Hepatitis B Research Papers - Academia.edu (original) (raw)

؉ T-cell responses are believed to play an important role in the control of human HBV infection. In the present study, HBcAg-specific, HLA-DR13*-restricted CD4 ؉ Th1-type T-cell clones were generated which secreted both gamma interferon and tumor necrosis factor alpha after in vitro antigen stimulation. These HBcAg-specific CD4 ؉ Th1-type T cells were able to lyse HBc peptide-loaded Epstein-Barr virus-transformed lymphoblastoid target cells in vitro. To examine whether these HLA-DR13*-restricted human CD4 ؉ Th1 T cells also display the same cytotoxic effects in vivo, we transferred peripheral blood leukocytes (PBL) derived from HBV-infected donors or an HBV-naïve donor sharing the DR13*, together with the HBcAg-specific CD4 ؉ Th1-type T

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- Immune response, Virology, Biological Sciences, Hepatitis B

Safety, reactogenicity and immunogenicity of GSK Biologicals' hexavalent DTPa-HBV-IPV/Hib vaccine (Infanrix)hexa) was assessed when used for primary vaccination at 3, 4 and 5 months of age (N = 2163), compared to the separate administration of DTPa-IPV/Hib and HBV vaccines (N = 720). A similar safety and reactogenicity profile was demonstrated for both vaccine regimens, as well as a good immune response for all antigen components. By offering protection against six diseases in a series of single injections, the hexavalent DTPa-HBV-IPV/Hib vaccine was shown to be a safe, well tolerated and immunogenic alternative to primary immunization with licensed separately administered vaccines.

- by Ulrich Heininger
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- Immune response, Biological Sciences, Hepatitis B, Infant

Persons at high risk for human immunodeficiency virus (HIV) infection are also likely to be at risk for other infectious pathogens, including hepatitis B virus (HBV) or hepatitis C virus (HCV). These are bloodborne pathogens transmitted through similar routes; for example, via injection drug use (IDU), sexual contact, or from mother to child during pregnancy or birth. In some settings, the prevalence of coinfection with HBV and/or HCV is high. In the context of effective antiretroviral therapy (ART), liver disease has emerged as a major cause of morbidity and mortality in HIV-infected persons. Further, coinfection with viral hepatitis may complicate the delivery of ART by increasing the risk of drug-related hepatoxicity and impacting the selection of specific agents (e.g., those dually active against HIV and HBV). Expert guidelines developed in the United States and Europe recommend screening of all HIV-infected persons for infection with HCV and HBV and appropriate management of those found to be chronically infected. Treatment strategies for HBV infection include the use of nucleos(t)ide analogues with or without anti-HIV activity and/or peginterferon alfa (PegIFN) whereas HCV treatment is limited to the combination of PegIFN and ribavirin (RBV). Current approaches to management of HIVinfected persons coinfected with HBV or HCV are discussed in this review.

- by jose medrano
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- Medical Microbiology, Treatment, Drug Discovery, Treatment Outcome

Background: In Greece, several new childhood vaccines were introduced recently but were reimbursed gradually and at different time points. The aim of this study was to assess immunization coverage and identify factors influencing complete and age-appropriate vaccination among children attending public nurseries in the municipal district of Athens. Methods: A cross-sectional study, using stratified sampling was performed. Immunization history was obtained from vaccination booklets. Demographic and socioeconomic data were obtained from school registries and telephone interviews. Vaccination rates were estimated by sample weighted proportions while associations between complete and age-appropriate immunization and potential determinants by logistic regression analysis. Results: A total of 731 children (mean age: 46, median: 48, range: 10-65 months) were included. Overall immunization coverage with traditional vaccines (DTP, polio, Hib, HBV, 1st dose MMR) was satisfactory, exceeding 90%, but the administration of booster doses was delayed (range: 33.7-97.4%, at 60 months of age). Complete vaccination rates were lower for new vaccines (Men C, PCV7, varicella, hepatitis A), ranging between 61-92%. In addition, a significant delay in timely administration of Men C, PCV7, as well as HBV was noted (22.9%, 16.0% and 27.7% at 12 months of age, respectively). Child's age was strongly associated with incomplete vaccination with all vaccines (p< 0.001), while as immigrant status was a predictor of incomplete (p=0.034) and delayed vaccination (p<0.001) with traditional vaccines. Increasing household size and higher maternal education were negatively associated with the receipt of all and newly licensed vaccines, respectively (p=0.035). Conclusions: Our findings highlight the need to monitor uptake of new vaccines and improve age-appropriate administration of booster doses as well as early vaccination against hepatitis B. Immigrant status, increased household size and high maternal education may warrant targeted intervention.

