This document discusses HCV and HBV co-infections in patients with HIV in Serbia. It provides an overview of how HAART has changed the course of HIV infection from a short survival period pre-HAART to a longer survival time currently. It also discusses the importance and prevalence of HCV and HBV co-infections in HIV patients. Discriminators and predictors of outcomes are analyzed before and after HAART treatment. The mortality rate among the studied patients with HIV was 13.5%.
- HBV is a major global health problem, infecting over 2 billion people worldwide and causing over 500,000 deaths annually.
- Egypt has intermediate prevalence of HBV infection, with carrier rates of 8% reported among children.
- Chronic HBV infection can lead to serious complications like cirrhosis and liver cancer if left untreated.
- Current antiviral treatments aim to suppress viral replication and reduce liver damage, but drug resistance remains a challenge.
This document provides guidelines from the WHO on chronic hepatitis C infection from April 2016. It discusses the global burden of HCV, noting over 700,000 deaths per year. New direct-acting antiviral medications have transformed HCV treatment, enabling shorter, oral regimens with over 90% cure rates and fewer side effects. The guidelines recommend screening high-risk populations and using RNA testing to confirm chronic infection before treatment. They provide guidance on clinical assessment, noting the importance of staging liver fibrosis/cirrhosis and assessing severity. Successful treatment results in reduced liver inflammation and fibrosis regression, lowering risks of liver cancer and transplant.
Hepatitis C is caused by the hepatitis C virus (HCV). The document discusses HCV including its structure, replication cycle, global prevalence, genotypes found in Pakistan, natural history, extrahepatic manifestations, diagnosis, treatment options, and predictors of response to treatment. Key points are that HCV has a broad global distribution, genotype 3 is most common in Pakistan, most infections become chronic, treatment involves pegylated interferon and ribavirin, and factors like younger age and lower HCV viral load predict better response to therapy.
Christian B. Ramers, M.D., M.P.H., of Family Health Centers of San Diego, presents "The HCV Treatment Revolution: A View from the Community Health Center" for AIDS Clinical Rounds at UC San Diego
Employability Of The Hepatitis B Positive Worker2Jesart De Vera
1. The document discusses recommendations for evaluating the employability of hepatitis B positive workers.
2. The minimum tests required for hepatitis B surface antigen (HBsAg) positive applicants include hepatitis B e antigen (HBeAg), alanine transaminase (ALT) levels, and ultrasound of the liver.
3. Applicants with elevated ALT or abnormal ultrasound cannot be cleared for employment and must undergo further evaluation. Applicants who are HBeAg positive with normal ALT and ultrasound can work but with restrictions.
Chronic hbv infection diagnosis and management dr neeraj nagaichDr .Neeraj Nagaich
This document discusses chronic hepatitis B infection, including its diagnosis and management. Some key points:
- Chronic hepatitis B is a worldwide public health problem, with three quarters of the world's population living in endemic regions. Nearly 75% of chronic carriers are Asian.
- It is an established cause of chronic hepatitis, cirrhosis, and the second most important carcinogen behind tobacco, causing up to 80% of hepatocellular carcinomas.
- The natural history and phases of chronic hepatitis B infection are described. Screening recommendations are provided for those at high risk. Diagnosis involves testing for HBsAg, HBcAb, HBsAb, and HBV DNA levels.
- Treatment
This document discusses hepatitis B and hepatitis C, including their background, epidemiology, screening guidelines, clinical tests, and patient management. It provides an overview of each virus, explaining their transmission, disease progression, screening algorithms and tests used. The screening guidelines and phases of chronic hepatitis B are reviewed. Treatment depends on the disease phase. New diagnoses of hepatitis C are addressed, including counseling, vaccination status evaluation, lifestyle interventions and monitoring.
- Around 2 billion people have been infected with hepatitis B virus (HBV) globally, with 300-400 million having chronic infections. HBV is the second most common cause of cancer after tobacco.
- Chronic HBV infection can lead to cirrhosis or hepatocellular carcinoma (HCC), with over 300,000 HBV-related HCC cases occurring annually worldwide.
- The HBV vaccine has significantly reduced the burden of chronic HBV and related complications like HCC, though vaccination rates remain suboptimal in some adult groups who are at higher risk.
- HBV is a major global health problem, infecting over 2 billion people worldwide and causing over 500,000 deaths annually.
- Egypt has intermediate prevalence of HBV infection, with carrier rates of 8% reported among children.
- Chronic HBV infection can lead to serious complications like cirrhosis and liver cancer if left untreated.
- Current antiviral treatments aim to suppress viral replication and reduce liver damage, but drug resistance remains a challenge.
This document provides guidelines from the WHO on chronic hepatitis C infection from April 2016. It discusses the global burden of HCV, noting over 700,000 deaths per year. New direct-acting antiviral medications have transformed HCV treatment, enabling shorter, oral regimens with over 90% cure rates and fewer side effects. The guidelines recommend screening high-risk populations and using RNA testing to confirm chronic infection before treatment. They provide guidance on clinical assessment, noting the importance of staging liver fibrosis/cirrhosis and assessing severity. Successful treatment results in reduced liver inflammation and fibrosis regression, lowering risks of liver cancer and transplant.
