extensive screening and educational programmes for these populations.

ESTRO ACROP guidelines for positioning, immobilisation and position verification of head and neck patients for radiation therapists

Directory of Open Access Journals (Sweden)

Michelle Leech

2017-03-01

Full Text Available Background and purpose: Over the last decade, the management of locally advanced head and neck cancers (HNCs has seen a substantial increase in the use of chemoradiation. These guidelines have been developed to assist Radiation TherapisTs (RTTs in positioning, immobilisation and position verification for head and neck cancer patients. Materials and methods: A critical review of the literature was undertaken by the writing committee.Based on the literature review, a survey was developed to ascertain the current positioning, immobilisation and position verification methods for head and neck radiation therapy across Europe. The survey was translated into Italian, German, Greek, Portuguese, Russian, Croatian, French and Spanish.Guidelines were subsequently developed by the writing committee. Results: Results from the survey indicated that a wide variety of treatment practices and treatment verification protocols are in operation for head and neck cancer patients across Europe currently.The guidelines developed are based on the experience and expertise of the writing committee, remaining cognisant of the variations in imaging and immobilisation techniques used currently in Europe. Conclusions: These guidelines have been developed to provide RTTs with guidance on positioning, immobilisation and position verification of HNC patients. The guidelines will also provide RTTs with the means to critically reflect on their own daily clinical practice with this patient group. Keywords: Head and neck, Immobilisation, Positioning, Verification

Performance of a video-image-subtraction-based patient positioning system

International Nuclear Information System (INIS)

Milliken, Barrett D.; Rubin, Steven J.; Hamilton, Russell J.; Johnson, L. Scott; Chen, George T.Y.

1997-01-01

Purpose: We have developed and tested an interactive video system that utilizes image subtraction techniques to enable high precision patient repositioning using surface features. We report quantitative measurements of system performance characteristics. Methods and Materials: Video images can provide a high precision, low cost measure of patient position. Image subtraction techniques enable one to incorporate detailed information contained in the image of a carefully verified reference position into real-time images. We have developed a system using video cameras providing orthogonal images of the treatment setup. The images are acquired, processed and viewed using an inexpensive frame grabber and a PC. The subtraction images provide the interactive guidance needed to quickly and accurately place a patient in the same position for each treatment session. We describe the design and implementation of our system, and its quantitative performance, using images both to measure changes in position, and to achieve accurate setup reproducibility. Results: Under clinical conditions (60 cm field of view, 3.6 m object distance), the position of static, high contrast objects could be measured with a resolution of 0.04 mm (rms) in each of two dimensions. The two-dimensional position could be reproduced using the real-time image display with a resolution of 0.15 mm (rms). Two-dimensional measurement resolution of the head of a patient undergoing treatment for head and neck cancer was 0.1 mm (rms), using a lateral view, measuring the variation in position of the nose and the ear over the course of a single radiation treatment. Three-dimensional repositioning accuracy of the head of a healthy volunteer using orthogonal camera views was less than 0.7 mm (systematic error) with an rms variation of 1.2 mm. Setup adjustments based on the video images were typically performed within a few minutes. The higher precision achieved using the system to measure objects than to reposition

Tuberculosis treatment among smear positive tuberculosis patients

International Nuclear Information System (INIS)

Munir, M.K.; Iqbal, R.; Shabbir, I.; Chaudhry, K

2012-01-01

Tuberculosis is a major health problem in many parts of the world. Delay in initiation of the treatment may result in prolonged infectious state, drug resistance, relapse and death. Objectives: To determine the factors responsible for not starting tuberculosis treatment among smear positive tuberculosis patients. Study type, settings and duration: This cross sectional study was done at Pakistan Medical Research Council TB Research Center, King Edward Medical University, Lahore, from fifth March 2010 to fifth December 2010. Patients and Methods: Fifty sputum smear positive patients of tuberculosis who did not register themselves in treatment register and presumably did not initiate anti tuberculosis treatment were contacted using telephone or traced by their home addresses. Once contact was established, they were inquired about the reasons for not starting tuberculosis treatment. Results: Of 50 patients 38(76%)belonged to the lower socio economic class and 12(24%) to the lower middle class. Fourteen patients (28%) were illiterate and 23(46%) had only 8 years of education. Of the 50 cases 41(82%) were taking treatment from traditional healers and 4% did not go back to the DOTS program. Physical condition of the patient, social, domestic and religious issues also played some role in default. Conclusions: Lack of health education and poverty were the main factors responsible for non compliance from treatment. Policy message: Sputum testing sites should have a paramedic who should educate the patients about the benefits of treatment and the dangers of default or partial treatment. (author)

Pattern of neuropsychological performance among HIV positive patients in Uganda

Directory of Open Access Journals (Sweden)

Parsons Thomas D

2007-04-01

Full Text Available Abstract Background Few studies have examined cognitive functioning of HIV positive patients in sub-Saharan Africa. It cannot be assumed that HIV positive patients in Africa exhibit the same declines as patients in high-resource settings, since there are differences that may influence cognitive functioning including nutrition, history of concomitant disease, and varying HIV strains, among other possibilities. Part of the difficulty of specifying abnormalities in neuropsychological functioning among African HIV positive patients is that there are no readily available African normative databases. The purpose of the current study was to evaluate the pattern of neuropsychological performance in a sample of HIV positive patients in comparison to HIV negative control subjects in Uganda. Methods The neuropsychological test scores of 110 HIV positive patients (WHO Stage 2, n = 21; WHO Stage 3, n = 69; WHO Stage 4, n = 20 were contrasted with those of 100 control subjects on measures of attention/concentration, mental flexibility, learning/memory, and motor functioning. Results Analysis of covariance (ANCOVA revealed significant group differences on measures of verbal learning and memory, speed of processing, attention and executive functioning between HIV seropositive and seronegative subjects. Conclusion Ugandan patients with HIV demonstrated relative deficits on measures of verbal learning and memory, speed of processing, attention, and executive functioning compared to HIV negative controls. These results from a resource limited region where clades A and D are prevalent are consistent with previous findings in the developed world where clade B predominates.

Seroprevalence of Epstein-Barr virus among HIV positive patients moreover and its association with CD4 positive lymphocyte count.

Directory of Open Access Journals (Sweden)

Alireza Abdollahi

2014-12-01

Full Text Available Opportunistic infections are the leading cause of hospitalization and morbidity in human immunodeficiency virus (HIV positive patients and are the most common cause of death between them. We aimed to measure IgG antibody against EBV viral capsid antigen (EBV-VCA IgG to determine the seroprevalence of this infection in HIV-positive population. A case-control study between September 2011 and October 2012 was conducted in a teaching hospital enrolling 114 HIV-positive patients as case group and 114 healthy individuals as control with similar age and sex. Enzyme-linked immunosurbant assay (ELISA technique was used for determination of EBV-VAC IgG in obtained samples. Of 114 serum samples obtained from HIV-positive patients, 103 (90.4% samples were found positive for EBV-VCA IgG antibody. There was no significant difference in seroprevalence of EBV VCA IgG antibody between patients received antiretroviral therapy and naive patients (91.5% vs. 87.5%, P>0.05. There was no statistically significant difference in EBV-VCA IgG seroprevalence between three groups of CD4+ in HIV positive group. In conclusion current study showed that seroprevalence of EBV in HIV-positive patients is higher than HIV-negative healthy participants; however, administration of HAART and CD4+ lymphocyte count did not reveal a significant effect in seroprevalence of EBV. Due to the significance of this virus in mortality and morbidity and causing certain malignancies in patients with AIDS, these patients are strongly recommended to be tested for this virus.

Our trial to improve patient positioning during mammography

International Nuclear Information System (INIS)

Nakayama, Takashi; Kotsuma, Yoshikazu; Hiramatsu, Sawako

2007-01-01

For effective breast cancer screening, reading of high-quality mammograms is essential, and for this purpose proper patient positioning during mammography is important. At our Shin-Osaka Mammography Seminar, which includes eight institutions, a physician and nine radiology technicians get together weekly in order to critically review mammogram reading and techniques for obtaining good mammograms. We have recognized that patient positioning has a great effect on mammogram quality, particularly for women in their 40 s who have dense mammary glands, and we have adopted a digital mammography system, or comparative mammography for such patients. Since July 2005, we have critically reviewed positioning every 3 or 4 months with the aim of improving our technique. Eight institutions have participated in this trial, each contributing mammograms taken recently from 20 to 30 consecutive participants, and the grade of positioning has been determined according to the Institutional Mammogram Estimation Standard (6 items, each scoring a maximum of 4 points, total 24 points) proposed by the Central Committee for Quality Control of Mammography Screening. The estimation has been done by both ourselves and committee members. When a total of 20 points or more is obtained and all 6 items score 3 points or more, it is considered that the positioning has been good, and this is termed ''Positioning A'' (P-A). On the other hand, if the total score is less than 20 points, and any one of the 6 items scores less than 3 points, it is considered that positioning has been inadequate, and this is termed ''Positioning-D'' (P-D). At the first review meeting, which was held before our critical study, P-A accounted for 48% of cases, and this had improved to 72% at the second meeting, and to 66% at the third. P-D accounted for 41% of cases at the first meeting, 20% at the second, and 21% at the third. Thus our trial involving discussion between a physician and technicians to critically review good

Comparative analysis of disease activity in patients of chronic hepatitis B virus, with and without super infection with hepatitis D virus; an experience at tertiary care centre

International Nuclear Information System (INIS)

Hassan, K.D.; Mahmood, T.; Farooq, M.U.

2008-01-01

The hepatitis D virus super-infection contributes significantly to the morbidity and mortality of hepatitis B virus infection. The objectives were to describe the incidence of Hepatitis D virus and comparative analysis of disease activity in patients of chronic hepatitis B virus, with and without super-infection of hepatitis D virus. This Cross-sectional comparative study was conducted at Department of Medicine and Gastroenterology Clinic Jinnah Postgraduate Medical Centre, Karachi, Pakistan from February 2007 to July 2007. HBsAg positive patients who attended our Gastroenterology clinic were selected for the study. After screening for Anti-HDV these patients were segregated in to Anti-HDV positive and negative groups. Data was analyzed on SPSS 12. Eighty-four patients were selected. Seventy-three patients who fulfilled the inclusion criteria were enrolled in to the study. Anti-HDV was positive in 23 (31.5%) patients. Among these 23 anti-HDV positive, HDV-RNA was detected in 15 (75%) patients. The differences of age, gender, marital status and area of residence whether rural or urban were not significant between the two groups. HBV-DNA was significantly suppressed in majority of anti- HDV positive patients (p=0.019). Mean serum ALT levels were significantly higher in patients who had HDV infection (p=0.014). HDV infection was common in this series of patients with a frequency of 31.5%. All patients of chronic HBV should be screened for HDV whether they are asymptomatic HBV carriers or have chronic active hepatitis particularly when they have raised serum ALT. (author)

Anti-Jo-1 antibody-positive patients show a characteristic necrotizing perifascicular myositis.

Science.gov (United States)

Mescam-Mancini, Lénaig; Allenbach, Yves; Hervier, Baptiste; Devilliers, Hervé; Mariampillay, Kuberaka; Dubourg, Odile; Maisonobe, Thierry; Gherardi, Romain; Mezin, Paulette; Preusse, Corinna; Stenzel, Werner; Benveniste, Olivier

2015-09-01

Idiopathic inflammatory myopathies can be classified as polymyositis, dermatomyositis, immune-mediated necrotizing myopathy, sporadic inclusion body myositis or non-specific myositis. Anti-Jo-1 antibody-positive patients are assigned to either polymyositis or dermatomyositis suggesting overlapping pathological features. We aimed to determine if anti-Jo-1 antibody-positive myopathy has a specific morphological phenotype. In a series of 53 muscle biopsies of anti-Jo-1 antibody-positive patients, relevant descriptive criteria defining a characteristic morphological pattern were identified. They were tested in a second series of anti-Jo-1 antibody-positive patients and compared to 63 biopsies from patients suffering from other idiopathic inflammatory myopathies. In anti-Jo-1 antibody-positive patients, necrotic fibres, which strongly clustered in perifascicular regions, were frequently observed. Sarcolemmal complement deposition was detected specifically in perifascicular areas. Inflammation was mainly located in the perimysium and around vessels in 90.6%. Perimysial fragmentation was observed in 90% of cases. Major histocompatibility complex class I staining was diffusely positive, with a perifascicular reinforcement. Multivariate analysis showed that criteria defining perifascicular pathology: perifascicular necrosis, atrophy, and perimysial fragmentation allow the distinction of anti-Jo-1 antibody-positive patients, among patients suffering from other idiopathic inflammatory myopathies. Anti-Jo-1 antibody-positive patients displayed perifascicular necrosis, whereas dermatomyositis patients exhibited perifascicular atrophy. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Surface protein mutations in chronic hepatitis B patients who received hepatitis B vaccine therapy

Directory of Open Access Journals (Sweden)

Maryam Daram

2014-09-01

Conclusion: In chronic carriers who already had HBsAg variants selected by the host-immune response, any immune stimulation by the vaccine had no effect on the chronic state of these patients or selected any remarkable escape mutants. Newer strategies should be considered based on third generation or the use of DNA vaccines or new adjuvants.

The representitativeness of patient position during the first treatment fractions

DEFF Research Database (Denmark)

Bertelsen, Anders; Nielsen, Morten; Westberg, Jonas

2009-01-01

BACKGROUND: During external radiotherapy daily or even weekly image verification of the patient position might be problematic due to the resulting workload. Therefore it has been customary to perform image verification only at the first treatment fraction. In this study it is investigated whether...... the patient position uncertainty at the initial three treatment fractions is representative for the uncertainty throughout the treatment course. METHODS: Seventy seven patients were treated using Elekta Synergy accelerators. The patients were immobilized during treatment by use of a customized VacFix bag...... and a mask of AquaPlast. Cone beam CT (CBCT) scans were performed at fractions 1, 2, and 3 and at the 10th and 20th treatment fractions. Displacements in patient position, translational and rotational, have been measured by an image registration of the CBCT and the planning CT scan. The displacements data...

Determination of Relative Frequency of HBS Ag, HCV and HIV Antibodies Serum Markers among Admitted Intravenous Drug Users in Infectious Disease Ward of Razi Hospital in Ahvaz, 2004-2005

Directory of Open Access Journals (Sweden)

Abdolrasool Nikkhooy

2012-07-01

Full Text Available Introduction: Intravenous drug users as a serious health problem in communities have economical and social effects as well as health and hygienic complications. Viral infections may be transmitted through drug injection by shared syringes among users. The aim of this study has been to determine the relative frequency of HBV, HCV and HIV infection’s markers as epidemiological data in Ahvaz. Materials & Methods: This retrospective cross sectional study was conducted on IV drug users (IVDUs who were admitted in infectious diseases ward of Razi Ahvaz Hospital in 2004-2005. The collected data of serum markers of these patients were coded, and statistical analyses were conducted. Results: 1890 patients were evaluated and 258 patients were IVDUs (14.6%. 154 patients (59.98% were tested for anti HCV-Ab of whom 65 patients were HCV-Ab positive (42.2%. 205 patients (79.45% were tested for anti HIV-Ab of whom 38 patients were HIV-Ab positive (18.53%. 67 patients (25.96% were tested for HBs-Ag of whom 15 patients were HBs-Ag positive (22.67%. 12 patients (4.65% were tested for anti HBc-Ab of whom 8 patients were HBc-Ab positive (66.66%. Conclusion: In this study, high infection rate relates to different causes such as increasing consumes of opium substances and recent differences in fumigated opium substances pattern toward injecting drug use in society level, which increases the prevalence of these infections, The present study determined some critical information about the prevalence of serum markers HBS Ag, HCV and HIV antibodies among intravenous drug users in southwestern of Iran.

Impact of HBV genotype and mutations on HBV DNA and qHBsAg levels in patients with HBeAg-negative chronic HBV infection.

Science.gov (United States)

Kuhnhenn, L; Jiang, B; Kubesch, A; Vermehren, J; Knop, V; Susser, S; Dietz, J; Carra, G; Finkelmeier, F; Grammatikos, G; Zeuzem, S; Sarrazin, C; Hildt, E; Peiffer, K-H

2018-04-10

HBV DNA and quantitative (q)HBsAg levels as prognostic markers for HBV-related disease are mostly validated in Asia and their significance in Western populations is uncertain. To analyse the impact of the HBV genotype and frequent mutations in precore (PC), basal core promoter (BCP) and preS on HBV DNA and qHBsAg levels. HBV DNA and qHBsAg serum levels of 465 patients with HBeAg-negative chronic HBV infection were correlated with the HBV genotype and mutations in PC, BCP and preS. For a detailed analysis of the molecular virology, genotype A2 genomes harbouring these mutations were analysed for replication efficacy and HBsAg release in cell culture. While no impact of the HBV genotype on HBV DNA levels was observed, qHBsAg levels differed up to 1.4 log among the genotypes (P HBV DNA levels (P HBV genome harbouring a preS deletion. In contrast, a perinuclear HBsAg accumulation was detected for the PC and BCP-variants, reflecting an impaired HBsAg release. qHBsAg serum levels depend on the HBV genotype and together with HBV DNA levels on frequent mutations in PC, BCP and preS in HBeAg-negative patients. qHBsAg cut-offs when used as prognostic markers require genotype-dependent validation. © 2018 John Wiley & Sons Ltd.

Optimal management of cervical cancer in HIV-positive patients: a systematic review

International Nuclear Information System (INIS)

Ntekim, Atara; Campbell, Oladapo; Rothenbacher, Dietrich

2015-01-01

The clinical management of cervical cancer in HIV-positive patients has challenges mainly due to the concerns on immune status. At present, their mode of management is similar to HIV-seronegative patients involving the use of chemotherapy and radiotherapy concurrently as indicated. HIV infection, cancer, radiotherapy, and chemotherapy lower immunity through reduction in CD4 cell counts. At present there are no treatment guidelines for HIV-positive patients. This study was done to systematically review the literature on cervical cancer management in HIV-positive patients and treatment outcomes. A systematic literature search was done in the major databases to identify studies on the management of HIV-positive patients with cervical cancer. Identified studies were assessed for eligibility and inclusion in the review following the guidelines of The Cochrane Handbook for Systematic Reviews and CRD's (Centre for Reviews and Dissemination) guidance for undertaking reviews in health care. Eight eligible studies were identified from the literature. Three of them were prospective while five were retrospective studies. Notably, the average age at diagnosis of cervical cancer in HIV-positive patients was a decade lower than in seronegative patients. There was no difference in distribution of stages of disease at presentation between HIV-positive and negative patients. Mild acute toxicity (Grades 1 and 2) was higher in HIV-positive patients than in HIV-negative patients in hematopoietic system. In the grades 3 and 4 reactions, anemia was reported in 4% versus 2% while gastrointestinal reactions were reported in 5% versus 2% respectively. In general, patients who were started early on HAART had higher rates of treatment completion. The study supports the suggestion that HAART should be commenced early at cervical cancer diagnosis in HIV-positive patients diagnosed with cervical cancer to ensure less toxicity and better treatment compliance

HIV, hepatitis B, and hepatitis C in Zambia

Directory of Open Access Journals (Sweden)

Kenneth C Kapembwa

2011-01-01

Full Text Available Objectives : Epidemiologic data of HIV and viral hepatitis coinfection are needed in sub-Saharan Africa to guide health policy for hepatitis screening and optimized antiretroviral therapy (ART. Materials and Methods: We screened 323 HIV-infected, ART-eligible adults for hepatitis B surface antigen (HBsAg and hepatitis C antibody (HCV Ab at a tertiary hospital in Lusaka, Zambia. We collected basic demographic, medical, and laboratory data to determine predictors for coinfection. Results: Of 323 enrolled patients, 32 (9.9%; 95% CI=6.7-13.2% were HBsAg positive, while 4 (1.2%; 95% CI=0.03-2.4% were HCV Ab positive. Patients with hepatitis B coinfection were more likely to be 200 IU/L was uncommon and did not differ between the two groups (3.4% vs. 2.3%; P=0.5. We were unable to determine predictors of hepatitis C infection due to the low prevalence of disease. Conclusions: HIV and hepatitis B coinfection was common among patients initiating ART at this tertiary care facility. Routine screening for hepatitis B should be considered for HIV-infected persons in southern Africa.