- by Koralia A Michail
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- Bioinformatics, Life Sciences, Medicine, Greece
- by Marianne Van Der Sande
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- Hepatitis B, Financial System, Health Services, Ministry of Health

We found that platelet depletion reduces intrahepatic accumulation of virus-specific cytotoxic T lymphocytes (CTLs) and organ damage in mouse models of acute viral hepatitis. Transfusion of normal but not activation-blocked platelets in platelet-depleted mice restored accumulation of CTLs and severity of disease. In contrast, anticoagulant treatment that prevented intrahepatic fibrin deposition without reducing platelet counts did not avert liver injury. Thus, activated platelets contribute to CTL-mediated liver immunopathology independently of procoagulant function.

- by Giovanni Sitia and +1
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- Pharmacology, Pharmacy, Immunology, Liver diseases

tetanus toxoids were unaflected by simultaneous administration of hepatitis B or Hib conjugate vaccine. Engerix-B vaccine was safe and immunogenic when given with other routine childhood immunizations at 2, 4 and 6 months of age, and shouldprovide long-term protection against hepatitis B virus infection. Copyright 0 1996 Elsevier Science Ltd. Engerix-B is a registered trademark of SmithKline Beecham

- by Joel Ward
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- Biological Sciences, Prospective studies, Hepatitis B, Infant
- by Samuel R. Friedman
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- Hepatitis C, Multivariate Analysis, Syphilis, Hepatitis B

With the global pandemic of hepatitis B and C infections, the incidence of Hepatocellular carcinoma (HCC) is rapidly increasing world wide. We identified glypican-3 (GPC3), a novel oncofetal gene over-expressed specifically in human HCC, as based on data of cDNA microarrays. As GPC3 is a GPI-anchored membrane protein and could be secreted, we attempted to detect secreted GPC3 protein in sera from HCC patients using Western blotting and ELISA. GPC3 protein was positive in sera of 40.0% (16/40) of HCC patients, and negative in sera from subjects with liver cirrhosis (LC) (0/13), chronic hepatitis (CH) (0/34), and healthy donors (0/60). All subjects were Japanese. Although 12 of 40 HCC patients were negative for both a-fetoprotein (AFP) and PIVKA-II well known tumor markers of HCC, four of these were GPC3-positive in the sera. We also observed vanishing GPC3 protein in the sera of three patients after the surgical treatment for HCC. On the other hand, immunohistochemical analysis revealed that HCC expressed GPC3 protein in all 14 HCC patients tested. In conclusion, GPC3, as defined in this study was shown to be a useful tumor marker for cancer-diagnosis for large numbers of patients with HCC.

- by Hiroshi Ashihara
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- Immunohistochemistry, Gene expression, Hepatitis B, Liver Cirrhosis

Vertical transmission of hepatitis B virus (HBV) can occur occasionally despite vaccination of the child. This vaccination breakthrough has been associated with high maternal viraemia. We treated eight highly viraemic (HBV-DNA ‡ 1.2 · 10 9 geq/mL) mothers with 150 mg of lamivudine daily during the last month of pregnancy. HBV-DNA, hepatitis B surface antigen (HBsAg), anti-HBs and anti-HBc of their offspring were measured at birth and at 3, 6 and 12 months, respectively. Twenty-four children, born to untreated HBsAg-positive mothers with HBV-DNA levels ‡1.2 · 10 9 geq/mL served as historical controls. All children received passive-active immunization at birth and were followed-up for 12 months. In the lamivudine group one of the eight children (12.5%) was still HBsAg and HBV-DNA positive at the age of 12 months. All other children seroconverted to anti-HBs and maintained seroprotection. In three children, HBV-DNA was temporarily detected by polymerase chain reaction. In the untreated historical control group, perinatal transmission occurred in seven of 25 children (28%). In highly viraemic HBsAgpositive mothers, reduction of viraemia by lamivudine therapy in the last month of pregnancy may be an effective and safe measure to reduce the risk of child vaccination breakthrough. This approach should be evaluated in a large controlled trial.

