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Farshadpour F, Taherkhani R, Farajzadeh H. Hepatitis B infection among β-thalassemia major patients in Bushehr province of southern Iran. J Immunoassay Immunochem 2023; 44:147-161. [PMID: 36587831 DOI: 10.1080/15321819.2022.2163178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This study was performed to determine the prevalence, genotype distribution and risk factors of hepatitis B virus (HBV) infection among β-thalassemia patients. ELISA was used to detect HBsAg and HBcAb. Molecular evaluation of HBV infection was performed by nested PCR, targeting S, X and pre-C regions of the genome, and sequencing. Of 126 thalassemia patients, 4 cases (3.17%) were positive for HBsAg, 23 cases (18.25%) were positive for HBcAb, and 6 cases (4.76%) had HBV viremia with genotype D, sub-genotype D3 and subtype ayw2. HBV prevalence among thalassemia patients was not statistically associated with gender distribution, place of residency, marital status and frequency of blood transfusion. HBsAg seroprevalence was significantly higher in Afghan immigrants and patients with ALT levels of 41-80 IU/L. The prevalence of HBV viremia was significantly higher among thalassemia patients aged >20 years compared to the patients aged <20 years. Moreover, 1.59% of thalassemia patients had seropositive occult HBV infection, which was positive for HBV-DNA and HBcAb but negative for HBsAg. Considering the relatively high prevalence of occult HBV infection among thalassemia patients, there is a possibility of their contamination through donated blood. Therefore, screening of donated blood based on detection of HBsAg cannot abolish HBV transmission through blood transfusion.
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Affiliation(s)
- Fatemeh Farshadpour
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Reza Taherkhani
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Hossein Farajzadeh
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
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Taherkhani R, Farshadpour F, Asayesh R. Prevalence and Genotypes of Hepatitis C Infection Among Hemodialysis Patients in Bushehr, Iran. Oman Med J 2023; 38:e481. [PMID: 37073372 PMCID: PMC10105900 DOI: 10.5001/omj.2023.60] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/26/2022] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To investigate the prevalence, genotype distribution, and risk factors of hepatitis C virus (HCV) infection among patients undergoing regular hemodialysis in Bushehr province in southern Iran. METHODS All chronic hemodialysis patients from the cities of Dashtestan, Genaveh, and Bushehr participated in this study. Enzyme-linked immunosorbent assay was used to detect anti-HCV antibodies. Molecular detection of HCV infection was performed by semi-nested reverse transcription polymerase chain reaction assay, targeting 5' untranslated region and core region of the genome, and sequencing. RESULTS Of 279 hemodialysis patients, 15 (5.4%) were positive for anti-HCV antibodies, and two (0.7%) patients had HCV viremia with genotype 3a. The hemodialysis patients had a significantly higher seroprevalence of HCV than the control group (p =0.007). Patients with Arab ethnicity had significantly higher anti-HCV seroprevalence compared to those with Fars ethnicity (p =0.026). Anti-HCV seropositivity was not statistically associated with the patients' sex, age group, place of residence, level of education, duration of hemodialysis, or history of blood transfusion. CONCLUSIONS Considering the high seroprevalence of HCV in hemodialysis patients, regular screening of these patients for HCV infection and prompt treatment of those found infected are recommended.
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Affiliation(s)
- Reza Taherkhani
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Fatemeh Farshadpour
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Reza Asayesh
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
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Dopico E, Rodriguez-Frias F, Ubillos I, Rando-Segura A, Garcia-Cehic D, Gregori J, Rando-Matos Y, Solsona L, Niubó J, Esteban JI, Costa J, Martínez MJ, Quer J. Prevalence of Hepatitis C Virus Infection, Genotypes and Subtypes in Migrants from Pakistan in Barcelona, Spain. Infect Drug Resist 2022; 15:4637-4644. [PMID: 36003985 PMCID: PMC9394658 DOI: 10.2147/idr.s367715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) is a major cause of chronic liver infection with 71 million people infected worldwide. Pakistan has the second highest prevalence of HCV infection and more than half (52%) of Pakistani living in Spain reside in Barcelona. The aim of this study was to analyse the seroprevalence and viraemic rate and determine the genotypes and subtypes of HCV among Pakistanis living in the southern metropolitan area of Barcelona. METHODS We included all Pakistani patients seeking primary healthcare in the southern metropolitan area of Barcelona from August 2011 to July 2014. Serum samples were screened for HCV antibodies. HCV viral load was determined by reverse transcription polymerase chain reaction and genotypes and subtypes were performed using Versant HCV Genotype and/or deep-sequencing. Screening for hepatitis B virus (HBV) was also carried out. RESULTS Among 5877 Pakistani patients, 565 (9.61%) were screened for anti-HCV antibodies, with 68 (12.04%) being positive. The viral load was determined in 65, with 31 presenting active infection and the viraemic rate was 47.69% (95% confidence interval 36.02-59.62). HCV genotyping and subtyping were performed in 24 individuals. Most infections corresponded to HCV genotype 3 (91.67%), and high resolution HCV subtyping was performed in 18 samples, 16 of which presented subtype 3a. One subject presented HBV coinfection with undetectable HBV DNA. During the study period, we identified a possible case of HCV vertical transmission followed by spontaneous viraemia clearance in a chronically infected mother with a C/T IL28B genetic polymorphism. CONCLUSION These results suggest that general HCV screening protocols in patients from high prevalence countries, such as Pakistan, would be helpful to identify and treat active HCV infections. This could avoid further transmission and contribute to building targeted health policies for micro-elimination of HCV infection in specific communities.