Prevalence and risk factors of hepatitis B and C virus infections in an impoverished urban community in Dhaka, Bangladesh

Directory of Open Access Journals (Sweden)

Salam Mohammed A

2010-07-01

Full Text Available Abstract Background Viral hepatitis is a serious global public health problem affecting billions of people globally, and both hepatitis B virus (HBV and hepatitis C virus (HCV infections are rapidly spreading in the developing countries including Bangladesh due to the lack of health education, poverty, illiteracy and lack of hepatitis B vaccination. Also there is lack of information on their prevalence among the general population. So, a population-based serological survey was conducted in Dhaka to determine the prevalence and risk factors of HBV and HCV infections. Methods Healthy individuals were selected for demographic and behavioural characteristics by stratified cluster sampling and blood tested for hepatitis B surface antigen (HBsAg, antibody to HBV core antigen (anti-HBc, and anti-HCV antibodies (anti-HCV. Results From June 2005-November 2006, 1997 participants were screened for HBsAg, anti-HBc and anti-HCV, 738 (37% were males with mean (SD age of 24 (14 years. HBV-seropositivity was documented in 582 (29% participants: 14 (0.7% were positive for HBsAg, 452 (22.6% for anti-HBc and 116 (5.8% for both HBsAg and anti-HBc. Four (0.2% participants were positive for anti-HCV, and another five (0.3% for both anti-HBc and anti-HCV. Ninety-six/246 (39% family members residing at same households with HBsAg positive participants were also HBV-seropositive [74 (30.1% for anti-HBc and 22 (8.9% for both HBsAg and anti-HBc], which was significantly higher among family members (39% than that of study participants (29% (OR 1.56; p Conclusions The results indicate intermediate level of endemicity of HBV infection in Dhaka community, with much higher prevalence among family members of HBsAg positive individuals but low prevalence of HCV infections, clearly indicating need for universal hepatitis B vaccination. The use of disposable needles for ear-nose-body piercing need to be promoted through public awareness programmes as a preventive strategy.

HIV positive patient with GBS-like syndrome.

Science.gov (United States)

Shepherd, Samantha J; Black, Heather; Thomson, Emma C; Gunson, Rory N

2017-08-01

Introduction. Guillain-Barré Syndrome (GBS) is an acute demyelinating polyneuropathy which can occur post-infection. Criteria of diagnosis of GBS include areflexia with progressive bilateral weakness in arms and legs. GBS can lead to severe respiratory and cardiac complications. The fatality rate can be up to 5 % in patients, depending on the severity of the symptoms. HIV can cause a range of neurological disorders including, on rare occasions, GBS. GBS can occur at any stage of HIV infection, highlighting the complexity of diagnosis of GBS within HIV patients. Case presentation. A 57 year old female with lumbar back pain radiating to the legs, poor mobility and tiredness, with reports of a viral-like illness four days previously, was initially diagnosed with a lower respiratory tract infection and discharged. Seventeen days later the patient was readmitted to hospital with progressive lower and upper limb weakness, areflexia and sensory loss. She was diagnosed with GBS and was unexpectedly discovered to be HIV-positive. HIV avidity was low indicating a recently acquired HIV infection. The patient was treated with intravenous immunoglobulin for five days for the GBS and commenced antriretrovirals for HIV. The patient was discharge from hospital 53 days after admission with walking aids and regular physiotherapy follow-up. . This case highlighted the need for all clinicians to be aware that patients with symptoms of GBS, regardless of clinical history should be offered an HIV test. GBS can be the first sign a patient is HIV-positive.

Anti-hepatitis B core antigen testing with detection and characterization of occult hepatitis B virus by an in-house nucleic acid testing among blood donors in Behrampur, Ganjam, Orissa in southeastern India: implications for transfusion

Directory of Open Access Journals (Sweden)

Panigrahi Rajesh

2010-08-01

Full Text Available Abstract Background Occult hepatitis B virus (HBV infection might transmit viremic units into the public blood supply if only hepatitis B surface antigen (HBsAg testing is used for donor screening. Our aim was to evaluate the prevalence of occult HBV infection among the HBsAg negative/antiHBc positive donations from a highly HIV prevalent region of India. Methods A total of 729 HBsAg negative donor units were included in this study. Surface gene and precore region were amplified by in house nucleic acid test (NAT for detection of occult HBV infection and surface gene was analyzed after direct sequencing. Results A total of 220 (30.1% HBsAg negative donors were antiHBc positive, of them 66 (30% were HBV DNA positive by NAT. HBV DNA positivity among 164 antiHBc only group, was 27.1% and among 40 antiHBs positive group was 30.0%. HBV/D (93.3% was predominant and prevalence of both HBV/C and HBV/A was 3.3%. Single or multiple amino acids substitutions were found in 95% samples. Conclusion Thus, a considerable number of HBV infected donors remain undiagnosed, if only HBsAg is used for screening. Addition of antiHBc testing for donor screening, although will lead to rejection of a large number of donor units, will definitely eliminate HBV infected donations and help in reducing HBV transmission with its potential consequences, especially among the immunocompromised population. The HBV genetic diversity found in this donor population are in accordance with other parts of India.

Anti-hepatitis B core antigen testing with detection and characterization of occult hepatitis B virus by an in-house nucleic acid testing among blood donors in Behrampur, Ganjam, Orissa in southeastern India: implications for transfusion.

Science.gov (United States)

Panigrahi, Rajesh; Biswas, Avik; Datta, Sibnarayan; Banerjee, Arup; Chandra, Partha K; Mahapatra, Pradip K; Patnaik, Bharat; Chakrabarti, Sekhar; Chakravarty, Runu

2010-08-27

Occult hepatitis B virus (HBV) infection might transmit viremic units into the public blood supply if only hepatitis B surface antigen (HBsAg) testing is used for donor screening. Our aim was to evaluate the prevalence of occult HBV infection among the HBsAg negative/antiHBc positive donations from a highly HIV prevalent region of India. A total of 729 HBsAg negative donor units were included in this study. Surface gene and precore region were amplified by in house nucleic acid test (NAT) for detection of occult HBV infection and surface gene was analyzed after direct sequencing. A total of 220 (30.1%) HBsAg negative donors were antiHBc positive, of them 66 (30%) were HBV DNA positive by NAT. HBV DNA positivity among 164 antiHBc only group, was 27.1% and among 40 antiHBs positive group was 30.0%. HBV/D (93.3%) was predominant and prevalence of both HBV/C and HBV/A was 3.3%. Single or multiple amino acids substitutions were found in 95% samples. Thus, a considerable number of HBV infected donors remain undiagnosed, if only HBsAg is used for screening. Addition of antiHBc testing for donor screening, although will lead to rejection of a large number of donor units, will definitely eliminate HBV infected donations and help in reducing HBV transmission with its potential consequences, especially among the immunocompromised population. The HBV genetic diversity found in this donor population are in accordance with other parts of India.

The Lumipulse G HBsAg-Quant assay for screening and quantification of the hepatitis B surface antigen.

Science.gov (United States)

Yang, Ruifeng; Song, Guangjun; Guan, Wenli; Wang, Qian; Liu, Yan; Wei, Lai

2016-02-01

Qualitative HBsAg assay is used to screen HBV infection for decades. The utility of quantitative assay is also rejuvenated recently. We aimed to evaluate and compare the performance of a novel ultra-sensitive and quantitative assay, the Lumipulse assay, with the Architect and Elecsys assays. As screening methods, specificity was compared using 2043 consecutive clinical routine samples. As quantitative assays, precision and accuracy were assessed. Sera from 112 treatment-naïve chronic hepatitis B patients, four patients undergoing antiviral therapy and one patient with acute infection were tested to compare the correlations. Samples with concurrent HBsAg/anti-HBs were also quantified. The Lumipulse assay precisely quantified ultra-low level of HBsAg (0.004 IU/mL). It identified additional 0.98% (20/2043) clinical samples with trance amount of HBsAg. Three assays displayed excellent linear correlations irrespective of genotypes and S-gene mutations (R(2)>0.95, PLumipulse assay did not yield higher HBsAg concentrations in samples with concomitant anti-HBs. Compared with other assays, the Lumipulse assay is sensitive and specific for detecting HBsAg. The interpretation of the extremely low-level results, however, is challenging. Quantitative HBsAg results by different assays are highly correlated, but they should be interpreted interchangeably only after conversion to eliminate the biases. Copyright © 2015 Elsevier B.V. All rights reserved.

Management of hepatitis B reactivation in patients receiving cancer chemotherapy

OpenAIRE

Huang, Yi-Wen; Chung, Raymond T.

2012-01-01

Hepatitis B virus (HBV) reactivation is well documented in previously resolved or inactive HBV carriers who receive cancer chemotherapy. The consequences of HBV reactivation range from self-limited conditions to fulminant hepatic failure and death. HBV reactivation also leads to premature termination of chemotherapy or delay in treatment schedules. This review summarizes current knowledge of management of HBV reactivation in patients receiving cancer chemotherapy. HBV surface antigen (HBsAg) ...

Target volume shape variation during irradiation of rectal cancer patients in supine position: Comparison with prone position

International Nuclear Information System (INIS)

Nijkamp, Jasper; Jong, Rianne de; Sonke, Jan-Jakob; Vliet, Corine van; Marijnen, Corrie

2009-01-01

Purpose: To quantify the inter-fraction shape variation of the mesorectum for rectal cancer patients treated with 5 x 5 Gy in supine position and compare it to variation in prone position. Methods and materials: For 28 patients a planning CT (pCT) and five daily cone-beam-CT (CBCT) scans were acquired in supine position. The mesorectal part of the CTV (MesoRect) was delineated on all scans. The shape variation was quantified by the distance between the pCT- and the CBCT delineations and stored in surface maps after online setup correction. Data were analyzed for male and female patients separately and compared to prone data. Results: A large range of systematic, 1-8 mm (1SD), and random, 1-5 mm, shape variation was found, comparable to prone patients. Random-shape variation was comparable for male and female patients, while systematic variation was 3 mm larger for female patients. Conclusions: Shape variation of the MesoRect is substantial, heterogeneous and different between male and female patients. Differences between supine and prone orientation, however, are small. Clinical margins should be differentiated in position along the cranio-caudal axis, in anterior-posterior direction and for gender. Margins should also be increased, even when online setup correction is used. Due to the small margin differences between prone and supine treatments, the setup choice should be determined on dose to the organs at risk.

[Status of seroepidemiology of hepatitis A, B and C in primary and middle school students in Shufu county, Xinjiang Uygur Autonomous Region of China].

Science.gov (United States)

Zhang, Z B; Xue, Z X; Han, Z G; Yang, Q Y; Zheng, X R; Zulipikaer, Tuerhong; Wang, M

2016-12-10

Objective: To explore the status of seroepidemiology on hepatitis A, B and C in primary and middle school students in Shufu county, Xinjiang Uygur Autonomous Region of China (Xinjiang) and to evaluate the effect of related immunization. Methods: Students in four towns and villages were selected by cluster random sampling method. HAV-IgG, HBsAg, HBsAb and HCV-IgG were detected in Feb to May, 2015. Results: The overall HAV-IgG positive rate was 99.75%, among 4 830 primary and middle school students. The positive rates were seen 99.92% in boys and 99.57% in girls, with difference statistically significant ( χ 2 =5.798, P =0.016). The overall HBsAg positive rate appeared as 3.02%, with 3.55% for boys and 2.47% for girls, with difference statistically significant ( χ 2 =4.782, P =0.029). The difference between age specific HBsAg positive rates also showed statistically significant ( χ 2 =71.990, P =0.000). HBsAg positive rate in the students in rural area (3.28%) was higher than that in the students in urban area (1.61%, χ 2 =6.019, P =0.014). HBsAb positive rate was 38.84%, and the differences between the age specific HBsAb positive rates appeared statistically significant ( χ 2 =837.699, P =0.000). HBsAg positive rate in students from the urban area (42.36%) was higher than those from the rural area (38.20%, χ 2 =4.598, P =0.032). 2 815 students, accounting for 58.28% of the total students, showed negative on both HBsAg and HBsAb. The overall HCV-IgG positive rate was 0.19%, and all appeared in students from the rural areas, with ethnicity solely as Uygur. Conclusions: The effect of hepatitis A vaccine was satisfactory in primary and middle school students in Shufu county but quiet a number of the students missed the vaccination. The infection rate of hepatitis C was low. Publicity and health education on hepatitis immunization and control should be revved up. Programs regarding primary and supplementary immunization on hepatitis, should be carried out timely

[Paresthesia and spinal anesthesia for cesarean section: comparison of patient positioning].

Science.gov (United States)

Palacio Abizanda, F J; Reina, M A; Fornet, I; López, A; López López, M A; Morillas Sendín, P

2009-01-01

To determine the incidence of paresthesia during lumbar puncture performed with the patient in different positions. A single-blind prospective study of patients scheduled for elective cesarean section, randomized to 3 groups. In group 1 patients were seated in the direction of the long axis of the table, with heels resting on the table. In group 2 they were seated perpendicular to the long axis of the table, with legs hanging from the table. In group 3 they were in left lateral decubitus position. Lumbar punctures were performed with a 27-gauge Whitacre needle. One hundred sixty-eight patients (56 per group) were enrolled. Paresthesia occurred most often in group 3 (P = .009). We observed no differences in blood pressure after patients moved from decubitus position to the assigned position. Nor did we observe between-group differences in blood pressure according to position taken during puncture. Puncture undertaken with the patient seated, heels on the table and knees slightly bent, is associated with a lower incidence of paresthesia than puncture performed with the patient seated, legs hanging from the table. Placing the patient's heels on the table requires hip flexion and leads to anterior displacement of nerve roots in the dural sac. Such displacement would increase the nerve-free zone on the posterior side of the sac, thereby decreasing the likelihood of paresthesia during lumbar puncture. A left lateral decubitus position would increase the likelihood of paresthesia, possibly because the anesthetist may inadvertently not follow the medial line when inserting the needle.

Non-invasive ventilation in HIV positive patients with sepsis and ...

African Journals Online (AJOL)

Method: We conducted an observational prospective cohort study for the NIV arm (in the first half of 2016) with a retrospective chart review for the controls that focused on HIV positive patients with sepsis and hypoxaemic respiratory failure. 77 consecutive HIV positive patients with sepsis and respiratory distress meeting the ...

Study on effectiveness of transfusion program in thalassemia major patients receiving multiple blood transfusions at a transfusion centre in Western India

Directory of Open Access Journals (Sweden)

Shah Neeraj

2010-01-01

Full Text Available Background : Children suffering from beta-thalassemia major require repeated blood transfusions which may be associated with dangers like iron overload and contraction of infections such as HIV, HCV, and HBsAg which ultimately curtail their life span. On the other hand, inadequate transfusions lead to severe anemia and general fatigue and debility. Materials and Methods: Data were obtained from 142 beta-thalassemia major patients aged 3 years or more receiving regular blood transfusions at a transfusion centre in Western India from 1 April 2009 to 30 June 2009. The clinical data and laboratory results were subsequently analyzed. Results: Of the 142 patients, 76 (53.5% were undertransfused (mean Hb <10 gm%. 96 (67% of the patients were taking some form of chelation therapy but out of them only 2 (2% were adequately chelated (S. ferritin <1000 ng/ml. 5 (3.5% of the patients were known diabetics on insulin therapy. 103 (72% of the patients were retarded in terms of growth. The prevalence of transfusion-transmitted infections (TTIs such as HCV, HIV, and HBsAg was respectively 45%, 2%, and 2%, with the prevalence of HCV being significantly more than the general population. The HCV prevalence showed positive correlation with the age of the patients and with the total no of blood transfusions received. As many as 15% (6 out of 40 children who were born on or after 2002 were HCV positive despite the blood they received being subjected to screening for HCV. Conclusions: The study suggests the need to step up the transfusions to achieve hemoglobin goal of 10 gm% (as per the moderate transfusion regimen and also to institute urgent and effective chelation measures with the aim of keeping serum ferritin levels below 1000 ng/ml to avoid the systemic effects of iron overload. In addition, strict monitoring of the children for endocrinopathy and other systemic effects of iron overload should be done. Rigid implementation of quality control measures for the

X-ray radiography equipment for patients in standing position

International Nuclear Information System (INIS)

Snijder, J.G.N.

1974-01-01

X-ray radiography equipment suited for patients in standing position is described. The patient's body centre of mass is indicated by its vertical projection line appearing on the X-ray image. To that end, an X-ray absorbing wire is positioned through the centre of mass by means of an electrical signal acting on a servomotor and derived from the pressure on three non-colinear points in the foot plate through an analogue computer

Construction and immunological evaluation of truncated hepatitis B core particles carrying HBsAg amino acids 119–152 in the major immunodominant region (MIR)

Energy Technology Data Exchange (ETDEWEB)

Su, Qiudong; Yi, Yao [National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Changbai Road 155, Changping District, Beijing 102206 (China); Guo, Minzhuo [Beijing Entry-Exit Inspection and Quarantine Beureau, Tianshuiyuan Lane 6, Chaoyang District, Beijing 100026 (China); Qiu, Feng; Jia, Zhiyuan; Lu, Xuexin; Meng, Qingling [National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Changbai Road 155, Changping District, Beijing 102206 (China); Bi, Shengli, E-mail: shengli_bi@163.com [National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Changbai Road 155, Changping District, Beijing 102206 (China)

2013-09-13

Highlights: •The conformational HBV neutralization antigen domain was successfully displayed on the surface of truncated HBc particles. •Appropriate dialysis procedures to support the renaturing environment for the protein refolding. •Efficient purification procedures to obtain high purity and icosahedral particles of mosaic HBV antigen. •Strong immune responses not only including neutralization antibody response but also Th1 cell response were induced in mice. -- Abstract: Hepatitis B capsid protein expressed in Escherichia coli can reassemble into icosahedral particles, which could strongly enhance the immunogenicity of foreign epitopes, especially those inserted into its major immunodominant region. Herein, we inserted the entire ‘α’ antigenic determinant amino acids (aa) 119–152 of HBsAg into the truncated HBc (aa 1–144), between Asp{sup 78} and Pro{sup 79}. Prokaryotic expression showed that the mosaic HBc was mainly in the form of inclusion bodies. After denaturation with urea, it was dialyzed progressively for protein renaturation. We observed that before and after renaturation, mosaic HBc was antigenic as determined by HBsAg ELISA and a lot of viruslike particles were observed after renaturation. Thus, we further purified the mosaic viruslike particles by (NH{sub 4}){sub 2}SO{sub 4} precipitation, DEAE chromatography, and Sepharose 4FF chromatography. Negative staining electron microscopy demonstrated the morphology of the viruslike particles. Immunization of Balb/c mice with mosaic particles induced the production of anti-HBs antibody and Th1 cell immune response supported by ELISPOT and CD4/CD8 proportions assay. In conclusion, we constructed mosaic hepatitis core particles displaying the entire ‘α’ antigenic determinant on the surface and laid a foundation for researching therapeutic hepatits B vaccines.