- by Hubert Niesters and +1
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- Medical Microbiology, Treatment Outcome, Risk assessment, Adolescent

Hepatitis B virus infection (HBV) is one of the most widespread, chronic viral infections in sub-Saharan Africa, and parts of South America. Therefore, efforts are being made to implement strategies aimed at reducing the incidence of hepatitis B viral infections. One route of HBV transmission is through unsafe blood transfusion, which could occur from the use of less sensitive laboratory diagnostic kits. Information on the sensitivity and specificity of these kits is however limited in many developing countries. This study was therefore performed to describe the prevalence of HBV infections and also to evaluate the performance of five rapid immunochromatographic kits commonly used in Ghana. A cross-sectional study was designed to describe the prevalence of HBsAg infection and also evaluate the performance of rapid kits used for screening hepatitis B in the northern part of Ghana. A total of 164 prospective blood donors were enrolled in this study from January 2012 to December 2013. ...

- by Michael Owusu
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- Ghana, Adolescent, Prospective studies, Hepatitis B

Treatment of chronic hepatitis B virus (HBV) infection is aimed at suppressing viral replication to the lowest possible level, and thereby to halt the progression of liver disease and prevent the onset of complications. Two categories of drugs are used in HBV therapy: the interferons, including standard interferon alfa or pegylated interferon alfa, and specific nucleoside or nucleotide HBV inhibitors that target the reverse-transcriptase function of HBV-DNA polymerase. The reported results of clinical trials have used varying definitions of efficacy, failure, and resistance based on different measures of virologic responses. This article discusses HBV virologic markers and tests, and their optimal use both for planning and reporting clinical trials and in clinical practice.

- by George Lau
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- Gastroenterology, Clinical Trial, Treatment Outcome, PCR

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- by Funda Dogruman-Al
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- Microbiology, Epidemiology, Medical Microbiology, Turkey

Objective: To identify seroprevalence of varicella and the relationship with their histories of experiences of varicella diseases and to provide appropriate immunization against varicella, mumps, measles, rubella and hepatitis B to medical students. Material and method: All of the medical students were eligible for participation after informed consents. Immunization history against varicella, mumps, measles, rubella (MMR) and hepatitis B were obtained from a questionnaire. A blood sample was obtained from each student for IgG antibody against VZV by ELISA. Medical students with an uncertain history or no documentation of hepatitis B vaccination were tested for HBsAg and anti-HBcIgG by ELISA. Results: There were 383 medical students enrolled. The mean age at enrollment was 21.6 years (median 21.4 years; range 18-25.8 years). Of 383 medical students, 372 (97.2%) had documents of receiving MMR immunizations. The blood samples were obtained from 374 of 383 (97.6%) medical students to id...

- by Phutsapong Srisawat
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- Thailand, Medicine, Medical Students, Hepatitis B

Most African countries do not initiate hepatitis B vaccination at birth. We conducted a non-randomized controlled trial comparing hepatitis B vaccination given at age 0, 6, and 14 weeks versus the current Côte d'Ivoire schedule of 6, 10, and 14 weeks. Pregnant women were enrolled at four health centers in Abidjan. At age 9 months, 0.5% of infants in both the birth and 6-week cohorts were positive for HBsAg and all were born to HBeAg-positive women. Among infants of HBeAg-positive mothers, 9 of 24 (37.5%) in the birth cohort and 10 of 17 (58.8%) in the 6-week cohort were HBsAg positive (adjusted OR, 2.7; 95% CI: 0.7-11.0). While both vaccine *

- by Pierre Chauvin
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- Adolescent, Biological Sciences, Pregnancy, Hepatitis B
- by Brian Edlin
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- Risk Taking, Hepatitis B, San Francisco, Western

