Risk Factors of HCV

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HCV Elimination Campaign and Risk Factors of HCV Infection in Arkhangai Province in Mongolia

HCV Elimination Campaign and Risk Factors of HCV Infection in Arkhangai Province in Mongolia

Background: Most viral hepatitis deaths in 2015 were due to chronic liver disease (720,000 deaths due to cirrhosis) and primary liver cancer (470,000 deaths due to hepatocellular carcinoma). Mongolia has a relatively high se- ro-prevalence of HCV nationally, approximately 6% (CDA Foundation/Polaris Observatory). Mongolia has a large burden of viral hepatitis, especially chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, which are associated with cancer and cirrhosis. Methods: All adults aged 40 - 65 years being tested for anti-HCV antibodies during the campaign of Arkhan- gai province. Risk assessment survey questionnaire that includes about beha- vioral and clinical factors potentially associated with HCV infection was used for optioning data. Statistical analysis that was done using SPSS version 21 was used for data analyzed. The relevant parametric and nonparametric tests were used for data analysis. Result: All 17,601 surveyed of individuals were tested for HCV by using ELISA test for detecting the anti-HCV Ab; 3289 of them were positive and 3049 of them had detected a viral load test. Most of screened population was female (9095, 52.0%), mainly herdsman (7206, 40.9%), married (15,425, 87.6%), educated secondary level school (11,997, 68.2%) and aged between (9289, 52.8%). Significantly high number of female (60.6%), retired people (31.4%), single (13.8%) and people aged 55 - 59 years (21.6%) were infected more HCV-positive than other groups. Patients with HCV were more likely than uninfected individuals to have undergone any kind of surgery, wound and bloodletting treatment in life time. In addition, individual’s job plays important role to get infected with HCV. Only 914 (5.2%) individuals were reported that had no risk factors. 16.6 percent of screened individual were reported they had at least 3 types of risk factors. In to- How to cite this paper: Byambasuren, A.,
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Evaluation of Risk Factors of HCV infection in Lahore, (Pakistan)

Evaluation of Risk Factors of HCV infection in Lahore, (Pakistan)

fact adds to the importance of prevention of this disease. Controlling the risk factors is one of the best measures of prevention and this has caused the medical world to search for risk factors of this disease through different studies. According to (Stephen A. villano, et al 1997), existing therapies are successful in less than one-third of cases, and no HCV vaccine is available, efforts to reduce HCV transmission are crucial to reduce the impact of this disease. However, Cirrhosis, Internal bleeding, Altered conscious level, Fluid retention, and Liver cancer. are the complications due to Hepatitis C. Di Bisceglie, et al (1991), Kiysowa, K., (1990), Terrault, N.A. & T.L. Wright. (1995) and Tong, M.J. (1995) studied the Chronic HCV infection, and found that it is strongly associated with cirrhosis, liver cancer, and end stage diseases requiring transplantation,
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Frequency of Various Risk Factors in HCV Positive Patients in Initial Diagnostic Phase

Frequency of Various Risk Factors in HCV Positive Patients in Initial Diagnostic Phase

The typical thing in our research was that in majority of patients there were more than one risk factor. IV drug addiction was less common in our locality, surgical and dental procedures, barber shave, safe delivery, needle prick and tat- too marks were special matter of concern to control. Pearson Correlation Sig. (2-tailed) of HCV was related to various risk factors which were statistically at significant levels. The correlation of blood and its products was not significant because of safe transfusion methods now a day due to proper screening of do- nors. Hepatitis C was a matter of concern in homosexual as well as heterosex- uals. The correlations of various risk factors were shown in Table 2.
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Prevalence and association of HBV and HCV infection with cardiovascular disease risk factors in a peri-urban population

Prevalence and association of HBV and HCV infection with cardiovascular disease risk factors in a peri-urban population

Data was analysed using SPSS 16. To check the null hypothesis that there is no relationship between HBV or HCV infection and CVD risk factors, univariate (chi square test and t-test) and multivariate (linear regression model) analyses was done. T-test and Chi-square tests were applied for comparison between sero-positive and sero- negative groups with p<0.05 being significant. To define the strength of association of HBV or HCV infection with CVD risk factors, linear regression model was used. In multivariable analysis, gender, DM, HTN, tobacco consumption and BMI were used for adjustment.
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HIV/HCV co-infection and associated risk factors among injecting drug users in Dar es Salaam, Tanzania: potential for HCV elimination