Hepatitis C is caused by the hepatitis C virus (HCV). The document discusses HCV including its structure, replication cycle, global prevalence, genotypes found in Pakistan, natural history, extrahepatic manifestations, diagnosis, treatment options, and predictors of response to treatment. Key points are that HCV has a broad global distribution, genotype 3 is most common in Pakistan, most infections become chronic, treatment involves pegylated interferon and ribavirin, and factors like younger age and lower HCV viral load predict better response to therapy.
Christian B. Ramers, M.D., M.P.H., of Family Health Centers of San Diego, presents "The HCV Treatment Revolution: A View from the Community Health Center" for AIDS Clinical Rounds at UC San Diego
Employability Of The Hepatitis B Positive Worker2Jesart De Vera
1. The document discusses recommendations for evaluating the employability of hepatitis B positive workers.
2. The minimum tests required for hepatitis B surface antigen (HBsAg) positive applicants include hepatitis B e antigen (HBeAg), alanine transaminase (ALT) levels, and ultrasound of the liver.
3. Applicants with elevated ALT or abnormal ultrasound cannot be cleared for employment and must undergo further evaluation. Applicants who are HBeAg positive with normal ALT and ultrasound can work but with restrictions.
Chronic hbv infection diagnosis and management dr neeraj nagaichDr .Neeraj Nagaich
This document discusses chronic hepatitis B infection, including its diagnosis and management. Some key points:
- Chronic hepatitis B is a worldwide public health problem, with three quarters of the world's population living in endemic regions. Nearly 75% of chronic carriers are Asian.
- It is an established cause of chronic hepatitis, cirrhosis, and the second most important carcinogen behind tobacco, causing up to 80% of hepatocellular carcinomas.
- The natural history and phases of chronic hepatitis B infection are described. Screening recommendations are provided for those at high risk. Diagnosis involves testing for HBsAg, HBcAb, HBsAb, and HBV DNA levels.
- Treatment
This document discusses hepatitis B and hepatitis C, including their background, epidemiology, screening guidelines, clinical tests, and patient management. It provides an overview of each virus, explaining their transmission, disease progression, screening algorithms and tests used. The screening guidelines and phases of chronic hepatitis B are reviewed. Treatment depends on the disease phase. New diagnoses of hepatitis C are addressed, including counseling, vaccination status evaluation, lifestyle interventions and monitoring.
- Around 2 billion people have been infected with hepatitis B virus (HBV) globally, with 300-400 million having chronic infections. HBV is the second most common cause of cancer after tobacco.
- Chronic HBV infection can lead to cirrhosis or hepatocellular carcinoma (HCC), with over 300,000 HBV-related HCC cases occurring annually worldwide.
- The HBV vaccine has significantly reduced the burden of chronic HBV and related complications like HCC, though vaccination rates remain suboptimal in some adult groups who are at higher risk.
BCC4: Pierre Janin on 4 Newer Agents for Hepatitis CSMACC Conference
Janin speaks on the dawn of a revolution for treating Hepatitis C. This was recorded at Bedside Critical Care Conference 4. Full postings can be found at www.intensivecarenetwork.com
This document provides an overview of chronic hepatitis B, including its epidemiology, virology, pathogenesis, natural history, clinical features, diagnosis, treatment, and guidelines. Some key points:
- Approximately 1/3 of the world's population has been infected with hepatitis B virus (HBV) and 350-400 million people are chronic carriers.
- HBV is classified into 8 genotypes that vary in prevalence around the world. HBV infects liver cells and can establish a lifelong infection by integrating into the host genome.
- Chronic HBV progresses through 5 phases and can lead to complications like cirrhosis and liver cancer if left untreated. Treatment aims to suppress HBV DNA levels and improve liver health. First
OBI is a complex entity that comprises many conditions and different situations. Patients who have recovered from acute hepatitis B can carry HBV genomes for a long time,
and the virus might aggravate the course of their liver disease, when other causes of liver damage are present.The availability of highly sensitive molecular methods
has made it possible to unveil several virological features of OBI, to show its worldwide diffusion, and to reveal its possible involvement in different clinical settings. Relevant evidence indicates that HBV persistence as an OBI represents an important risk factor for HCC development.
This document is an essay submitted by Dr. Hesham Noaman Abdelraheem Mustafa for a Master's degree in Tropical Medicine from Cairo University. It discusses hepatitis B virus (HBV) prevalence worldwide and in Egypt, updated clinical issues in diagnosis, and modern treatment modalities. The aim is to provide an overview of HBV epidemiology and management. It reviews the relevant literature and was supervised by Dr. Laila Ahmad Mohammad and Dr. Ahmad Nabil Lotfy Hassan of Cairo University's Tropical Medicine Department.
Hepatitis B virus (HBV) infection is a major global public health problem, with an estimated 400-500 million people chronically infected worldwide. Each year there are around 10 million new cases and 1.3 million deaths, making HBV the 5th most common cause of cancer and 10th leading cause of death globally. India has an intermediate prevalence of HBV infection at around 3% of the population, or approximately 37 million carriers, and contributes significantly to the global disease burden.
The document summarizes information about several hepatitis viruses including HAV, HBV, HCV, HDV, and HEV. It provides details on their geographical distribution, modes of transmission, clinical presentation, natural history, and markers used to diagnose infection. Highlights include that HBV is a major cause of liver cancer and cirrhosis worldwide, with 400 million chronic carriers. Chronic HBV infection progression can lead to complications like liver failure, cancer, and death if left untreated.
