BACKGROUND:Hepatitis B virus(HBV)is encountered sporadically the year round in Bangladesh.It results in a wide range of liver diseases,with asymptomatic acute hepatitis at one end to hepatocellular carcinoma(HCC)at th...BACKGROUND:Hepatitis B virus(HBV)is encountered sporadically the year round in Bangladesh.It results in a wide range of liver diseases,with asymptomatic acute hepatitis at one end to hepatocellular carcinoma(HCC)at the other end of the spectrum. METHODS:All 1018 individuals of different age groups and sex with varied religious,educational and social backgrounds were tested for HBsAg by ELISA.The positive samples were further tested by ELISA for HBeAg.Before testing,blood samples were preserved at-20℃.The study was conducted in a semi-urban location on the outskirts of Dhaka. RESULTS:Of the 1018 individuals,5.5%tested positive for HBsAg.None were tested positive for anti-HCV.Among the HBsAg-positive population,58.93%were HBeAg- positive and the rest 41.07%HBeAg-negative.There was a male predominance and those who were tested positive were mostly between 16 and 50 years of age.Major risk factors for exposure to HBV appeared to be injudicious use of injectable medications,treatment by unqualified, traditional practitioners,mass-vaccination against cholera and smallpox,barbers and body piercing. CONCLUSION:HBV remains a major cause of morbidity and mortality in Bangladesh and we have a long way to go before we may bid farewell to this deadly menace.展开更多
AIM To characterize antiviral therapy eligibility among hepatitis B virus(HBV)-infected adults at a university hospital in Zambia.METHODS Hepatitis B surface antigen-positive adults(n=160)who were h IV-negative and re...AIM To characterize antiviral therapy eligibility among hepatitis B virus(HBV)-infected adults at a university hospital in Zambia.METHODS Hepatitis B surface antigen-positive adults(n=160)who were h IV-negative and referred to the hospital after a routine or clinically-driven HBV test were enrolled.Alanine Aminotransferase(ALT),Aspartate Aminotransferase(AST),platelet count,hepatitis B e-antigen,and HBV DNA were measured.Liver fibrosis/cirrhosis was assessed by physical examination,AST-to-platelet ratio index,and transient elastography.In antiviral therapy-na?ve individuals,we described hBV stages and antiviral therapy eligibility per World health Organization(WhO)and by hBV test(routine vs clinical).Elevated ALT was>19 in women and>30 U/L in men.Among treatmentexperienced individuals,we described medication side effects,adherence,and viral suppression.RESULTS The median age was 33 years,71.9%were men,and 30.9%were diagnosed with HBV through a clinicallydriven test with the remainder identified via routine testing(at the blood bank,community events,etc.).Among 120 treatment-na?ve individuals,2.5%were categorized as immune tolerant,11.7%were immune active,35.6%were inactive carriers,and 46.7%had an indeterminate phenotype.Per WhO guidelines,13(10.8%)were eligible for immediate antiviral therapy.The odds of eligibility were eight times higher for those diagnosed at clinical vs routine settings(adjusted odds ratio,8.33;95%CI:2.26-29.41).Among 40 treatmentexperienced hBV patients,virtually all took tenofovir,and a history of mild side effects was reported in 20%.Though reported adherence was good,12 of 29(41.4%)had HBV DNA>20 IU/m L.CONCLUSION Approximately one in ten HBV-monoinfected Zambians were eligible for antivirals.Many had indeterminate phenotype and needed clinical follow-up.展开更多
文摘BACKGROUND:Hepatitis B virus(HBV)is encountered sporadically the year round in Bangladesh.It results in a wide range of liver diseases,with asymptomatic acute hepatitis at one end to hepatocellular carcinoma(HCC)at the other end of the spectrum. METHODS:All 1018 individuals of different age groups and sex with varied religious,educational and social backgrounds were tested for HBsAg by ELISA.The positive samples were further tested by ELISA for HBeAg.Before testing,blood samples were preserved at-20℃.The study was conducted in a semi-urban location on the outskirts of Dhaka. RESULTS:Of the 1018 individuals,5.5%tested positive for HBsAg.None were tested positive for anti-HCV.Among the HBsAg-positive population,58.93%were HBeAg- positive and the rest 41.07%HBeAg-negative.There was a male predominance and those who were tested positive were mostly between 16 and 50 years of age.Major risk factors for exposure to HBV appeared to be injudicious use of injectable medications,treatment by unqualified, traditional practitioners,mass-vaccination against cholera and smallpox,barbers and body piercing. CONCLUSION:HBV remains a major cause of morbidity and mortality in Bangladesh and we have a long way to go before we may bid farewell to this deadly menace.
基金Supported by School of Medicine at University of Alabama at BirminghamFogarty International Center,No.K01TW009998+1 种基金National Institute of Allergy and Infectious Diseases,U.S.National Institutes of Health,No.U01AI069924Swiss National Science Foundation(to Wandeler G),No.PZ0093_154730
文摘AIM To characterize antiviral therapy eligibility among hepatitis B virus(HBV)-infected adults at a university hospital in Zambia.METHODS Hepatitis B surface antigen-positive adults(n=160)who were h IV-negative and referred to the hospital after a routine or clinically-driven HBV test were enrolled.Alanine Aminotransferase(ALT),Aspartate Aminotransferase(AST),platelet count,hepatitis B e-antigen,and HBV DNA were measured.Liver fibrosis/cirrhosis was assessed by physical examination,AST-to-platelet ratio index,and transient elastography.In antiviral therapy-na?ve individuals,we described hBV stages and antiviral therapy eligibility per World health Organization(WhO)and by hBV test(routine vs clinical).Elevated ALT was>19 in women and>30 U/L in men.Among treatmentexperienced individuals,we described medication side effects,adherence,and viral suppression.RESULTS The median age was 33 years,71.9%were men,and 30.9%were diagnosed with HBV through a clinicallydriven test with the remainder identified via routine testing(at the blood bank,community events,etc.).Among 120 treatment-na?ve individuals,2.5%were categorized as immune tolerant,11.7%were immune active,35.6%were inactive carriers,and 46.7%had an indeterminate phenotype.Per WhO guidelines,13(10.8%)were eligible for immediate antiviral therapy.The odds of eligibility were eight times higher for those diagnosed at clinical vs routine settings(adjusted odds ratio,8.33;95%CI:2.26-29.41).Among 40 treatmentexperienced hBV patients,virtually all took tenofovir,and a history of mild side effects was reported in 20%.Though reported adherence was good,12 of 29(41.4%)had HBV DNA>20 IU/m L.CONCLUSION Approximately one in ten HBV-monoinfected Zambians were eligible for antivirals.Many had indeterminate phenotype and needed clinical follow-up.