Why HIV Positive Patients on Antiretroviral Treatment and/or ...

African Journals Online (AJOL)

Why HIV Positive Patients on Antiretroviral Treatment and/or Cotrimoxazole Prophylaxis Use Traditional Medicine: Perceptions of Health Workers, Traditional Healers and Patients: A Study in Two Provinces of South Africa.

The Universal Patient Centredness Questionnaire: scaling approaches to reduce positive skew

Directory of Open Access Journals (Sweden)

Bjertnaes O

2016-11-01

Full Text Available Oyvind Bjertnaes, Hilde Hestad Iversen, Andrew M Garratt Unit for Patient-Reported Quality, Norwegian Institute of Public Health, Oslo, Norway Purpose: Surveys of patients’ experiences typically show results that are indicative of positive experiences. Unbalanced response scales have reduced positive skew for responses to items within the Universal Patient Centeredness Questionnaire (UPC-Q. The objective of this study was to compare the unbalanced response scale with another unbalanced approach to scaling to assess whether the positive skew might be further reduced. Patients and methods: The UPC-Q was included in a patient experience survey conducted at the ward level at six hospitals in Norway in 2015. The postal survey included two reminders to nonrespondents. For patients in the first month of inclusion, UPC-Q items had standard scaling: poor, fairly good, good, very good, and excellent. For patients in the second month, the scaling was more positive: poor, good, very good, exceptionally good, and excellent. The effect of scaling on UPC-Q scores was tested with independent samples t-tests and multilevel linear regression analysis, the latter controlling for the hierarchical structure of data and known predictors of patient-reported experiences. Results: The response rate was 54.6% (n=4,970. Significantly lower scores were found for all items of the more positively worded scale: UPC-Q total score difference was 7.9 (P<0.001, on a scale from 0 to 100 where 100 is the best possible score. Differences between the four items of the UPC-Q ranged from 7.1 (P<0.001 to 10.4 (P<0.001. Multivariate multilevel regression analysis confirmed the difference between the response groups, after controlling for other background variables; UPC-Q total score difference estimate was 8.3 (P<0.001. Conclusion: The more positively worded scaling significantly lowered the mean scores, potentially increasing the sensitivity of the UPC-Q to identify differences over

CLINICOPATHOLOGICAL FACTORS ASSOCIATED WITH POSITIVE PREOPERATIVE AXILLARY ULTRASOUND SCANNING IN BREAST CANCER PATIENTS

Directory of Open Access Journals (Sweden)

Lona Jalini

2016-01-01

Full Text Available Background: Axillary lymph node status is the most important breast cancer prognostic factor. Preoperative axillary ultrasound examination (PAUS is used to triage patients for sentinel lymph node biopsy (SLNB or axillary lymph node dissection (ALND. We assessed the detection rate of lymph node metastases by PAUS in a screening unit and evaluated associations between clinicopathological factors and PAUS positivity. Patients and Methods: This was a single-centre retrospective analysis of data extracted from a hospital breast cancer database and clinical records. Clinical, radiological, and pathological and prognostic indices were compared between PAUS-positive and PAUS-negative patients subsequently found to have lymph node metastases on histopathological analysis. Results: Two hundred and two patients were eligible for analysis. 50.5% of lymph node-positive patients were correctly identified as PAUS positive. Patients with PAUS-positive lymph nodes had less favorable disease characteristics, namely clinically palpable lymph nodes, higher Nottingham prognostic (NPI index, high lymph node burden according to the European Society of Medical Oncology (ESMO group classification, and larger, grade 3 tumors with lymphovascular invasion and extranodal spread. Moreover, PAUS-positive patients had more macrometastases and lymph node involvement than PAUS-negative patients. Conclusion: PAUS-positive patients and PAUS-negative (SLNB-positive patients have different clinicopathological characteristics. The presence of LVI, extranodal spread, grade 3 histology, or large tumors with poor prognostic indices in PAUS-negative patients should be regarded with caution and perhaps prompt second-look ultrasound examination.

Family correlates of depression among hiv positive patients ...

African Journals Online (AJOL)

Background information: HIV infection may impact negatively on family relationship and vice versa. Members of the family of HIV positive patients may become frustrated because of the stigma of having a family member with HIV infection, and the burden of having to care for the patient. This can result into the family ...

Positive Predictive Value of True Bacteremia according to the Number of Positive Culture Sets in Adult Patients.

Science.gov (United States)

Kitaura, Tsuyoshi; Chikumi, Hiroki; Fujiwara, Hiromitsu; Okada, Kensaku; Hayabuchi, Tatsuya; Nakamoto, Masaki; Takata, Miyako; Yamasaki, Akira; Igishi, Tadashi; Burioka, Naoto; Shimizu, Eiji

2014-12-01

Performing multiple blood culture sets simultaneously is a standard blood culture methodology, although it is often difficult to distinguish true bacteremia from contamination when only one of several blood culture sets is positive. This study clarified the relationship between the number of positive blood culture sets and clinical significance in patients with positive blood culture. Patients aged 18 years and over with at least 1 positive blood culture were enrolled. Positive blood culture episodes were categorized from clinical records as true bacteremia, contamination, or unknown clinical significance. The associations among episodes of true bacteremia, isolated bacteria, the number of positive blood culture sets from among the performed sets, and the clinical background of patients were analyzed. Among a total of 407 episodes, 262, 67 and 78 were true bacteremia, contamination and unknown clinical significance, respectively. The positive predictive values (PPVs) of 1 out of 1, 1 out of 2 and 2 out of 2 positive sets in cases of Staphylococcus aureus, were 81.3%, 50% and 100% respectively; those in cases of coagulase-negative Staphylococci were 20.5%, 10.8% and 63.5%, respectively. Almost all cases of Escherichia coli, Pseudomonas aeruginosa, Klebsiella species and Candida species were true bacteremia. The probability of true bacteremia was strongly associated with recent surgery in multivariate analysis (P sets from among the performed sets varies by microorganism. Therefore, PPVs calculated using this method may help physicians distinguish true bacteremia from contamination.

Delay in treatment seeking of smear positive tuberculous patients

International Nuclear Information System (INIS)

Bhatti, A.T.; Zahid, M.

2010-01-01

To assess and identify the causes and circumstances leading to delays in health seeking and diagnosis of tuberculosis patients as they often present with advance disease resulting in increased morbidity and mortality. Settings Department of Tuberculosis, DOTS clinic DHQ Hospital, Vehari. Methodology One (author) inspiration diagnosed smear positive pulmonary tuberculosis patients were included. Information was gathered through interviews and from TB-01 card. Results Maximum patients were in age group of 16-40 years. Median patient delay was 4-6 months; jobless, homeless personnel had longer delay. The main reason for delay was that the symptoms were not considered serious enough. Delay in presentation of smear positive cases may be due to the lack of awareness of patients and the incompetence of some health workers. Training and supervision of staff and awareness campaigns targeted at the population and involvement of private sector will improve TB control in Vehari. (author)

Comparison between Human Immunodeficiency Virus Positive and Negative Patients with Tuberculosis in Southern Brazil

Directory of Open Access Journals (Sweden)

Lucélia Henn

1999-05-01

Full Text Available The objective of this study is to determine the different characteristics of human immunodeficiency virus (HIV positive and negative patients treated for tuberculosis (TBC in a tertiary hospital in Southern Brazil. We conducted a retrospective cohort study over a 5-year period, from January 1992 through December 1996. We reviewed medical charts of patients from our institution who received TBC treatment. We reviewed 167 medical charts of patients with confirmed TBC. HIV positivity was detected in 74 patients. There were statistically significant difference between HIV positive and negative patients in sex and age. HIV-infected patients showed significantly more signs of bacteremia than HIV-negative patients. Extra-pulmonary TBC was present respectively in 13 (17.6% and 21 (22.6% HIV positive and negative patients. There was a significant difference between chest radiograph presentation in HIV positive and negative patients. There were significantly lower hematocrit, hemoglobin, leukocyte and lymphocyte levels in HIV-positive compared to HIV-negative patients. Outcome was significantly different in the two groups with a death rate of 36.5% and 10.8% in HIV-positive and in HIV-negative patients. The difference between HIV positive and negative patients may have importance in the diagnosis, management and prognosis of patients with TBC.

Natural Killer Cell Characteristics in Patients With Chronic Hepatitis B Virus (HBV) Infection Are Associated With HBV Surface Antigen Clearance After Combination Treatment With Pegylated Interferon Alfa-2a and Adefovir

NARCIS (Netherlands)

Stelma, Femke; de Niet, Annikki; Tempelmans Plat-Sinnige, Marjan J.; Jansen, Louis; Takkenberg, R. Bart; Reesink, Hendrik W.; Kootstra, Neeltje A.; van Leeuwen, Ester M. M.

2015-01-01

The role of natural killer (NK) cells in the process of hepatitis B virus (HBV) surface antigen (HBsAg) clearance and whether their phenotype is related to treatment outcome in patients with chronic hepatitis B are currently unknown. Patients with chronic hepatitis B (HBV DNA load, >17 000 IU/mL)

Clinical performance of a new hepatitis B surface antigen quantitative assay with automatic dilution

Directory of Open Access Journals (Sweden)

Ta-Wei Liu

2015-01-01

Full Text Available Hepatitis B virus surface antigen (HBsAg levels reflect disease status and can predict the clinical response to antiviral treatment; however, the emergence of HBsAg mutant strains has become a challenge. The Abbott HBsAg quantification assay provides enhanced detection of HBsAg and HBsAg mutants. We aimed to evaluate the performance of the Abbott HBsAg quantification assay with automatic sample dilutions (shortened as automatic Architect assay, compared with the Abbott HBsAg quantification assay with manual sample dilutions (shortened as manual Architect assay and the Roche HBsAg quantification assay with automatic sample dilutions (shortened as Elecsys. A total of 130 sera samples obtained from 87 hepatitis B virus (HBV-infected patients were collected to assess the correlation between the automatic and manual Architect assays. Among the 87 patients, 41 provided 42 sera samples to confirm the linearity and reproducibility of the automatic Architect assay, and find out the correlation among the Elecsys and two Architect assays. The coefficients of variation (0.44–9.53% and R2 = 0.996–1, which were both determined using values obtained from the automatic Architect assay, showed good reproducibility and linearity. Results of the two Architect assays demonstrated a feasible correlation (n = 130 samples; R = 0.898, p  0.93 in all cases. In conclusion, the correlation between the automatic and manual dilution Architect assays was feasible, particularly in the HBeAg-negative and low DNA groups. With lower labor costs and less human error than the manual version, the Abbott automatic dilution Architect assay provided a good clinical performance with regard to the HBsAg levels.

Evaluation of vaccination efficiency against HBV among Syrian multitransfused patients.

Science.gov (United States)

Yazji, Wadad; Habal, Wafaa; Menem, Fawza

2018-03-05

This cross-sectional study estimates HBV prevalence and evaluates vaccination efficiency among multitransfused patients. 159 patients with various hemoglobinopathies were tested for HBsAg, anti-HBs, and anti-HBc, using enzyme-linked immunosorbent assay (ELISA). The serological results were then compared with the relevant documentation in medical records. Seropositivity of HBV was detected in 1/8 of recruited patients. Serological immunity was found in only half of patients, while the other half were either infected or non-immune. The vaccination against HBV appeared inefficient in almost half of vaccinated patients and was not documented in the medical records of 1/6 of patients. Thus, multitransfused patients are at risk of acquiring hepatitis B infection. Applying prophylactic vaccination, documenting vaccine doses, and monitoring immune response are highly recommended.

Treating depression in HIV-positive patients affects adherence

Directory of Open Access Journals (Sweden)

M Y H Moosa

2012-08-01

Full Text Available Aim. To determine changes in adherence to antiretroviral therapy (ART in HIV-positive patients with depression, following treatment with an antidepressant or psychotherapy. Methods. The study was prospective, randomised and controlled. Consenting volunteers aged ≥18 years and stable on ART for ≥6 months were included in the study. Sociodemographic data were obtained, and a clinical diagnostic evaluation and the Hamilton Depression rating scale (HAMD were performed on all subjects at entry to and at the end of the study. Participants found to be depressed were randomly assigned antidepressant treatment (20 mg citalopram or interpersonal psychotherapy (IPT (5 sessions. Medication was dispensed at each visit and patients were asked to return all unused medication to determine ART adherence. The study was approved by the University of the Witwatersrand. Results. Sixty-two HIV-positive persons receiving ART participated; 30 were not depressed (control group and 32 were depressed (patient group. No significant differences in demographic characteristics existed between the control and patient groups. Mean ART adherence at the start of the study was 99.5% (standard error (SE ±0.46 and 92.1% (SE ±1.69 in the control and patients groups, respectively. Mean ART adherence at the end of the study changed marginally in the control group (99.7%; SE ±0.46 and increased significantly in the patient group (99.5%; SE± 0.13 (p>0.05. The mean ART adherence rate of patients who received pharmacotherapy increased from 92.8% to 99.5%, and of those who received psychotherapy increased from 91.1% to 99.6% (p>0.05. There was no significant association between the increased adherence in the patient group and baseline demographic and clinical characteristics, irrespective of antidepressant therapy or IPT (p>0.05. Conclusion. Successful treatment of depression with an antidepressant or psychotherapy was associated with improved ART adherence, independent of the type

Technical study of craniospinal irradiation in pediatric patients with patient position and field matching

Energy Technology Data Exchange (ETDEWEB)

Itoh, Masanori; Ise, Toshihide; Umezu, Mikio [Kangawa Children' s Medical Center, Yokohama (Japan); Hioki, Minoru

2000-05-01

Craniospinal irradiation (CSI) in leukemia and medulloblastoma patients is usually a three-field technique that involves parallel-opposed lateral cranial fields adjacent and orthogonal to a posterior spinal field. Since sedation is often necessary for pediatric patients, the supine position is more favorable than the prone position for respiratory monitoring. We practiced CSI in the supine position in one case of leukemia and three cases of medulloblastoma. Each location of the isocenter was determined by moving the couch to fit the center of the CSI on the basis of incisura intertragica. The angles of collimator rotation and couch rotation were calculated according to each treatment field size. The junction was also moved 2 cm day by day during the course of treatment so that over- and underdose at the junction would be prevented. The supine position did not allow us to visually confirm the proper junction between the lateral cranial fields and the spinal field. However, we succeeded in practicing complete conjunction between the fields by proper collimator and couch rotations on the assessment of the film-dose method. CSI in the supine position is naturally comfortable for pediatric patients and seems effective in pediatric treatments, which often require respiratory monitoring for sedation. (author)

Patient positioning and its influence on dose distribution

International Nuclear Information System (INIS)

Morrissey, J.; Moss, R.; Watkins, P.

2000-01-01

In comparison to conventional radiotherapy, the positioning of a patient for BNCT treatment has some unique aspects. In particular, the neutron beam coming from the core of a nuclear research reactor is fixed and horizontal. In particular, a head fixation mask, which is prepared at the patient referral hospital, is included in the CT images. The mask allows reproducible positioning for use during the treatment. Fiducial markers placed on the mask before imaging, provide reference points. The INEEL treatment planning code used in Petten produces a beam angle, and beam line entrance and exit co-ordinates. These are related to the fiducial marker co-ordinates. A spreadsheet, named COSINE, developed at Petten produces positioning co-ordinates from the data produced by the rtt MC code. These co-ordinates are related to a positioning frame, which allows the marking of the beams on the mask. In order to have reliable treatment data, the influence of small deviations of angle or target point on dose distribution must be known. To demonstrate this, a number of beams have been calculated with the Petten beam, with slight variations and compared with an approved plan. (author)

Using the prone position for ventilated patients with respiratory failure: a review.

Science.gov (United States)

Wright, Angie D; Flynn, Maria

2011-01-01

this review explored the evidence relating to prone positioning in ventilated patients diagnosed with respiratory failure, including acute lung injury (ALI) or adult respiratory distress syndrome (ARDS). mortality rates for ventilated patients with ALI or ARDS are high, and there is a growing body of evidence suggesting that the position these patients are nursed in may influence clinical outcomes. However, there are no guidelines to inform nursing practice in positioning these patients. Medline, Scopus, Cinahl and the Cochrane Library databases were searched for original research reports or systematic reviews of evidence between 2000 and 2009. Reference lists of retrieved papers were hand searched and included studies were analysed using the Critical Appraisal and Skills Programme framework. A narrative data synthesis considered the strengths and limitations of studies, and findings were collated and interpreted. Application of the search strategy identified a systematic review, currently underway, which has not yet reported and 14 relevant studies eligible for inclusion in this review. Analysis showed considerable variation in study design, but suggests that PaO(2) /FiO(2) ratio, incidence of VAP and mortality may be positively affected by prone positioning. evidence of the clinical benefits associated with prone positioning is inconclusive and provides little guidance for nursing practice. There is a need for further research into the clinical outcomes of prone positioning, and greater understanding of the practicalities of prone positioning critically ill patients is required. nurses have a central role to play in the continual assessment and management of this patient group, including the position they are nursed in, not only to ensure the best clinical outcomes but also to provide care and comfort to the patient and their family. It is therefore important that their nursing practice and interventions are informed by the best available evidence.

Is seroprevalence of hepatitis B and C among blood donors changing in Northern Pakistan?

International Nuclear Information System (INIS)

Butt, T.; But, B.