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Affiliation(s)
- Eva Dopico
- Microbiology Department, Laboratori Clínic Territorial Metropolitana Sud, Hospital Universitari de Bellvitge, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Francisco Rodriguez-Frias
- Biochemistry Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Biochemistry and Molecular Biology Department, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - Itziar Ubillos
- Laboratory Clínic Territorial Metropolitana Sud, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain
| | - Ariadna Rando-Segura
- Biochemistry Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Damir Garcia-Cehic
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Josep Gregori
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Yolanda Rando-Matos
- Equip d’Atenció Primària Florida Nord, Gerència d’Àmbit d’Atenció Primària Metropolitana Sud, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Luis Solsona
- Equip d’Atenció Primària Florida Nord, Gerència d’Àmbit d’Atenció Primària Metropolitana Sud, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Jordi Niubó
- Microbiology Department, Laboratori Clínic Territorial Metropolitana Sud, Hospital Universitari de Bellvitge, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Juan Ignacio Esteban
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Josep Costa
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Microbiology Department, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Miguel J Martínez
- Microbiology Department, Hospital Clínic, University of Barcelona, Barcelona, Spain
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Josep Quer
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Biochemistry and Molecular Biology Department, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
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Malik GF, Zakaria N, Majeed MI, Ismail FW. Viral Hepatitis - The Road Traveled and the Journey Remaining. Hepat Med 2022; 14:13-26. [PMID: 35300491 PMCID: PMC8922334 DOI: 10.2147/hmer.s352568] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/24/2022] [Indexed: 12/16/2022] Open
Abstract
Hepatitis is defined as inflammation of the liver and is commonly due to infection with The hepatotropic viruses - hepatitis A, B, C, D and E. Hepatitis carries one of the highest disease burdens globally and has caused significant morbidity and mortality among different patient populations. Clinical presentation varies from asymptomatic or acute flu-like illness to acute liver failure or chronic liver disease, characterized by jaundice, hepatomegaly and ascites among many other signs. Eventually, this can lead to fibrosis (cirrhosis) of the liver parenchyma and carries a risk of development into hepatocellular carcinoma. Hepatitis B and C are most notorious for causing liver cirrhosis; in 2019, an estimated 296 million people worldwide had chronic hepatitis B infection and 58 million are currently estimated to have chronic hepatitis C, with 1.5 million new infections of both hepatitis B and C, occurring annually. With the help of latest serological biomarkers and viral nucleic acid amplification tests, it has become rather simple to efficiently screen, diagnose and monitor patients with hepatitis, and to commence with appropriate antiviral treatment. More importantly, the development of vaccinations against some of these viruses has greatly helped to curb the infection rates. Whilst there has been exceptional progress over the years in the management of viral hepatitis, many hurdles still remain which must be addressed in order to proceed towards a hepatitis-free world. This review will shed light on the origin and discovery of the hepatitis viruses, the global epidemiology and clinical symptoms, diagnostic modalities, currently available treatment options, the importance of prevention, and the journey needed to move forward towards the eradication of its global disease burden.
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Affiliation(s)
- Ghulam Fareed Malik
- Section of Gastroenterology, Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | - Noval Zakaria
- Section of Gastroenterology, Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | | | - Faisal Wasim Ismail
- Section of Gastroenterology, Department of Medicine, The Aga Khan University, Karachi, Pakistan
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Taherkhani R, Farshadpour F. Prevalence, genotype distribution and mutations of hepatitis B virus and the associated risk factors among pregnant women residing in the northern shores of Persian Gulf, Iran. PLoS One 2022; 17:e0265063. [PMID: 35271684 PMCID: PMC8912131 DOI: 10.1371/journal.pone.0265063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/22/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Considering perinatal transmission and the high rate of chronic hepatitis B virus (HBV) infection in infants, diagnosis of HBV infection during pregnancy and timely interventions are of great importance. Therefore, this study was performed to investigate the prevalence and genotype distribution of HBV infection and the associated risk factors among pregnant women in the northern shores of the Persian Gulf, South of Iran. METHODS Serum samples of 1425 pregnant women were tested for the presence of HBsAg and HBcAb by ELISA (HBsAg one-Version ULTRA and HBc Ab ELISA kits, DIA.PRO, Milan, Italy). The seropositive samples were tested for the presence of HBV DNA by nested PCR, targeting S, X, pre-core (pre-C), and basal core promoter (BCP) regions of the HBV genome. The amplified fragments were sequenced by Sanger dideoxy sequencing technology to evaluate the genotype distribution and mutations of HBV infection by using the MEGA 7 software. The HBV seropositive pregnant women were tested for HCV and HIV coinfections by ELISA (HCV Ab and HIV Ab/Ag ELISA kits, DIA.PRO, Milan, Italy). RESULTS Of 1425 participants, 15 pregnant women (1.05%, 95% CI: 0.64%-1.73%) were positive for HBsAg, 41 women (2.88%, 95% CI: 2.10%-3.88%) were positive for HBcAb, and 5 women (0.35%, 95% CI: 0.15% -0.82%) had HBV viremia with genotype D, sub-genotype D3 and subtype ayw2. One of the viremic samples was positive for HBcAb but negative for HBsAg, which is indicative of an occult HBV infection. HBsAg seroprevalence was higher among pregnant women aged 20 to 29 years, women in the third trimester of pregnancy, residents of Khormuj city, Afghan immigrants, illiterate women, and pregnant women with a history of tattoo and HBV vaccination. The highest rate of HBcAb seroprevalence was observed in residents of Borazjan city, Turk ethnicity, the age group >39 years, and those women with more parities and a history of abortion. Nevertheless, HBV seroprevalence among pregnant women was not statistically associated with these variables. In contrast, HBcAb seropositivity was significantly associated with the history of tattoo (P = 0.018). According to mutations analyses, seven amino acid substitutions in the HBsAg, one point mutation in the pre-C region, and five points mutations in the BCP region were detected. Besides, the BCP mutations caused amino acid substitutions in the X protein. Of note, the conversion of Ala → Val at amino acid 168 (A168V) and Thr → Pro at amino acid 127 (T127P) were detected in HBsAg of the occult HBV strain. CONCLUSION These results indicate a relatively low prevalence of HBV infection among pregnant women in the South of Iran, while tattooing is a risk factor for exposure to HBV infection. Moreover, all of the HBV-positive pregnant women were asymptomatic and unaware of their infection. Therefore, routine screening for HBV markers during pregnancy, appropriate treatment of HBV-infected women, and HBV vaccination are recommended to decrease mother-to-child transmission of HBV.