Occult hepatitis B virus infection (OBI) is defined by an undetectable HBsAg but detectable intrahepatic HBV DNA. It can be seropositive (anti-HBc+) or seronegative (anti-HBc-). OBI is characterized by very low or undetectable HBV DNA levels due to strong suppression of viral replication through immune pressure and epigenetic factors. However, OBI can reactivate and cause acute hepatitis. It also poses long-term risks like progression of liver disease to cirrhosis and development of hepatocellular carcinoma through its tumorigenic properties and persistent necroinflammation. Detection requires highly sensitive PCR techniques.
Hepatitis C is a global health problem that causes 700,000 deaths per year. In Bangladesh, 1% of the population has HCV. New guidelines recommend screening high-risk groups and treating with direct-acting antiviral drugs, which have cure rates over 90% and shorter treatment durations compared to previous interferon-based regimens. Proper treatment can prevent cirrhosis, liver cancer and death from HCV. While challenges remain, scientists hope to eliminate HCV globally by 2030 with new pan-genotypic drugs. Prevention through injection safety, screening blood products, and educating healthcare workers is also important to control the disease.
Management Of Chronic Hepatitis B
by Dr S Khan
Courtesy Of Javed iqbal Farooqi
http://www.drkhanblogs.com/2015/05/management-of-chronic-hepatitis-b.html
Hepatitis c. diagnosis and treatment.assld guidelines.2016 .2017Dr. Afzal Haq Asif
A 45-year-old woman presented with fatigue, weakness, loss of appetite, and anemia. Liver function tests showed elevated AST, ALT, and bilirubin levels indicating liver inflammation and damage. A liver biopsy revealed necroinflammation and fibrosis. This suggests a diagnosis of chronic hepatitis C, which would be confirmed by a positive HCV RNA test. The best course of action would be to treat the patient with direct-acting antiviral therapy to cure the hepatitis C infection, advise lifestyle changes to protect the liver, and monitor for complications like cirrhosis or liver cancer.
Chronic hepatitis B infection is a major global health issue, affecting around 248 million people. Current treatments like nucleoside analogues and interferon are not curative and have limitations. New therapies targeting the hepatitis B virus directly or the host immune response are in development. Direct-acting antivirals in clinical trials inhibit the viral polymerase, capsid formation, HBsAg secretion, and RNase H. Host-targeting approaches trial immune enhancers, viral entry inhibitors, vaccines, and pro-apoptotic drugs. Promising preclinical candidates additionally modulate immunity, epigenetics, interferons, and cyclophilins. These novel therapies aim to achieve functional cures for chronic hepatitis B.
This document summarizes a review article about occult hepatitis B virus (HBV) infection. Occult HBV infection is defined as detecting HBV DNA in serum or liver tissue in individuals who test negative for the hepatitis B surface antigen (HBsAg) but may test positive for other hepatitis B markers. The prevalence of occult HBV infection varies globally and can range from 1% to 95% depending on factors like diagnostic techniques used and endemicity of HBV infection in a population. Occult HBV infection can favor progression of liver diseases like fibrosis, cirrhosis, and hepatocellular carcinoma. Sensitive HBV DNA amplification assays are the standard for detecting occult HBV infection.
Hepatitis B virus causes hepatitis B disease. It is a DNA virus with an enveloped nucleocapsid core containing viral DNA. The virus particle is known as a Dane particle. HBV infects hepatocytes in the liver through virus-specific receptors. It has a small genome that encodes the surface, core and polymerase proteins. HBV is transmitted through blood, sexual contact and perinatally from mother to child. The virus persists in hepatocytes leading to chronic infection in around 5% of cases. Chronic infection increases the risk of liver cancer. HBV is diagnosed through detection of surface antigen, core antibody and DNA. Vaccination provides effective prevention through induction of protective antibodies.
Hepatitis B virus infection is a major public health problem in the Middle East, where the majority of countries have intermediate to high endemicity. Mother-to-child and childhood transmission are the main modes of transmission in the region. While vaccination programs have been introduced, coverage and prevention strategies vary between countries.
Approach to case of chronic hepatitis B after suspicion or establishment of an acute Hepatitis B- covering diagnosis, management, medications available, vaccination and followup.
Este documento describe la tuberculosis, una enfermedad infecciosa causada por la bacteria Mycobacterium tuberculosis que afecta principalmente los pulmones. La tuberculosis es una de las principales causas de muerte en el mundo, con más de 10 millones de casos nuevos y 2 millones de muertes cada año. Factores como la pobreza, la malnutrición y el VIH/SIDA aumentan el riesgo de contraer la enfermedad.
BCC4: Pierre Janin on 4 Newer Agents for Hepatitis CSMACC Conference
Janin speaks on the dawn of a revolution for treating Hepatitis C. This was recorded at Bedside Critical Care Conference 4. Full postings can be found at www.intensivecarenetwork.com
This document provides an overview of chronic hepatitis B, including its epidemiology, virology, pathogenesis, natural history, clinical features, diagnosis, treatment, and guidelines. Some key points:
- Approximately 1/3 of the world's population has been infected with hepatitis B virus (HBV) and 350-400 million people are chronic carriers.