HIV/HCV co-infection and associated risk factors among injecting drug users in Dar es Salaam, Tanzania: potential for HCV elimination

The prevalence of HCV infection in this study was es- timated to be 16.2% and ranged from 13.0 to 20.1%. This estimate is lower than the global prevalence of 52.3% but similar to that of sub-Saharan Africa estimated to be 21.8% [1]. On the other hand, our estimate is more than half (57%) of what was estimated earlier in the city [11]. The observed difference could be explained by differ- ences in the recruitment methods. The previous study included PWID enrolled in methadone substitution ther- apy who most likely represented a selected population. While duration since injection did not differ between those enrolled and those not enrolled in OST (p = 0.104) it is possible that PWID on OST are more likely to have been high-risk injectors who had succumbed adverse consequences forcing them to enroll for treatment. These results, however, differ from what has been pub- lished elsewhere [1–3, 20]. Various studies including a Cochrane Review and meta-analysis have provided evi- dence that OST and NSP are associated with reduced risk of HCV infection [21]. To effectively realize a sub- stantial reduction in HCV infection rates, research and Table 3 Modified Poisson regression modeling of socio-demographic risk factors for HCV infection among PWID in Dar es Salaam, Tanzania
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TO STUDY SEROPREVALENCE AND VARIOUS RISK FACTORS ASSOCIATED WITH HCV IN HEPATIC DISORDERS

TO STUDY SEROPREVALENCE AND VARIOUS RISK FACTORS ASSOCIATED WITH HCV IN HEPATIC DISORDERS

hepatic disorders. Aim: To study seroprevalence of HCV in liver disorders and risk factors associated with liver disorders and HCV. Material and Methods: The study was conducted on 100 patients of hepatic disorders admitted in Medicine wards of Rajindra Hospital, Patiala. Detailed history was taken with special emphasis on risk factors like blood transfusion, alcohol, drug addiction, needle-injury, multiple sexual contacts and perinatal transmission. Then blood was tested for Anti HCV abs. Results: Seroprevalence of HCV in patients with hepatic disorders was 40%. Out of 40, 35
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Seroprevalence and risk factors for HIV, HCV, HBV and syphilis among blood donors in Mali

Seroprevalence and risk factors for HIV, HCV, HBV and syphilis among blood donors in Mali

Risk factors associated with HIV, HBV and HCV infections Univariate and multivariate logistic regression analyses were performed to assess independent associations be- tween socio-demographic data and HIV, HBV or HCV infections. In univariate analysis, HIV was significantly associated with being married (odds ratio [OR], 1.57 [95%CI, 1.16–2.15], p = 0.016 ) and education level lower than secondary school (OR, 1.69 [95% CI, 1.28–2.25], p = 0.002 ). HIV also tended to be associated with greater age (OR, 1.01 [95%CI, 1.00–1.03], p = 0.06 ). In multivari- able analysis, HIV was only associated with education level (OR, 1.54 [95%CI, 1.15–2.07], p = 0.016 ). In univari- ate analysis, HBV-infection was significantly associated with being male (OR, 1.32 [95%CI, 1.10–1.59], p = 0.013 ) and this result was consistent in multivariable analysis (OR, 1.37 [95%CI, 1.14–1.66], p = 0.005 ) adjusting for age, education level, marital status and type of blood do- nation. Education level lower than secondary school was also associated with HBV in multivariable analysis (OR, 1.17 [95%CI, 1.05–1.31], p = 0.021 ). Living outside Bamako was the only factor associated with HCV in multivariable analysis adjusting for gender, age and edu- cation level (OR, 1.83 [95%CI, 1.41–2.35], p = 0.0001 ) (Table 3).
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Seroprevalence of hepatitis B surface antigen and anti HCV antibody and its associated risk factors among pregnant women attending maternity ward of Felege Hiwot Referral Hospital, northwest Ethiopia: a cross sectional study

Seroprevalence of hepatitis B surface antigen and anti HCV antibody and its associated risk factors among pregnant women attending maternity ward of Felege Hiwot Referral Hospital, northwest Ethiopia: a cross sectional study

Methods: Hospital based cross-sectional study was conducted from November 2013 to January 2014. Blood samples were randomly collected from 384 pregnant women. Data on socio-demographic characteristics, obstetric and potential risk factors were collected using semi-structured questionnaire. Chromatographic kits were used to detect the presence of HBsAg and antibodies against HCV in serum samples of the studied subjects. Chi-square test was used for assessing the association between socio-demographic variables and HBV and HCV status. Logistic regression analysis was done to determine the strength of association between risk factors and HBV or HCV infection. P-values less than 0.05 were considered as significant.
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Most common genotypes and risk factors for HCV in Gaza strip: a cross sectional study