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Affiliation(s)
- Reza Taherkhani
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Fatemeh Farshadpour
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
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Beykaso G, Mulu A, Giday M, Berhe N, Selamu M, Mihret A, Teklehaymanot T. Burden and Transmission Risks of Viral Hepatitis in Southern Ethiopia: Evidence Needed for Prevention and Control Measures. Risk Manag Healthc Policy 2021; 14:4843-4852. [PMID: 34880693 PMCID: PMC8646867 DOI: 10.2147/rmhp.s336776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/13/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) and hepatitis C virus (HCV) are significant causes of liver-associated morbidity and mortality for millions of people globally. Ethiopia is one of the viral hepatitis-endemic countries with no national strategy for surveillance and limited data. As such, this study aimed to investigated the extent and associated risk factors of HBV and HCV among community members in southern Ethiopia. METHODS A community-based cross-sectional study was conducted from January 2020 to August 2020. A structured questionnaire was used to collect behavioral and sociodemographic data. Serum samples were collected and assayed for seromarkers of HBV (HBsAg, anti-HBc, and anti-HBs) and HCV (anti-HCV) using ELISAs. In HBsAg-positive samples, HBV DNA was further quantified using RT-PCR. Data were entered into EpiData 3.1 and analyzed using SPSS 21.0. Descriptive statistics and logistic regression analysis were employed. RESULTS The study included 693 participants. Seromarkers for HBsAg, anti-HCV, anti-HBc, and anti-HBs were found to be 9.5%, 1.4%, 31.1%, and 14.3%, respectively. In 66 HBsAg positives, 57 (86.4%) had quantifiable HBV DNA. Prevalence of current HBV infection (HBsAg+, anti-HBc+, anti-HBs-) and lifetime exposure (positive for either HBsAg or anti-HBc) to HBV were 8.7% and 31.9%, respectively, and 63.1% of participants were vulnerable or had no evidence of prior HBV infection (HBsAg-, anti-HBc-, anti-HBs-). On multivariate logistic regression analysis, multiple sexual contacts, family history of hepatitis infection, alcohol consumption, and khat chewing were significantly associated with HBV. The seroprevalence of HBV was relatively high in this study area. CONCLUSION This study showed high prevalence of HBV infection, but low prevalence of HCV. This indicates that HBV is a major health problem in this community. Population-based surveillance, care, and treatment, as well as behavioral change and education programs, should be enhanced to minimize risk exposure.
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Affiliation(s)
- Gizachew Beykaso
- Department of Molecular Biology and Immunology, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Andargachew Mulu
- Department of Virology, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Mirutse Giday
- Department of Molecular Biology and Immunology, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nega Berhe
- Department of Molecular Biology and Immunology, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Markos Selamu
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Adane Mihret
- Department of Virology, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Tilahun Teklehaymanot
- Department of Molecular Biology and Immunology, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Farshadpour F, Taherkhani R, Bakhtiari F. Prevalence and Predominant Genotype of Hepatitis C Virus Infection and Associated Risk Factors among Pregnant Women in Iran. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9294276. [PMID: 34589552 PMCID: PMC8476243 DOI: 10.1155/2021/9294276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/02/2021] [Accepted: 08/24/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Knowledge regarding the prevalence and risk factors of hepatitis C virus (HCV) infection among pregnant women can give clue to health care providers regarding the appropriate management of HCV infection. Therefore, this study was conducted to determine the prevalence, genotypic pattern, and risk factors of HCV infection among pregnant women in the northern shores of the Persian Gulf, south of Iran. METHODS From January 2018 to June 2019, serum samples were obtained from 1425 pregnant women, ages ranging from 14 to 46 years (28.1 ± 5.99). Serum samples were tested for detection of anti-HCV antibodies using an enzyme-linked immunosorbent assay (ELISA) (HCV Ab ELISA kit, Dia.Pro, Milan, Italy). Following the extraction of nucleic acid, the molecular evaluation of HCV infection was performed by seminested reverse transcriptase-polymerase chain reaction assay (RT-PCR), targeting the 5' untranslated region (5'UTR) and core of HCV genome and sequencing. RESULTS Of the 1425 pregnant women, 19 women (1.33%, 95% CI: 0.85%-2.07%) were positive for anti-HCV antibodies. The majority of HCV-seropositive women were in the third trimester of pregnancy, educated, and had a history of blood transfusion, abortion, surgery, or dentistry. Moreover, Arab and Fars pregnant women and those aged >39 years had the highest rate of HCV seroprevalence. Nevertheless, none of these variables were significantly associated with HCV seropositivity. In contrast, HCV seropositivity was associated with place of residency, so that residents of Khormuj city had significantly higher HCV seroprevalence compared to the residents of other cities (OR: 7.05; 95% CI: 1.75-28.39; P = 0.006). According to the molecular evaluation, 9 of the 19 HCV-seropositive pregnant women (47.37%) had HCV viremia with genotype 3a. CONCLUSION This study reports the HCV prevalence of 1.33% for anti-HCV antibodies and 0.63% for HCV RNA among pregnant women in the south of Iran. Considering the asymptomatic nature of chronic HCV infection and the fact that vertical transmission is possible in women with detectable viremia, therefore, screening of women before pregnancy is recommended to reduce the risk of HCV infection and its complications during pregnancy.