- HBV is classified into 8 genotypes that vary in prevalence around the world. HBV infects liver cells and can establish a lifelong infection by integrating into the host genome.
- Chronic HBV progresses through 5 phases and can lead to complications like cirrhosis and liver cancer if left untreated. Treatment aims to suppress HBV DNA levels and improve liver health. First
OBI is a complex entity that comprises many conditions and different situations. Patients who have recovered from acute hepatitis B can carry HBV genomes for a long time,
and the virus might aggravate the course of their liver disease, when other causes of liver damage are present.The availability of highly sensitive molecular methods
has made it possible to unveil several virological features of OBI, to show its worldwide diffusion, and to reveal its possible involvement in different clinical settings. Relevant evidence indicates that HBV persistence as an OBI represents an important risk factor for HCC development.
This document is an essay submitted by Dr. Hesham Noaman Abdelraheem Mustafa for a Master's degree in Tropical Medicine from Cairo University. It discusses hepatitis B virus (HBV) prevalence worldwide and in Egypt, updated clinical issues in diagnosis, and modern treatment modalities. The aim is to provide an overview of HBV epidemiology and management. It reviews the relevant literature and was supervised by Dr. Laila Ahmad Mohammad and Dr. Ahmad Nabil Lotfy Hassan of Cairo University's Tropical Medicine Department.
Hepatitis B virus (HBV) infection is a major global public health problem, with an estimated 400-500 million people chronically infected worldwide. Each year there are around 10 million new cases and 1.3 million deaths, making HBV the 5th most common cause of cancer and 10th leading cause of death globally. India has an intermediate prevalence of HBV infection at around 3% of the population, or approximately 37 million carriers, and contributes significantly to the global disease burden.
The document summarizes information about several hepatitis viruses including HAV, HBV, HCV, HDV, and HEV. It provides details on their geographical distribution, modes of transmission, clinical presentation, natural history, and markers used to diagnose infection. Highlights include that HBV is a major cause of liver cancer and cirrhosis worldwide, with 400 million chronic carriers. Chronic HBV infection progression can lead to complications like liver failure, cancer, and death if left untreated.
Occult hepatitis B virus infection (OBI) is defined by an undetectable HBsAg but detectable intrahepatic HBV DNA. It can be seropositive (anti-HBc+) or seronegative (anti-HBc-). OBI is characterized by very low or undetectable HBV DNA levels due to strong suppression of viral replication through immune pressure and epigenetic factors. However, OBI can reactivate and cause acute hepatitis. It also poses long-term risks like progression of liver disease to cirrhosis and development of hepatocellular carcinoma through its tumorigenic properties and persistent necroinflammation. Detection requires highly sensitive PCR techniques.
Hepatitis C is a global health problem that causes 700,000 deaths per year. In Bangladesh, 1% of the population has HCV. New guidelines recommend screening high-risk groups and treating with direct-acting antiviral drugs, which have cure rates over 90% and shorter treatment durations compared to previous interferon-based regimens. Proper treatment can prevent cirrhosis, liver cancer and death from HCV. While challenges remain, scientists hope to eliminate HCV globally by 2030 with new pan-genotypic drugs. Prevention through injection safety, screening blood products, and educating healthcare workers is also important to control the disease.
Management Of Chronic Hepatitis B
by Dr S Khan
Courtesy Of Javed iqbal Farooqi
http://www.drkhanblogs.com/2015/05/management-of-chronic-hepatitis-b.html
Hepatitis c. diagnosis and treatment.assld guidelines.2016 .2017Dr. Afzal Haq Asif
A 45-year-old woman presented with fatigue, weakness, loss of appetite, and anemia. Liver function tests showed elevated AST, ALT, and bilirubin levels indicating liver inflammation and damage. A liver biopsy revealed necroinflammation and fibrosis. This suggests a diagnosis of chronic hepatitis C, which would be confirmed by a positive HCV RNA test. The best course of action would be to treat the patient with direct-acting antiviral therapy to cure the hepatitis C infection, advise lifestyle changes to protect the liver, and monitor for complications like cirrhosis or liver cancer.
Chronic hepatitis B infection is a major global health issue, affecting around 248 million people. Current treatments like nucleoside analogues and interferon are not curative and have limitations. New therapies targeting the hepatitis B virus directly or the host immune response are in development. Direct-acting antivirals in clinical trials inhibit the viral polymerase, capsid formation, HBsAg secretion, and RNase H. Host-targeting approaches trial immune enhancers, viral entry inhibitors, vaccines, and pro-apoptotic drugs. Promising preclinical candidates additionally modulate immunity, epigenetics, interferons, and cyclophilins. These novel therapies aim to achieve functional cures for chronic hepatitis B.
This document summarizes a review article about occult hepatitis B virus (HBV) infection. Occult HBV infection is defined as detecting HBV DNA in serum or liver tissue in individuals who test negative for the hepatitis B surface antigen (HBsAg) but may test positive for other hepatitis B markers. The prevalence of occult HBV infection varies globally and can range from 1% to 95% depending on factors like diagnostic techniques used and endemicity of HBV infection in a population. Occult HBV infection can favor progression of liver diseases like fibrosis, cirrhosis, and hepatocellular carcinoma. Sensitive HBV DNA amplification assays are the standard for detecting occult HBV infection.