2017-01-01

Objective: To determine seroprevalence of hepatitis B and C among blood donors in 2009 and comparing with the seroprevalence in 2014. Study Design: Cross sectional study with retrospective data collection. Place and Duration of Study: Foundation University Medical College and Fauji Foundation Hospital, Rawalpindi. Data in 2009 and in 2014 were collected. Material and Methods: The blood samples collected from individuals from Province of Khyber Pakhtunkhawa, Azad Kashmir and Northern Punjab including Rawalpindi-Islamabad and comprised 3776 (in the year 2009) and 6740 (in the year 2014) adults ranging from 18 to 60 years who reported to Fauji Foundation Hospital, Rawalpindi voluntarily or as a compulsion to donate blood for their patients. Results: During 2009, there were 71 (1.88 percent) and 113 (2.99 percent) donors positive for hepatitis B surface antigen (HBsAg) and anti hepatitis C virus (Anti HCV) respectively out of a total of 3776 donors whereas during 2014 there were 106 (1.57 percent) and 174 (2.58 percent) donors positive for HBsAg and anti HCV respectively out of a total donors of 6740. There was no statistical significant difference between the year (2009 and 2014) and seroprevalence of HBsAg (p=0.239) and HCV positive donors (p=0.215). Conclusion: There is no significant change in seroprevalence of hepatitis B and C among blood donors during 2014 as compared to 2009 in Northern Pakistan. (author)

Predicting Likelihood of Having Four or More Positive Nodes in Patient With Sentinel Lymph Node-Positive Breast Cancer: A Nomogram Validation Study

International Nuclear Information System (INIS)

Unal, Bulent; Gur, Akif Serhat; Beriwal, Sushil; Tang Gong; Johnson, Ronald; Ahrendt, Gretchen; Bonaventura, Marguerite; Soran, Atilla

2009-01-01

Purpose: Katz suggested a nomogram for predicting having four or more positive nodes in sentinel lymph node (SLN)-positive breast cancer patients. The findings from this formula might influence adjuvant radiotherapy decisions. Our goal was to validate the accuracy of the Katz nomogram. Methods and Materials: We reviewed the records of 309 patients with breast cancer who had undergone completion axillary lymph node dissection. The factors associated with the likelihood of having four or more positive axillary nodes were evaluated in patients with one to three positive SLNs. The nomogram developed by Katz was applied to our data set. The area under the curve of the corresponding receiver operating characteristics curve was calculated for the nomogram. Results: Of the 309 patients, 80 (25.9%) had four or more positive axillary lymph nodes. On multivariate analysis, the number of positive SLNs (p < .0001), overall metastasis size (p = .019), primary tumor size (p = .0001), and extracapsular extension (p = .01) were significant factors predicting for four or more positive nodes. For patients with <5% probability, 90.3% had fewer than four positive nodes and 9.7% had four or more positive nodes. The negative predictive value was 91.7%, and sensitivity was 80%. The nomogram was accurate and discriminating (area under the curve, .801). Conclusion: The probability of four or more involved nodes is significantly greater in patients who have an increased number of positive SLNs, increased overall metastasis size, increased tumor size, and extracapsular extension. The Katz nomogram was validated in our patients. This nomogram will be helpful to clinicians making adjuvant treatment recommendations to their patients.

Side effects after myelography with Dimer Xsup(R) (Iocarmat) with subsequent positioning of the patients in the sitting or lying position

International Nuclear Information System (INIS)

Norstedt, M.

1982-01-01

92 patients were examined after lumbar myelography with the water-soluble contrast medium Iocarmat (Dimer Xsup(R)) in order to find out if side effects have any relation with the patient's position after the myelographic examination. In one group, the patients were laid with their upper part of the body positioned higher while the others were allowed to lie flat. The comparative investigation covering both groups of patients revealed the following results: 1) In 11% of the flat-lying patients there were generalised spasms which was not the case as far as the sitting patients were concerned. This is why the author advises against a flat positioning of the patient. 2) The frequency of headache decreased when the patients were lying flat which, however, does not mean a statistical significance. 3) Other side effects registered (myoclonus, tonic spasm in the legs, paraesthesia, increase in existing root pain and neck pain, nausea and vomiting) occurred in both groups nearly to the same extent, independently of the position of the patient. (orig./MG) [de

Is there a positive bias in false recognition? Evidence from confabulating amnesia patients.

Science.gov (United States)

Alkathiri, Nura H; Morris, Robin G; Kopelman, Michael D

2015-10-01

Although there is some evidence for a positive emotional bias in the content of confabulations in brain damaged patients, findings have been inconsistent. The present study used the semantic-associates procedure to induce false recall and false recognition in order to examine whether a positive bias would be found in confabulating amnesic patients, relative to non-confabulating amnesic patients and healthy controls. Lists of positive, negative and neutral words were presented in order to induce false recall or false recognition of non-presented (but semantically associated) words. The latter were termed 'critical intrusions'. Thirteen confabulating amnesic patients, 13 non-confabulating amnesic patients and 13 healthy controls were investigated. Confabulating patients falsely recognised a higher proportion of positive (but unrelated) words, compared with non-confabulating patients and healthy controls. No differences were found for recall memory. Signal detection analysis, however, indicated that the positive bias for false recognition memory might reflect weaker memory in the confabulating amnesic group. This suggested that amnesia patients with weaker memory are more likely to confabulate and the content of these confabulations are more likely to be positive. Copyright © 2015 Elsevier Ltd. All rights reserved.

Mixing of multi-modal images for conformational radiotherapy: application to patient re positioning

International Nuclear Information System (INIS)

Vassal, P.

1998-01-01

This study shows a procedure of patient re positioning by comparative evaluation between the position of the patient and the theoretical expected position of the patient; the stagger between the two information gives the error of installation in translation and rotation. A correction is calculated and applied to the treatment environment (position and orientation of the patient, position and orientation of the irradiation source). The control system allows to determine the precise position of the tumor volume. The echography allows to determine the position of an organ.The surface captor is used to localize the tumors of the face or of the brain, with the respect to the face, the acquisition and the treatment of information take only few minutes. The X rays imager is applied for the localization of bones structures. (N.C.)

Illness Representations of HIV Positive Patients Are Associated with Virologic Success.

Science.gov (United States)

Leone, Daniela; Borghi, Lidia; Lamiani, Giulia; Barlascini, Luca; Bini, Teresa; d'Arminio Monforte, Antonella; Vegni, Elena

2016-01-01

Introduction: It is important for HIV positive patients to be engaged in their care and be adherent to treatment in order to reduce disease progression and mortality. Studies found that illness representations influence adherence through the mediating role of coping behaviors. However, no study has ever tested if patient engagement to the visits mediate the relationship between illness perceptions and adherence. This study aimed to explore illness representations of HIV positive patients and test the hypothesis that illness representations predict adherence through the mediating role of a component of behavioral engagement. Methods: HIV-positive patients treated with highly active antiretroviral therapy (HAART) for at least one year and presenting to a check-up visit were eligible to participate in the study. Patients completed the Illness Perception Questionnaire-Revised. Behavioral engagement was measured based on the patients' clinical attendance to the check-up visits; adherence to HAART was measured by viral load. Undetectable viral load or HIV-RNA perception that the disease does not have serious consequences on patient's life and the prevalence of negative emotions toward HIV were associated with virologic success. On the contrary, the patient's perception that the disease has serious consequences on his/her life and the prevalence of positive emotions were associated with virologic failure. This model showed good fit indexes (CFI = 1; TLI = 1; RMSEA = 0.00; and WRMSR = 0.309). Discussion: Results do not support the mediating role of behavioral engagement in the relationship between illness representations and adherence. As perception of serious consequences coupled with positive emotions are directly associated with virologic failure, clinicians should take them into account to promote treatment adherence.

Peg-interferon plus nucleotide analogue treatment versus no treatment in patients with chronic hepatitis B with a low viral load: a randomised controlled, open-label trial

NARCIS (Netherlands)

de Niet, Annikki; Jansen, Louis; Stelma, Femke; Willemse, Sophie B.; Kuiken, Sjoerd D.; Weijer, Sebastiaan; van Nieuwkerk, Carin M. J.; Zaaijer, Hans L.; Molenkamp, Richard; Takkenberg, R. Bart; Koot, Maarten; Verheij, Joanne; Beuers, Ulrich; Reesink, Hendrik W.

2017-01-01

Antiviral treatment is currently not recommended for patients with chronic hepatitis B with a low viral load. However, they might benefit from acquiring a functional cure (hepatitis B surface antigen [HBsAg] loss with or without formation of antibodies against hepatitis B surface antigen

Reversible Thrombocytopenia after Gabapentin in an HIV-Positive Patient

Directory of Open Access Journals (Sweden)

Mohammed Basith

2018-01-01

Full Text Available Gabapentin has become increasingly used in psychiatric practice specifically for anxiety disorders. Even though gabapentin is not approved by the US Food and Drug Administration to treat anxiety, physicians sometimes use it as an alternative to benzodiazepines in patients with a history of substance abuse. Gabapentin is also prescribed when individuals are at risk of thrombocytopenia which is not considered a side effect. Among patients at risk of thrombocytopenia are those positive for human immunodeficiency virus (HIV. Here we present a case of an HIV-positive man who presented for inpatient psychiatric care with severe anxiety and a history of alcohol and benzodiazepine abuse. In this patient, gabapentin worsened thrombocytopenia after repeated exposure to this medication. We suggest caution when considering gabapentin for patients with preexisting low platelet counts, as there seems to be a risk for worsening thrombocytopenia with this antiepileptic in the presence of HIV infection.

Prevalence of positive ppd in a cohort of rheumatoid arthritis patients.

Science.gov (United States)

Tamborenea, Maria Natalia; Tate, Guillermo; Mysler, Eduardo; Debonis, Jose; Schijedman, Adrian

2010-03-01

The main objective of this study is to determine the prevalence of positive and anergic tuberculin skin test (ppd) in a rheumatoid arthritis cohort of patients (RA) and assess the association among ppd results and clinical and treatment variables. Patients with RA diagnosis were included. The ppd was done by Mantoux method. Positive result was considered when indurations were equal or greater than 5 mm. Anergic reaction was defined when the indurations was 0 mm. We included 105 patients (N = 105). The prevalence of positive ppd was 12.4% (n = 13), while the 87.6% (n = 92) presented a negative result. The 69.5% (n = 73) of the population were anergic to ppd. Patients with negative result received higher steroids dosages than patients with positive ppd (p ppd (p = 0.021, OR 0.72, 95% CI 0.55-0.95). Anergic and non-anergic patients were separated in groups, and a new analysis was done. The higher dosage of methotrexate was associated to tuberculine anergy (p = 0.025). In the multivariable model, the methotrexate dosage was a significant and independent predictor of tuberculine anergy (p = 0.005, OR 1.14, 95% CIs 1.04-1.24). In conclusion, in our cohort, the prevalence of positive ppd was lower than others studies. Among analyzed variables, the high steroid dose was a significant and independent predictor of negative ppd. The methotrexate treatment and dose were associated with ppd anergy.

Prediction value of serum HBV large surface protein in different phases of HBV infection and virological response of chronic hepatitis B patients.

Science.gov (United States)

Liu, Can; Wu, Wennan; Shang, Hongyan; Lin, Sheng; Xun, Zhen; Huang, Er; Lin, Jinpiao; Yang, Bin; Ou, Qishui

2018-06-01

Serum HBV large surface protein (HBV-LP) is an envelope protein that has a close relationship with HBV DNA level. This study is to explore the prediction value of HBV-LP in different phase of HBV infection and during antiviral therapy in chronic hepatitis B (CHB) patients. A retrospective study was conducted in 2033 individuals, which included 1677 HBV infected patients in different phases and 356 healthy controls. HBV-LP, HBV serum markers and HBV DNA were detected by ELISA, CMIA and qRT-PCR, respectively. 85 CHB patients receiving PegIFNα or ETV were divided into virological response (VR) and partial virological response (PVR). The dynamic changes of HBV DNA and HBV-LP were observed. The level of HBV-LP in 2033 individuals was shown as: HBeAg-positive hepatitis > HBeAg-positive infection > HBeAg-negative hepatitis > HBeAg-negative infection > healthy controls. HBV-LP was positive in all patients whose HBV DNA > 1.0E + 06 IU/ml. When HBsAg was 1000 IU/ml, HBV DNAs were all negative if HBV-LP HBV-LP with HBV DNA was 100% in case of HBV-LP > 4.0 S/CO in HBeAg-positive patients and HBV-LP > 2.0 S/CO in HBeAg-negative ones. During antiviral therapy, baseline HBV-LP was lower in VR patients than that in PVR patients. The optimal cut-off points to predict VR by baseline HBV-LP were 32.4 and 28.6 S/CO for HBeAg-positive and HBeAg-negative hepatitis patients, respectively. HBV-LP may be a useful marker for distinguishing the different phases of HBV infection. Moreover, baseline HBV-LP level can be used for predicting VR of CHB patients. Copyright © 2018 Elsevier B.V. All rights reserved.

Gastrointestinal diseases in HIV-positive patients: ultrasonography and computed tomography in a study of 85 patients

International Nuclear Information System (INIS)

Garcia, S.; Yague, D.; Garcia, C.; Villalon, M.; Pascual, A.; Artigas, J.M.

1998-01-01

Gastrointestinal diseases constitute the second most common group conditions affecting HIV-positive patients after respiratory diseases. Gastrointestinal involvement may even be the first sign of the disease, a facto which demonstrates the importance of its proper assessment. To demonstrate the utility of computed tomography and ultrasound in the study of gastrointestinal and hepatobiliary diseases in the HIV-positive patient. We review a series of 85 HIV-positive patients presenting gastrointestinal symptomatology who underwent ultrasonography and/or computed tomography. the definitive diagnosis was achieved in all the patients by microbiological or histopathological means. In our series 36.4% the patients had presented systemic TB, 23.52% CMV infection, 17.64% Cryptosporidium infection and 17.64% MAI infection. Much lower incidences were found for Mycobacterium xenopi. M. kansai and Leishmania infection. The presence of lymphoma was confirmed in 7.05% of the patients and Koposi's sarcoma in 0.95%. In these patients, the most common finding on imaging studies in lymph node involvement, followed by diffuse hepatosplenomegaly. Imaging techniques, especially ultrasonography and computed tomography, are useful in these patients: although they do not provide the diagnosis, they do contribute data of prognostic and therapeutic importance. (Author) 11 refs

INTRACRANIAL MASS LESIONS IN HIV-POSITIVE PATIENTS ...

African Journals Online (AJOL)

'encephalitis of obscure origin', brain abscess and tuberculoma / mycobacterial ... Studies of IML in HN-positive patients emanate primarily from the ... Fig. 3. Mass on this CT scan found to be due to toxoplasmosis. Table H. Histological findings in the operated cases. Total biopsied/operated. 38'. Diagnosis. 0. Toxoplasmosis.

The relationship between skin manifestations and CD4 counts among hiv positive patients

International Nuclear Information System (INIS)

Rad, F.; Ghaderi, E.; Moradi, G.; Mafakheri, L.

2008-01-01

Skin manifestations are common clinical features among HIV positive patients. The aim of this study was to document skin manifestations and their relationships with CD4 cell counts among HIV positive patients in Sanandaj. This was a descriptive study. The patients were examined for skin disorders by a dermatologist and CD4 counts were obtained from the patient's medical records. Independent samples T test were used for data analysis. In this study 66 (94.3%) patients had at least one skin problem. Fungal infections were the most common cause. The eight most common types of mucocutaneous problems were gingivitis, pallor, itching, photosensitivity, seborrheic dermatitis, candidiasis, folliculitis and tinea versicolor. The most common manifestation was gingivitis. Mean CD4 cell counts were lower in individuals with viral and bacterial skin diseases (P <0.05). The results of this study indicated that skin problems were common among HIV positive patients. Patients with advanced stages of skin disorders had relatively lower CD4 counts. Therefore examination of skin is recommended for all HIV positive patients for early detection of skin disorders, as early diagnosis and management of dermatologic problems will improve the quality of life in HIV positive patients. (author)

An electromechanical, patient positioning system for head and neck radiotherapy

Science.gov (United States)

Ostyn, Mark; Dwyer, Thomas; Miller, Matthew; King, Paden; Sacks, Rachel; Cruikshank, Ross; Rosario, Melvin; Martinez, Daniel; Kim, Siyong; Yeo, Woon-Hong

2017-09-01

In cancer treatment with radiation, accurate patient setup is critical for proper dose delivery. Improper arrangement can lead to disease recurrence, permanent organ damage, or lack of disease control. While current immobilization equipment often helps for patient positioning, manual adjustment is required, involving iterative, time-consuming steps. Here, we present an electromechanical robotic system for improving patient setup in radiotherapy, specifically targeting head and neck cancer. This positioning system offers six degrees of freedom for a variety of applications in radiation oncology. An analytical calculation of inverse kinematics serves as fundamental criteria to design the system. Computational mechanical modeling and experimental study of radiotherapy compatibility and x-ray-based imaging demonstrates the device feasibility and reliability to be used in radiotherapy. An absolute positioning accuracy test in a clinical treatment room supports the clinical feasibility of the system.

Liver fibrosis in treatment-naïve HIV-infected and HIV/HBV co-infected patients: Zambia and Switzerland compared.

Science.gov (United States)

Wandeler, Gilles; Mulenga, Lloyd; Vinikoor, Michael J; Kovari, Helen; Battegay, Manuel; Calmy, Alexandra; Cavassini, Matthias; Bernasconi, Enos; Schmid, Patrick; Bolton-Moore, Carolyn; Sinkala, Edford; Chi, Benjamin H; Egger, Matthias; Rauch, Andri

2016-10-01

To examine the association between hepatitis B virus (HBV) infection and liver fibrosis in HIV-infected patients in Zambia and Switzerland. HIV-infected adults starting antiretroviral therapy in two clinics in Zambia and Switzerland were included. Liver fibrosis was evaluated using the aspartate aminotransferase-to-platelet-ratio index (APRI), with a ratio >1.5 defining significant fibrosis and a ratio >2.0 indicating cirrhosis. The association between hepatitis B surface antigen (HBsAg) positivity, HBV replication, and liver fibrosis was examined using logistic regression. In Zambia, 96 (13.0%) of 739 patients were HBsAg-positive compared to 93 (4.5%) of 2058 in Switzerland. HBsAg-positive patients were more likely to have significant liver fibrosis than HBsAg-negative ones: the adjusted odds ratio (aOR) was 3.25 (95% confidence interval (CI) 1.44-7.33) in Zambia and 2.50 (95% CI 1.19-5.25) in Switzerland. Patients with a high HBV viral load (≥20000 IU/ml) were more likely to have significant liver fibrosis compared to HBsAg-negative patients or patients with an undetectable viral load: aOR 3.85 (95% CI 1.29-11.44) in Zambia and 4.20 (95% CI 1.64-10.76) in Switzerland. In both settings, male sex was a strong risk factor for significant liver fibrosis. Despite the differences in HBV natural history between Sub-Saharan Africa and Europe, the degree of liver fibrosis and the association with important risk factors were similar. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

False positive seroreactivity to brucellosis in tuberculosis patients: a prevalence study

Directory of Open Access Journals (Sweden)

Mojtaba Varshochi

2011-03-01

Full Text Available Mojtaba Varshochi1,2, Jafar Majidi2, Marjan Amini1, Kamyar Ghabili3, Mohammadali M Shoja31Department of Infectious Disease, Tabriz University of Medical Sciences, Tabriz, Iran; 2Infectious Disease and Tropical Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, IranBackground: The rising worldwide incidence of tuberculosis (TB increases the demand for knowledge about its potential seroreactivity with other microbial agents. A few reports and the authors’ experiences indicate that tuberculosis may result in a false-positive brucellosis serology. This may cause a diagnostic challenge because of the close clinical resemblance of these two infections.Objective: The aim of the present prevalence study was to elucidate brucellosis seroreactivity in patients with active TB.Methods: Ninety-eight patients with newly diagnosed and active TB were studied using an enzyme-linked immunosorbent assay (ELISA and Wright’s and Coombs–Wright’s tests. Seventy-five healthy individuals were used as controls. The patients showed signs of recovery after starting a standard anti-TB regimen and had no clinical evidence of brucellosis at a subsequent 6-month follow-up. The data were analyzed statistically by Fisher’s exact test using SPSS 11.0.Results: We found that 9.2% of TB patients versus 1.3% of healthy controls had positive results on the anti-Brucella IgG ELISA (P = 0.04. Five TB patients were found to have agglutination on Wright’s tests, while none of the controls showed agglutination.Conclusion: Active TB patients may have some seroreactivity with Brucella antigens, and Brucella IgG ELISA may give a false positive in these patients. Clinicians should consider false positive brucellosis seroreactivity in patients with active TB.Keywords: false positive serology, ELISA, diagnosis

Pregnancy in HIV-Positive Patients: Effects on Vaginal Flora

Directory of Open Access Journals (Sweden)

Cristina Vallone

2012-01-01

Full Text Available A high proportion of HIV-infected pregnant women present pathogenic organisms in their lower genital tract. This has been associated with the development of postpartum morbility, HIV transmission to the partner and offspring, and other gynaecological conditions, such as cervical dysplasia or cancer. Vaginal flora alterations can range from 47% in Western countries to 89% in Africa in pregnant HIV-positive patients, much higher than about 20% of the general population. Pathogen organism retrieval is high. As peripartum complications due to vaginal infections seem higher in HIV-positive patients, accurate investigation and treatment of such infections are strongly mandatory.