Most common genotypes and risk factors for HCV in Gaza strip: a cross sectional study

Viral RNA Extraction and HCV RT-PCR amplification Viral RNA was extracted from 140 μl serum samples using the QIAamp viral RNA Extraction kit according to the manufactures recommendations (Qiagen, Germany). Both cDNA synthesis and PCR amplification of target sequences were performed in a single tube using the QIA- GEN one step RT-PCR kit (Qiagen, Germany). The reac- tions were carried out in 25 μl reaction volumes using 10 μl RNA in the presence of 0.6 μM of each primer, 400 μM of each dNTP and 5 units RNase inhibitor. The reaction cycling conditions were: one cycle at 50°C for 30 minutes and one cycle at 95°C for 15 minutes followed by 40 cycles of 95°C for one minute, 55°C for one minute and 72°C for one minute. Finally the reactions were allowed to complete at 72°C for 10 minutes and held at 4°C. The products were analyzed on 2% agarose gel and stained with ethedium bromide. The PCR products were purified from the gel using the Qiaquick Gel Extraction Kit accord- ing to the manufacture instructions (Qiagen, Germany). HCV genotyping and sequence analysis
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A Birth cohort testing intervention identified hepatitis c virus infection among patients with few identified risks: a cross sectional study

A Birth cohort testing intervention identified hepatitis c virus infection among patients with few identified risks: a cross sectional study

Data have demonstrated that approximately 77 % of all HCV-infected persons in the U.S. were born between 1945 and 1965 [16] and adults in this cohort have a HCV infection prevalence of 3.2 %, approximately five fold higher than other adults outside of this age cohort [17]. Therefore, in the U.S. one-time testing of all pa- tients born during 1945–1965, birth-cohort testing, is now recommended by the Centers for Disease Control and Prevention and the US Preventive Services Task Force in addition to risk-based testing [18–20]. In addition, it is possible that a birth-cohort-based testing strategy is more effective for identification of HCV- infected patients who have no known risk factors or medical indications for HCV testing. To investigate this, we examined the characteristics and risk factors of HCV- Ab + persons who were identified during a pre- intervention phase when risk-based testing was the standard of care vs. after a birth-cohort testing interven- tion. We hypothesized that patients identified as HCV- Ab + using a birth-cohort testing strategy would be less likely to have documented risk factors or medical in- dications as compared to patients identified as HCV- Ab + by traditional risk-based testing strategy.
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Major risk factors for primary hepatocellular carci- noma include infection with HBV or HCV, alcoholic liver disease, and nonalcoholic fatty liver disease (3, 17, 18).The distribution of these risk factors among patients with hepatocellular carcinoma is highly vari- able, depending on geographic region and race or ethnic group (17,19).Worldwide, chronic HBV infec- tion accounts for approximately 50% of all cases of primary Hepatocellular carcinoma and virtually all childhood cases. The other virus that is associated is HCV and the estimated risk of primary Hepatocellu- lar carcinoma is 15 to 20 times as high among per- sons infected with HCV as it is among those who are not infected (2, 20,21). The other endocrine disease that has shown epidemiological association is Type 2 Diabetes mellitus (DM). Several case–control and a few cohort studies have shown that on average, pri- mary Hepatocellular carcinoma is twice as likely to develop in persons with type 2 diabetes as compared with those who do not have diabetes (18).
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Prevalence of Hepatitis C Virus and Associated Risk Factors among Inmates at New Bell Prison, Douala, Cameroon

Prevalence of Hepatitis C Virus and Associated Risk Factors among Inmates at New Bell Prison, Douala, Cameroon