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Affiliation(s)
- Fatemeh Farshadpour
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
- Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Reza Taherkhani
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
- Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Farkhondeh Bakhtiari
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
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Kassa Y, Million Y, Biset S, Moges F. Hepatitis B and Hepatitis C Viral Infections and Associated Factors Among Prisoners in Northeast Ethiopia. J Blood Med 2021; 12:561-570. [PMID: 34267568 PMCID: PMC8275151 DOI: 10.2147/jbm.s314556] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/16/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Hepatitis is an inflammation of the liver and often caused by viruses. Hepatitis viruses are the leading causes of liver-related morbidity and mortality worldwide, with Hepatitis B and C viruses share the great majority. Studies have shown that prison settings are one of the high-risk environments for the transmission of these viruses. However, there is limited information on the seroprevalence and associated factors of hepatitis B and C viral infection among Ethiopian prisoners. METHODS A facility-based cross-sectional study was conducted among 339 prisoners in Dessie town, Ethiopia from February to April 2020. Hepatitis B surface antigen and antibody against hepatitis C virus in serum were determined using Enzyme-Linked Immunosorbent Assay. We imputed the data using "EpiData 3.1" software and exported it to Statistical Package for Social Sciences version 20.0 for analysis, and a p-value of <0.05 was considered statistically significant. RESULTS The overall seroprevalence of hepatitis B surface antigen and anti-hepatitis C virus among prisoners was 22/339 (6.5%) (95% CI = 3.8-9.4), and 4/339 (1.2%) (95% CI = 0.0-2.4), respectively. Multiple sexual partners, previous imprisonment, body tattooing, and contact with the jaundiced patient were independently associated with hepatitis B virus infection. Prisoners who had a history of blood transfusion, and dental extraction were independently associated with hepatitis C virus infection. CONCLUSION The seroprevalence of hepatitis B and hepatitis C viral infection among Dessie town prisoners was intermediate and low, respectively. The finding of a significant association between the presence of Hepatitis B surface antigen and hepatitis C virus antibodies among prisoners and factors calls for the need of serological testing for both Hepatitis B and C viruses to high-risk individuals. Strengthening screening strategies and prevention programs in prison settings is advisable to prevent disease transmission.
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Affiliation(s)
- Yeshimebet Kassa
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yihenew Million
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sirak Biset
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Feleke Moges
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Taherkhani R, Taherkhani S, Farshadpour F. Dynamics of host immune responses to SARS-CoV-2. World J Clin Cases 2021; 9:4480-4490. [PMID: 34222416 PMCID: PMC8223819 DOI: 10.12998/wjcc.v9.i18.4480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 04/07/2021] [Accepted: 04/23/2021] [Indexed: 02/06/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the most recent global health threat, is spreading throughout the world with worrisome speed, and the current wave of coronavirus disease 2019 (COVID-19) seems to have no mercy. While this mysterious virus challenges our ability to control viral infections, our opportunities to control the COVID-19 pandemic are gradually fading. Currently, pandemic management relies on preventive interventions. Although prevention is a good strategy to mitigate SARS-CoV-2 transmission, it still cannot be considered an absolute solution to eliminate this pandemic. Currently, developing a potent immunity against this viral infection seems to be the most promising strategy to drive down this ongoing global tragedy. However, with the emergence of new challenges in the context of immune responses to COVID-19, the road to control this devastating pandemic seems bumpier; thus, it is pivotal to characterize the dynamics of host immune responses to COVID-19, in order to develop efficient prophylactic and therapeutic tools. This begs the question of whether the effector mechanisms of the immune system are indeed potent or a possible contributing factor to developing more severe and lethal forms of COVID-19. In this review, the possible role of the immunopathologic phenomena including antibody-dependent enhancement, cytokine storm, and original antigenic sin in severity and mortality of COVID-19 will be discussed.
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Affiliation(s)
- Reza Taherkhani
- Department of Virology, Bushehr University of Medical Sciences, Bushehr 7514633341, Iran
- Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr 7514633341, Iran
| | - Sakineh Taherkhani
- School of Medicine, Arak University of Medical Sciences, Arak 3848176589, Iran
| | - Fatemeh Farshadpour
- Department of Virology, Bushehr University of Medical Sciences, Bushehr 7514633341, Iran
- Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr 7514633341, Iran
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Seroepidemiology of Hepatitis B and C Virus Infections: A Five-Year Retrospective Study among Blood Donors in Saboba District in the Northern Region of Ghana. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5599705. [PMID: 34055986 PMCID: PMC8133840 DOI: 10.1155/2021/5599705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/21/2021] [Accepted: 04/29/2021] [Indexed: 11/17/2022]
Abstract
Methods A five-year hospital-based retrospective study was carried out among 8605 blood donors comprising 8517 males and 88 females using data on blood donors from Saboba Assemblies of God Hospital located in the Saboba District in the Northern Region of Ghana from 2013 to 2017. Blood bank records on HBV and HCV potential blood donors who visited the hospital to donate blood were retrieved. Donor demographic details, i.e., age and gender, were also recovered. Donors who were registered to the hospital but were not residents of the Northern Region were excluded from the study. Donors with incomplete records were also excluded from the study. The data was managed using Microsoft Excel spreadsheet 2016 and analysed using GraphPad Prism statistical software. Results The overall prevalence of asymptomatic viral hepatitis B and C infections in the general adult population was 9.59% (95% CI: 9.00-10.20) and 12.71% (95% CI: 12.00-13.40), respectively, with an HBV/HCV coinfection rate of 2.23% (95% CI: 1.90-2.60). The number of donors generally declined with advancement in years from 2038 (23.68%) since 2013 to as low as 1169 (13.59%) in 2016, except for 2017 where a sharp increase of 1926 (22.38%) was observed. The first and second highest proportions of donors fell within the age categories of 20-29 (51.53% (4434)) and 30-39 (32.90% (2831)) respectively. The seroprevalence rate of HBV, HCV, and HBV/HCV coinfection rates were generally higher among the female group than those observed among the male category. The year-to-year variation in HBV, HCV, and HBV/HCV infections was statistically significant. The highest year-to-year HBV seropositivity rate was 11.48% in the year 2013, while that for HCV and HBV/HCV coinfection was 16.24% and 5.85%, respectively, both documented in the year 2014. HBV and HBV/HCV coinfection rates were highest among donors aged <20 years old, while HCV seroprevalence was highest among donors aged 50-59 years old. Significantly higher odds of HBV/HCV coinfection (OR = 5.2; 95% CI:3.3-8.1) was observed in the 2014 compared to the year 2013. Donors aged <20years were at higher risks of HBV and HBV/HCV coinfection rates compared to the other age groups. Conclusion The seroprevalence of HBV and HCV among donors in the Saboba District of the Northern Region of Ghana is endemic. The HBV/HCV coinfection rate also raises serious concern owing to its high prevalence rate among the younger age. Intensive public health education coupled with mobile screening and mass vaccination of seronegative individuals is advised so as to help curb further spread of the infection and in effect help safeguard the health status of potential donors in the district.