Breast Gangrene in an HIV-Positive Patient

Science.gov (United States)

Venkatramani, V; Pillai, S; Marathe, S; Rege, SA; Hardikar, JV

2009-01-01

Introduction Breast gangrene has been reported as a complication following puerperal sepsis, breast surgery, nipple piercings, warfarin toxicity, etc. We report a case of primary breast gangrene in an HIV-positive individual which, to the best of our knowledge, is the first of its kind. Case report A 40-year-old previously healthy woman presented with fulminating left breast gangrene. She was detected to be HIV positive. Mastectomy was performed. The detailed management of the condition is discussed. Conclusion Severe necrotising infections may be initial manifestations of HIV infection and patients with such infections should be screened for HIV. PMID:19622255

Factors other than hepatitis B virus responsible for hepatocellular carcinomas in lower social class

International Nuclear Information System (INIS)

Pervez, T.; Anwar, M.S.

2002-01-01

Objective: To find out the role of other etiological agents besides hepatitis B virus in the genesis of Hepatocellular carcinoma (HCC) in our social classes. Design: A hospital-based observational study. Place and Duration of Study: The study was conducted in oncology department of services Hospital, Lahore from December 1997 to February 2001. Patients and Methods: One hundred patients of hepatocellular carcinoma ware divided into three groups based on monthly income. Lower socioeconomic group had monthly income less than 3,000 Pakistani rupees. Middle socioeconomic group had monthly income between 3,000-1,000 Pakistani rupees and upper socioeconomic group heard monthly income of more than 10,000 Pakistani rupees. Percentages of HCC patients positive for HbsAg in different socioeconomic groups in our population were compared to assess the social class difference, the possibility and correlation of other factors present in our classes for the formation of hepatocellular carcinoma besides hepatitis B virus. Results: We found that there was no significant difference in HbsAg positively in different classes. Conclusion: If HBV was only responsible for this disease than there should have been consistency in the outcome. But as there is a higher prevalence of HCC in poor class, this reflects that other etiological agents are also operating. This needs further evaluation. (author)

Exploring Positive Survivorship Experiences of Indigenous Australian Cancer Patients

Science.gov (United States)

Tam, Laura; Garvey, Gail; Meiklejohn, Judith; Martin, Jennifer; Adams, Jon; Walpole, Euan; Fay, Michael; Valery, Patricia

2018-01-01

Amongst Indigenous Australians, “cancer” has negative connotations that detrimentally impact upon access to cancer care services. Barriers to accessing cancer services amongst Indigenous Australians are widely reported. In contrast, factors that facilitate this cohort to successfully navigate cancer care services (“enablers”) are scarcely reported in the literature. Through qualitative interviews, this article examines factors that assist Indigenous Australians to have positive cancer experiences. Semi-structured interviews were conducted with twelve adult Indigenous oncology patients recruited from a tertiary hospital in Queensland, Australia during 2012–2014. Data generated from the interviews were independently reviewed by two researchers via inductive thematic analytical processes. Discussions followed by consensus on the major categories allowed conclusions to be drawn on potential enablers. Two major categories of enablers were identified by the researchers: resilience and communication. Individual’s intrinsic strength, their coping strategies, and receipt of support improved participant’s resilience and consequently supported a positive experience. Communication methods and an effective patient-provider relationship facilitated positive experiences for participants. Despite potential barriers to access of care for Indigenous cancer patients, participants in the study demonstrated that it was still possible to focus on the positive aspects of their cancer experiences. Many participants explained how cancer changed their outlook on life, often for the better, with many feeling empowered as they progressed through their cancer diagnosis and treatment processes. PMID:29342934

Ocular vestibular evoked myogenic potential in patients with benign paroxysmal positional vertigo

Directory of Open Access Journals (Sweden)

Mozhgan Masoom

2014-06-01

Full Text Available Background and Aim: Since utricle is the main damaged organ in benign paroxysmal positional vertigo (BPPV, ocular vestibular evoked myogenic potential (oVEMP may be an appropriate method to evaluate the utricule dysfunction and the effect of disease recurrence rate on it. This study aimed to record myogenic potential in patients with benign paroxysmal positional vertigo.Methods: In a cross-sectional study, ocular myogenic potential was recorded in 25 healthy subjects and 20 patients with benign paroxysmal positional vertigo using 500 Hz-tone bursts (95 dB nHL.Results: In the affected ear, mean amplitude was lower and mean threshold was higher than those in the unaffected ear and in the normal group (p<0.05. Mean amplitude asymmetry ratio of patients was more than the healthy subjects (p0.05. Frequencies of abnormal responses in the affected ears were higher than in unaffected ears and in the normal group (p<0.05. Furthermore, the patients with recurrent vertigo showed more abnormalities than the patients with non-recurrent (p=0.030.Conclusion: In the recurrent benign paroxysmal positional vertigo, ocular vestibular evoked myogenic potential showed more damage in the utricle, suggesting this response could be used to evaluate the patients with benign paroxysmal positional vertigo.

Liver cancer: expression features of hepatitis B antigens

Directory of Open Access Journals (Sweden)

V. A. Tumanskiy

2013-12-01

Full Text Available Introduction. Hepatocellular carcinoma (HCC is currently the fifth most common malignancy in men and the eighth in women worldwide. According to the latest European Union countries’ statistics the incidence of HC cancer is about 8,29 per 100000 accidents, cholangiocellular (CC cancer – 0,9-1,3 per 100 thousand of population per year[10,14]. Hepatitis B virus (HBV is the major etiologic factor for the development of HCC [18]. People chronically infected with HBV are 20 times more likely to develop liver cancer than uninfected people [1,22,28]. Many studies have shown the association between Hepatitis B virus (HBV and hepatitis C virus (HCV infections and the development of cholangiocarcinoma (CCA [4,6,9,11,12]. At the same time, the expression features of HBsAg, HBcAg in HCC and CCA have not been studied clearly yet. Aim of investigation: to study the expression features of hepatitis B antigens in tumor tissue from patients with hepatocellular carcinoma and cholangiocarcinoma. Materials and methods. The complex pathomorphological research was performed using liver biopsies of 87 patients aged from 33 up to 83 years, where 50 (57,47% of them had HCC carcinoma and 37 (42,53% had cholangiocellular cancer. 15 patients among examined 87 ones were ill with chronic viral hepatitis (11 were ill with HCV, 3 – HBV B, 1 – HBV + HCV before, 72 cancer patients, corresponding to the clinical data, never had this one in their past medical history. The localization of hepatitis B surface antigen (HBsAg and core antigen (HBcAg was investigated by an indirect immunoperoxidase method in formalin-fixed, paraffin-embedded liver specimens obtained from 50 (57,47% patients with hepatocellular carcinoma and 37 (42,53% patients with cholangiocarcinoma. using antibodies Rb a-Hu Primary Hepatitis B Virus Core Antigen (HBcAg and Mo a-Hu Primary Hepatitis B Virus Surface Antigen (HBsAg, Сlone 3E7, and visualization system DAKO EnVision+ with diaminobenzidine. Liver

SU-E-J-21: Setup Variability of Colorectal Cancer Patients Treated in the Prone Position and Dosimetric Comparison with the Supine Position

Energy Technology Data Exchange (ETDEWEB)

Kim, A; Foster, J; Chu, W; Karotki, A [Sunnybrook Health Sciences Centre/Odette Cancer Centre, Toronto, Ontario (Canada)

2015-06-15

Purpose: Many cancer centers treat colorectal patients in the prone position on a belly board to minimize dose to the small bowel. That may potentially Result in patient setup instability with corresponding impact on dose delivery accuracy for highly conformal techniques such as IMRT/VMAT. Two aims of this work are 1) to investigate setup accuracy of rectum patients treated in the prone position on a belly board using CBCT and 2) to evaluate dosimetric impact on bladder and small bowel of treating rectum patients in supine vs. prone position. Methods: For the setup accuracy study, 10 patients were selected. Weekly CBCTs were acquired and matched to bone. The CBCT-determined shifts were recorded. For the dosimetric study, 7 prone-setup patients and 7 supine-setup patients were randomly selected from our clinical database. Various clinically relevant dose volume histogram values were recorded for the small bowel and bladder. Results: The CBCT-determined rotational shifts had a wide variation. For the dataset acquired at the time of this writing, the ranges of rotational setup errors for pitch, roll, and yaw were [−3.6° 4.7°], [−4.3° 3.2°], and [−1.4° 1.4°]. For the dosimetric study: the small bowel V(45Gy) and mean dose for the prone position was 5.6±12.1% and 18.4±6.2Gy (ranges indicate standard deviations); for the supine position the corresponding dose values were 12.9±15.8% and 24.7±8.8Gy. For the bladder, the V(30Gy) and mean dose for prone position were 68.7±12.7% and 38.4±3.3Gy; for supine position these dose values were 77.1±13.7% and 40.7±3.1Gy. Conclusion: There is evidence of significant rotational instability in the prone position. The OAR dosimetry study indicates that there are some patients that may still benefit from the prone position, though many patients can be safely treated supine.

Magnetic resonance angiography for patients with positional vertigo

Energy Technology Data Exchange (ETDEWEB)

Seo, Toru; Tominaga, Satoru; Fujiki, Hiroya (Takarazuka City Hospital, Hyogo (Japan)); Kumoi, Takeo

1993-11-01

Magnetic resonance angiography (MRA) can image the blood vessels without invasion. Using MRA, we studied the vascular morphology of the vertebral artery in patients with positional nystagmus and vertigo. Fifteen patients without vestibular disorder such as benign positional vertigo were examined. Six cases underwent conventional vertebral angiography, including digital subtraction angiography (DSA) for comparison with MRA. In all cases. we observed the vertebral artery from the bifurcation to the basilar artery with MRA. In 12 cases, abnormal findings of elongation, bending, narrowing or obstruction of the vertebral artery were found. In five cases, arterial compression and elongation increased in association with head rotation. A difference in the vessel diameter on each side was observed in 4 cases. Accordingly, some abnormal vessels were found in 14 of 15 cases in our study. This rate was very close to previous results obtained with conventional angiography. In two cases, MRA findings differed from conventional angiography due to peculiar artifacts of MRA. Therefore, MRA may be the first choice for the patients with vertigo, followed by conventional angiography, if necessary. (author).

Magnetic resonance angiography for patients with positional vertigo

International Nuclear Information System (INIS)

Seo, Toru; Tominaga, Satoru; Fujiki, Hiroya; Kumoi, Takeo.

1993-01-01

Magnetic resonance angiography (MRA) can image the blood vessels without invasion. Using MRA, we studied the vascular morphology of the vertebral artery in patients with positional nystagmus and vertigo. Fifteen patients without vestibular disorder such as benign positional vertigo were examined. Six cases underwent conventional vertebral angiography, including digital subtraction angiography (DSA) for comparison with MRA. In all cases. we observed the vertebral artery from the bifurcation to the basilar artery with MRA. In 12 cases, abnormal findings of elongation, bending, narrowing or obstruction of the vertebral artery were found. In five cases, arterial compression and elongation increased in association with head rotation. A difference in the vessel diameter on each side was observed in 4 cases. Accordingly, some abnormal vessels were found in 14 of 15 cases in our study. This rate was very close to previous results obtained with conventional angiography. In two cases, MRA findings differed from conventional angiography due to peculiar artifacts of MRA. Therefore, MRA may be the first choice for the patients with vertigo, followed by conventional angiography, if necessary. (author)

An investigation of an outbreak of viral hepatitis B in Modasa town, Gujarat, India

Directory of Open Access Journals (Sweden)

Disha A Patel

2012-01-01

Full Text Available Background: Most outbreaks of viral hepatitis in India are caused by hepatitis E. Recently in the year 2009, Modasa town of Sabarkantha district in Gujarat witnessed the outbreak of hepatitis B. Purpose: An attempt was made to study the outbreak clinically and serologically, to estimate the seropositivity of hepatitis B Virus among the cases and their contacts and to know the seroprevalence of hepatitis B envelope antigen (HBeAg and IgM antibody against hepatitis B core antigen (IgM HBcAb out of all the Hepatitis B surface Antigen (HBsAg positive ones. Materials and Methods: Eight hundred and fifty-six (856 cases and 1145 contacts were evaluated for hepatitis B markers namely HBsAg, HBeAg and IgM HBcAb by enzyme-linked immuno Sorbent Assay (ELISA test. Results: This outbreak of viral hepatitis B in Modasa, Gujarat was most likely due to unsafe injection practices. Evidence in support of this was collected by Government authorities. Most of the patients and approximately 40% of the surveyed population gave history of injections in last 1.5-6 months. Total 664/856 (77.57% cases and 20/1145 (1.75% contacts were found to be positive for HBsAg. 53.41% of the positive cases and 52.93% of the positive contacts were HBeAg-positive and thus in a highly infectious stage. Conclusions: Inadequately sterilized needles and syringes are an important cause of transmission of hepatitis B in India. Our data reflects the high positivity rate of a hepatitis B outbreak due to such unethical practices. There is a need to strengthen the routine surveillance system, and to organise a health education campaign targeting all health care workers including private practitioners, especially those working in rural areas, as well as the public at large, to take all possible measures to prevent this often fatal infection.

Detention and positioning system for patient Treatment with conventional radiotherapy

International Nuclear Information System (INIS)

Hueso Bernad, Nuria; Tirado Porcar, Miriam; Del Castillo Arres, M. Jose; Broseta Tormos, M. Mercedes; Franch Martinez, Silvia; Suarez Dieguez, Raquel; Roures Ramos, M.Teresa

2009-01-01

The first step in what we call in radiotherapy S imulation and Planning o f radiation, is the correct choice of patient position and methods to use for this position is maintained along both the simulation and planning as the radiation treatment. The choice of position is directly linked to the choice of immobilizer to be used. (Author)

Hepatitis B Virus Infection and Oral Lichen Planus: A Report from Northeast of Iran

Directory of Open Access Journals (Sweden)

Mohammad Amin Khajavi

2018-06-01

Full Text Available Introduction: Lichen planus is a chronic inflammatory disease in oral mucosa and skin. Recently, reports have demonstrated a possible relationship between lichen planus and liver diseases. During the past decade, there has been a hypothesis regarding viral etiological agents that have been found to be in association with hepatotrophic viruses known as Hepatitis B and C with LP. This research was studied in Mashhad, northeast of Iran, to find a relationship between OLP and HBV infection. Methods: Age and gender of 134 patients (with OLP and 134 controls (without OLP were not matched and their serum samples were respectively screened for HBsAg by ELISA (third generation and polymerase chain reaction (PCR for HBV-DNA. Results: Tests were positive (for both HBsAg and HBV-DNA for 9 patients (6.71% with OLP and 2 healthy individuals (1.49% infected with HBV (P=0.03. Conclusion: There was a relationship between HBV and OLP in our population. Based on our findings, it is recommended that viral serology for Hepatitis B and OLP patients be conducted as a routine screening process.

17 Smear positive pulmonary tuberculosis among HIV patients ...

African Journals Online (AJOL)

conducted in February 2009 to assess the effect of the level of CD4 lymphocyte ... development of smear positive pulmonary TB (PTB) among HIV patients before ..... (2000) Impact of combination antiretroviral therapy on the risk of tuberculosis.

Evaluation of positioning errors of the patient using cone beam CT megavoltage

International Nuclear Information System (INIS)

Garcia Ruiz-Zorrilla, J.; Fernandez Leton, J. P.; Zucca Aparicio, D.; Perez Moreno, J. M.; Minambres Moro, A.

2013-01-01

Image-guided radiation therapy allows you to assess and fix the positioning of the patient in the treatment unit, thus reducing the uncertainties due to the positioning of the patient. This work assesses errors systematic and errors of randomness from the corrections made to a series of patients of different diseases through a protocol off line of cone beam CT (CBCT) megavoltage. (Author)

Evaluation of liver function tests in scleroderma patients.

Science.gov (United States)

Salem, Gehan Ibrahim Abdelrazek; Abdulrahman, Awni Ali

2012-08-01

Systemic sclerosis is a clinically heterogeneous, systemic disorder which affects the connective tissue of the skin, internal organs, and the walls of blood vessels. It is characterized by alterations of the microvasculature, disturbances of the immune system and by massive deposition of collagen and other matrix substances in the connective tissue. This study was done to evaluate the frequency of liver disease in patients with scleroderma and, secondarily, to study the frequency of infection of hepatitis B and C virus in these patients and determine frequency of serum auto-antibodies in this disease. We studied patients with scleroderma, localized or systemic, in the outpatient clinic of rheumatology and dermatology departments, at King Khalid University Hospital. As for a comparison, healthy persons coming to the clinic with the same mean age were considered as control group. Forty patients with the diagnosis of scleroderma included in this work, 35% had elevated gamma-glutamyl-transferase (γ-GT), 30% had elevated alkaline phosphatase (AP) and in 17.5%, the alanine-amino-transferase (ALT) was above the reference values. The ALT had changed to be more in scleroderma patients than in controls. Twenty percent (20%) of the patients tested positive for anti-smooth muscle antibodies (anti-SMA) and only one patient had anti-mitochondrial antibodies (AMA). There was no statistical difference between the two groups regarding antibody testing. Anti-HCV antibodies were observed in one patient, and HBsAg was detected in another scleroderma patient. There was no patient with clinically significant hepatic disease. In this study, although changes in liver enzymes in patients with scleroderma were not uncommon, there was no scleroderma patient with clinical manifestations of liver disease.

Radioimmunoassay in the detection of the hepatitis Be antigen/antibody system in asymptomatic carriers of hepatitis B surface antigen

International Nuclear Information System (INIS)

Pastore, G.; Dentico, P.; Angarano, G.; Schiraldi, O.; Zanetti, A.R.; Ferroni, P.

