Age wise distribution of cases has shown for anti HIV, HBsAg, and anti HCV in table 3. In case of HIV antibody the highest incidence of positivity was noted in the age group of 21-30 (27.6%) followed by 11-20 years (12.5%).The incidence of HBsAg positivity is 8% with highest positivity rate in the age group of 61-70 years (33.33%) and 31-40 years (17.78%) from STD patients. The prevalence of anti HCV positivity was 9% with highest incidence of 66.66% in the age group of 61-70 years (Patients attending dialysis unit) followed by 33.33% in the age group of 51-60 years. M.Pistello et.al  reported 6.3% anti HCV in the age group of less than 20 years, 62% in the age group of 20 to 40
A research was conducted by Baye Gelaw and Yohans Mengistu  to determine the prevalence of HBV, HCV and malaria parasites among blood donors in Amhara and Tigray Regional state. The researchers collected blood samples using cross sectional survey from blood donors in northern part of Ethiopia. The socio demographic characteristics of blood donors were assessed using structural questionnaire. The collected blood samples were screened for HBV, HCV and malaria parasites. Their result show that the prevalence of HBV, HCV and malaria parasites were 6.2%, 1.7% and 1% respectively. a similar research was conducted to determine the seroprevalence of HIV, HBV, HCV and syphilis infections among blood donors at Gondar University teaching hospital north western Ethiopia. A retrospective analysis of consecutive blood donors' records covering the period between January 2003 and December 2007 was conducted. Logistic regression analysis was used to determine risk factors associated with HIV, HBV, HCV and syphilis infections. The researchers findings shows from the total of 6361 consecutive blood donors, 607 (9.5%) had serological evidence of infection with at least one pathogen and 50 (0.8%) had multiple infections. The overall seroprevalence of HIV, HBV, HCV and syphilis was 3.8%, 4.7%, 0.7%, and 1.3% respectively. Among those with multiple infections, the most common combinations were HIV - syphilis 19 (38%) and HIV - HBV 17 (34%). The seropositivity of HIV was significantly increased among female blood donors, first time donors, housewives, merchants, soldiers, drivers and construction workers. Significantly increased HBV seropositivity was observed among farmers, first time donors and age groups of 26 - 35 and 36 - 45 years. Similarly, the seroprevalence of syphilis was significantly increased among daily labourers and construction workers. Statistically significant association was observed between syphilis and HIV infections, and HCV and HIV infections. Moreover, significantly declining trends of HIV, HCV and syphilis seropositivity were observed over the study period. From the above two reviewed literature’s one can learn the methods and tools employed to analyze the result are good enough in showing statistical associations and the prevalence of the infectious diseases but the hidden patterns and knowledge’s remain untapped.
Hepatitis B virus (HBV) is generally recognized as highly infectious and associated with long term occurrence of disease and death due to complications like cirrhosis, por- tal hypertension, and Hepato-cellular carcinoma. Approxi- mately greater than 2 billion people have been infected by HBV and 350 million individual people have chronic infection [1, 4]. The common high-riskgroups for HBV infections are parenteral drug abusers, institutionalized persons, health care personnel, multiply transfused pa- tients, organ transplant patients, hemodialysis patients, highly promiscuous persons, sexual transmission and newborn infants born to mothers with hepatitis B virus . The virus is highly infectious and relatively easy to be transmitted from one infected person to another by blood to blood contact, during birth, unprotected sex, and by sharing needles and has a relatively increase the preva- lence in the tropics .
This study investigated the seroprevalence of HBV and HCV among HIV positive study participants and tried to assess levels of liver enzymes and CD4 count for HIV mono infected, HIV-HBV and HIV-HCV co-infected and HIV-HBV-HCV triple infected individuals. The overall prevalence (11.7%) of hepatitis (both HBV and HCV) among the study participants was very high. In this study, HIV-HBV co-infection rate was 5.6% which is more or less comparable with 7.1% prevalence  among blood donors in the same hospital. However, the present prevalence was lower as compared to studies reported in Nigeria (9.2%) , Ethiopia (10.9%)  and Malawi (20.4%) . In the present study, the preva- lence of HIV-HBV co-infection was higher in males than females (9.4%% vs 3.4%) which are in line with some other reports [29-31]. Generally, as several studies reported and anticipated in different parts of the world,
Seroprevalences of HIV, HBV and HCV infections among women receiving ANC at the Yaoundé Central Hospital were respectively 13.1%, 9.4% and 1.7%. They were 1.4% and 0.6% respectively for HIV/HBV and HIV/HCV co- infections. Independent risk factors for HIV infection were the primary level of study and the multiplicity of sexual partners. The multiplicity of sexual partners was the only independent risk factor associated to the HBV infection. No factor was associated with HCV infection. As already done with HIV, implementation of free testing for viral hepatitis B and C infections, and intensification of immunization against viral hepatitis B among women of childbearing age and pregnant women could improve maternal- fetal prognosis. The decrease of the treatment cost of viral hepatitis could facilitate access to treatment and thus slow the spread of the responsible viruses.