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11
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Farshadpour F, Taherkhani R. Antibody-Dependent Enhancement and the Critical Pattern of COVID-19: Possibilities and Considerations. Med Princ Pract 2021; 30:422-429. [PMID: 33882487 PMCID: PMC8339023 DOI: 10.1159/000516693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 04/20/2021] [Indexed: 12/14/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), a pandemic infection with profound effects on human society, has challenged our ability to control viral infections. Although at the beginning of the COVID-19 outbreak, the epidemic seemed controllable in Southern Iran, the disease presented a critical pattern as of May 2020. After a few months of the emergence of COVID-19, its severity and mortality increased dramatically. It has been proposed that antibodies produced during previous exposure to local circulating human coronaviruses or possibly severe acute respiratory syndrome coronavirus 2 might contribute to the development of more severe and lethal presentations of COVID-19 possibly by triggering antibody-dependent enhancement. The binding of virions complexed with antibodies to Fcγ receptors on the target cells initiates receptor-mediated signaling events, leading to enhanced expression of inflammatory cytokines and suppression of intracellular antiviral responses at the transcriptome level, followed by endocytosis of the virus and subsequent activation of immune cells. The activated immune cells might accumulate in the lung and promote cytokine storm and lymphopenia. Furthermore, the formation of immune complexes can promote complement activation and subsequent tissue damage. Although there are currently no clinical data to support this hypothesis, a better understanding of these immunopathologic phenomena and their relation to the disease course and severity might give insights into the development of the most efficient prophylactic and therapeutic approaches. This review demonstrates the critical pattern of COVID-19 in Southern Iran and highlights the possible interplay of factors leading to this condition.
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Affiliation(s)
- Fatemeh Farshadpour
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
- Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Reza Taherkhani
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
- Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
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12
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Wei J, Wang L, Yang X. Game analysis on the evolution of COVID-19 epidemic under the prevention and control measures of the government. PLoS One 2020; 15:e0240961. [PMID: 33095788 PMCID: PMC7584231 DOI: 10.1371/journal.pone.0240961] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 10/06/2020] [Indexed: 12/12/2022] Open
Abstract
In this paper, the interaction strategies and the evolutionary game analysis of the actions taken by the government and the public in the early days of the epidemic are incorporated into the natural transmission mechanism model of the epidemic, and then the transmission frequency equations of COVID-19 epidemic is established. According to the cumulative confirmed cases of COVID-19 in the UK and China, the upper limit of the spread of COVID-19 in different evolutionary scenarios is set. Using SPSS to perform logistic curve fitting, the frequency fitting equations of cumulative confirmed cases under different evolution scenarios are obtained respectively. The analysis result shows that the emergency response strategy adopted by the government in the early days of the epidemic can effectively control the spread of the epidemic. Combined with the transmission frequency equation of COVID-19 epidemic, measures taken by the government are analyzed. The influence of each measure on the frequency variable is judged and then the influence on the spread of the epidemic is obtained. Finally, based on the above analysis, the government is advised to adhere to the principles of scientific, initiative and flexibility when facing major epidemics.
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Affiliation(s)
- Jinyu Wei
- School of Management, Tianjin University of Technology, Tianjin, China
| | - Li Wang
- School of Management, Tianjin University of Technology, Tianjin, China
| | - Xin Yang
- Zhonghuan Information College Tianjin University of Technology, Tianjin, China
- * E-mail:
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13
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Mirzazadeh A, Hosseini-Hooshyar S, Shahesmaeili A, Bahramnejad A, Barshan A, Mousavian G, Najafi E, Sharifi H, Haghdoost AA, Briceno A, McFarland W, Page K. Barriers and motivators to participation and retention in HIV/HCV cohort studies among people who inject drugs: a community consultation in Iran. Subst Abuse Treat Prev Policy 2020; 15:56. [PMID: 32758246 PMCID: PMC7405425 DOI: 10.1186/s13011-020-00298-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 07/22/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The lack of robust estimates of HIV/HCV incidence among people who inject drugs (PWID) in Iran calls for well-designed prospective cohort studies. Successful recruitment and follow-up of PWID in cohort studies may require formative assessment of barriers PWID are faced with in participation and retention in cohort studies and factors they think may facilitate their engagement in such studies. Using a focus group discussion (FGD) format, we conducted a consultation with PWID in southeast Iran to recognize those barriers and motivators. METHODS Using targeted sampling and through snowball referrals, we recruited PWID (aged≥18, injected in last 6 months) from community-based drop-in centers (DICs), homeless shelters, and through outreach efforts to participate in four FGDs (one women-only). Socio-demographic characteristics, injection behaviors and self-reported HCV/HIV testing and diagnosis history were obtained. Then, a semi-structured FGD guide was applied to explore barriers and motivators to participation and retention in cohort studies among study participants. All FGD sessions were recorded and transcribed verbatim, removing any identifying information. The content of FGDs were analyzed by thematic analysis using an inductive approach. RESULTS In total, 30 individuals (10 women) participated in the study. The median age of participants was 35 (IQR 31-40), with majority (73.3%) reporting injecting drug use within the last month. Only 40.0% reported ever being tested for HCV whereas a larger proportion (63.4%) reported ever being tested for HIV. While the majority were willing to participate in cohort studies, breach of confidentiality, fear of positive test results, perceived required commitment, and marginalization were reported as barriers to participation and retention in such studies. Monetary incentive, the thought of a better life, protection from police interventions and trust between health workers and PWID were addressed as motivators of engagement in cohort studies among PWID. CONCLUSIONS Strategies to enhance data security and reduce stigma associated with injecting drug use along with involving peer workers in research, providing pre and post-test counselling and education and addressing the needs of more marginalized groups potentially through integrated healthcare programs and housing support are among few approaches that may help address barriers and strengthen the motivators for successful cohort studies among this population.