1980-01-01

A radioimmunoassay for hepatitis e antigen (HBeAg) and antibody to e (anti-HBe) was developed and sera of 71 asymptomatic chronic carriers of hepatitis B surface antigen (HBsAg), in 44 of whom liver biopsy was obtained, were tested. In addition, testing for Dane particle associated DNA polymerase activity was performed in all sera. HBeAg was detected in 14 subjects (19.7%) and anti-HBe in 46 (64.8%). The highest proportion of HBeAg positivity (40%) was found among carriers with histological evidence of chronic hepatitis, whereas anti-HBe was present in 80% of carriers with normal liver histology, in 58% of carriers with non-specific reactive hepatitis and in 60% of carriers with chronic liver lesions. DNA polymerase activity was present in 92.8% of sera positive for HBeAg, in 13% of sera positive for anti HBe, and in 9% of sera negative for both markers. Our results demonstrate that not all HBsAg carriers reactive to HBeAg show evidence of chronic hepatitis nor, conversely, that anti-HBe is invariably associated with the healthy carrier state of HBsAg. Finally, circulating Dane particles, as revealed by the presence of serum specific DNA polymerase activity, may also be present in anti-HBe positive sera other than those of some HBsAg carriers lacking both HBeAg and anti-HBe. (orig.) [de

The influence of patient positioning uncertainties in proton radiotherapy on proton range and dose distributions

Energy Technology Data Exchange (ETDEWEB)

Liebl, Jakob, E-mail: jakob.liebl@medaustron.at [EBG MedAustron GmbH, 2700 Wiener Neustadt (Austria); Francis H. Burr Proton Therapy Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114 (United States); Department of Therapeutic Radiology and Oncology, Medical University of Graz, 8036 Graz (Austria); Paganetti, Harald; Zhu, Mingyao; Winey, Brian A. [Francis H. Burr Proton Therapy Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114 (United States)

2014-09-15

Purpose: Proton radiotherapy allows radiation treatment delivery with high dose gradients. The nature of such dose distributions increases the influence of patient positioning uncertainties on their fidelity when compared to photon radiotherapy. The present work quantitatively analyzes the influence of setup uncertainties on proton range and dose distributions. Methods: Thirty-eight clinical passive scattering treatment fields for small lesions in the head were studied. Dose distributions for shifted and rotated patient positions were Monte Carlo-simulated. Proton range uncertainties at the 50%- and 90%-dose falloff position were calculated considering 18 arbitrary combinations of maximal patient position shifts and rotations for two patient positioning methods. Normal tissue complication probabilities (NTCPs), equivalent uniform doses (EUDs), and tumor control probabilities (TCPs) were studied for organs at risk (OARs) and target volumes of eight patients. Results: The authors identified a median 1σ proton range uncertainty at the 50%-dose falloff of 2.8 mm for anatomy-based patient positioning and 1.6 mm for fiducial-based patient positioning as well as 7.2 and 5.8 mm for the 90%-dose falloff position, respectively. These range uncertainties were correlated to heterogeneity indices (HIs) calculated for each treatment field (38% < R{sup 2} < 50%). A NTCP increase of more than 10% (absolute) was observed for less than 2.9% (anatomy-based positioning) and 1.2% (fiducial-based positioning) of the studied OARs and patient shifts. For target volumes TCP decreases by more than 10% (absolute) occurred in less than 2.2% of the considered treatment scenarios for anatomy-based patient positioning and were nonexistent for fiducial-based patient positioning. EUD changes for target volumes were up to 35% (anatomy-based positioning) and 16% (fiducial-based positioning). Conclusions: The influence of patient positioning uncertainties on proton range in therapy of small lesions

Predicting the short-term risk of diabetes in HIV-positive patients

DEFF Research Database (Denmark)

Petoumenos, Kathy; Worm, Signe W; Fontas, Eric

2012-01-01

HIV-positive patients receiving combination antiretroviral therapy (cART) frequently experience metabolic complications such as dyslipidemia and insulin resistance, as well as lipodystrophy, increasing the risk of cardiovascular disease (CVD) and diabetes mellitus (DM). Rates of DM and other...... glucose-associated disorders among HIV-positive patients have been reported to range between 2 and 14%, and in an ageing HIV-positive population, the prevalence of DM is expected to continue to increase. This study aims to develop a model to predict the short-term (six-month) risk of DM in HIV...

Evaluation of the KEMRI Hep-cell II test kit for detection of hepatitis B ...

African Journals Online (AJOL)

To evaluate the Hep-cell II test, blood samples were collected from blood donors and processed for detection of HBsAg using Hep-cell II based on the test principle and procedure outlined by the manufacturer. ELISA Axsym HBsAg test was used as golden standard. Of the 400 samples tested, 287 (71.8%) were positive by ...

Anti-tuberculosis therapy-induced hepatotoxicity among Ethiopian HIV-positive and negative patients.

Directory of Open Access Journals (Sweden)

Getnet Yimer

2008-03-01

Full Text Available To assess and compare the prevalence, severity and prognosis of anti-TB drug induced hepatotoxicity (DIH in HIV positive and HIV negative tuberculosis (TB patients in Ethiopia.In this study, 103 HIV positive and 94 HIV negative TB patients were enrolled. All patients were evaluated for different risk factors and monitored biochemically and clinically for development of DIH. Sub-clinical hepatotoxicity was observed in 17.3% of the patients and 8 out of the 197 (4.1% developed clinical hepatotoxicity. Seven of the 8 were HIV positive and 2 were positive for HBsAg.Sub-clinical hepatotoxicity was significantly associated with HIV co-infection (p = 0.002, concomitant drug intake (p = 0.008, and decrease in CD4 count (p = 0.001. Stepwise restarting of anti TB treatment was also successful in almost all the patients who developed clinical DIH. We therefore conclude that anti-TB DIH is a major problem in HIV-associated TB with a decline in immune status and that there is a need for a regular biochemical and clinical follow up for those patients who are at risk.

Seropositivity for hepatitis B and C in voluntary blood donors

International Nuclear Information System (INIS)

Shah, S.M.A.; Ali, A.

2010-01-01

After the introduction of blood banks and better storage techniques blood is more widely used in patients for various indications. In Pakistan more than 1.5 million pints of blood are collected each year. Hepatitis B and C virus infections are known to occur in the general population and due to their mode of transmission through blood and blood products, it has made safe blood transfusion difficult and screening of blood absolutely necessary. Objectives of this study were to estimate frequency of Hepatitis B and C in blood donors of local area and recommend measures for safe blood transfusion. Methods: This retrospective cross-sectional study was conduced at the Blood Bank, Department of Pathology, Khyber Teaching Hospital, Peshawar from January 01, 2007 to December 31, 2008. It was carried out on 32,042 voluntary, non-remunerated healthy blood donors. They were screened for Hepatitis B surface antigen (HBsAg) and anti-hepatitis C antibodies (anti-HCV antibodies) by ELISA. The patients' age ranged from 18-52 years. They were all males. Results: Out of 32,042 donors, 632 (1.97%) patients were positive for HBsAg, and 502 (1.57%).were positive for anti-HCV antibodies. Conclusion: Incidence of Hepatitis B and C is varying in different areas. It is recommended that properly screened blood only, using a reliable method like ELISA, be transfused to the patients. (author)

Prevalence and Determinants of Chronic periodontitis in HIV positive patients in Nigeria

Directory of Open Access Journals (Sweden)

Kehinde Adesola Umeizudike

2014-08-01

Full Text Available Objective: To determine the prevalence and determinants of chronic periodontitis in HIV positive patients. Methods: A total of 120 HIV positive patients attending the dedicated HIV outpatient clinic of the Lagos University Teaching Hospital, Nigeria were recruited for the study. Their periodontal status was assessed using the community periodontal index of treatment needs. Their CD4+ cell count was determined using the flow-cytometer method. The risk factors for periodontitis including age, gender, education, smoking, CD4+ cell counts, bleeding on probing (BOP were determined. Results: Prevalence of periodontitis was high (63.3% in the HIV positive patients. In a bivariate analysis, significant associations were observed between severity of periodontitis and age ≥35 years (P=0.021, male gender (P=0.005, smoking (P=0.040 and ≥3 community periodontal index of treatment needs sextants exhibiting BOP (P=0.004. In a binary logistic regression, independent predictors of periodontitis were ≥3 sextants exhibiting BOP (odds ratio 1.738, 95% CI 1.339 to 2.256, P=0.000 and age ≥35 years (odds ratio 1.057, 95% CI 1.005 to 1.111, P=0.030. The CD4+ cell counts were not associated with periodontitis in the HIV positive patients (P=0.988. Conclusions: A high prevalence of periodontitis was found among the HIV positive Nigerian patients in this study. Older age ≥35 years and BOP were the determinants of periodontitis. There is therefore a need for close periodontal monitoring of HIV positive Nigerian patients with emphasis on preventive, professional oral prophylaxis.

Human papilloma virus dermatosis in human immunodeficiency virus-positive patients: A 14-year retrospective study in 965 patients.

Science.gov (United States)

Nuno-Gonzalez, Almudena; Losa Garcia, Juan Emilio; López Estebaranz, José Luis; Martin-Rios, María Dolores

2017-05-10

The incidence of the human papilloma virus (HPV) has not dropped in HIV-positive patients despite the discovery of antiretroviral therapy (ART). Our goal is to assess the prevalence of HPV in HIV patients and its relationship with the epidemiological and virological characteristics of HIV patients. Retrospective cohort of 965 patients diagnosed with HIV from 1998 to 2012. We analyzed patients' demographic factors and factors related to the HPV. Of the 965 patients examined, 333 consulted a dermatologist. Of these, 52 patients had genital warts (15.6%), 43 had common warts (12.9%) and 8% had both conditions. In total, 28.5% of patients had a skin lesion caused by HPV. This is the first longitudinal observational study carried out on HIV-positive patients in the era of ART in which HPV infection is the most common skin pathology. We observed a similar trend in countries with access to ART. This study spreads awareness on the importance of preventing HPV and the difficulty of treating it in HIV-positive patients. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Clinical significance of elevated serum aminotransferases levels in asymptomatic individuals with hepatitis C infection

International Nuclear Information System (INIS)

Nafees, M.; Ditta, A.; Jafferi, G.

2010-01-01

Background: Hepatitis C is a common and important cause of chronic liver disease that often remains asymptomatic and most of the times discovered incidentally by routine serologic or biochemical testing. Aminotransferases (AST and ALT) reflect alterations in liver function/inflammation in liver diseases. The current study was conducted to examine the utilization and limitations of these biochemical markers in subjects with asymptomatic HCV infection. Aims and Objectives: To find out how many subjects with asymptomatic HCV infection have normal or elevated serum AST and ALT levels. Subjects and Methods: Study Design: Cross sectional. Study Duration: Seven months from November 2008 to July 2009. Study Universe: Services Hospital, Lahore. Study Population: This study included 413 subjects attending the outpatient departments of hospital with minor complaints. The random population of subjects was referred to the clinical laboratory of Services Hospital, Lahore for LFTs, HBsAg and anti-HCV screening from OPD department of the hospital. A total of 413 persons of all ages were analyzed during this study. There were 263 subjects who were sero - positive for anti-HCV (141 females, 122 males; median age 35 +- 11.34 years) and 150 in the control group (80 of them were females and 70 males with median age 32 +- 12.97 years) were sero-negative for both HBsAg and anti - HCV. Subjects Selection Criteria: In this study, only anti - HCV sero - positive subjects were included who was sero - negative for HBsAg or dual infection (both HBsAg and anti - HCV) and not on anti - viral therapy. Control group was sero - negative for both - HBsAg and anti - HCV antibodies. Data Collection: We assayed levels of serum aminotransferases (AST and ALT) and screened blood for HBsAg and anti-HCV. ELISA technique was used for viral hepatitis markers. Results: Out of 263 subjects tested positive for anti-HCV antibodies in their blood, 90.76 % and 87.45 % had elevated AST and ALT levels (ALT = 40 U

Does the Supine Position Affect the Nasal Profile in Rhinoplasty Patients? A Comparison of Nasal Anthropometric Measurements in Different Body Positions.

Science.gov (United States)

Kim, Su Jin; Ryu, In Yong; Kim, Sung Wan; Lee, Kun Hee

2017-10-16

Rhinoplasty surgeons are aware that the nasal profile differs according to body position, namely, the erect position in the consultation room vs the supine position on the operating table. It is not clear whether this difference is caused by an optical illusion or skin laxity due to positional change. To evaluate anthropometric measurements of the nose with different body positions and determine whether the supine position affects the nasal profile. In this retrospective study, 103 patients who underwent primary rhinoplasty were enrolled. Preoperatively, all patients underwent lateral cephalography in the erect position, and facial computed tomography (CT), in the supine position. We measured four nasal anthropometric parameters (the nasofrontal, nasolabial, and nasomental angles, and Simon's ratio) on lateral cephalograms and facial CT images, and compared these parameters between the two body positions. The nasofrontal angle was greater on facial CT than on cephalograms (P sex, or body mass index (P > 0.05 each). We found no significant difference (P > 0.05) between the two positions in the nasolabial angle, nasomental angle, or Simon's ratio. The supine position does affect the nasal profile, especially in the radix area. Surgeons need to consider this difference in patients undergoing rhinoplasty. 2. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

Lumbar Lordosis of Spinal Stenosis Patients during Intraoperative Prone Positioning

Science.gov (United States)

Lee, Su-Keon; Song, Kyung-Sub; Park, Byung-Moon; Lim, Sang-Youn; Jang, Geun; Lee, Beom-Seok; Moon, Seong-Hwan; Lee, Hwan-Mo

2016-01-01

Background To evaluate the effect of spondylolisthesis on lumbar lordosis on the OSI (Jackson; Orthopaedic Systems Inc.) frame. Restoration of lumbar lordosis is important for maintaining sagittal balance. Physiologic lumbar lordosis has to be gained by intraoperative prone positioning with a hip extension and posterior instrumentation technique. There are some debates about changing lumbar lordosis on the OSI frame after an intraoperative prone position. We evaluated the effect of spondylolisthesis on lumbar lordosis after an intraoperative prone position. Methods Sixty-seven patients, who underwent spinal fusion at the Department of Orthopaedic Surgery of Gwangmyeong Sungae Hospital between May 2007 and February 2012, were included in this study. The study compared lumbar lordosis on preoperative upright, intraoperative prone and postoperative upright lateral X-rays between the simple stenosis (SS) group and spondylolisthesis group. The average age of patients was 67.86 years old. The average preoperative lordosis was 43.5° (± 14.9°), average intraoperative lordosis was 48.8° (± 13.2°), average postoperative lordosis was 46.5° (± 16.1°) and the average change on the frame was 5.3° (± 10.6°). Results Among all patients, 24 patients were diagnosed with simple spinal stenosis, 43 patients with spondylolisthesis (29 degenerative spondylolisthesis and 14 isthmic spondylolisthesis). Between the SS group and spondylolisthesis group, preoperative lordosis, intraoperative lordosis and postoperative lordosis were significantly larger in the spondylolisthesis group. The ratio of patients with increased lordosis on the OSI frame compared to preoperative lordosis was significantly higher in the spondylolisthesis group. The risk of increased lordosis on frame was significantly higher in the spondylolisthesis group (odds ratio, 3.325; 95% confidence interval, 1.101 to 10.039; p = 0.033). Conclusions Intraoperative lumbar lordosis on the OSI frame with a prone

Positive and Negative Perfectionism in Migrainus Patients Compaired with Control Group

Directory of Open Access Journals (Sweden)

H Afshar

2008-01-01

Full Text Available ABSTRACT: Introduction & Objective: The positive and negative effects of perfectionism on human cognition, affection and behavior have been emphasized. Perfectionism has been conceptualized as a multidimensional construct, with both adaptive and maladaptive aspects, which is one of the common personality traits that cause lifelong stress in human and results in anxiety, depression and physical and mental distress.The aim of this study was to assess the positive and negative perfectionism in migrainus patients in comparison with control group. Materials & Methods: This is an analytical (Case-control study which was performed on 91 migraine patients and 88 healthy individuals. The pqtients and controls completed a standard 40 item questionnaire for perfectionism – PANPS (20 for positive and 20 for negative perfectionism . The patients in both groups were matched for gender and age. Mean of positive and negative perfectionism scores for two groups was statistically analysed using SPSS software. Results: Mean positive perfectionism score was 83.47±8.5 for migraine group and 65.47±7.54 for control group (p=0.0001. The difference between two groups was significant. Mean of negative perfectionism score was 74.12±10.6 for migraine group and 51.79±7.8 for control group(p=0.0001. Conclusion: The results show that migraine patients have higher mean of perfectionism scores than healthy individuals. Based on this study and other clinical experiences more attention to psychotherapy is necessary for better management of migraine and recognition of personality profile in migraine patient helps to reduce patient’s complaints.

Verification of the positioning of radiotherapy patients with two webcams

Energy Technology Data Exchange (ETDEWEB)

Píriz, Gustavo; Lucas, Manuela; Bertini, Diego; Doldán, Raquel, E-mail: oncosur@oncosur.com.uy [Oncosur, Florida (Uruguay); Banguero, Yolma; Frederico, Marcel, E-mail: ybanguero@cin.edu.uy [Unidad de Radioproteccion, Centro de Invetigaciones Nucleares, Universidad de la Republica, Montevideo (Uruguay)

2017-07-01

In radiotherapy, high doses are given to the volumes that are to be irradiated and the organs at risk have to be protected. This implies putting great care into the patient's position and the reproducibility of the patient during all treatment sections. In our center the position during the treatment is bounded with thermoplastic masks, and the reproducibility between different sections is checked with daily photos during the treatment. For the evaluation of the photos we stick spheres of 8 mm of diameter to the fixing masks. We captured photos with two webcams that are less than 90 cm from the isocenter, one from the left and the other from the right. A quick visual evaluation allows you to detect changes in the position of the radius of the sphere. We present an absolute calibration methodology of the position of the sphere with two webcams. (author)

Markers to differentiate between Kaposi's sarcoma and tuberculous pleural effusions in HIV-positive patients.

Science.gov (United States)

Coleman, M; Finney, L J; Komrower, D; Chitani, A; Bates, J; Chipungu, G A; Corbett, E; Allain, T J

2015-02-01

Kaposi's sarcoma (KS) and tuberculosis (TB) commonly cause pleural effusions in high human immunodeficiency virus (HIV) burden resource-limited countries. Differentiating between them is challenging, as pleural biopsy and TB culture are rarely available. To identify markers to differentiate between TB effusions and KS effusions in HIV-positive patients, and to compare liquid culture and Xpert MTB/RIF in pleural fluid. Fifty HIV-positive patients with pleural effusions recruited in Malawi underwent pleural ultrasound and aspiration. Fluid visual inspection, cell count, bacterial culture, glucose/protein, solid and liquid TB culture and Xpert were performed. The mean age of the patients was 32 years; 30/50 (60%) were male and 29 (58%) had cutaneous/oral KS. Thirteen (26%) pleural fluid samples were liquid culture-positive for TB, while 9/13 (69%) were Xpert-positive. Three (10.3%) KS patients had culture-positive TB effusions; 17 (58.6%) had KS effusions. The relative risk of TB in KS patients increased with limited KS, loculated fluid and low glucose. Eleven (52.3%) non-KS patients had culture-positive TB effusions associated with male sex, straw-coloured fluid and fibrin stranding on ultrasound. KS patients were most likely to have KS effusion, but TB should be considered. Most non-KS patients had TB, supporting the use of World Health Organization guidelines. Xpert identified two thirds of liquid culture-positive results.