Having ever worked outside of Pakistan was inversely associated with HCV seropositivity. Although this associ- ation was statistically significant in Quetta only, a protec- tive effect was also seen among IDUs in Lahore. The protective effect of working abroad may be explained by a shorter exposure to injection-related risk behaviors while working abroad and having greater economic resources. Previous reports suggested that HIV had been imported into Pakistan from migrant workers who had gone abroad, mainly to the Gulf States for temporary work, returning home unknowingly infected with HIV [39,40]. Since HIV was non-existent in our sample, we found no support for this hypothesis in relation to HCV infection. Self-reported homelessness was also associated with HCV seropositivity but is most likely a marker for low socioeco- nomic status or other risk behaviors not fully assessed in this study.
Methods: We searched Pubmed, EMBASE and Scopus for studies reporting the epidemiology of viral hepatitis B, C and D in Malawi from 1990 to 2018. Articles reporting prevalence estimates were included provided they described details of participant selection, inclusion criteria and laboratory methods (detection of HBsAg, anti-HCV or anti-HDV antibody, HCV antigen or HCV RNA or HDV RNA). We assessed study quality using a prevalence assessment tool. Where appropriate, a pooled prevalence was calculated using a DerSimonian Laird random effects model. Results: Searches identified 199 studies, 95 full text articles were reviewed and 19 articles were included. Hepatitis B surface antigen (HBsAg) seroprevalence was assessed in 14 general population cohorts. The pooled prevalence among adults was 8.1% (95% CI 6.1, 10.3). In 3 studies where HBsAg was stratified by HIV status, no effect of HIV on HBsAg prevalence was observed (OR 1.2 (95% CI: 0.8, 1.6, p = 0.80)). In a single study of HIV/HBV infected individuals, anti- hepatitis D antibody (anti-HDV) prevalence was low (1.5%). HCV antibody prevalence (anti-HCV) ranged from 0.7 to 18.0% among 12 cohorts in general populations. Among three studies which used PCR to confirm current infection, the pooled rate of HCV RNA confirmation among anti-HCV positive individuals was only 7.3% (95% CI: 0.0, 24.3). Conclusions: Hepatitis B is highly prevalent in Malawi. There is a paucity of epidemiological data from rural areas where 85% of the population reside, and the Northern region. Priority research needs include large-scale representative community studies of HBV, HDV and HCVseroprevalence, assessment of children following introduction of the HBV vaccine in 2002, prevalence estimates of viral hepatitis among individuals with cirrhosis and HCC and data on HCV prevalence using PCR confirmation, to support a viral hepatitis strategy for Malawi.
In this study, 53.2% of HIV patients had a history of multiple sexual partners. Among patients with this exposure, the prevalence of HBsAg was 13.2% which is signi ﬁ cantly higher than those without such exposure (13.2% versus 2.9%, AOR=7.08, 95% CI=2.29 – 21.9, P=0.001). This ﬁ nd- ing is in line with similar studies conducted in South Gondar, Ethiopia, 9 in Brazil, 38 and in Mexico. 39 This ﬁ nding supports the fact that people who have multiple sexual partners will be prone to HBV infection and other sexually transmitted disease. 40 It also supports the fact that adoles- cents having sex with multiple partners are at higher risk of acquiring SDTs including HIV and unplanned pregnancy. 41 A higher prevalence of HBsAg was seen in HIV patients with CD4 count<200 cells/ μ L than in those with CD4 count ≥ 500 cells/ μ L; this study showed statistically signi ﬁ - cant association between HBV infection and low CD4 count (AOR=15.34, 95% CI=4.77 – 49.3, P=0.000). This ﬁ nding is similar to studies done in Tigray, northern Ethiopia, 18 in Nepal, 42 and in Thailand. 43 This signi ﬁ cant association might be due to the fact that at a lowered CD4 count, re- emergence of HBV replication occurs due to spontaneous reverse seroconversion marked by the disappearance of anti- hepatitis B surface antibodies and reappearance of HBsAg.