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Affiliation(s)
- Ali Mirzazadeh
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
- Department of Epidemiology and Biostatistics, Institute for Global Health Sciences, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.
| | - Samira Hosseini-Hooshyar
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Armita Shahesmaeili
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | | | | | - Ghazal Mousavian
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Esmail Najafi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali-Akbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Alya Briceno
- University of California San Francisco, San Francisco, CA, USA
| | - Willi McFarland
- Department of Epidemiology and Biostatistics, Institute for Global Health Sciences, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
- University of California San Francisco, San Francisco, CA, USA
| | - Kimberly Page
- Epidemiology, Biostatistics and Preventive Medicine, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
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14
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Behzadifar M, Azari S, Gorji HA, Rezapour A, Bragazzi NL. The challenges of hepatitis C management in Iran: A qualitative study with patients. Int J Health Plann Manage 2019; 35:e56-e65. [PMID: 31679166 DOI: 10.1002/hpm.2927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 10/08/2019] [Accepted: 10/08/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The patient's perspective concerning the treatment process and the knowledge of the challenges and problems that they encounter can help to improve their treatment conditions. AIM The present study aimed at analyzing the experiences of hepatitis C virus (HCV) patients in Iran and the challenges encountered during the management and treatment process. METHODS Semi-structured in-depth and face-to-face interviews were conducted. The criteria for selecting patients were as follows: HCV-positive subjects, with confirmed diagnosis of HCV, and under treatment. Content analysis was used to analyze the data. MAXQDA Ver11 software was used to better manage data. This study is based on the "Consolidated Criteria for Reporting Qualitative Research" (COREQ) checklist. RESULTS Twenty-one HCV patients were interviewed. The mean age of participants was 36.14 ± 11.29 years. Seven themes with 20 subthemes emerged from the content analysis of the interviews, namely, (a) disease-related stigma, (b) lack of knowledge, (c) psychological problems, (d) financial problems, (e) complications of treatment, (f) lack of family and community support, and (g) health-care system. CONCLUSION The findings of this study showed that a range of economic, social, and cultural problems could affect the treatment of HCV patients. Health policy and decision makers should try to provide them with a better management.
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Affiliation(s)
- Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Samad Azari
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hasan Abolghasem Gorji
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nicola Luigi Bragazzi
- Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
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15
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Shokri S, Mahmoudvand S, Taherkhani R, Farshadpour F, Jalalian FA. Complexity on modulation of NF-κB pathways by hepatitis B and C: A double-edged sword in hepatocarcinogenesis. J Cell Physiol 2019; 234:14734-14742. [PMID: 30741410 DOI: 10.1002/jcp.28249] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/17/2019] [Accepted: 01/22/2019] [Indexed: 01/24/2023]
Abstract
Nuclear factor-κB (NF-κB), a family of master regulated dimeric transcription factors, signaling transduction pathways are active players in the cell signaling that control vital cellular processes, including cell growth, proliferation, differentiation, apoptosis, morphogenesis, angiogenesis, and immune responses. Nevertheless, aberrant regulation of the NF-κB signaling pathways has been associated with a significant number of human cancers. In fact, NF-κB acts as a double-edged sword in the vital cellular processes and carcinogenesis. This review provides an overview on the modulation of the NF-κB signaling pathways by proteins of hepatitis B and C viruses. One of the major NF-κB events that are modulated by these viruses is the induction of hepatocellular carcinoma. Given the central function of NF-κB in carcinogenesis, it has turned out to be a considerable therapeutic target for cancer therapy.
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Affiliation(s)
- Somayeh Shokri
- Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Virology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shahab Mahmoudvand
- Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Virology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Reza Taherkhani
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Fatemeh Farshadpour
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Farid Azizi Jalalian
- Department of Virology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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16
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Damola AB, Adeniji JA, Bakarey AS. Hepatitis C virus seropositivity and the risk factors for transmission among blood donors in some selected centers in Lagos State, Southwest Nigeria. J Immunoassay Immunochem 2019; 40:528-539. [PMID: 31378189 DOI: 10.1080/15321819.2019.1647853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Introduction: Hepatitis C virus (HCV) infects about 0.5% to 2.3% of the world population with most of the cases occurring in developing countries. It is primarily transmitted through transfusion of blood and blood products. There exists dearth of information on burden and circulation of HCV and their attendant health challenges in Nigeria. This study was therefore designed to determine the seroprevalence rate and risk of HCV transmission among blood donors in Lagos State Nigeria. Methodology: Blood samples were collected between January 2002 and December 2006 from 3,002 consenting (Male = 2,922; Female = 80; Age range = 18-63; Median age = 32 years) donors in five selected public hospitals' blood donation centers between 2002 and 2006. Sera was tested for anti-HCV by ELISA technique. Demographic and other relevant information were obtained by a semi-structured questionnaire to assess risk factors for HCV transmission. Results: This study found an overall rate of 3.1% for anti-HCV among the blood donors sampled. Highest rate of 6.0% for HCV was found among participants age ranged ≥50 years and lowest in the age group 40-49 years. Prevalence of HCV was higher in female (6.3%) than in male (3.0%) and was 0.21 times less risky in female compared to their male counterparts (OR = 1.29, 95%CI 0.11-1.31). By location, MSCH had the highest HCV rate (3.9%) and lowest (2.1%) in GHOA. Sharing of sharps for tattoo/tribal markings had a statistical association (p = .0379) with HCV infection. However, no significant difference was found by gender (CI = 0.99-2.01; p = .1002), age (CI = 0.79-1.55; p = .1001) and location (p = .5326). Conclusion: The relatively high prevalence of HCV infection detected and the risk of transmission among blood donors in this study are of public health importance. Hence, the institution of appropriate measures to stem down the trend of HCV circulation among this population in Nigeria is therefore advocated.