New approach to imaging HIV-positive patients with pyrexia of undetermined origin

International Nuclear Information System (INIS)

Buscombe, J.; Miller, R.; Lui, D.; Ell, P.J.

1990-01-01

This paper established if imaging with Tc-99m human immunoglobulin (HIG) in addition to Ga-67 citrate increased the diagnostic sensitivity in patients who have pyrexia of unknown origin (PUO) and who have tested positive for human immunodeficiency virus (HIV). The authors studied 18 HIV-positive patients with PUO for 3 or more weeks. Imaging was performed 4 and 20 hours after administration of 200 MBq of Tc-99m HIG and 24, 48, and (if indicated) 72 hours after administration of 300 MBq of Ga-67. Anterior whole body and relevant spot view were obtained for both agents. Twenty-four sites of infection were confirmed microbiologically in 12 patients. Ga-67 scan results were positive in 22 of these sites, and Tc-99m HIG results were positive in 13; the nine Ga-positive sites that were Tc-negative were intrathoracic (one Pneumocystis carinii, eight Mycobacterium intracellulare)

Positioning bedridden patients to reduce interface pressures over the sacrum and great trochanter.

Science.gov (United States)

Yoshikawa, Y; Maeshige, N; Sugimoto, M; Uemura, M; Noguchi, M; Terashi, H

2015-07-01

In this study, we evaluated the effect of hip-joint rotation on the interface pressure over the sacrum and greater trochanter with a new protocol for positioning of bedridden elderly patients. The interface pressure values over the sacrum and greater trochanter in bedridden patients were evaluated. These were collected in the supine position, 90° lateral position, and 30° and 40° laterally inclined positions with external rotation or neutral positioning of the hip joint. Each interface pressure was assessed with a device measuring pressure distribution, after which, the peak pressure index (PPI) was calculated. In the 17 patients examined, the PPI over the sacrum in the supine position was significantly greater than that in other positions. In the 30° and 40° laterally inclined positions, the PPIs over the greater trochanter were significantly lower in the neutral position of the hip joint compared with those in the external rotation position. Our findings revealed the effects of hip-joint rotation on the interface pressure for the greater trochanter, possibly due to the increased distance between the greater trochanter and the sacrum caused by neutral position of the hip joint. The results demonstrate that it is to best place the hip joint in a neutral position when the legs are in contact with the bed in order to distribute the pressure over the greater trochanter in the 30° and 40° laterally inclined positions. These results can be applied to the clinical setting to improve patient positioning and decrease pressure ulcers. The authors declare that they have no competing financial interests.

Positioning patient-perceived medical services to develop a marketing strategy.

Science.gov (United States)

Jung, Minsoo; Hong, Myung-Sun

2012-01-01

In today's medical market, marketing philosophy is being rapidly transformed from customer searching to patient satisfaction and service improvement. The principal objective of this study was to contribute to the establishment of a desirable medical marketing strategy, through the factors of customer satisfaction and the positioning of patients' perceptions by marketing institutions. The data were collected from 282 students of the College of Public Health and Medicine in Seoul. The survey tools were developed using the SERVQUAL scale. Analysis in this study involved both statistical and network analysis. The former was used to verify the determinants of service satisfaction as perceived by respondents, via factor analysis and multiple regression analysis. The latter was obtained using a positioning map and 2-mode network analysis with the matrix data converted from raw data. The determining factors for patient satisfaction were identified as facilities, accessibility, process, physicians, and medical staff. The regression equation was significant (R = 0.606), and the most influential variable was the service quality of physicians (β = .569). According to multidimensional scaling, the positioning of medical institutions indicated that patients' perceptions were affected by hospital size and specialization. By recognizing and managing patient satisfaction, medical institutions are able to foster customer loyalty and, in turn, to enhance service quality. It is necessary to develop an adequate marketing mix to provide better medical services and to overcome medical competition among institutions.

Factors that enable nurse-patient communication in a family planning context: a positive deviance study.

Science.gov (United States)

Kim, Young Mi; Heerey, Michelle; Kols, Adrienne

2008-10-01

Family planning programmes in developing countries need a better understanding of nurse-patient communication in order to improve the quality of counselling. To identify factors in the clinic and in the community that enable nurses and patients to communicate effectively with one another. The study explored the personal experiences of nurses and patients who communicate especially effectively during family planning consultations (so-called "positive deviants"). Sixty-four randomly selected public clinics located in East Java, Indonesia. Seven positive deviant nurses and 32 positive deviant patients were identified from among 64 nurses and 768 patients who participated in an earlier patient coaching study. Flooding prevented 5 patients from participating in the study, reducing their number to 27. Investigators conducted: (1) a content analysis of qualitative data collected by structured in-depth interviews and focus-group discussions (FGDs) with positive deviant nurses and patients, and (2) analyses of variance (ANOVA) of quantitative data on clinic, nurse, and patient characteristics. Positive deviant nurses identified four factors, listed in rough order of importance, that helped them communicate effectively: independent study to strengthen their knowledge and skills; communication aids; feedback from colleagues; and motivation stemming from a desire to help people, patients' appreciation, husband's support, and increased income. Positive deviant patients identified five enabling factors: motivation due to their need for a service; confidence in their own communication skills; positive feedback from nurses; belief in patients' right and responsibility to communicate with nurses; and communication aids. Insights from positive deviant nurses and patients suggest that efforts to improve nurse-patient communication should go beyond conventional communication skills training. Managers should consider a mix of clinic-based interventions (such as peer feedback

Breast cancer patients' narratives about positive and negative communication experiences

DEFF Research Database (Denmark)

Thomsen, Dorthe K; Pedersen, Anette F; Johansen, Mikael B

2007-01-01

. Thus, qualitative studies of communication are also needed. Fifteen breast cancer patients were interviewed 3 months after finishing adjuvant treatment. They were asked to tell a 10 minute narrative and recall five experiences from treatment. Themes were extracted using categories derived from previous...... research while at the same time being sensitive to new elaborations and categories. The participants reported both positive and negative communication-related experiences from a wide range of treatment situations. Two major themes emerged: Information giving as professional care-giving and meeting......Health staff-patient communication is increasingly considered an important issue in cancer research. However, questionnaires addressing satisfaction with communication limit the issues patients can raise, do not address the context of communication and often show a strong positive skew in responses...

PREVENTION OF POST-TRANSFUSION HEPATITIS BY SCREENING OF ANTIBODY TO HEPATITIS B CORE ANTIGEN IN HEALTHY BLOOD DONORS

Directory of Open Access Journals (Sweden)

Sudha Bhat

2011-01-01

Full Text Available

Background: Transfusion-associated hepatitis B viral infection continues to be a major problem in India even after adoption of mandatory screening for HBsAg by ELISA method. The high incidence of TAHBV is reported in patients receiving multiple transfusions.

Objective: To study the seroprevalence of hepatitis B core antibody among healthy voluntary blood donors

Subjects and Methods: The study was conducted in the department of Transfusion Medicine of a tertiary care referral hospital. A total of 12,232 volunteers after passing through the stringent criteria were selected for blood donation. Donor samples were tested for all mandatory transfusion transmissible infections and anti HBc IgM (Monolisa HBc IgM PLUS:BIO-RAD, France. Reactive results were confirmed by repeat testing in duplicate. Donor data was analyzed using SPSS software and Chi-square test was used to calculate the significance of difference between the groups.

Results:A total of 12,232 healthy voluntary blood donors were recruited. Majority (93.4% were males. Median age of donor population was 26 years (range: 18-60 years. Eighty six (0.7% were positive for HBsAg, which comes under “low prevalence (<2% zone” as per WHO. On screening for HBcAg Ig M, 15 (0.1% were found to be positive and none were HBsAg reactive. There was no significance of difference in the mean age between reactive and non-reactive donors.

Conclusion:Evaluating the usefulness of anti-HBc screening is critical. Anti HBcAg IgM screening may be included in routine screening of donors as it is an indicator of occult HBV during window period. The cost and the unnecessary wastage of the blood units when they are positive for anti HBsAg along with the core antibody need to be studied.

Viral hepatitis and HIV-associated tuberculosis: Risk factors and TB treatment outcomes in Thailand

Directory of Open Access Journals (Sweden)

Likanonsakul Sirirat

2008-07-01

Full Text Available Abstract Background The occurrence of tuberculosis (TB, human immunodeficiency virus (HIV, and viral hepatitis infections in the same patient poses unique clinical and public health challenges, because medications to treat TB and HIV are hepatotoxic. We conducted an observational study to evaluate risk factors for HBsAg and/or anti-HCV reactivity and to assess differences in adverse events and TB treatment outcomes among HIV-infected TB patients. Methods Patients were evaluated at the beginning, during, and at the end of TB treatment. Blood samples were tested for aspartate aminotransferase (AST, alanine aminotransferase (ALT, total bilirubin (BR, complete blood count, and CD4+ T lymphocyte cell count. TB treatment outcomes were assessed at the end of TB treatment according to international guidelines. Results Of 769 enrolled patients, 752 (98% had serologic testing performed for viral hepatitis: 70 (9% were reactive for HBsAg, 237 (31% for anti-HCV, and 472 (63% non-reactive for both markers. At the beginning of TB treatment, 18 (26% patients with HBsAg reactivity had elevated liver function tests compared with 69 (15% patients non-reactive to any viral marker (p = 0.02. At the end of TB treatment, 493 (64% were successfully treated. Factors independently associated with HBsAg reactivity included being a man who had sex with men (adjusted odds ratio [AOR], 2.1; 95% confidence interval [CI], 1.1–4.3 and having low TB knowledge (AOR, 1.8; CI, 1.0–3.0. Factors most strongly associated with anti-HCV reactivity were having injection drug use history (AOR, 12.8; CI, 7.0–23.2 and living in Bangkok (AOR, 15.8; CI, 9.4–26.5. The rate of clinical hepatitis and death during TB treatment was similar in patients HBsAg reactive, anti-HCV reactive, both HBsAg and anti-HCV reactive, and non-reactive to any viral marker. Conclusion Among HIV-infected TB patients living in Thailand, markers of viral hepatitis infection, particularly hepatitis C virus

Hepatitis B virus surface antigen impairs myeloid dendritic cell function: a possible immune escape mechanism of hepatitis B virus

Science.gov (United States)

Op den Brouw, Marjoleine L; Binda, Rekha S; van Roosmalen, Mark H; Protzer, Ulrike; Janssen, Harry L A; van der Molen, Renate G; Woltman, Andrea M

2009-01-01

Chronic hepatitis B virus (HBV) infection is the result of an inadequate immune response towards the virus. Myeloid dendritic cells (mDC) of patients with chronic HBV are impaired in their maturation and function, resulting in more tolerogenic rather than immunogenic responses, which may contribute to viral persistence. The mechanism responsible for altered mDC function remains unclear. The HBV-infected patients display large amounts of HBV particles and viral proteins in their circulation, especially the surface antigen HBsAg, which allows multiple interactions between the virus, its viral proteins and DC. To assess whether HBV directly influences mDC function, the effects of HBV and HBsAg on human mDC maturation and function were investigated in vitro. As already described for internalization of HBV by DC, the present study shows that peripheral blood-derived mDC of healthy controls also actively take up HBsAg in a time-dependent manner. Cytokine-induced maturation in the presence of HBV or HBsAg resulted in a significantly more tolerogenic mDC phenotype as demonstrated by a diminished up-regulation of costimulatory molecules and a decreased T-cell stimulatory capacity, as assessed by T-cell proliferation and interferon-γ production. In addition, the presence of HBV significantly reduced interleukin-12 production by mDC. These results show that both HBV particles and purified HBsAg have an immune modulatory capacity and may directly contribute to the dysfunction of mDC in patients with chronic HBV. The direct immune regulatory effect of HBV and circulating HBsAg particles on the function of DC can be considered as part of the mechanism by which HBV escapes immunity. PMID:18624732

Comparison of frequency of hepatitis B and hepatitis C in pregnant women in urban and rural area of district Swat

International Nuclear Information System (INIS)

Khattak, S.T.; Marwat, M.A.

2009-01-01

This retrospective analytical study was carried out to observe the frequency of Hepatitis B and Hepatitis C among the pregnant women of Swat. The study was carried out from January 2008 to December 2008. It was a retrospective study based on review of records of pregnant women admitted to Labour Room of Obstetrics/Gynaecology Unit, Saidu Teaching Hospital, Swat. Patients were screened for Hepatitis B and C by Immuno Chromatographic Technique (ICT) device. The findings were recorded on proforma and analysed. Those found positive on screening test were confirmed by ELISA. Total number of patients screened was 5607. The frequency of Hepatitis B and C (Combined) was 223 (3.98%), out of which 77 (1.37%) were HBsAg positive, 141 (2.52%) were anti HCV positive and 5 (0.09%) were both HBsAg and anti HCV positive. The frequency of Hepatitis B amongst age groups 14-19 , 20-29, 30-39 and 40-49 years were 2/77, 33/77, 40/77, and 2/77) respectively. The frequency of Hepatitis C amongst age groups 14-19, 20-29,30-39 and 40-49 years was 4/141, 59/141, 67/141 and 11/141 respectively. The frequency of Hepatitis B and C in multigravida was 41/77, 67/141, in grand multigravida it was 20/77, 43/141 and in primigravida it was 16/77, 31/141 respectively. The frequency of Hepatitis B and Hepatitis C amongst urban and rural population was 32 (39.02%) and 50 (60.98%); and 40 (27.40%) and 106 (72.60%) respectively. The frequency of Hepatitis B and C (Combined) in urban, rural population were 72 (31.58 %) and 156 (68.15 %) respectively. HBsAg and HCV was common infections in pregnant women of Swat. Therefore, every pregnant woman undergoing delivery and/or any other surgical procedure must be screened for Hepatitis B and Hepatitis C. (author)

Antibody-mediated immunotherapy against chronic hepatitis B virus infection.

Science.gov (United States)

Gao, Ying; Zhang, Tian-Ying; Yuan, Quan; Xia, Ning-Shao

2017-08-03

The currently available drugs to treat hepatitis B virus (HBV) infection include interferons and nucleos(t)ide analogs, which can only induce disease remission and are inefficient for the functional cure of patients with chronic HBV infection (CHB). Since high titers of circulating hepatitis B surface antigen (HBsAg) may be essential to exhaust the host anti-HBV immune response and they cannot be significantly reduced by current drugs, new antiviral strategies aiming to suppress serum hepatitis B surface antigen (HBsAg) could help restore virus-specific immune responses and promote the eradication of the virus. As an alternative strategy, immunotherapy with HBsAg-specific antibodies has shown some direct HBsAg suppression effects in several preclinical and clinical trial studies. However, most described previously HBsAg-specific antibodies only had very short-term HBsAg suppression effects in CHB patients and animal models mimicking persistent HBV infection. More-potent antibodies with long-lasting HBsAg clearance effects are required for the development of the clinical application of antibody-mediated immunotherapy for CHB treatment. Our recent study described a novel mAb E6F6 that targets a unique epitope on HBsAg. It could durably suppress the levels of HBsAg and HBV DNA via Fcγ receptor-dependent phagocytosis in vivo. In this commentary, we summarize the current research progress, including the therapeutic roles and mechanisms of antibody-mediated HBV clearance as well as the epitope-determined therapeutic potency of the antibody. These insights may provide some clues and guidance to facilitate the development of therapeutic antibodies against persistent viral infection.

Detection of TT Virus Among Thalassaemic Children With Chronic Viral Hepatitis B and C Receiving Irradiated and Non Irradiated RBCs

International Nuclear Information System (INIS)

El-Maghraby, D.F.; EL-Shafie, A.I.; El-Sayed, S.A.; Alkady, M.M.

2010-01-01

TTV was first identified in the serum of a patient with post transfusion hepatitis of unknown etiology in 1997.As a consequence of the high prevalence of TTV in blood donors, thalassemia patients frequently acquire various genotypes of this virus through therapeutic blood transfusions.TTV as a cause of chronic hepatitis has not yet determined . Ten healthy and twenty-eight poly-transfused thalassemia children were evolved in this study where ten patients were receiving irradiated RBCs and eighteen receiving non irradiated ones.TTV was detected in serum samples by semi-nested polymerase chain reaction (PCR) using TTV-specific primer. Transaminases levels, hepatitis B and C virus markers were interpreted for possible association with TTV infection. As a result, TTV was found in 50% of thalassemia patients and in 20 % of the controls. Among thalassemia patients, isolated HBsAG, isolated HCV-AB, HBsAG and TTV-DNA and HCV-AB and TTV-DNA distributions were: 6 (21.43%) ,8 ( 28.57%) , 4 ( 14.29%) and 10 (35.7%) respectively. Regarding thalassemia patients receiving irradiated RBCs, the frequency of viral infections were 8(80%), 2(20%) and 0% for TTV co-infections, isolated HBV and isolated HCV, respectively. On the other hand, the prevalence of viral infections among patients receiving non irradiated RBCs were 6(33.3%), 4(22.2%) and 8(44.5%) for TTV co-infection, isolated HBV and isolated HCV, respectively. These data may give evidence that radiation raises the levels of blood safety especially regarding HCV. Furthermore, liver transaminase levels were significantly higher in all patients versus the controls, meanwhile, transaminase values were not different in HBsAG-positive subjects as compared with subjects who had both HBsAG and TTV-DNA positive. Also, there was no significant difference between isolated HCV infection and HCV and TTV co-infection. So, no convincing evidence was found to support TTV involvement in the D. F. EL-MAGHRABY, et al. / J. Rad. Res. Appl. Sci

The relationship between positive or negative phrasing and patients' coping with lateral epicondylitis.

Science.gov (United States)

Lee, Dong Oh; Gong, Hyun Sik; Kim, Jeong Hwan; Rhee, Seung Hwan; Lee, Young Ho; Baek, Goo Hyun

2014-04-01

Research suggests that phrases with negative content can affect patients' response to medical procedures and how they cope with medical illnesses. We hypothesized that patients with lateral epicondylitis who describe their condition in positive phrases cope better than those who do not. We prospectively followed up 91 patients with lateral epicondylitis for 12 months. The patients indicated their baseline coping status based on the Pain Catastrophizing Scale (PCS) and were discharged with a wait-and-see policy. During follow-up interviews, the patients described the nature of their condition in their own words and were then categorized into either positive or negative phrasing groups. We compared these two groups regarding current coping status and whether they had sought additional treatment. We also analyzed for the factors associated with these outcomes. There were no significant differences in baseline PCS scores between the two groups. At follow-up, patients in the positive phrasing group (n = 62) had significantly lower PCS scores and were less likely to seek additional treatment than those in the negative phrasing group (n = 29). Multivariable analyses showed that positive phrasing and low pain levels were independently associated with improvement in PCS scores and that negative phrasing and depression were independently associated with patients' seeking additional treatment. Patients' positive phrasing about their condition are associated with improvement in their coping status and with less use of medical resources in the case of lateral epicondylitis. This study suggests that patients with more positive attitudes toward their illness cope and comply better when a wait-and-see treatment is recommended by their physicians. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Anti-glomerular basement membrane glomerulonephritis in an HIV positive patient: case report

Directory of Open Access Journals (Sweden)

Eduardo José Bellotto Monteiro

Full Text Available We report on a case of a patient with HIV infection, diagnosed 18 months prior to the development of an anti-glomerular basement membrane (anti-GBM rapidly progressive glomerulonephritis; this is probably the first report of such an association. A 30-year-old white man presented with elevation of serum creatinine (1.3 - 13.5 mg/dL within one month. At admission, the urinalysis showed proteinuria of 7.2 g/L and 8,000,000 erythrocytes/mL. Renal biopsy corresponded to a crescentic diffuse proliferative glomerulonephritis mediated by anti-GBM, and serum testing for anti-GBM antibodies was positive; antinuclear antibodies (ANA and anti-neutrophilic cytoplasmic antibodies (ANCA were also positive. The patient underwent hemodyalisis and was treated with plasmapheresis, cyclophosphamide and prednisone. The association described here is not casual, as crescentic glomerulonephritis is not common in HIV-positive patients, anti-GBM glomerulonephritis is rare and anti-GBM antibodies are frequently observed in HIV-positive subjects when compared to the overall population. Based on the current case and on the elevated frequency of the positivity for such antibodies in this group of patients, it is advisable to be aware of the eventual association between these two conditions and to promote an active search for anti-GBM antibodies and early diagnosis of eventual urinary abnormalities in HIV-positive subjects, considering the severity of anti-GBM glomerulonephritis.