Few studies have investigated the prevalence of CMV in the population of pregnant adolescents in Brazil. The present article is the first to report the high seropreva- lence of anti-CMV IgG in pregnant adolescents from Pará (96.3%), which is similar to observations in preg- nant women aged 12 to 19 years in Ribeirão Preto  and pregnant women in general from Mato Grosso do Sul , Espírito Santo  and developing countries [43, 44]. However, a higher percentage (2.2%) of preg- nant adolescents in our study presented anti-CMV IgM (reactivation, reinfection or recent infection) compared to pregnant women from Mato Grosso do Sul (0.05%), where the age group was older . This scenario is worrying, because CMV is one of the main infectious agents associated with congenital malformation. Thus, pregnancy at an early age carries a higher risk of infec- tion and consequent vertical transmission of CMV.
Hepatitis C virus is a pathogen causing significant mortality & morbidity throughout the world including India. HCV is a flavivirus. More than 200 million carrier of HCV exist in the world and constitute the reservoir of this infection. The carrier rate of HCV infects ranges from 10-20%.  HCV is the commonest cause of post transfusion hepatitis accounting for nearly 80-90% of cases. Most of the HCV infections are sub clinical, and in more than 50% of cases, HCV infections leads to chronic persistent & active infections accompanied by complications of liver cirrhosis, autoimmune diseases, cryoglobulinanemia and hepatocellular carcinoma (HCC) which may develop after about 25-35 yrs.  These viruses are highly infectious (About hundred times more than HIV virus). Globally, HCV has infected more than 170 million people and thus represents a viral pandemic
If PEP is offered, the following information should be discussed with the patient: 1) the unproven benefit and known toxicities of antiretrovirals; 2) the importance of close follow-up; 3) the benefit of adherence to recommended dosing; and 4) the necessity of early initiation of PEP to optimize potential benefits (i.e., as soon as possible after and up to 72 hours after the assault). Providers should emphasize that PEP appears to be well-tolerated in both adults and children and that severe adverse effects are rare. Clinical management of the survivor should be implemented according to the following guidelines. Specialist consultation on PEP regimens is recommended if HIV exposure during the assault was possible and if PEP is being considered. The sooner PEP is initiated after the exposure, the higher the likelihood that it will prevent HIV transmission if HIV exposure occurred; however, distress after an assault also might prevent the survivor from accurately weighing exposure risks and benefits of PEP and from making an informed decision to start such therapy. If use of PEP is judged to be warranted, the survivor should be offered a 3–5-day supply of PEP, and a follow-up visit should be scheduled several days later to allow for additional counseling.
A small but significant transfusion risk of pathogenic viruses exists due to the inability of current serologic screening tests either to identify recently infected donors in the preserocon- version window phase of infection or to detect antigenic vari- ants of these viruses. In recent years, applications of nucleic acid amplification tests (NATs) have significantly reduced the preseroconversion “window period” (M. P. Busch, Program Ab- str. 52nd Annu. Meet. Am. Assoc. Blood Bank, p. 354–363, 1999). A typical NAT involves sample preparation, target-specific amplification, and detection. Over the last several years, sev- eral methods for sequence-specific probe capture of viral nu- cleic acids to specific particles have been developed (5, 16). Recently, several amplification-based multiplex assays (1, 5, 8, 15, 21) have been developed by different laboratories and com- panies. Although a multiplex assay for detecting hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunode- ficiency virus type 1 (HIV-1) has been reported (5), the sample preparation process is labor-intensive and time-consuming. Thus, there is a need in testing centers for a system providing automated high-throughput sample preparation, along with automated amplification and detection. The main criteria for such a system are (i) complete automation with high-through- put sample processing, (ii) simultaneous detection of major
Continuous variables were described with median and interquartile range [IQR] and categorical variables as number and percentages. The prevalence of HIV, HBV and HCV was expressed with a 95% confidence interval (CI95%) and group’s comparison was performed using Chi-2 test for categorical variables. Univariable and mul- tivariable (including gender, age, education level (none, primary school, secondary school, higher), marital status, geographical setting and type of blood donation covari- ates) logistic regression analyses were performed with R (v3.6.1)  software to identify risk factors of each in- fection. Factors associated with HIV, HBV or HCV in- fection with a P value of < 0.20 in the univariate logistic regression analyses were included in the multiple logistic regression model. The level of significance for each ana- lysis was set at 0.05.
Every year more than 90 million units of blood are col- lected worldwide . Each transfusion carries a risk of transmitting blood-borne pathogens, including mainly human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis. To improve blood transfusion safety, the World Health Organization (WHO) recommends an integrated strategy including establishment of well-organized blood transfusion ser- vices, prioritization of blood donation from voluntary non-remunerated donors, screening of donated blood for at least the four major transfusion-transmissible infections (TTI) with quality-assured assays, rational use of blood and implementation of effective quality control systems . Selection of blood donors with low TTI risk followed by effective laboratory screening is the critical part of the process, since it has reduced the risk of transmission to very low levels in the past 20 years [3,4]. Nevertheless, particularly in low-resource countries, a significant proportion of donated blood remains unsafe as it is either not screened for all major TTIs or not in a quality-controlled manner [1,5].