Hepatitis B virus causes hepatitis B disease. It is a DNA virus with an enveloped nucleocapsid core containing viral DNA. The virus particle is known as a Dane particle. HBV infects hepatocytes in the liver through virus-specific receptors. It has a small genome that encodes the surface, core and polymerase proteins. HBV is transmitted through blood, sexual contact and perinatally from mother to child. The virus persists in hepatocytes leading to chronic infection in around 5% of cases. Chronic infection increases the risk of liver cancer. HBV is diagnosed through detection of surface antigen, core antibody and DNA. Vaccination provides effective prevention through induction of protective antibodies.
Hepatitis B virus infection is a major public health problem in the Middle East, where the majority of countries have intermediate to high endemicity. Mother-to-child and childhood transmission are the main modes of transmission in the region. While vaccination programs have been introduced, coverage and prevention strategies vary between countries.
Approach to case of chronic hepatitis B after suspicion or establishment of an acute Hepatitis B- covering diagnosis, management, medications available, vaccination and followup.
Este documento describe la tuberculosis, una enfermedad infecciosa causada por la bacteria Mycobacterium tuberculosis que afecta principalmente los pulmones. La tuberculosis es una de las principales causas de muerte en el mundo, con más de 10 millones de casos nuevos y 2 millones de muertes cada año. Factores como la pobreza, la malnutrición y el VIH/SIDA aumentan el riesgo de contraer la enfermedad.
Este documento trata sobre la tuberculosis. Explica que es una enfermedad granulomatosa crónica causada por el bacilo Mycobacterium tuberculosis, que afecta principalmente los pulmones. Las personas con mayor riesgo son aquellas con pobreza, desnutrición, enfermedades como diabetes o silicosis, o con sistemas inmunes debilitados. La infección puede ser primaria o secundaria, presentándose lesiones diferentes en cada caso.
The document discusses hepatitis B, including its epidemiology, transmission, clinical presentations, natural history, and virology. Some key points:
- Hepatitis B is endemic in many parts of Asia and Africa, with transmission primarily vertical or sexual.
- Acute hepatitis B often resolves on its own but can lead to chronic infection in 5-10% of cases.
- Chronic hepatitis B can take forms associated with wild type virus or pre-core mutants, and may progress to cirrhosis or liver cancer over decades.
- The virus replicates via an RNA intermediate and reverse transcription, forming cccDNA in the nucleus that maintains infection.
1. Hepatitis B virus (HBV) is a serious disease that can cause lifelong infection, liver cirrhosis, liver cancer, liver failure, and death. It is 100 times more infectious than HIV.
2. HBV is transmitted through contact with infectious blood or body fluids and can lead to either an acute or chronic infection. Chronic infections may progress to complications like cirrhosis or liver cancer.
3. Treatment options for chronic HBV infection include nucleoside/nucleotide analogues like entecavir and tenofovir, as well as interferon-alpha. Vaccination and immunoglobulin can prevent HBV infection in high-risk groups or following exposure.
HIV infection is caused by a retrovirus that can lead to AIDS if not treated. It is transmitted through bodily fluids and can be diagnosed through viral load tests, p24 antigen tests, HIV antibody tests, and Western blot. If left untreated, it progresses from acute infection to asymptomatic infection and eventually symptomatic infection and AIDS. Antiretroviral therapy is recommended for all infected individuals to suppress the virus and preserve immune function. The goals of treatment are to durably suppress the virus, restore immune function, and prevent transmission. Response is monitored through clinical, virologic, and immunologic measures.
Hepatitis C virus (HCV) was identified in the 1970s and can lead to chronic liver disease. Globally, an estimated 71 million people have chronic HCV infection. In India, the prevalence is estimated between 0.5-1.5% with genotype 3 being most common. HCV is transmitted through blood and blood products, unsafe medical injections, and from mother to child. Most infections become chronic, potentially leading to cirrhosis or liver cancer over time. Screening and treatment have advanced significantly in recent decades to help eliminate HCV transmission through blood and cure chronic infections.
Hepatitis B is a viral infection that affects the liver and is transmitted through contact with infected blood or body fluids. It remains a major global health problem, with over 250 million chronic carriers worldwide.
In Nigeria, the prevalence of hepatitis B is high, with an estimated 19 million people currently infected. Mother-to-child transmission during birth is the most common mode of infection in highly endemic areas like Nigeria.
While most adults clear the virus, chronic infection develops in the majority of those infected as newborns or children. This puts them at risk of developing serious liver conditions like cirrhosis or liver cancer later in life. Vaccination and antiviral treatment can help prevent or manage the infection.
Hepatitis B is a viral infection that affects the liver. It is caused by the hepatitis B virus and is transmitted through contact with infected blood or bodily fluids. The virus can cause both acute and chronic infections. Chronic infections may lead to serious health issues like liver damage, cirrhosis, and liver cancer. Hepatitis B is a major global health problem, with millions of people infected worldwide. Vaccination is the most effective way to prevent hepatitis B infection.
The document summarizes various hepatitis viruses including Hepatitis A, B, C, D and E viruses. It discusses the clinical features, transmission, diagnosis and treatment of these viruses. It also briefly describes other viruses that can cause hepatitis such as cytomegalovirus, Epstein Barr virus and yellow fever virus.