Vertigo in patients with benign paroxysmal positional vertigo.

Science.gov (United States)

Kentala, E; Pyykkö, I

2000-01-01

We retrieved information on 59 patients, 19 men and 40 women, with benign paroxysmal positional vertigo (BPPV) from the database of the otoneurologic expert system (ONE). The original number of patients was greater, but we excluded all those with hearing loss of any origin. The patients filled in a questionnaire concerning their symptoms, earlier diseases, accidents and tobacco and alcohol use. This information was then integrated with results of audiometric, otoneurologic and imaging studies. The mean age at onset of symptoms was 44 years. Most patients had had vertiginous spells for anxiety than the others [r(53) = 0.40, p floating sensation. The floating vertigo was most often provoked by pressure changes [r(54) = 0.41, p < 0.01] or changes in visual surroundings [r(54) = 0.52, p < 0.01].

Changing trends of hepatitis b seromarkers amongst pakistani population: a laboratory-based review

International Nuclear Information System (INIS)

Zafar, A.; Khan, E.; Khan, M.S.; Moiz, B.; Jafri, W.

2013-01-01

Objective: To study the changing trends of hepatitis B markers tested at Aga Khan University Hospital clinical laboratory according to the internationally recognised classification of hepatitis B profile. Methods: The retrospective study involved analysis of laboratory records of hepatitis B profiles of all patients collected from January 2001 to December 2008 at the Aga Khan University Hospital's clinical laboratory. Patients with complete profile tested were categorised according to the Centre for Diseases Control classification of hepatitis B profile. SPSS 16 was used for statistical analysis. Results: A total of 185,825 patients had serological markers for hepatitis B tested. Mean-age of reactive hepatitis B surface antigen (HBsAg) patients was 30+-12.5 years. HBsAg reactivity was significantly higher in males than females (34% vs 12%; p <0.0001). HBsAg showed a slight decline in the percentage reactivity during the 8-year study period, while a gradual increase in hepatitis B surface antibody (HBsAb) reactivity was observed. Of the total, 23% patients belonged to the 'susceptible to infection' category; 39% patients were classified as 'chronically-ill'; 12% patients were categorised as 'immune due to hepatitis B vaccination'. 3% patients were classed as 'acutely infected'. Overall, samples received from Peshawar, Quetta and Larkana showed very high reactivity rates. Conclusion: The study substantiated the general perception that levels of HBsAg is showing a decreasing trend, while levels of HBsAb are increasing perhaps due to better vaccination of population. (author)

Metabolic syndrome in human immunodeficiency virus positive patients

Directory of Open Access Journals (Sweden)

Sarita Bajaj

2013-01-01

Full Text Available Aims and Objectives : To assess the prevalence of metabolic syndrome (MetS in human immunodeficiency virus (HIV positive patients. Prevalence of MetS was compared in patients who were not on highly active antiretroviral therapy (HAART to patients who were on HAART. Materials and Methods: Seventy HIV positive cases were studied. Pregnant and lactating women, patients on drugs other than HAART known to cause metabolic abnormalities and those having diabetes or hypertension were excluded. Cases were evaluated for MetS by using National Cholesterol Education Program Adult Treatment Panel-III. Results: 47 cases were on HAART and 23 cases were not on HAART. Fasting Blood Glucose ≥100 mg/dl was present in 28.6% cases, out of whom 27.7% were on HAART and 30.4% were not on HAART (P = 0.8089. 12.9% cases had BP ≥130/≥85 mm Hg, out of whom 14.9% were on HAART and 8.7% were not on HAART (P = 0.4666. 42.9% cases had TG ≥150 mg/dl, out of whom 44.7% were on HAART and 39.1% were not on HAART (P = 0.6894. HDL cholesterol was low (males <40 mg/dl, females <50 mg/dl in 50% cases, out of whom 55.3% were on HAART and 39.1% were not on HAART (P = 0.2035. Conclusions: Prevalence of MetS was 20%. Majority of patients had only one component of MetS (32.9%. Low HDL was present in 50%, followed by raised triglycerides in 42.9%. Waist circumference was not increased in any of the patients. There was no statistically significant difference between those on HAART and those not on HAART in distribution of risk factors and individual components of MetS.

Effect of Positive Psychotherapy in Depression Symptoms and Character Strengths in Cancer Affected Patients

Directory of Open Access Journals (Sweden)

R Khodabakhash

2015-05-01

Full Text Available The purpose of this research was to study the effect of positive psychotherapy on depression symptoms and character strengths in cancer affected patients. Based on a quasi-experimental design by available sampling, 58 cancer patients were investigated. 30 patients were assigned in two groups: 15 patients in positive psychotherapy group (treatment and 15 patients as control group. In the present research, Oxford Happiness-Depression Questionnaire (OHDQ and Values In Action Inventory of Strengths (VIA-IS were used. The results showed that the positive psychotherapy was effective in reducing depression, increasing the character strengths and virtues, improving meaningful, pleasant and engaged life of cancer patients.

Joint positions matter for ultrasound examination of RA patients-increased power Doppler signal in neutral versus flat position of hands.

Science.gov (United States)

Husic, Rusmir; Lackner, Angelika; Stradner, Martin H; Hermann, Josef; Dejaco, Christian

2017-08-01

Position of joints might influence the result of US examination in patients with RA. The purpose of this work was to compare grey-scale (GS) and power Doppler (PWD) findings obtained in neutral vs flat position of hands. A cross-sectional study of 42 RA patients with active disease. Two dimensional and 3D sonography of wrists and MCP joints were conducted in two different joint positions: neutral position, which is a slight flexion of the fingers with relaxed extensor muscles; and flat position, where all palm and volar sides of fingers touch the Table. Two dimensional GS synovitis (GSS) and PWD signals were scored semi-quantitatively (0-3). For 3D sonography, the percentage of PWD voxels within a region of interest was calculated. GSS was not quantified using 3D sonography. Compared with neutral position, 2D PWD signals disappeared in 28.3% of joints upon flattening. The median global 2D PWD score (sum of all PWD scores of an individual patient) decreased from 8 to 3 ( P < 0.001), and the global 3D PWD voxel score from 3.8 to 0.9 ( P < 0.001). The reduction of PWD scores was similar in all joints (2D: minus 50%, 3D: minus 66.4-80.1%). Inter- and intrareader agreement of PWD results was good (intraclass correlation coefficient: 0.75-0.82). In RA, a neutral position of the hands is linked to a higher sensitivity of 2D and 3D sonography in detecting PWD signals at wrists and MCP joints, compared with a flat position. Standardization of the scanning procedure is essential for obtaining comparable US results in RA patients in trials and clinical routines. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Frequency of hepatitis B and C in central punjab

International Nuclear Information System (INIS)

Alam, M.; Tariq, W.U.Z.

2006-01-01

The purpose of this study was to assess the frequency of HBsAg and anti-HCV among apparently young health adults belonging to central Punjab. A total of 2038 young healthy adults belonging to central Punjab were included in the study. HBsAg and anti-HCV screening was done by rapid tests kits (Chromatographic immunoassay) and positive cases were confirmed by ELISA method from AFIP Rawalpindi. The district wise frequency of HBsAg and anti-HCV in our study was Sargodha (5.85%, 3.01%), Khushab (1.81%, 1.55%), Mianwali (0.75%, 1.50%), Faisalabad (7.31%, 10.45%), Jhang (7.02%, 5.84%), Toba Tak Singh (6.25%, 7.5%) respectively. This study indicates that there is high frequency HBsAg and anti-HCV among young adults belonging to central Punjab particularly, in Faisalabad, Jhang and Toba Tak Singh districts. (author)

[Manegement and countermeasures against tuberculous patients with chronic positive sputum].

Science.gov (United States)

Sato, K

1996-01-01

We studied measures for the prevention and treatment of chronic positive-sputum tuberculosis. Most physicians treating chronic intractable pulmonary tuberculosis are concerned about treatment and control measures. However, both the medical and social aspects of the disease must be dealt with. The study of the medical aspects of tuberculosis used data on patients at the Tokyo National Chest Hospital and other sanitoria in Japan. The socioeconomic study employed data from a health center in Tokyo. Recently, new cases of tuberculosis are concentrated in socioeconomically high risk groups, such as the homeless and illegal aliens, in a few large cities. Patients in these groups often have multidrug-resistant tuberculosis (MDRTB), including many patients with relapsing tuberculosis. However, it is dificult to keep such patients under treatment because of poor compliance and patient dropout. The results of our study are summarized as follows: 1. Prevention and treatment of chronic intractable tuberculosis should involve both the medical and socioeconomic aspects of the disease. 2. Surgical treatment offers benefits for patients with chronically positive sputum. Therefore, surgery should be recommended to patients with chronic intractable MDRTB. 3. If resistance to both isoniazid and rifampin is demonstrated, it is better to replace all ineffective drugs with a new effective regimen than to add a single drug to a failing regimen.

An ultrasound-based comparative study on carotid plaques in HIV-positive patients vs. atherosclerotic and arteritis patients: atherosclerotic or inflammatory lesions?

Science.gov (United States)

Maggi, Paolo; Perilli, Francesco; Lillo, Antonio; Carito, Valentina; Epifani, Giuseppe; Bellacosa, Chiara; Pastore, Giuseppe; Regina, Guido

2007-02-01

We have previously described two cases of HIV-1-positive patients undergoing surgery for stenosis of the internal carotid arteries. Histology revealed an extensive inflammatory infiltration of the vascular wall and no evidence of atheromasic plaque. This unexpected pattern of carotid damage prompted us to perform a more accurate investigation of the characteristics of carotid plaques in a group of HIV-positive patients. The results were compared with those obtained from young patients affected by atherosclerosis of the epi-aortic vessels and patients with arteritis. The patients underwent ultrasonography of the epi-aortic vessels using one of the latest generation power color-Doppler with 7.5 MHz probes. The study population included 61 HIV-positive patients and 47 HIV-negative patients (37 atherosclerotic and 10 with arteritis). Compared with HIV-negative atherosclerotic patients, there were significantly higher proportions of HIV-positive patients with iso-hypoechogenic lesions (81.8 vs. 29%) that were homogeneous both in their parietal and endoluminal portions (96.7 vs. 21.6% and 88.5 vs. 54.0%, respectively), with a smooth or slightly irregular surface (99.0 vs. 56.7%) (P=0.001 for all differences). No statistically significant differences were seen between HIV-positive and arteritis patients. Our study evidenced that the ultrasonographic structure of the epi-aortic lesions in HIV-positive patients substantially differ from those of the plaques in atherosclerotic patients, although they share similar characteristics with patients affected by arteritis. Further investigations are warranted to better define the structure and the mechanism of onset of these lesions.

Comparison of clinico-radiological features of patients with positive cultures of nontuberculous mycobacteria and patients with tuberculosis

International Nuclear Information System (INIS)

Ba-Hammam, Ahmed; Sharif, Yasir; Masood, Mohammad; Isnani, Arthur; Youssef, Ismael; Kambal, Abdelmageed; Shaikh, Shaffi

2005-01-01

To identify the clinico-radiological features of patients with positive cultures for nontuberculous mycobacteria (NTM) and compare those to a sample of patients with tuberculosis (MTB). A laboratory database was used to retrieve all specimens submitted to King Khalid University Hospital, Riyadh, mycobacteriology laboratory for mycobacterial smears and cultures during the period from October 1999-April 2002. Using this database, the original records of the mycobacteriology laboratory and a review of the patient's health records, a standard proforma was completed that included demographic, clinical, radiological and laboratory information on patients included in this study. The patients were divided into 2 groups; the NTM group, which included patients with positive cultures for NTM and the MTB group, which included a sample of patients with documented tuberculosis. During the study period, 286 patients had positive mycobacterial cultures. Seventy patients (24.5%) grew NTM and 216 (75.5%) grew MTB. For patients with MTB, 54 patients were included as per the selection protocol of the study. There was no difference between the 2 groups in all measured demographic variables. The presence of weight loss and fever was significantly more in the MTB group. Radiologically, the presence of hilar adenopathy was more significant among patients with MTB than those with NTM (17% versus 4%, p=0.02). However, bronchiectatic changes were seen significantly more among NTM patients compared to patients with MTB (26% versus 11%, p=0.03). The isolation of NTM in the mycobacteriology laboratory is high. The clinico-radiological features were not sufficiently specific to differentiate patients with NTM from patients with MTB. Local studies are needed to explore NTM disease in various developing countries and identify the NTM species causing infections in non-immunosuppressed patients in each locality. (author)

Use of nitrocellulose blotting for the study of hepatitis B surface antigen electrophoresed in agarose gels

Energy Technology Data Exchange (ETDEWEB)

McMichael, J C; Greisiger, L M; Millman, I [Institute for Cancer Research, Philadelphia, PA (USA). Fox Chase Cancer Center

1981-08-28

Nitrocellulose-protein blotting of serum electrophoresed in agarose gels has been adapted for the study of hepatitis B surface antigen (HBsAg). /sup 125/I-labeled anti-HBs was used as the antigen probe, and the electrophoretic migration was monitored by autoradiography. The method required 3 ..mu..l or less of serum and could detect as little as 1 pg of purified HBsAg. Typically, the authors observed two bands of HBsAg; a moving band which migrated about one-third the distance moved by human serum albumin and a non-migratory band which remained at the loading site. Some examples of the use of the method include: (1) empirical methods for correlating HBsAg concentration in serum to film darkness; (2) observations of mobility changes in serial sera from dialysis patients with chronic HBsAg antigenemia; and (3) detection of related antigens such as antigen from the PLC/PRF/5 hepatoma tissue culture line and the cross-reacting woodchuck hepatitis virus surface antigen (WHsAg).

Ipsilateral shoulder pain in patients following lung resection in the decubitus position.

Science.gov (United States)

Bando, Takae; Kondo, Kazuya; Onishi, Chiemi; Kajiura, Koichiro; Takizawa, Hiromitsu; Yamada, Kazuyo; Sato, Hiromi; Imai, Yoshie

2018-03-01

To examine the frequency, influencing factors and clinical course of shoulder pain in patients following lung resection. Thoracoscopes have been introduced in the surgical treatment of lung cancer and allow for less invasive surgery with a minimal incision. However, decubitus position-related shoulder pain on the operated side has not yet been investigated. A longitudinal descriptive study. Patients who underwent lung resection in the decubitus position. Patients were interviewed 2 days before surgery and once daily for 5 days after surgery. Interview items included background data, the concomitant use of epidural anaesthesia, operative duration, the presence of preoperative shoulder stiffness (excluding shoulder pain), type of surgery and site of operation. The intensity of pain was approximately 5 on an 11-point numerical rating scale. Descriptive statistics on patient backgrounds were obtained using SPSS Statistics 22 for Windows. Of the 74 patients who underwent lung resection in a decubitus position, 30 (40.5%) developed shoulder pain on the operated side. The highest rating occurred 1 day after surgery and decreased over time. The following two factors were found to influence shoulder pain on the operated side: operative duration (Z = -2.63; p = .01) and the presence of preoperative shoulder stiffness (excluding shoulder pain) (χ 2  = 4.16; p = .04). This study demonstrated that approximately 40% of patients who underwent lung resection in the decubitus position developed shoulder pain. The presence of postoperative shoulder pain was related to both the duration of the operation and to the presence of preoperative shoulder stiffness. Although the shoulder pain resolves within 4 days, it causes the patient additional discomfort and distress. Therefore, further research is needed on positioning for thoracotomy in order to investigate ways to reduce or eliminate this complication of lung surgery. © 2017 John Wiley & Sons Ltd.

Non-typhoidal Salmonella and Campylobacter infections among HIV-positive patients in Denmark

DEFF Research Database (Denmark)

Larsen, I.K.; Gradel, Kim Oren; Helms, M.

2011-01-01

Non-typhoidal Salmonella (NTS) and Campylobacter are common causes of diarrhoea in human immunodeficiency virus (HIV)-positive patients. To investigate if incidence has changed since the introduction of highly active antiretroviral therapy (HAART), we combined data from The Danish Surveillance Re...... population. Moreover our study suggests that there is an increased incidence of Campylobacter-related illness among homosexual men in the HIV-positive population.......Non-typhoidal Salmonella (NTS) and Campylobacter are common causes of diarrhoea in human immunodeficiency virus (HIV)-positive patients. To investigate if incidence has changed since the introduction of highly active antiretroviral therapy (HAART), we combined data from The Danish Surveillance...... Registry for Enteric Pathogens and The Danish National Hospital Registry. We found that the incidences of NTS- and Campylobacter-related illness among HIV-positive patients in Denmark have declined since the introduction of HAART, although the incidences remained higher compared to the background...

The influence of patient positioning in breast CT on breast tissue coverage and patient comfort

Energy Technology Data Exchange (ETDEWEB)

Roessler, A.C.; Althoff, F.; Kalender, W. [Erlangen Univ. (Germany). Inst. of Medical Physics; Wenkel, E. [University Hospital of Erlangen (Germany). Radiological Inst.

2015-02-15

The presented study aimed at optimizing a patient table design for breast CT (BCT) systems with respect to breast tissue coverage and patient comfort. Additionally, the benefits and acceptance of an immobilization device for BCT using underpressure were evaluated. Three different study parts were carried out. In a positioning study women were investigated on an MRI tabletop with exchangeable inserts (flat and cone-shaped with different opening diameters) to evaluate their influence on breast coverage and patient comfort in various positioning alternatives. Breast length and volume were calculated to compare positioning modalities including various opening diameters and forms. In the second study part, an underpressure system was tested for its functionality and comfort on a stereotactic biopsy table mimicking a future CT scanner table. In the last study part, this system was tested regarding breast tissue coverage. Best results for breast tissue coverage were shown for cone-shaped table inserts with an opening of 180 mm. Flat inserts did not provide complete coverage of breast tissue. The underpressure system showed robust function and tended to pull more breast tissue into the field of view. Patient comfort was rated good for all table inserts, with highest ratings for cone-shaped inserts. Cone-shaped tabletops appeared to be adequate for BCT systems and to allow imaging of almost the complete breast. An underpressure system proved promising for the fixation of the breast during imaging and increased coverage. Patient comfort appears to be adequate.