pling method were interviewed to collect data on sociodemographic status, duration of incarceration, number of incarcerations and risk factors for HCV transmission. Blood samples were collected for screening of anti-HCV anti- bodies via HEPA-SCAN HCV CARD Test. Positive samples had a confirma- tory ELISA test. Data were analysed using EPI DATA 4.4.0.0 software. Statis- tical significance was set at a p < 0.05. Of the 940 prisoners selected, 94.1% (884) were males. The mean age of the study population was 33.81 ± 10.35 years (extremes: 14 and 74 years). HCV prevalence was 4.4% (40). The use of non-injectable illicit drugs (OR 2.87 95% CI 1.44 - 5.73) (p = 0.002) but not injectable illicit drugs (OR 1.91 95% CI 0.43 - 8.41) (p = 0.42), male homo- sexuality (OR 17.45 95% CI 7.58 - 40.13) (p < 0.001), sharing of needles (OR 3.45 95% CI 1.59 - 7.83) (p = 0.001), past history of tattooing or piercing (OR 5.94 95% CI 2.80 - 12.16) (p < 0.001) and age ≥ 50 (OR 4.069; 95% CI 1.9 - 8.68) (p = 0.003) were significantly associated with HCV antibodies positivity. Inmates in New Bell Central Prison accumulate risk factors for viral hepatitis How to cite this paper: Kowo, M.P., An-
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Factors associated with HCV risk practices in methadone-maintained patients: the importance of considering the couple in prevention interventions

Factors associated with HCV risk practices in methadone-maintained patients: the importance of considering the couple in prevention interventions

We used a chi-squared test and a Wilcoxon test for, re- spectively, categorical and continuous variables, in order to compare characteristics of patients at enrollment in terms of HCV risk practices. The impact of time on methadone treatment and potential risk factors on HCV risk practices was assessed using a Logistic mixed model. We tested whether the following factors were associated with reporting at least one HCV risk practice: 1) socio- demographic characteristics: sex, age, high school certifi- cate, having children, employment, living in a couple, unstable housing; 2) Alcohol consumption and drug consumption other than opiates : alcohol dependence, cocaine use, current injection; 3) Mental health prob- lems: suicidal risk and depressive symptoms; 4) History of drug use: history of drug overdose and of drug injec- tion, age at first regular drug use and at first injection; 5) Drug using network: drug using friends and living in a couple (or not) with a drug user (or not).
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Weighing the benefits of hepatocellular carcinoma surveillance against potential harms

Weighing the benefits of hepatocellular carcinoma surveillance against potential harms

There are several risk factors for liver cirrhosis, including chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, alcohol-related liver disease (ARLD), and obesity- related non-alcoholic fatty liver disease (NAFLD). Other causes include cholestatic and autoimmune liver diseases, metabolic liver diseases, and cryptogenic cirrhosis. In Asian and African nations, viral etiologies are more common. Their prevalence varies in European countries and in Italy and Spain, where there is a relatively higher HCC incidence and mortality, the differences have been attributed to the prevalence of HCV. 5 In the UK, where the prevalence of viral
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Variation in Both IL28B and KIR2DS3 Genes Influence Pegylated Interferon and Ribavirin Hepatitis C Treatment Outcome in HIV 1 Co Infection

Variation in Both IL28B and KIR2DS3 Genes Influence Pegylated Interferon and Ribavirin Hepatitis C Treatment Outcome in HIV 1 Co Infection

Pegylated-IFN and ribavirin remains the current treatment for chronic HCV infection in patients co-infected with HIV-1, but this regimen has low efficacy rates, particularly for HCV genotype 1/4 infection, has severe side effects and is extremely costly. Therefore, accurate prediction of treatment response is urgently required. We have recently shown that the NK cell gene, KIR2DS3 and a SNP associated with the IL28B gene synergise to increase the risk of chronic infection in primary HCV mono-infected patients. Identification of SNPs associated with the IL28B gene has also proven very powerful for predicting patient response to treatment. Patients co-infected with HIV-1 are of particular concern given they respond less well to HCV treatment, have more side effects and suffer a more rapid liver disease progression. In this study, we examined both IL28B and KIR2DS3 for their ability to predict treatment response in a cohort of HIV-1/HCV co-infected patients attending two treatment centres in Europe. We found that variation in both host genetic risk factors, IL28B and KIR2DS3, was strongly associated with sustained virological response (SVR) to treatment in our co-infected cohort (n = 149). The majority of patients who achieved a rapid virological response (RVR) achieved a SVR. However, it is currently impossible to predict treatment outcome in patients who fail to achieve an RVR. In our cohort, the presence of host genetic risk factors, IL28B-T and KIR2DS3 alleles, resulted in increased odds of treatment failure in these RVR negative patients (n = 88). Our data suggests that testing for host genetic factors will improve predicting treatment responsiveness in the clinical management of co-infected patients, and provides further evidence of the importance of the innate immune system in the immune response to HCV.
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Prevalence of Hepatitis C Virus in Lymphoproliferative Disorders

Prevalence of Hepatitis C Virus in Lymphoproliferative Disorders

Results: There was no significant difference for risk factors for hepatitis C virus infection in both the groups except for the increase in number of surgical procedures being carried out in the control group. There was no significant difference in the presence of rheumatoid factor antibody in both the groups and cryoglobulins were not positive in any individual. Five percent patients with lymphoproliferative disorders and 3.4% with non- hematological malignancies were positive for anti HCV. HCV RNA was detected in 29.2% cases and 31.0% in controls.