Taller Banco de Sangre - Complicaciones infecciosasfaquintero
1) The document discusses infectious complications that can arise from blood transfusions, focusing on hepatitis viruses and HIV.
2) Several hepatitis viruses (A, B, C, D, and E) can be transmitted through blood transfusions if the donor is actively infected but asymptomatic. HIV transmission through transfusions was a major issue in the 1980s before effective screening.
3) Modern screening tests have greatly reduced but not eliminated the risk of transmitting infectious diseases through blood transfusions. Ongoing challenges include emerging pathogens and the persistence of infections like HCV in the bloodstream.
This document summarizes chronic viral hepatitis caused by hepatitis B, C, and D viruses. It describes the modes of transmission, clinical manifestations, laboratory diagnosis, and morphology of each virus. Chronic hepatitis B and C can lead to cirrhosis and liver cancer over many years. Hepatitis B and D viruses can only replicate in hepatocytes infected with hepatitis B virus. Laboratory tests for hepatitis B, C, and D include detecting viral antigens, antibodies, RNA, and liver enzymes to determine infection and disease status.
This document summarizes the natural history of hepatitis B virus (HBV) infection in 3 sentences:
Acute HBV infection may resolve or progress to chronic infection in 5-10% of cases, with chronic infection following an immune tolerant phase, immune clearance phase resulting in chronic hepatitis, or transition to an inactive carrier state. Chronic HBV infection can lead to cirrhosis or hepatocellular carcinoma over 30-50 years and reactivation is possible, particularly with immunosuppression. HBV infection may be due to wild type virus or pre-core mutants that emerge during transition to the inactive carrier phase.
This document discusses viral hepatitis, focusing on types B, C, D, and E. It provides details on:
1) Modes of transmission including parenteral, perinatal, sexual, and foodborne routes. High risk groups include health workers, recipients of blood transfusions, drug users, and infants of carrier mothers.
2) Diagnosis methods like antigen/antibody testing and RNA detection to determine acute vs chronic infection.
3) Prevention strategies like vaccination for hepatitis A and B, injection and blood safety, harm reduction, and access to clean water and sanitation.
4) Global and national control efforts like the WHO strategy and India's national viral hepatitis program to increase testing
This document summarizes information about Hepatitis virus prepared by Abubakr Sdiq Sargaty. It provides an overview of different Hepatitis viruses including HAV, HBV, HCV, HDV and HEV. Key details include their nucleic acid, mode of transmission, severity and chronicity. The document also discusses viral replication, geographic distribution, clinical features, pathogenesis, diagnosis and treatment of Hepatitis B virus in more depth. It emphasizes the importance of vaccination programs in eliminating HBV transmission.
- HIV was first recognized in 1981 among IV drug users and transfusion recipients. By 1985, the extent of the epidemic became clear.
- HIV is an RNA virus that binds host cells via its envelope proteins gp120 and gp41. Its replication cycle takes around 2 days.
- HIV primarily targets CD4+ T cells. Infection leads to their decline and ultimately immunodeficiency if untreated.
- HIV has several phases: acute infection, clinical latency, AIDS. Disease progression can be slowed but not stopped without treatment.
Hepatitis B, C & D Viruses
This document summarizes key information about hepatitis B, C, and D viruses. It discusses the etiology, pathology, clinical features, diagnosis, treatment and prevention of each virus. Hepatitis B virus is a hepadnavirus that can cause both acute and chronic infection. Hepatitis C virus is a flavivirus that often leads to chronic infection. Hepatitis D virus can only infect those also infected with hepatitis B and increases the severity of liver disease. Vaccination and blood screening are important prevention strategies for these viral hepatitises.
The document discusses hepatitis B virus (HBV) and hepatitis B. It provides definitions and details about the epidemiology, transmission, clinical manifestations, pathogenesis, and serologic and virologic markers of HBV infection. Some key points include:
- HBV is a viral infection of the liver that affects around 2 billion people worldwide and causes over 1 million deaths annually.
- It is transmitted through contact with infectious blood or body fluids from an infected person.
- Clinical manifestations range from an acute self-limiting illness to chronic lifelong infection associated with cirrhosis and liver cancer.
- HBV pathogenesis involves the virus gaining entry into liver cells and using the host cell machinery to replicate. The host immune
La hepatitis se refiere a la inflamación del hígado. Puede ser causada por varios factores, incluidas infecciones virales. Hay varios tipos de hepatitis viral, cada uno causado por un virus diferente. Los tipos más comunes incluyen:
Hepatitis A (VHA): Este tipo de hepatitis suele transmitirse a través de alimentos o agua contaminados. Causa una infección aguda en el hígado, pero la mayoría de las personas se recuperan completamente con el tiempo. Existe una vacuna disponible para la hepatitis A, que se recomienda para los viajeros a áreas con mal saneamiento.
Hepatitis B (VHB): La hepatitis B generalmente se transmite a través del contacto con sangre infectada, fluidos corporales o de madre a hijo durante el parto. Puede causar infecciones agudas y crónicas. Las infecciones crónicas por VHB pueden llevar a complicaciones graves como cirrosis y cáncer de hígado. Existen vacunas disponibles para prevenir la hepatitis B.