An evaluation of three new rapid diagnostic test kits for human immunodeficiency virus types 1 and 2 (HIV-1/2), hepatitis B surface antigen (HBsAg), and syphilis involved a two-phase comparison of rapid diagnostic assays using prospectively collected from hospitals and clinics in Ho Chi Minh City, Vietnam. After specificity and sensitivity testing, three new rapid diagnostic test kits were tested in parallel with six commonly used diagnostic test kits. The Determine HIV-1/2 test had fewer indeterminate or equivocal results than the Capillus HIV-1/HIV-2 or HIV Blot 2.2 tests. However, the Determine HIV-1/2 test yielded one false-positive result when compared with the Serodia HIV, HIV Blot 2.2, and microparticle enzyme immunoassay (IMx) HIV tests. The Serodia HBsAg test yielded more false-negative results when compared with the Determine HBsAg diagnostic test kit. The results of the syphilis diagnostic tests evaluated in this clinical trial consistently agreed with those of the rapid plasma reagin test for syphilis. The Determine Syphilis Treponema pallidum (TP) test had three false-positive results compared with the Serodia TP and the Serodia TP•particle agglutination (PA) tests, which had two false-positive results that were confirmed as negative by an ELISA. Application of these serologic tests within this comparative evaluation framework, using the World Health Organization alternative testing strategies, proved to be an effective way to determine serostatus related to HIV, hepatitis B, and syphilis.

- by Truong Xuan
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- Clinical Trial, Public Health, Vietnam, HIV

The antiviral effect against hepatitis B virus (HBV) of artemisinin, its derivative artesunate and other compounds highly purified from traditional Chinese medicine remedies, were investigated. HBV production by permanently transfected HepG2 2.2.15 cells was determined by measuring the release of surface protein (HBsAg) and HBV-DNA after drug exposure (0.01-100 M) for 21 days. The forms of HBV-DNA released were investigated by Southern-blotting. Neutral Red retention test was used to evaluate drug-induced toxicity on host cells. The compounds were classified according to their potential interest as follows: (i) none: they had no effect on viral production (daidzein, daidzin, isonardosinon, nardofuran, nardosinon, tetrahydronardosinon and quercetin); (ii) low: they were able to markedly reduce viral production, but also induced toxicity on host cells (berberine and tannic acid) or they had no toxic effect on host cells but only had a moderate ability to reduce viral production (curcumin, baicalein, baicalin, bufalin, diallyl disulphide, glycyrrhizic acid and puerarin); (iii) high: they induced strong inhibition of viral production at concentrations at which host cell viability was not affected (artemisinin and artesunate). Moreover, artesunate in conjunction with lamivudine had synergic anti-HBV effects, which warrants further evaluation of artemisinin/artesunate as antiviral agents against HBV infection.

- by Rocío García Macías
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- Chinese Medicine, Medical Microbiology, PCR, Cell line

is associated with more severe liver damage and an increased risk of fulminant disease. HDV is a single-stranded RNA virus that encodes a single protein, the delta antigen, which is expressed in two forms, small (S-HDAg) and large (L-HDAg). Here we show that although HDV ribonucleoproteins are mainly detected in the nucleus, they are also present in the cytoplasm of cells infected with HDV or transfected with HDV cDNA. Making use of an heterokaryon assay, we demonstrate that HDV ribonucleoproteins shuttle continuously between the nucleus and the cytoplasm. In the absence of HDV RNA, both forms of the delta antigen are retained in the nucleus, whereas in the absence of the delta antigen, HDV RNA is predominantly detected in the cytoplasm. Coexpression of HDV RNA and S-HDAg (which binds to the viral RNA and contains a nuclear localization signal) results in nuclear accumulation of the viral RNA. This suggests that HDV RNA mediates export of viral particles to the cytoplasm whereas the delta antigen triggers their reimport into the nucleus.

- by Ezio David
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- RNA, Cell line, Hepatitis B, Liver
- by Hiroshi Yatsuhashi
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- Japan, Adolescent, Medicine, Hepatitis B

Hepatitis B is a major burden in Pakistan. A cross-sectional study was conducted in Peshawar, from 9th June to 19th June 2010. Cluster random sampling was done. Confidence level of 95% and confidence interval of 5 was used to derive sample size. Parents of 506 children were asked about their hepatitis B immunization status who were aged 4 years or under. Questions on demographics, income, education, accessibility and occupation, knowledge and views on immunization were asked. Forty health personnel were interviewed for their views. In all, 62.2% children were completely vaccinated. Reasons for not being immunized included unawareness, busy schedule, long distance to the centre and various misconceptions. Education, mothers' knowledge and views on immunization, income, closer accessibility, were the main factors associated with immunization. Health personnel thought lack of awareness among people, low accessibility and poor incentives as the shortcomings in immunization. It is recommended that effective steps should be taken to ensure better coverage.