In this cross-sectional study, higher rates of HIV, HBV, and HCV infections among patients demonstrate the necessity of rou- tine viral studies before surgical proce- dures. Mainly the patients were in age range from 25 to 50 years that is in congru- ence with the age range of subjects with HIV in Iran ranging from 15 to 44 years. Previous positive surgical history has also been mentioned as a risk factor for HIV and HCV infections in similar studies (7, 8) that was also approved in current study. Also positive history of previous medical diseas- es in most patients with hepatitis was pre- viously seen in other studies.
The total of 686 donors blood samples form January to May in Tripoli blood bank were screened for HIV, HBV and HCV, their age were ranged from 16 to 93 years old (mean age 33.5±8.5) (Fig. 1). The majority of the donors were males (683, or 99.6%) and only 3 donors (0.4%) were females (Table 1). Donors occupations were concentrated mainly in free workers and less in students (Fig. 2). The donors were from different regions of the Tripoli metropolitan area like Tagora, Soq Aljomaha in the east, Alfernag, Almadina Alrithia in the center and Alsrage, Hayalandlas in the west (Fig. 3). The total 344 (50.1%) were donors who had non- tested before and have very highrisk to transfer hepatitis to others, if not diagnosed during the window gap, and 342 (49.9%) were tested before, who are less dangers because they are repeaters of blood donation (Table 2).
To date, risk of HBV reactivation during treatment with ledipasvir/sofosbuvir seems low, and our patient is only the second case described in literature . Regard- ing frequency of the event, reassuring data are available from a recent study by Sulkowski et al., which retro- spectively reanalyzed HBV markers in serum samples of 173 HCV-infected patients without active HBV or HIV infection and treated with a combination of ledipasvir/ sofosbuvir. Notably, HBV reactivation during or after HCV clearance was found in none out of the 103 previ- ously HBV-exposed patients . Differently, in patients with HCV and HBV co-infection, transitory HBV DNA reactivation rate seems very high, reaching 88% of a small case series treated with ledipasvir/sofosbuvir . Since accurate information regarding risk of HBV reacti- vation in patients undergoing DAA therapy is lacking, an important prospective study is ongoing in patients
A total of 12 (20%) PHC patients were positive for anti- HCV and 8 (67%) of these patients were over 45 years of age (66.7%) and the other remaining 4 (33%) were below 45 years. All the control patients from blood donors were negative for anti-HCV antibodies. The difference in males and females infected with HCV was not significant (p > 0.05). The mean age of patients who were positive for anti-HCV was 51.26 years and the age range was 16-70 years. The odds ratio or relative risk for the development of PHC in anti-HCV positive patients could not be ascer- tained because none of the control individuals was posi- tive and the calculation required an integer for the reference sample. Of the 12 patients who were anti-HCV- positive, 4 had AFP levels greater than 400 ng/ml whilst two had their AFP levels within the normal range (0-10 ng/ml). The prevalence of HBsAg was significantly higher than that of anti- HCV both in PHC patients and controls (p < 0.05). The presence of both anti-HCV and HBsAg was noted in 5 patients. It was also noted that more than half of the patients had infection with HBV and/or HCV. The relative risk of developing PHC was strongly associ- ated with HBV infection. The unadjusted odds ratio for PHC development was high (1.615; 95% CI 0.69 - 1.65) for overall HBV infection. For those patients with HBsAg alone, the risk for PHC development, using the cases which were negative for HBsAg as a reference group and healthy individuals as controls, was still high (odds ratio
In HIV infection, MT has been linked to immune acti- vation (IA)  and correlates with the clinical outcome independently of CD4+ counts and HIV RNA levels [7,8]; thus, a common pathogenic role of MT in fuelling viral hepatic illness has been hypothesized. Accordingly, in keeping with these findings, MT has been shown to accelerate liver disease progression in cohorts of HIV- infected and HIV uninfected patients [9-11], and hamper the response to pegylated-interferon-α/ribavirin treat- ment in HCV/HIV co-infected patients . Most re- cently, in a retrospective case–control study of HIV + and HIV- Ugandan subjects with detectable liver stiffness/ cirrhosis in the absence of HCV infection, Redd et al. demonstrated a significant association between monocyte activation and liver disease only in HIV-infected patients, that appeared however unrelated to MT .
8. Mansour Ghanaei F, Fallah MS, Jafarshad R, et al. Prevalence of hepatitis B and hepatitis C, and their risk factors among Guilan blood donors. The Scientific Journal of Iranian Blood Transfusion Organization. 2007; 4(5): 331-6. [Persian]