Hepatitis C (VHC): La hepatitis C se transmite principalmente a través del contacto con sangre infectada, a menudo compartiendo agujas u otros utensilios de consumo de drogas. También se puede transmitir a través del contacto sexual o de madre a hijo durante el parto. La hepatitis C puede llevar a una enfermedad hepática crónica y, en algunos casos, puede requerir tratamiento antiviral. No hay una vacuna para la hepatitis C, pero ha habido avances significativos en las opciones de tratamiento.
Hepatitis D (VHD): Este tipo de hepatitis solo ocurre en personas que ya están infectadas con hepatitis B. El VHD se considera un virus "auxiliar", ya que requiere la presencia de VHB para replicarse. La infección por VHD puede empeorar mucho la hepatitis B.
Hepatitis E (VHE): Similar a la hepatitis A, la hepatitis E generalmente se transmite a través de agua o alimentos contaminados. Es más común en áreas con saneamiento deficiente y puede causar hepatitis aguda. Aunque existe una vacuna para la hepatitis E, no está ampliamente disponible.
La hepatitis viral puede tener una amplia gama de síntomas, que incluyen fatiga, ictericia (coloración amarillenta de la piel y los ojos), dolor abdominal, náuseas, vómitos y más. Algunas formas de hepatitis viral pueden llevar a enfermedad hepática crónica, cirrosis e incluso cáncer de hígado si no se tratan.
Las estrategias de prevención incluyen practicar una buena higiene, usar protección durante las actividades sexuales, evitar compartir agujas u objetos personales que puedan estar contaminados con sangre y vacunarse cuando las vacunas estén disponibles (hepatitis A y B).
Si sospechas que tienes hepatitis o has estado expuesto a alguno de los virus, es importante consultar a un profesional médico para obtener un diagnóstico adecuado, tratamiento y orientación.
Hepatitis" means inflammation of the liver and also refers to a group of viral infections that affect the liver .
The most common types are Hepatitis A, Hepatitis B, and Hepatitis C.
Viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation.
An estimated 4.4 million Americans are living with chronic hepatitis; most do not know they are infected
Virus is an obligatory intracellular parasite made up of protein and RNA/DNA that replicates solely within host cells. Hepatitis C virus (HCV) is a small enveloped RNA virus that causes both acute and chronic hepatitis. It is classified into 11 genotypes and infects approximately 170 million people worldwide, with 50-80% developing chronic infection. HCV is transmitted through blood and bodily fluids, with the most common routes being contaminated needles and transfusions. While 80% of infections are asymptomatic, acute symptoms may include fatigue, nausea, and jaundice. HCV is diagnosed through antibody screening and molecular tests like PCR. Treatment aims to halt disease progression and includes antiviral drugs like interferon, ribavirin, and direct
David L. Wyles, MD of UC San Diego Department of Medicine presents"Acute HCV Infection in HIV+ MSM: Sexual Transmission of a Non-Sexually Transmitted Disease?"
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4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
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jovan ranin - overview of HCV and HBV co-infections in patients with HIV in Serbia
1. Overview of HCV and HBV co-
infections in patients with HIV in
Serbia
Jovan Ranin
2. Course of HIV
infection
HAART – Highly Active Anti-Retroviral
Therapy – dramatically changed the course of HIV
infection
art era HAART era
high incidence of OI lower incidence of OI
the incubation period of 7 - 10 the incubation period of several
years decades
short survival period longer survival time
high rate of morbidity and improved quality of life
mortality
comorbidities:
poor quality of life
• metabolic diseases
• non-AIDS malignancies
• ESLD caused by HCV or/and HBV co-
infections
3. Importance of HCV and HBV co-
infections in patients with HIV
infection
1. similar mode of transmission longer survival with HAART
2. high rate of chronicity
high incidence of progression of co-infections
co-infections is more frequently
increased rate of morbidity and
mortality of ESLD in HIV infection
4. Prevalence of HCV and HBV co-
infections in the world
number of cases
• HIV – 33 million (60 million) 1
• HCV – 170 million 2
• HBV – 500 million 3
prevalence of HCV and HBV co-infections
• HIV/HCV – 15 – 33 % 4
• HIV/HBV – 6 – 14 % 5
• up to 90 % of HIV patients are seropositive for HBV antibodies 5
1
Del Rio C PPID 2010; 2 WHO 2007; 3 Koziel MJ PPID 2010; 4 Alberti A J Hepatol 2005; 5 Alter MJ J Hepatol 2006
5. Impact of HIV infection and HAART
on the course of HCV and HBV co-
infections
HIV infection 1, 2
• increased the frequency of viral persistence after acute infection
• higher level of HCV RNA in peripheral blood
• more frequently reappearance of HBV markers
• faster progression to cirrhosis
• higher prevalence of devolopment of ESLD and HCC
• higher rate of mortality
HAART 3, 4
• hepatotoxicity of HIV drugs