- by muhammad adil
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- Pakistan, Developing Countries, Health, Medicine

Background: The third stage of labour includes the separation and detachment of the placenta from the uterine wall, and ends with complete expulsion of the placenta and membrane. This period is the most hazardous stage for the birthing woman due to the risk of profuse hemorrhage. Severe bleeding is the most important cause of maternal deaths. Active management of third stage of labour effectively reduces the occurrence of hemorrhage. Objective: The objective of this study was to assess factors associated with Knowledge, Attitude, and Practice of Midwifes on active management of third stage of labour at selected health centers of Addis Ababa. Methods: Institution based cross sectional study was conducted among Midwives in health center of Addis Ababa. Convenience sampling was carried out to select 136 Midwives who were working in the 26 health center of Addis Ababa. The questionnaires contained closed ended questions which covered socio demographic information, knowledge, attitude an...

- by Rahel Yaekob
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- Psychology, HIV and AIDS education, Malaysia, Medicine

Tramadol is a synthetic opioid agonist used extensively in human and, to a lesser extent, veterinary medicine throughout the world. The clinical efficacy and pharmacokinetic profile of intravenous (i.v.) and extradural (e.d.) tramadol (2 mg/kg) and its o-desmethyl metabolite were studied in dogs undergoing tibial plateau levelling osteotomy (TPLO). Intra-operative cardiorespiratory variables were monitored and post-operative pain was assessed using the short form of the Glasgow Composite Pain Scale. A rapid (<5 min) and effective production of o-desmethyl tramadol was recorded. The pharmacokinetic profile was similar for tramadol and its metabolite irrespective of the route of administration. E.d. tramadol provided sufficient intra- and post-operative analgesia without significant clinical side-effects, but the post-operative analgesia was comparable to that following i.v. administration and the e.d. route could therefore not be considered a practical alternative to the i.v. route.

- by Martina Gallo
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- Biological Sciences, Dogs, Hepatitis B, Liver Cirrhosis

Oligonucleotides containing immunostimulatory CpG motifs (CpG ODN) have been shown to be potent Th1-type adjuvants for augmenting antigen-speci®c responses in mice against hepatitis B surface antigen (HBsAg). The hepatitis B virus (HBV) infects only humans and great apes and appears to exist among wild chimpanzees and orangutans. An outbreak of HBV among orangutans being rehabilitated for re-introduction to the jungle caused the death of several animals. A prophylactic vaccination program revealed that orangutans are quite hypo-responsive to a current commercial vaccine compared to results obtained previously in humans and chimpanzees. Addition of CpG ODN to hepatitis B vaccine greatly increased the seroconversion rate and the titers of antibody against HBsAg (anti-HBs). This is the ®rst demonstration of CpG DNA in a great ape and the results have important implications for the vaccination of humans against HBV and other diseases.

- by irma suparto
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- Biological Sciences, DNA, Hepatitis B, Virus

The new england journal of medicine 2674 * The most common adverse events are those that occurred in 10 percent or more of the patients in any treatment group. † Fisher's exact test was used for the comparison with the placebo-adefovir... more

- by Seng Lim
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- Gastroenterology, Adolescent, Hepatitis B, Liver Cirrhosis
- by aldo manzin
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- Medical Microbiology, Adolescent, Hepatitis B, Mutation
- by Michael Chudy
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- Microbiology, Medical Microbiology, Clinical Virology, Hepatitis B

Hepatitis B virus (HBV) is causally linked to acute and chronic form of hepatitis, which due to continuous immune mediated inflammation and scarring may lead to cirrhosis and/or hepatocellular carcinoma. HBV spread via exchange of infected bodily fluids underlie unique public health considerations due to similarities with other community related issues such as sexually transmitted diseases (eg HIV) blood borne pathogens (Hepatitis-C) and perinatal transmissions (TORCH complex).