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Affiliation(s)
- A B Damola
- Department of Virology, College of Medicine, University of Ibadan , Ibadan , Nigeria
| | - J A Adeniji
- Department of Virology, College of Medicine, University of Ibadan , Ibadan , Nigeria
| | - A S Bakarey
- Institute for Advanced Medical Research & Training, College of Medicine, University College Hospital, University of Ibadan , Ibadan , Nigeria
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17
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Comparison of prevention, screening and treatment of hepatitis C in Iran, Egypt and Georgia. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30053-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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18
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Behzadifar M, Gorji HA, Rezapour A, Bragazzi NL. Comparison of prevention, screening and treatment of hepatitis C in Iran, Egypt and Georgia. J Virus Erad 2019; 5:116-121. [PMID: 31191915 PMCID: PMC6543481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Hepatitis C virus (HCV) infection represents one of the major public health challenges worldwide. HCV is a blood-borne pathogen associated with a high rate of mortality and imposes a dramatic societal and economic burden on health systems. Untreated chronic HCV infection can progress to liver cirrhosis and cancer. Lessons can be learned from countries such as Egypt and Georgia that are considered to be 'on-track' for the World Health Organization HCV elimination targets, as well as countries such as Iran that are 'working towards elimination'. This article compares HCV-related policies and strategies in Iran, Egypt and Georgia to identify programme strengths and limitations that could inform policy and decision makers in Iran. Controlling and eliminating HCV remain a serious public health challenge. The rising HCV incidence could generate a dramatic economic burden in the coming years. Therefore, Iran requires a strategic plan to fight HCV. Adequate cultural and social infrastructures are needed. Centres specifically devoted to the diagnosis and management of this infection should be used for screening and delivery of inexpensive and high-quality testing. Quick initiation of treatment should take place at lower costs to facilitate access to treatment.
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Affiliation(s)
- Masoud Behzadifar
- Health Management and Economics Research Center,
Iran University of Medical Sciences,
Tehran,
Iran
| | - Hasan Abolghasem Gorji
- Health Management and Economics Research Center,
Iran University of Medical Sciences,
Tehran,
Iran,Corresponding author: Hasan Abolghasem Gorji
| | - Aziz Rezapour
- Health Management and Economics Research Center,
Iran University of Medical Sciences,
Tehran,
Iran
| | - Nicola Luigi Bragazzi
- School of Public Health,
Department of Health Sciences (DISSAL),
University of Genoa,
Italy
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19
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Behzadifar M, Gorji HA, Rezapour A, Bragazzi NL. The hepatitis C infection in Iran: a policy analysis of agenda-setting using Kingdon's multiple streams framework. Health Res Policy Syst 2019; 17:30. [PMID: 30917837 PMCID: PMC6438031 DOI: 10.1186/s12961-019-0436-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 03/10/2019] [Indexed: 01/08/2023] Open
Abstract
Background Hepatitis C virus (HCV) infection causes a large number of deaths annually worldwide. Policies play an important role in regulating healthcare agendas and prioritising of health-related issues. Understanding these priorities is very important in health. The objective of this study was to investigate HCV-related issues and their influence on agenda-setting in Iran. Methods A qualitative design was used. Data were collected by carrying out a review of documents and interviews. A comprehensive search was conducted to identify documents related to HCV-related policies in Iran. Semi-structured interviews were conducted with both purposive and snowball sampling of 14 interviewees related to the HCV programme in Iran, including government officials, civil society, development partnership members and academicians. Documents and interview data were analysed manually and using MAXQDA Version 10 software. Kingdon’s multiple streams framework was used to guide data analysis. Results The factors which influenced HCV-related agenda-setting were lack of proper information of the HCV epidemiology before the 1990s, lack of diagnostic facilities, neighbouring countries with high HCV prevalence, the stigma of HCV, high prevalence in prisoners, international evidence and high costs generated by HCV. The factors related to policy were effective treatment methods, drug production inside Iran, Iran Hepatitis Network, support outside government group elites and academicians. The factors related to political will were international influence, changes in the government and parliament support. Conclusion The findings of this study showed that there are various national and international factors that play a role in shaping HCV-related policies. It seems that, if HCV is put into the agenda, it can be eliminated in Iran by 2030 by supporting and implementing appropriate programmes from decision- and policy-makers.
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Affiliation(s)
- Masoud Behzadifar
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hasan Abolghasem Gorji
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nicola Luigi Bragazzi
- School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
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20
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Mahmoudvand S, Shokri S, Taherkhani R, Farshadpour F. Hepatitis C virus core protein modulates several signaling pathways involved in hepatocellular carcinoma. World J Gastroenterol 2019; 25:42-58. [PMID: 30643357 PMCID: PMC6328967 DOI: 10.3748/wjg.v25.i1.42] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 12/07/2018] [Accepted: 12/13/2018] [Indexed: 02/06/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is the fifth most common cancer, and hepatitis C virus (HCV) infection plays a major role in HCC development. The molecular mechanisms by which HCV infection leads to HCC are varied. HCV core protein is an important risk factor in HCV-associated liver pathogenesis and can modulate several signaling pathways involved in cell cycle regulation, cell growth promotion, cell proliferation, apoptosis, oxidative stress and lipid metabolism. The dysregulation of signaling pathways such as transforming growth factor β (TGF-β), vascular endothelial growth factor (VEGF), Wnt/β-catenin (WNT), cyclooxygenase-2 (COX-2) and peroxisome proliferator-activated receptor α (PPARα) by HCV core protein is implicated in the development of HCC. Therefore, it has been suggested that this protein be considered a favorable target for further studies in the development of HCC. In addition, considering the axial role of these signaling pathways in HCC, they are considered druggable targets for cancer therapy. Therefore, using strategies to limit the dysregulation effects of core protein on these signaling pathways seems necessary to prevent HCV-related HCC.