• “flare” of HCV or HBV infection - IRIS
• immune reconstitution improve surveillance of HCV and HBV co-
infections
1 Goedert JJ i sar J Infect Dis 2000; 2 Goedert JJ i sar Blood 2002; 3 Qurishi N i sar Lancet 2004; 4 Mehta SH i sar
Hepatology 2005
6. Impact of HCV and HBV co-
infections on the course of HIV
infection
remains unclear
controversial results of the studies
• interfere with immune reconstitution induced by HAART 1
• no influence on immune reconstitution 2
• interfere with immune reconstitution, but without influence
on progression of HIV infection to AIDS 3
• no impact on rate of mortality in patients with HIV infection 3
• interaction with HAART 4
• decreased drug metabolism
• decreased HCV – specific immune reconstitution
• increased susceptibility to mitochondrial dysfunction
1
Greub G i sar. Lancet 2000; 2 Sulkowski MS i sar. JAMA 2002; 3 Sullivan PS i sar. AIDS 2006; 4 Wit FW i sar. J Infect
Dis 2002
7. Design of
study
longitudinal cohort study
840 patients with HIV infection were followed
study period was 1997 – 2010
patients were included into the study until June 2009
mean time of follow-up was 71,9 ± 42,2 months
inclusion criteriums:
• HIV infection diagnosed accordingly with CDC clasification system from
1993 and revised in 2008
• using HAART
logistic regression and Cox proportional hazards regression models
within SPSS
three parts of study
8. 1. before HAART
discriminators for groups of patients with HCV and HBV co-infections
compared with HIV mono-infection: immunological, epidemiological and
clinical features
2. one - year HAART
predictors of immunological, virological and clinical effects of HAART:
HCV and HBV co-infections
3. long - term HAART
predictors of immunological, virological and clinical effects of
HAART:
HCV and HBV co-infections
9. Prevalence of HCV and HBV
co-infection in studied
patients
N = 840
HIV/HBV HIV/HCV/HBV
HIV/HCV 4,5%
1,7%
23,9%
HIV
69,4%
10. Discriminators for patients with
HIV/HCV co-infection before HAART
negative discriminators positive discriminators
95% CI
gender OR
msm heterosex
0.070 2.525 hemophilia ivdu
0.276
10.079 30.295
3.807 transfusion
1.012 ALT
1.020 AST
1.775 CD4 < 100
CD4 baseline 0.997
1.660
AIDS
0.01 0.1 1 10 100
logistic regression univariate model
11. Discriminators for patients with HIV/HCV
co-infection before HAART
negative discriminators positive discriminators
gender 95% CI
6.851
OR
heterosex 9.500 hemophilia
0.113
1.735 AIDS
0.01 0.1 1 10 100
logistic regression multivariate model
12. Discriminators for patients with HIV/HBV
co-infection before HAART
negative discriminators
95% CI
gender
OR
0.079
ivdu
0.113
0.01 0.1 1
logistic regression multivariate model
13. Predictors for
immunological failure after
one year on HAART CD4 < 350
positive predictors
no significant:
HBV co-infection
HCV/HBV co-infection
AIDS
4.122
age
1.042
95% CI
HCV
1.580 OR
1 10
logistic regression multivariate model
14. Predictors for devoloping
of IRIS after one year on
HAART
IRIS – Immune Restoration Inflammatory
Syndrome
negative predictors positive predictors
no significant:
HBV co-infection
AIDS HCV/HBV co-infection
1.545
age
1.015
STI 0.554
95% CI
1.375 HCV HR
0.1 1 10
multivariate Cox proportional hazards regression model
15. Predictors for virological-
immunological success with long-
term HAART
success – und pVL and CD4 ≥ 350
negative predictors positive predictors
no significant:
AIDS
0.733
HBV co-infection
gender
STI 0.218
0.673
HCV/HBV co-infection
HCV 0.607
CD4 < 100 95% CI
0.563 HR
1.001 CD4 prim
0.1 1 10
multivariate Cox proportional hazards regression model
16. Causes of deaths of patients
with HIV infection in Serbia
N = 113
the mortality is 13.5 %
other
AIDS 33.6%
23.9%
non-AIDS Ca
15.0%
cardio 12.5% ESLD 15.0%
17. Predictors for deaths of patients
with HIV infection on long-term
HAART
negative predictors positive predictors
95%CI
HR
age
1.032 no significant:
gender 0.574
HBV co-infection
CD4 prim 0.998 HCV/HBV co-infection
2.081 HCV
0.1 1 10
multivariate Cox proportional hazards regression model
18. Conclusion
(I)
prevalence of HCV and HBV co-infection in Serbia
• similar as in other Europian countries
• HCV – 23,9 %
• HBV – 4,5 %
• HCV/HBV – 1,7 %
mortality of HIV patients in Serbia
• mortality is 13,5 %
• ESLD caused 15 % of deaths which is higher rate compared with era
before HAART (12 %) 1
• HCV co-infection is predictor for mortality, while HBV co-infection is not
associated with risk for death
1
Brmbolić B. Phd 1992.
19. Conclusion
(II)
HCV co-infection
• intensify CD4 limfopeny in natural history of HIV infection
• cause faster progression of natural history of HIV infection to AIDS
• interfere with immune reconstitution in first year of HAART
• provocate devolopment of IRIS
• cause immunological-virological failure of long-term HAART
• has negative effect on survival of patient with HIV infection
HBV co-infection
• it is not associate with immunological, virological and clinical
characteristics of simultaneous HIV infection
20. It is necessery to improve treatment
of HCV infection for patient with
HIV/HCV co-infection