Introduction. The success of renal transplantation as a treatment for end-stage renal disease has created a chronic shortage of donor organs. We present our experience in transplanting kidneys from donors with hepatitis B virus (HBV) or hepatitis C virus (HCV) among matched serology-positive recipients. Materials and Methods. From January 2002 to November 2005, 44 patients with end-stage renal disease and HCV seropositivity underwent kidney transplantation. In 28 transplants in HCVϩ recipients, the donor was HCVϩ (DCϩ/RCϩ) and in 16 of these cases the donor (one living donor) was HCVϪ (DCϪ/RCϩ). In the same period 14 patients with HBV infection and HbsAg seropositivity underwent kidney transplantation: eight received their graft from a cadaveric HbsAg-positive donor (DBϩ/RBϩ), while six patients received their graft from an HbsAg-negative donor.

- by Vito Sparacino and +1
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- Kidney transplantation, Survival Analysis, Treatment Outcome, Hepatitis C

Many human blood proteins are synthesised in the liver. Their serum levels may decrease or increase due to liver disorders and some of them serve as useful biomarkers. Determination of serum concentration of different biomarkers has important role in diagnosis of liver diseases and in monitoring the course of disease. In this work 3 serum markers associated with liver disorders were compared. The aim was to assess whether these biomarkers exhibit specific distribution pattern in different types of liver disease: liver neoplasia (primary hepatocellular carcinoma [HC] or metastatic liver disease [MLD] from colon cancer), viral hepatitis C (HCV) and the parasitic infection echinococcosis. Serum concentrations of alpha-fetoprotein (AFP), ferritin and insulin-like growth factor I (IGF-I) were determined in patients with liver disease and compared between patient groups and with healthy persons. Serum AFP and ferritin levels exhibited similar pattern of change in patients with liver neopl...

- by O. Nedic and +1
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- Hepatitis C, Liver diseases, Hepatitis B, Hepatocellular Carcinoma

Virus-like particles (VLPs) of the recombinant hepatitis B virus (HBV) core protein (HBc) are routinely used in HBV diagnostics worldwide and are of potential interest as carriers of foreign peptides (e.g., immunological epitopes and targeting addresses, and/or as vessels for packaged diagnostic and therapeutic nanomaterials). Despite numerous reports exploiting different expression systems, a rapid and comprehensive large-scale methodology for purification of HBc VLPs from yeast is still lacking. Here, we present a convenient protocol for highly efficient production and rapid purification of endotoxin-free ayw subtype HBc VLPs from the methylotrophic yeast Pichia pastoris. The HBc gene expression cassette along with the geneticin resistance gene was transferred to the P. pastoris genome via homologous recombination. A producer clone was selected among 2000 transformants for the optimal synthesis of the target protein. Fermentation conditions were established ensuring biomass accumulation of 163 g/L. A simple combination of pH/heat and salt treatment followed by a single anion-exchange chromatography step resulted in a more than 90% pure preparation of HBc VLPs, with a yield of about 3.0 mg per 1 g of wet cells. Purification is performed within a day and may be easily scaled up if necessary. The quality of HBc VLPs was verified by electron microscopy. Mass spectrometry analysis and direct polyacrylamide gel staining revealed phosphorylation of HBc at at least two sites. To our knowledge, this is the first report of HBc phosphorylation in yeast.

- by Andris Kazaks and +1
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- Electron Microscopy, Mass Spectrometry, Pharmaceutical Technology, Gene expression
- by Daniel Ginard and +1
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- Inflammatory Bowel Disease, Hepatitis B, Clinical Sciences, The American

Background Although fever is part of the normal infl ammatory process after immunisation, prophylactic antipyretic drugs are sometimes recommended to allay concerns of high fever and febrile convulsion. We assessed the eff ect of prophylactic administration of paracetamol at vaccination on infant febrile reaction rates and vaccine responses.

- by Roman Prymula
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- Czech Republic, Hepatitis B, Chemoprevention, Infant
- by Ben Berkhout
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- Microbiology, Molecular Evolution, Medical Microbiology, Biology