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Affiliation(s)
- Shahab Mahmoudvand
- Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 6135715794, Iran
- Department of Medical Virology, School of Medicine, Hamadan University of Medical Sciences, Hamadan 6517838736, Iran
| | - Somayeh Shokri
- Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 6135715794, Iran
- Department of Medical Virology, School of Medicine, Hamadan University of Medical Sciences, Hamadan 6517838736, Iran
| | - Reza Taherkhani
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr 7514633341, Iran
| | - Fatemeh Farshadpour
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr 7514633341, Iran
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21
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Farshadpour F, Taherkhani R, Ravanbod MR, Eghbali SS. Prevalence and Genotype Distribution of Hepatitis C Virus Infection among Patients with Type 2 Diabetes Mellitus. Med Princ Pract 2018; 27:308-316. [PMID: 29621783 PMCID: PMC6170927 DOI: 10.1159/000488985] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 04/05/2018] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE This study was conducted to determine the prevalence and genotype distribution of hepatitis C virus (HCV) infection among patients with type 2 diabetes mellitus (DM). SUBJECTS AND METHODS We included 556 consecutive patients with confirmed type 2 DM attending the Diabetic Clinic of the Bushehr University of Medical Sciences and 733 nondiabetic subjects as controls. Serum levels of fasting blood sugar (FBS), alanine transaminase (ALT), aspartate transaminase (AST), total cholesterol (TCH), and triglycerides (TG) were measured by enzymatic colorimetric methods, and the presence of anti-HCV antibodies was determined by enzyme-linked immunosorbent assay. Semi-nested reverse transcriptase-polymerase chain reaction (RT-PCR) followed by sequencing was performed on all anti-HCV-seropositive samples. Data were analyzed using the Statistical Package for the Social Sciences 17, and descriptive statistics, χ2 test, Fisher exact test, and the Student t test were used for analysis. RESULTS The seroprevalence of HCV in the diabetic patients was 1.98% (11/556), which was higher than HCV prevalence among the nondiabetic controls (4/733, 0.54%) (p = 0.032). No significant differences in ALT, AST, FBS, TG, and TCH levels were found between the HCV-seropositive and HCV-seronegative diabetic patients, although HCV-seropositive diabetic patients tended to have higher ALT, AST, and TCH levels, but lower TG and FBS levels than HCV-seronegative patients. In logistic regression analysis, only AST levels were significantly associated with HCV seropositivity among diabetic patients. The AST level of 41-80 IU/L was the only significant predictive variable for HCV seropositivity in the diabetic patients (odds ratio, 4.89; 95% CI: 1.06-22.49; p = 0.041). Of the 11 HCV-seropositive diabetic patients, 10 (91%) had HCV viremia with genotype 3a. CONCLUSION Patients with type 2 DM had a higher prevalence of HCV infection than controls, and HCV seropositivity was independent of biochemical parameters.
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Affiliation(s)
- Fatemeh Farshadpour
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Reza Taherkhani
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mohammad Reza Ravanbod
- Department of Internal Medicine, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Seyed Sajjad Eghbali
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
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The critical role of injecting drug users on the spatial distribution of hepatitis C virus; a study in the West of Iran. GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH 2018; 11:S129-S133. [PMID: 30774819 PMCID: PMC6347991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
AIM This study was conducted to provide a clear epidemiological picture of HCV spatial pattern. BACKGROUND Hepatitis C virus (HCV) is one of the major problems of public health, that its spatial and spatiotemporal pattern remain unclear in Hamadan province. METHODS We used the scan statistic to identify the spatial and spatiotemporal clusters of HCV in Hamadan province with an emphasis on considering the role of carrier's and injecting drug users (IDUs) cases. We repeated the same analysis to estimate the effect of some influencing factors on the formation of clusters. All HCV cases that had been recorded by deputy health of Hamadan University of Medical Sciences during 2008-2016 were included in this study. RESULTS The location of the purely spatial cluster for carriers, IDUs and total of cases were similar to each other, a cluster consisting of Toyserkan, Nahavand, Asadabad, Malayer and Bahar cities. However, after adjustment, the location of the identified cluster for both carries and IDUs cases changed to a cluster consisting of Asadabad, Bahar, Toyserkan and Nahavand cities. This cluster also observed for spatiotemporal clusters carriers, IDUs and total of cases even after adjustment. CONCLUSION Although further studies in individual level are needed, our results revealed that spatial distribution of HCV in Hamadan province (especially in clusters areas) can strongly dependent on the distribution of IDUs cases. Consequently, the effectiveness of HCV combating programs is subjected to properly controlling these case through various counseling, behavioral and therapeutic programs.
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Taherkhani R, Farshadpour F. Global elimination of hepatitis C virus infection: Progresses and the remaining challenges. World J Hepatol 2017; 9:1239-1252. [PMID: 29312527 PMCID: PMC5745585 DOI: 10.4254/wjh.v9.i33.1239] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 09/01/2017] [Accepted: 09/16/2017] [Indexed: 02/06/2023] Open
Abstract
Today, with the introduction of interferon-free direct-acting antivirals and outstanding progresses in the prevention, diagnosis and treatment of hepatitis C virus (HCV) infection, the elimination of HCV infection seems more achievable. A further challenge is continued transmission of HCV infection in high-risk population specially injecting drug users (IDUs) as the major reservoir of HCV infection. Considering the fact that most of these infections remain undiagnosed, unidentified HCV-infected IDUs are potential sources for the rapid spread of HCV in the community. The continuous increase in the number of IDUs along with the rising prevalence of HCV infection among young IDUs is harbinger of a forthcoming public health dilemma, presenting a serious challenge to control transmission of HCV infection. Even the changes in HCV genotype distribution attributed to injecting drug use confirm this issue. These circumstances create a strong demand for timely diagnosis and proper treatment of HCV-infected patients through risk-based screening to mitigate the risk of HCV transmission in the IDUs community and, consequently, in the society. Meanwhile, raising general awareness of HCV infection, diagnosis and treatment through public education should be the core activity of any harm reduction intervention, as the root cause of failure in control of HCV infection has been lack of awareness among young drug takers. In addition, effective prevention, comprehensive screening programs with a specific focus on high-risk population, accessibility to the new anti-HCV treatment regimens and public education should be considered as the top priorities of any health policy decision to eliminate HCV infection.
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Affiliation(s)
- Reza Taherkhani
- the Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr 7514633341, Iran
| | - Fatemeh Farshadpour
- the Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr 7514633341, Iran.
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