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Hepatitis C Virus in HIV Co-morbid Pregnancies in Jos, Nigeria

Hepatitis C Virus in HIV Co-morbid Pregnancies in Jos, Nigeria

Table 3 showed a demonstration of risk factors and HCV acquisition. More subjects (18.8%) among the study group admitted to having had blood transfusion in the past compared with those who did not have blood transfusion (6.1%). In the control group however, all the subjects who tested positive for HCV (2.6%) had no history of blood transfusion. In the study group, those with multiple sexual partners were twice more prone to have HCV than those with single partners {9.8%vs4.9%, P=0.24}. In the control group however, those who had multiple sex partners (2.5%) were marginally higher than those who had single partners (2.4%). None of the subjects studied had a history of intravenous drug usage (IDU). More subjects (8.8%) with history of STD tested positive for HCV compared with those who never had (7.0%) in the study group {p=0.71}. This finding is similar to that in the control group (3.6% vs 1.3%).Those that drank alcohol were not affected in the study group. They were however more affected in the control group. None of the subjects in the study group admitted to smoking. Those who did not smoke were affected in the controls (2.5%) while those who smoked were not (0%).
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In developed countries, the rapid improvement of healthcare conditions and the introduction of anti- HCV screening for blood donors have led to a sharp decrease in the prevalence of iatrogenic hepatitis C but the epidemic continues in developing countries where such control measures are inadequate or ab- sent (15). Most previous studies, put the seropreva- lence of HCV among pregnant women in our setting between 0.5 -9.2% (21-24), they involved assays for antibodies to HCV alone. The prevalence of HCV is important in pregnancy because of the risk of trans- mission to their neonate and it takes mothers with active HCV infection to transmit the infection to their neonates(25). Hence the need to determine the HCV seroprevalence, antigaenemia and associated risk factors among pregnant women at the University of Ilorin Teaching Hospital (UITH) Ilorin, Nigeria. Also there is paucity of information on HCV infec- tion in pregnancy and most previous studies were antibody test especially in Nigeria.
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Serum uric acid is an independent predictor of new-onset diabetes after living-donor kidney transplantation

Serum uric acid is an independent predictor of new-onset diabetes after living-donor kidney transplantation

rejection, cadaveric kidney transplantation, chronic in- fection with HCV, and the type of immunosuppression used [1, 3, 5]. Furthermore, SUA is correlated with metabolic syndrome and T2DM [8, 9, 23–25]. Another T2DM risk might also be a NODAT risk; therefore, we included known T2DM risks in model 2 for multivari- ate analysis. HOMA-IR and I-I tended to be higher in patients in the highest tertile for SUA values than for those in the lower 2 tertiles. However, after adjusting for both factors, they were not associated with NODAT. Known risk factors for NODAT relating to transplant- ation are included in model 3. Older age has consist- ently been an important contributing factor to the development of T2DM and NODAT [1, 2, 26] and is an important determinant of β-cell dysfunction after renal transplantation [27]. Our recipients represent a rela- tively young population for T2DM onset, with median ages of 39 and 47 years in non-NODAT and NODAT patients, respectively.
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Hepatocellular Carcinoma: Known and Emerging Risk Factors

Hepatocellular Carcinoma: Known and Emerging Risk Factors

It has been reported that annual risk of HCC is 0.5% and 0.8% for asympto- matic HBsAg carriers and for patients with chronic HBV disease, respectively; the effective annual risk increases by 100 times for HBV cirrhotic people [5]. Although 70% - 90% of HCC occurs in cirrhotic HBV carriers, HBV chronic in- fection is a well-known cause of HCC also in absence of cirrhosis (Figure 2). The risk of developing hepatocellular carcinoma in patients with persistent HBV infection is greater among males and correlates with the duration of infection, high levels of HBV viral load and infection with genotype “C” of HBV [10]. Co-factors such as family history of HCC, exposure to mycotoxins (aflatoxin), alcohol abuse or tobacco dependence, HCV and/or HDV co-infections, greatly increase the risk of HCC [11] [12].
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