Objective: To identify the most common hepatitis B virus (HBV) genotype in Jordan Methods: Patients were recruited from the Central Blood Bank and hepatology clinic in Al-Bashir Hospital from 2010 to 2013 and tested at the Central Laboratory Directorate. Demographic data, HBeAg status, ALT and HBV DNA were collected for all patients. 491 blood samples were examined between 2010 and 2013, 262 (53.3%) were of male gender and 229 (46.6%) were female. Individuals were categorized after clinical and serological testing in chronic hepatitis B patients 72 (14.6%) and healthy inactive HBsAg carriers 419 (85.3%). All patients with acceptable titer were tested for HBV genotype. Results: From the 491 examined individuals, seventy two had HBV DNA values more than 2000 IU/ml (14.6%) while 419 had HBV DNA less than 2000 IU/ml (85.3%). Fifty four patients (10.9%) were HBeAg positive while 379 (89.1%) were HBeAg negative. Genotype D was the only genotype detected in our study group (100%). Conclusion: Our study showed that the predominant genotype in Jordan is genotype D which is in concordance with genotypes found in Middle East. In addition, most of our Jordanian individuals infected with HBV are healthy carriers, with majority of them having HBeAg negative serologic marker. On the other hand, the majority of patients with active hepatitis B, showed HBeAg positive serological marker.

- by Waseem Hamoudi and +1
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- Hepatitis B
- by Man-fung Yuen
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- Molecular Biology, Hepatitis C, Comorbidity, Hepatitis B
- by Gora Lo
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- Medicine, Senegal, Multivariate Analysis, Hepatitis B

Background. Infections such as malaria, schistosomiasis, hepatitis B and HIV have been suggested as major causes of the nephrotic syndrome (NS) in African children. We retrospectively analysed the course of the NS in 32 children from Ghana and reviewed the literature on NS from 18 different African countries for the presence of 'the tropical nephrotic syndrome'. Methods. Thirty-two children (22 boys, 10 girls, median age 12 years, range 1-18 years) with NS were treated from 2000-2003 at Battor Hospital, Ghana. Thirteen out of 32 children underwent a renal biopsy which was investigated by light, immune and electron microscopy. All 32 patients were initially treated with oral prednisone (PRED) therapy (29 with standard therapy for 8 weeks and three individually tailored), and steroid-resistant children received also intravenous methylprednisolone pulses (three children) or oral cyclophosphamide (two children). Results. All patients fulfilled the clinical and laboratory criteria of a NS. The initial median serum creatinine was 65 mmol/l (range 44-133 mmol/l). Renal biopsy was performed in 13/32 children and revealed focal and segmental glomerulosclerosis (FSGS) in 10 patients, minimal change disease (MCNs) in two and no conclusive result in one patient. Glomerular immune complex deposition was absent in all biopsies. After treatment with PRED, oedema disappeared in 24/32 patients; however, proteinuria normalized in 16/32 patients only. The NS relapsed in 9/16 steroid-sensitive patients after cessation of PRED therapy, and two children were frequent relapsers. however, steroid resistance and FSGS resulted in a high mortality.

- by James Doe
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- Electron Microscopy, Ghana, Adolescent, Biopsy

1 Luz FB, Gaspar TAP, Kalil-Gaspar N et al. Multicentric reticulohistiocytosis. J Eur Acad Dermatol Venereol 2001; 15: 524 -531. 2 Goltz RW, Laymon CW. Multicentric reticulohistiocytosis of the skin and synovia. A case of multicentric reticulohistiocytosis in a 6-year-old girl. J Rheumatol 1998; 25: 794-797. 6 Snow JL, Muller SA. Malignancy-associated multicentric reticulohistiocytosis: a clinical, histological and immunophenotypic study. Br J Dermatol 1995; 133: 71-76. 7 Valencia IC, Colsky A, Berman B. Multicentric reticulohistiocytosis associated with recurrent breast carcinoma. J Am Acad Dermatol 1998; 39: 864-866. 8 Saito K, Fujii K, Awazu Y et al. A case of systemic lupus erythematosus complicated with multicentric reticulohistiocytosis (MRH): successful treatment of MRH and lupus nephritis with cyclosporin A. Lupus 2001; 10: 129-132. 9 Morris-Jones R, Walker M, Hardman C. Multicentric reticulohistiocytosis associated with Sjogren's syndrome.

- by Esin Korkut
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- Turkey, Adolescent, Biopsy, Hepatitis B

Mujer de 79 años con vida basal activa entre cuyos ante- cedentes personales destacan: hipertensión arterial tratada con un ARA II, hipercolesterolemia a tratamiento con dieta, AIT a tratamiento con Tromalyt 300, colitis microscópica a tratamiento con Lixacol, nódulo tiroideo bien controlado, hipoacusia perceptiva bilateral y varios episodios sincopa- les diagnosticados de probable crisis comicial tratados con Tegretol (carbamacepina). Acude

- by papu ana
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- Hepatitis B
- by Praveen Kumar
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- Pediatrics, Epidemiology, Documentation, Risk

and lower titers (P Ͻ 0.001) of ATIs, as well as higher serum concentrations of infliximab (P Ͻ 0.001). Farrell et al. (Gastroenterology 2003;124:917-924) also reported that ATIs were associated with loss of response (73% vs. 0%, P Ͻ 0.0001), severe infusion reactions, and that concurrent immunomodulators (including highdose prednisone) reduced ATI formation (P Ͻ 0.007). In a placebocontrolled trial, they showed that infusing 200 mg of intravenous hydrocortisone before all infliximab infusions trended towards decreased ATI formation (26% vs. 42%, P ϭ 0.06) (Gastroenterology 2003;124:917-924). The incidence of ATIs in the ACCENT I trial was also numerically lowest (6%) in patients receiving both baseline corticosteroids and immunomodulators, 10% in those receiving immunomodulators alone, 17% for corticosteroids alone, and 18% in those receiving neither (Lancet 2002;359:1541-1549.

- by Laurie Blendis
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- Gastroenterology, Hepatitis B, Mutation, Clinical Sciences

Objective: To estimate the age-specific seroprevalence of hepatitis B surface antigen (HBsAg) in children upto 14 years of age. Methods: Equal number (115 each) of apparently healthy children of both sexes of different age groups i.e. <1, 1-4, 5-9 and 10-14 years, attending pediatric outpatient services and Well Baby Clinic of the hospital were tested for HBsAg using ELISA test. Positive results were confirmed by a second ELISA. Results: Overall 4.35% (95%CI, 2.44-6.25) of the 460 children tested were HBsAg positive. The prevalence rate was the highest (6.09%) in the 1-4 year age category. In the <1, 5-9 and 10-14 year age groups it was 4.35%, 4.35% and 2.61% respectively. The overall male to female ratio was 2.1:1, with no significant difference in seropositivity rates (P = 0.816).The difference in the prevalence rates between the rural (4.84%) and urban populations (3.77%) was also statistically insignificant (P = 0.577). Conclusion: Average HBsAg positivity in the pediatric population in this region is 4.35% (95%CI, 2.44-6.25). The prevalence progressively increases and peaks in the 1-4 years age group. It is least in 10-14 years age group.

- by Kamran Afzal
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- Risk assessment, Adolescent, Medicine, Probability

Background: LiveWell Initiative LWI is a self-funded nonprofit social enterprise which thrives on innovation. The organization has, for 5 years, supervised MPH and Dr. PH Practicums for the Harvard T. H. Chan School of Public Health, Harvard University, Boston, USA. It also supervises PhD thesis at University of Helsinki, Finland. At the inception of COVID-19, LWI designed and compiled three (3) sets of study protocols in response to the COVID-19 response in Africa with a goal to arriving at a practical and affordable solution to the pandemic using 4-Aminoquinolines. Method: A concurrent cohort/descriptive study of observation in patients exposed to HCQ/CQ prophylaxis and treatment with HCQ/CQ and Quinine with categorization as specified as not critically ill, critically ill but not on a ventilator and critically ill on a ventilator. One hundred and twenty-three (123) subjects were categorized into shelter-in-place, self-quarantine and self-isolation (Not critically ill, critically ill but not on a ventilator and critically ill on a ventilator). The 4-Aminoquinolines were administered with macrolide and zinc sulphate as appropriate for a defined duration and doses. Results: The preliminary study of the 123 subjects covering all categories listed above resulted in 100% positive outcomes; nil death, nil relapse in symptomatic persons and total recovery with no relapse after 6 weeks lockdown, and asymptomatic persons post-prophylaxis, after 6 weeks lockdown. The results have been gathered principally from clinician reported outcomes with a few patient reported outcomes. Conclusion: These repurposed drugs with unique strengths- Chloroquine and its analogue Hydroxychloroquine as well Quinine, hold sway in the treatment of COVID-19.

- by Ewaoche S U N D A Y Itodo
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- Gastroenterology, Preventive medicine, Herbal Medicine, Hepatitis B